# Semaglutide verlaagt inflammatoire monocyten en beenmergactiviteit bij diabetes type 2

*geplaatst 2026-10-07 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehag627 · https://hartvaat.nl/2026/09/29/semaglutide-verlaagt-inflammatoire-monocyten-en-beenmergactiviteit-bij-diabetes-/*

In een kleine studie (n=16) bij patiënten met diabetes type 2 leidde zes maanden semaglutide tot significante dalingen van HbA1c, gewicht, hsCRP en circulerende inflammatoire CD16+-monocyten. PET-CT en beenmergaspiraten toonden aan dat semaglutide de activiteit in het beenmerg remt en monocyten daar retentieert, wat mogelijk de inflammatoire daling verklaart. Deze bevindingen bieden een mechanistisch inzicht in het cardiovasculaire beschermende effect van GLP-1-receptoragonisten, hoewel klinische impact voor de dagelijkse praktijk nog onduidelijk blijft.

## English: Potential bone marrow-driven reduction of circulating inflammatory monocytes by semaglutide in Type 2 diabetes.

In a small mechanistic study (n=16) of patients with type 2 diabetes, six months of semaglutide significantly reduced HbA1c, body weight, hsCRP, and circulating inflammatory CD16+ monocytes. PET-CT and bone marrow aspirates indicated that semaglutide suppresses bone marrow activity and promotes monocyte retention there, offering a potential mechanism for the cardiovascular benefits of GLP-1 receptor agonists. While the findings are intriguing, the small sample size and exploratory design limit immediate clinical translation.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce cardiovascular disease (CVD) in type 2 diabetes (T2D) and have anti-inflammatory effects in experimental studies, but their mechanism of action in humans remains unclear. This study characterized the cardiovascular-haematopoietic axis in individuals with T2D receiving semaglutide, as a potential mediator of GLP-1RA cardioprotective properties. METHODS: In 16 individuals with T2D [63.2 ± 6.1 years, 37.5% female, weight 82.3 ± 15.3 kg, body mass index (BMI) 28.33 ± 3.5 kg/m2, LDL cholesterol 2.2 ± 0.9 mmol/L, glycated haemoglobin (HbA1c) 78.1 ± 13.1 mmol/mol, high-sensitivity C-reactive protein (hsCRP) 1.9 (1.2, 5.8) mg/L], blood and sternal bone marrow aspirates (subset, n = 14) were collected at baseline and after 6 months of semaglutide ≤2.0 mg weekly. Circulating monocytes and haematopoietic precursors were quantified by flow cytometry, plasma cytokines using an nELISA™ assay (Nomic Bio) and inflammatory macrophages in coronary arteries, bone marrow, and spleen by gallium-68-labelled DOTA-(Tyr3)-octreotate (68Ga-DOTATATE) positron emission tomography-computed tomography scans. RESULTS: After 6 months of semaglutide, significant reductions in HbA1c (-21.1 mmol/mol, P < .0001), weight (-6.7 kg, P < .001), BMI (-2.5 kg/m2, P < .001), and hsCRP (-1.0 mg/L, P = .005) were observed. Circulating CD16+ monocytes were markedly lower (-18.8%, P = .034), with increased bone marrow retention correlating with weight loss, alongside reductions in interleukin-1 receptor antagonist, leptin, E-selectin, intercellular adhesion molecule-1 (ICAM-1), C-C motif chemokine ligand 2, C-C motif chemokine ligand 11, and C-X-C motif chemokine ligand 13. Gallium-68-labelled DOTA-(Tyr3)-octreotate PET-CT showed lower bone marrow uptake (-17.5%, P = .037), but not in spleen or coronary arteries. CONCLUSIONS: Semaglutide in T2D potentially reduces circulating inflammatory monocytes, increases bone marrow retention, and lowers markers of endothelial inflammation, with no reduction in coronary artery inflammatory macrophages. Semaglutide is associated with lower bone marrow 68Ga-DOTATATE uptake, which may relate to anti-inflammatory effects relevant to CVD risk.

Auteurs: Charlotte J Teunis, Thomas J C Collins, Reindert F Oostveen, Annette E Neele, Menno de Winther, Nick S Nurmohamed, Jarom Heijmans, Maaike Winkelmeijer, Kim E Dzobo, Mark E Cooper, Daniël H van Raalte, Max Nieuwdorp, Hein J Verberne, Erik S G Stroes, Andrew J Murphy, Jeffrey Kroon, Nordin M J Hanssen

---
Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehag627. Bijgewerkt 2026-09-30T01:12:44Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.