Weight Management Profile – Baseline GLP-1 / GIP-GLP-1
Weight Management Profile – Initial GLP-1 / GIP-GLP-1 Assessment is an extended package of investigations designed to assess general health, carbohydrate and lipid metabolism, liver, kidney and thyroid function, as well as selected nutritional markers before a medical consultation regarding weight management treatment.
The package may be used for the assessment of patients being considered for therapies from the GLP-1 or GIP/GLP-1 classes, including treatments based on semaglutide or tirzepatide.
The profile does not replace a medical consultation and, on its own, does not constitute an indication to initiate treatment. The need for GLP-1 / GIP-GLP-1 therapy is determined exclusively by a physician based on an individual clinical assessment.
Semaglutide is a GLP-1 receptor agonist, while tirzepatide acts as a dual GIP and GLP-1 receptor agonist; both medicines have authorised indications in the EU for weight management in certain patients with obesity or overweight associated with comorbidities.
Components
| Investigation group | Included tests | What it evaluates |
| Hematological and inflammatory assessment | Complete blood count (without ESR); Erythrocyte sedimentation rate (ESR) | Key hematological parameters and the presence of nonspecific inflammatory changes |
| Carbohydrate metabolism and insulin resistance | Glycated hemoglobin (HbA1c); HOMA2 (Glucose, Insulin, HOMA2 Index) | Glycemic control, insulin resistance, insulin sensitivity and pancreatic beta-cell function |
| Lipid profile | Total cholesterol; HDL cholesterol; LDL cholesterol; Triglycerides | Lipid metabolism and cardiometabolic risk |
| Liver and biliary function | Total bilirubin; Direct bilirubin; ALT; AST; GGT; Alkaline phosphatase (ALP); Total protein; Albumin | Hepatocellular integrity, bilirubin metabolism, cholestatic component and protein synthesis |
| Pancreatic assessment | Lipase; Pancreatic alpha-amylase | Pancreatic enzyme activity |
| Kidney function | eGFR (CKD-EPI) + Serum creatinine; Urea | Renal filtration function and nitrogen metabolism |
| Thyroid function | TSH; Calcitonin | Thyroid function and additional assessment of thyroid C cells |
| Nutritional status | Ferritin; Vitamin B12; Vitamin D (25-OH vitamin D) | Iron stores and the status of important micronutrients |
| Urine assessment | Urinalysis with urine sediment examination | Urinary parameters and changes in the urine sediment |
Role of the investigation
The profile provides the physician with a baseline overview of metabolic and glycemic status, cardiometabolic risk, liver and kidney function, thyroid function and nutritional status before making a therapeutic decision.
The results may help identify abnormalities that need to be assessed or corrected before or alongside treatment and provide baseline values that can be compared with subsequent results obtained during monitoring.
Indications
- medical consultation for the management of overweight or obesity;
- consideration of therapy with a GLP-1 agonist or a dual GIP/GLP-1 agonist;
- overweight associated with disorders of carbohydrate metabolism;
- insulin resistance;
- dyslipidemia;
- liver or kidney disease;
- thyroid dysfunction;
- risk of nutritional deficiencies.
Depending on the clinical situation, the physician may recommend additional tests, including:
- completion of a comprehensive ultrasound examination**:** thyroid gland, abdominal organs and genitourinary system;
- exclusion of pregnancy in women of reproductive potential; when pregnancy cannot be reliably excluded, β-hCG testing is recommended before treatment initiation.
Weight-loss treatment should not be initiated during pregnancy. Semaglutide should not be used during pregnancy, while tirzepatide is not recommended during pregnancy; treatment is prescribed and selected exclusively by the physician after assessment of the individual indications, contraindications and risks.
Procedure
Venous blood is collected for hematological, biochemical and hormonal investigations. A separate urine sample is required for urinalysis.
After the results are obtained, they should be interpreted by the physician together with the medical history, clinical examination, weight, body mass index, comorbidities and concomitant treatments.
Sources:
https://www.ema.europa.eu/en/medicines/human/EPAR/wegovy
https://www.ema.europa.eu/en/documents/product-information/mounjaro-epar-product-information_en.pdf
https://www.ncbi.nlm.nih.gov/books/NBK611612/
https://pubmed.ncbi.nlm.nih.gov/39632534/
https://library.usmf.md/sites/default/files/2025-02/Ghid%20practic%20pentru%20evaluarea%20si%20tratamentul%20adultilor%20cu%20obezitate.pdf