This randomized, open label, head to head clinical trial directly compares tirzepatide and semaglutide in adults with obesity and metabolic syndrome (N=120, age 20-65, 1:1 randomization). Participants undergo deep phenotyping at baseline, 6 months, and 12 months, including DXA (regional fat, lean mass, and BMD), MRI PDFF (liver fat), 7 site skinfold thickness, grip strength, fasting biochemistry, and AI processed 12 lead ECGs. Centralized biobanking of serum, plasma, and PBMCs enables targeted and discovery multi omic analyses.
Age 20-65 years.
BMI ≥27 kg/m² with metabolic syndrome (ATP III or IDF criteria).
Stable background medications (antihypertensives, statins, etc.) for ≥3 months.
Able and willing to provide informed consent and comply with study procedures.
History of diabetes; history of pancreatitis; personal/family history of medullary thyroid carcinoma or MEN2.
eGFR <30 mL/min/1.73 m², decompensated liver disease, NYHA class III-IV heart failure.
Recent (<3 months) acute coronary syndrome, stroke, or coronary revascularization.
Current use of GLP 1RA, tirzepatide, or other incretin based therapies within 3 months.
Tri-Service General Hospital
Lead sponsor
National Science and Technology Council, Taiwan
Collaborator