AgingNCT07444073
Assessing Biological Aging in a Real-World Medical Weight Loss Program Using the LinAge2 Clinical Clock
An observational study of Aging and Obesity & Overweight, run by National University of Singapore at 2 sites in Singapore.
Trial summary
This study examines whether routine treatment with semaglutide or tirzepatide, prescribed with lifestyle coaching in a real-world weight-management program, is associated with changes in biological age measured by the LinAge2 clinical aging clock over 6 months. Read more about this study
- Who is it for?
- Ages 40 to 89 years
- Conditions the study is for
- Aging, Obesity & Overweight
- What is being tested?
- Not applicable. This is an observational study.
- How many people
- 440 participants
- Where
- 2 sitesSingapore
- Study dates
- 1 Jun 2026to 31 Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 89 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adults aged 40-89 years who are overweight or obese and newly enrolled in the NOVI Health weight management program in Singapore. Participants are selected from routine clinical practice at the NOVI Health clinic.
Who may be able to join
- Adults aged 40-89 years, who are newly enrolled in the NOVI OP+ weight management program.
- BMI of ≥ 30 kg/m2 (obesity); OR
- BMI of ≥ 27 kg/m2 to < 30 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition e.g. dysglycemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidemia, obstructive sleep apnea or cardiovascular disease.
Who cannot join
- Pregnancy or lactation.
- Non-ambulatory status, total blindness, complete hearing loss, or inability to speak.
- Medical history of, or self-reported, psychiatric illness, congenital or irreversible neurodegenerative diseases, cognitive impairment, or eating disorders that may affect adherence or assessment outcomes.
- On GLP-1 RA, sulfonylurea or insulin medications for the past 3 months.
- Active cancer on chemotherapy or immunotherapy.
- Known hypersensitivity or contraindications to GLP-1 RAs.
- Any condition, in the opinion of the attending clinician, that would jeopardize participant safety or interfere with study compliance.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Hui Ching Michelle Lee, PhD contact
Singapore2 sites
NOVI Health (T3 Health PTE LTD)
Singapore, 068914
Hui Ching Michelle Lee, PhD, +65 82822765, michelle.lee@novi-health.com
Sue-Anne Ee Shiow Toh, MA MBBChir MSc
National University of Singapore
Singapore, 119077
About this study
This study examines whether routine treatment with semaglutide or tirzepatide, prescribed with lifestyle coaching in a real-world weight-management program, is associated with changes in biological age measured by the LinAge2 clinical aging clock over 6 months.
Read the detailed description
This study will evaluate whether routine treatment with semaglutide or tirzepatide, prescribed in conjunction with lifestyle coaching support as part of standard-of-care in a real-world clinical weight-loss program, is associated with changes in biological age as measured by the LinAge2 clock. Aging is a primary driver of chronic disease, functional decline, and mortality. Obesity, through mechanisms such as mitochondrial dysfunction, oxidative stress, and chronic inflammation, may accelerate biological aging. Given that GLP-1 receptor agonists such as semaglutide and tirzepatide improve metabolic and cardiovascular health, this study will examine whether these benefits extend to biological aging as quantified by LinAge2, a clinical aging clock derived from standard clinical biomarkers.
This is a six-month prospective observational cohort study involving approximately 440 adults aged 40-89 years who are overweight or obese and newly enrolled in the weight management program at NOVI Health (T3 Health PTE LTD), a private healthcare provider in Singapore. Clinical care and program delivery are provided by NOVI Health as part of routine practice. Participants will receive standard-of-care GLP-1 RA therapy (semaglutide or tirzepatide) together with personalized diet and physical activity interventions. Study procedures include baseline and six-month visits at the NOVI Health clinic, where anthropometry, body composition, blood and urine samples, questionnaires, and functional performance assessments will be conducted. Blood and urine samples will be collected by trained and certified nurses or phlebotomists, analyzed by an accredited external laboratory, and discarded thereafter; no biological materials will be stored.
The National University of Singapore (NUS) research team provides scientific leadership in study design and conducts the development and application of the LinAge2 biological aging clock and analyses of de-identified data generated during routine clinical care at NOVI Health. NUS is not involved in participant recruitment, informed consent, clinical procedures, drug prescription, or biospecimen handling. The primary outcome is change in LinAge2 biological age from baseline to six months. Secondary outcomes include changes in body composition, cardiometabolic biomarkers, and functional clinical measures.
- Conditions
- Aging, Obesity & Overweight
- Being tested
- Not applicable. This is an observational study.
- Keywords
- LinAge2, Biological Age, GLP-1 Receptor Agonist, Semaglutide, Tirzepatide, Weight Management Program, Lifestyle, Real-World Evidence, Cardiometabolic Biomarkers, Body Composition, Prospective Cohort
- Medical subject headings
- Obesity, Overweight
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Not applicable. This is an observational study.Other
Not applicable. This is an observational study.
| Study group | Role | What they receive |
|---|---|---|
| NOVI Health weight management cohort | Adults newly enrolled in the NOVI Health weight management program receiving standard-of-care GLP-1 receptor agonist therapy (semaglutide or tirzepatide) and lifestyle coaching (diet and physical activity) as part of routine clinical care. Medication type is determined by routine clinical care and patient-clinician decision-making, not by the research study. Receives: Other: Not applicable. This is an observational study. |
What is being measured
The primary outcome is the main question the study is designed to answer.
LinAge2 Biological Age
The primary outcome of this study is to determine the change in LinAge2 biological age estimates in response to the NOVI Health weight management program, which comprises GLP-1 RA therapy alongside personalized diet and physical activity interventions.
Measured: Baseline and 6 months
Secondary outcomes (30)
Change in Body Composition: Body Weight
Body weight measured in kilograms (kg); outcome is change from baseline to 6 months.
Measured: Baseline and 6 months
Change in Body Composition: Body Mass Index (BMI)
BMI calculated as weight (kg) divided by height (m²), reported in kg/m².
Measured: Baseline and 6 months
Change in Body Composition: Waist Circumference
Waist circumference measured in centimeters (cm) using a measuring tape
Measured: Baseline and 6 months
Change in Body Composition: Hip Circumference
Waist circumference measured in centimeters (cm) using a measuring tape
Measured: Baseline and 6 months
Change in Body Composition: Waist-to-Hip Ratio
Waist-to-hip ratio calculated as waist circumference / hip circumference
Measured: Baseline and 6 months
Change in Pulse Rate
Pulse rate measured in beats per minute (bpm)
Measured: Baseline and 6 months
Change in Blood Pressure
Systolic and Diastolic blood pressure measured in mmHg
Measured: Baseline and 6 months
Change in Body Composition: Body Fat Percentage
Body fat percentage (%) measured using a Tanita body composition analyzer (bioimpedance)
Measured: Baseline and 6 months
Change in Body Composition: Muscle Mass
Muscle mass measured in kilograms (kg) using a Tanita body composition analyzer (bioimpedance)
Measured: Baseline and 6 months
Change in Body Composition: Basal Metabolic Rate
Basal metabolic rate measured in kilocalories per day (kcal/day) as estimated by a Tanita body composition analyzer (bioimpedance)
Measured: Baseline and 6 months
Change in Body Composition: Metabolic Age
Metabolic age (years) estimated by a Tanita body composition analyzer (bioimpedance)
Measured: Baseline and 6 months
Change in Functional Clinical Measures: Handgrip Strength (Southampton protocol)
Handgrip strength measured using a handheld dynamometer following the Southampton protocol; reported in kilograms (kg)
Measured: Baseline and 6 months
Change in Functional Clinical Measures: Change in Chester Step Test Estimated VO₂max
Chester Step Test performed to estimate VO₂max, reported in mL/kg/min
Measured: Baseline and 6 months
Change in Functional Clinical Measures: Change in Five-Times Sit-to-Stand Test Time
Time to complete five sit-to-stand repetitions, reported in seconds
Measured: Baseline and 6 months
Change in Cardiometabolic: Glycohemoglobin (HbA1c)
Glycohemoglobin measured as percent (%)
Measured: Baseline and 6 months
Change in Cardiometabolic: Glucose
Glucose measured in mmol/L
Measured: Baseline and 6 months
Change in Cardiometabolic: Total Cholesterol
Total cholesterol measured in mmol/L
Measured: Baseline and 6 months
Change in Cardiometabolic: High-Density Lipoprotein (HDL) Cholesterol
HDL cholesterol measured in mmol/L
Measured: Baseline and 6 months
Change in Cardiometabolic: Triglycerides
Triglycerides measured in mmol/L
Measured: Baseline and 6 months
Change in Cardiometabolic: C-Reactive Protein (CRP)
C-reactive protein measured in mg/dL
Measured: Baseline and 6 months
Change in Hepatic: Alanine Aminotransferase (ALT)
ALT measured in U/L
Measured: Baseline and 6 months
Change in Hepatic: Aspartate Aminotransferase (AST)
AST measured in U/L
Measured: Baseline and 6 months
Change in Renal: Serum Creatinine
Creatinine measured in µmol/L
Measured: Baseline and 6 months
Change in Renal: Blood Urea Nitrogen
Blood urea nitrogen measured in mmol/L
Measured: Baseline and 6 months
Change in Renal: Urine Albumin
Urine albumin measured in mg/L
Measured: Baseline and 6 months
Questionnaire: PAR-Q Physical Activity Readiness Questionnaire
PAR-Q questionnaire (7 items). Reported as number of "Yes" responses (0-7)
Measured: Baseline and 6 months
Questionnaire: Smoking status
Self-reported smoking status assessed by questionnaire and categorized as current smoker, former smoker, or never smoker.
Measured: Baseline and 6 months
Questionnaire: Self-reported health
Question 1: General health condition. Self-rated general health assessed by a single questionnaire item with 5 response options (Excellent, Very good, Good, Fair, Poor).
Question 2: Health compared with 1 year ago. Self-rated health compared with 1 year ago assessed by a single questionnaire item with response options (Better, About the same, Worse).
Measured: Baseline and 6 months
Questionnaire: Co-morbidity index (22 conditions)
Number of self-reported comorbidities from a prespecified 22-condition (hypertension, diabetes mellitus, renal impairment, asthma, anemia, arthritis, coronary heart disease, angina, previous myocardial infarction, previous stroke, emphysema, thyroid disease, obesity, chronic bronchitis, liver disease, malignancy, osteoporosis, previous hip fracture, previous wrist fracture, previous spine fracture, cognitive impairment, and overnight hospitalization)
Measured: Baseline
Questionnaire: Healthcare use index
Self-reported number of healthcare visits in the past 12 months (count). From None to 13 times or more.
Measured: Baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Mar 2026
- Study start1 Jun 2026 (estimated)
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for AgingStudies of the same condition, open and under way.
- More trials run by National University of SingaporeThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 440 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National University of Singapore
- Sponsor type
- University, hospital or other
- Collaborators
- T3 Health PTE LTD
- Responsible party
- Principal investigator, Jan Gruber, National University of Singapore
- Investigators
- Jan Gruber, PhD, Principal investigator, National University of Singapore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07444073
- Sponsor's protocol ID
- NUS-IRB-2025-845
- Status last verified
- Jun 2026
- First submitted
- 12 Feb 2026
- Last updated
- 1 Jul 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: De-identified individual participant data (IPD) underlying the results reported in publications will be shared upon reasonable request after primary publication. Requests will be reviewed by the study team and require a data use agreement. Data will be provided in de-identified form and will not include direct identifiers.
Publications
Fong S, Pabis K, Latumalea D, Dugersuren N, Unfried M, Tolwinski N, Kennedy B, Gruber J. Principal component-based clinical aging clocks identify signatures of healthy aging and targets for clinical intervention. Nat Aging. 2024 Aug;4(8):1137-1152. doi: 10.1038/s43587-024-00646-8. Epub 2024 Jun 19.
PubMed 38898237
Study at a glance
From the registry record, last updated by the sponsor on 1 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessing Biological Aging in a Real-World Medical Weight Loss Program Using the LinAge2 Clinical Clock
- ClinicalTrials.gov ID
- NCT07444073
- Acronym / sponsor ID
- NUS-IRB-2025-845
- Conditions
- Aging, Obesity & Overweight
- Keywords
- LinAge2, Biological Age, GLP-1 Receptor Agonist, Semaglutide, Tirzepatide, Weight Management Program, Lifestyle, Real-World Evidence
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 440 participants (estimated)
- Lead sponsor
- National University of SingaporeUniversity, hospital or other
- Collaborators
- T3 Health PTE LTD
- Study start
- 1 Jun 2026 (estimated)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 2 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study examines whether routine treatment with semaglutide or tirzepatide, prescribed with lifestyle coaching in a real-world weight-management program, is associated with changes in biological age measured by the LinAge2 clinical aging clock over 6 months.
Detailed description
This study will evaluate whether routine treatment with semaglutide or tirzepatide, prescribed in conjunction with lifestyle coaching support as part of standard-of-care in a real-world clinical weight-loss program, is associated with changes in biological age as measured by the LinAge2 clock. Aging is a primary driver of chronic disease, functional decline, and mortality. Obesity, through mechanisms such as mitochondrial dysfunction, oxidative stress, and chronic inflammation, may accelerate biological aging. Given that GLP-1 receptor agonists such as semaglutide and tirzepatide improve metabolic and cardiovascular health, this study will examine whether these benefits extend to biological aging as quantified by LinAge2, a clinical aging clock derived from standard clinical biomarkers.
This is a six-month prospective observational cohort study involving approximately 440 adults aged 40-89 years who are overweight or obese and newly enrolled in the weight management program at NOVI Health (T3 Health PTE LTD), a private healthcare provider in Singapore. Clinical care and program delivery are provided by NOVI Health as part of routine practice. Participants will receive standard-of-care GLP-1 RA therapy (semaglutide or tirzepatide) together with personalized diet and physical activity interventions. Study procedures include baseline and six-month visits at the NOVI Health clinic, where anthropometry, body composition, blood and urine samples, questionnaires, and functional performance assessments will be conducted. Blood and urine samples will be collected by trained and certified nurses or phlebotomists, analyzed by an accredited external laboratory, and discarded thereafter; no biological materials will be stored.
The National University of Singapore (NUS) research team provides scientific leadership in study design and conducts the development and application of the LinAge2 biological aging clock and analyses of de-identified data generated during routine clinical care at NOVI Health. NUS is not involved in participant recruitment, informed consent, clinical procedures, drug prescription, or biospecimen handling. The primary outcome is change in LinAge2 biological age from baseline to six months. Secondary outcomes include changes in body composition, cardiometabolic biomarkers, and functional clinical measures.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| NOVI Health weight management cohort | – | Other: Not applicable. This is an observational study.Adults newly enrolled in the NOVI Health weight management program receiving standard-of-care GLP-1 receptor agonist therapy (semaglutide or tirzepatide) and lifestyle coaching (diet and physical activity) as part of routine clinical care. Medication type is determined by routine clinical care and patient-clinician decision-making, not by the research study. |
Who may qualify
- Ages
- 40 to 89 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adults aged 40-89 years who are overweight or obese and newly enrolled in the NOVI Health weight management program in Singapore. Participants are selected from routine clinical practice at the NOVI Health clinic.
Key inclusion criteria (3 listed)
- Adults aged 40-89 years, who are newly enrolled in the NOVI OP+ weight management program.
- BMI of ≥ 30 kg/m2 (obesity); OR
- BMI of ≥ 27 kg/m2 to < 30 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition e.g. dysglycemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidemia, obstructive sleep apnea or cardiovascular disease.
Key exclusion criteria (7 listed)
- Pregnancy or lactation.
- Non-ambulatory status, total blindness, complete hearing loss, or inability to speak.
- Medical history of, or self-reported, psychiatric illness, congenital or irreversible neurodegenerative diseases, cognitive impairment, or eating disorders that may affect adherence or assessment outcomes.
- On GLP-1 RA, sulfonylurea or insulin medications for the past 3 months.
- Active cancer on chemotherapy or immunotherapy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Not applicable. This is an observational study.Not applicable. This is an observational study. | Other | NOVI Health weight management cohort |
Primary outcome
LinAge2 Biological Age
Time frame: Baseline and 6 months
The primary outcome of this study is to determine the change in LinAge2 biological age estimates in response to the NOVI Health weight management program, which comprises GLP-1 RA therapy alongside personalized diet and physical activity interventions.
30 secondary outcomes
Change in Body Composition: Body Weight
Time frame: Baseline and 6 months
Change in Body Composition: Body Mass Index (BMI)
Time frame: Baseline and 6 months
Change in Body Composition: Waist Circumference
Time frame: Baseline and 6 months
Change in Body Composition: Hip Circumference
Time frame: Baseline and 6 months
Change in Body Composition: Waist-to-Hip Ratio
Time frame: Baseline and 6 months
Change in Pulse Rate
Time frame: Baseline and 6 months
Change in Blood Pressure
Time frame: Baseline and 6 months
Change in Body Composition: Body Fat Percentage
Time frame: Baseline and 6 months
Change in Body Composition: Muscle Mass
Time frame: Baseline and 6 months
Change in Body Composition: Basal Metabolic Rate
Time frame: Baseline and 6 months
Change in Body Composition: Metabolic Age
Time frame: Baseline and 6 months
Change in Functional Clinical Measures: Handgrip Strength (Southampton protocol)
Time frame: Baseline and 6 months
Change in Functional Clinical Measures: Change in Chester Step Test Estimated VO₂max
Time frame: Baseline and 6 months
Change in Functional Clinical Measures: Change in Five-Times Sit-to-Stand Test Time
Time frame: Baseline and 6 months
Change in Cardiometabolic: Glycohemoglobin (HbA1c)
Time frame: Baseline and 6 months
Change in Cardiometabolic: Glucose
Time frame: Baseline and 6 months
Change in Cardiometabolic: Total Cholesterol
Time frame: Baseline and 6 months
Change in Cardiometabolic: High-Density Lipoprotein (HDL) Cholesterol
Time frame: Baseline and 6 months
Change in Cardiometabolic: Triglycerides
Time frame: Baseline and 6 months
Change in Cardiometabolic: C-Reactive Protein (CRP)
Time frame: Baseline and 6 months
Change in Hepatic: Alanine Aminotransferase (ALT)
Time frame: Baseline and 6 months
Change in Hepatic: Aspartate Aminotransferase (AST)
Time frame: Baseline and 6 months
Change in Renal: Serum Creatinine
Time frame: Baseline and 6 months
Change in Renal: Blood Urea Nitrogen
Time frame: Baseline and 6 months
Change in Renal: Urine Albumin
Time frame: Baseline and 6 months
Questionnaire: PAR-Q Physical Activity Readiness Questionnaire
Time frame: Baseline and 6 months
Questionnaire: Smoking status
Time frame: Baseline and 6 months
Questionnaire: Self-reported health
Time frame: Baseline and 6 months
Questionnaire: Co-morbidity index (22 conditions)
Time frame: Baseline
Questionnaire: Healthcare use index
Time frame: Baseline
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Jul 2026.
- Background: PubMed 38898237Fong S, Pabis K, Latumalea D, Dugersuren N, Unfried M, Tolwinski N, Kennedy B, Gruber J. Principal component-based clinical aging clocks identify signatures of healthy aging and targets for clinical intervention. Nat Aging. 2024 Aug;4(8):1137-1152. doi: 10.1038/s43587-024-00646-8. Epub 2024 Jun 19.
- LinAge2 clinical aging clockLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided. De-identified individual participant data (IPD) underlying the results reported in publications will be shared upon reasonable request after primary publication. Requests will be reviewed by the study team and require a data use agreement. Data will be provided in de-identified form and will not include direct identifiers.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Hui Ching Michelle Lee, PhD contact
Jan Gruber, PhD principal investigator
National University of Singapore
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Aging and Obesity & Overweight, run by National University of Singapore at 2 sites in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Zhi Meng Lim, MSc (+65 90084510, zmlim@nus.edu.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
LinAge2 Biological Age (time frame: Baseline and 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07444073, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jul 2026.