Influence of glucagon-like peptide-1 receptor agonists on fat accumulation in patients with diabetes mellitus and non-alcoholic fatty liver disease or obesity: A systematic review and meta-analysis of randomized control trials

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-04-04 DOI:10.1016/j.jdiacomp.2024.108743

Wanrun Xie, Zhenzhen Hong, Bo Li, Baoliang Huang, Shaobin Dong, Yuqi Cai, Lingyan Ruan, Qianhui Xu, Lunpan Mou, Yi Zhang

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引用次数: 0

Abstract

Aim

This systematic review and meta-analysis aimed to comprehensively evaluate the impact of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in individuals with diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) or obesity.

Methods

A search of PubMed, Embase, and Web of Science until October 2023 identified 13 Randomized Controlled Trials (RCTs) meeting the inclusion criteria. Bias risk was assessed using the Cochrane risk-of-bias instrument. Statistical analysis utilized standard mean differences (SMD) in Review Manager 5.4. Heterogeneity and publication bias were assessed. This study used the protocol registered with the Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY2023110020).

Results

GLP-1RA treatment significantly reduced VAT (SMD −0.55, 95 % CI [−0.90, −0.19]), SAT (SMD −0.59, 95 % CI [−0.99, −0.19]), body weight (SMD −1.07, 95 % CI [−1.67, −0.47]), and body mass index (BMI) (SMD −1.10, 95 % CI [−1.74, −0.47]) compared to controls. Heterogeneity was observed for VAT (I² = 79 %, P < 0.01), SAT (I² = 73 %, P < 0.01), body weight (I² = 82 %, P < 0.01), and BMI (I² = 82 %, P < 0.01). No publication bias was detected for VAT (P = 0.57) and SAT (P = 0.18). GLP-1RA treatment improved fasting blood glucose (FBG), postprandial glucose (PPG), hemoglobin A1c (HbA1c), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and fibrosis-4 (FIB-4).

Conclusions

This meta-analysis highlights GLP-1RAs' potential to reduce fat accumulation, body weight, and BMI and improve glycemic control in individuals with diabetes mellitus and NAFLD or obesity. These findings supported using GLP-1RAs as promising therapeutic agents to address abnormal adipose tissue distribution and metabolic dysfunction.

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胰高血糖素样肽-1 受体激动剂对糖尿病合并非酒精性脂肪肝或肥胖症患者脂肪堆积的影响：随机对照试验的系统回顾和荟萃分析

目的本系统综述和荟萃分析旨在全面评估胰高血糖素样肽 1 受体激动剂（GLP-1RAs）对糖尿病合并非酒精性脂肪肝（NAFLD）或肥胖症患者的内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的影响。方法截至 2023 年 10 月，通过对 PubMed、Embase 和 Web of Science 的检索，共发现 13 项符合纳入标准的随机对照试验（RCT）。偏倚风险采用 Cochrane 偏倚风险工具进行评估。统计分析使用了 Review Manager 5.4 中的标准平均差 (SMD)。对异质性和发表偏倚进行了评估。结果GLP-1RA治疗显著降低了VAT（SMD -0.55, 95 % CI [-0.90，-0.19]）、SAT（SMD -0.59，95 % CI [-0.99，-0.19]）、体重（SMD -1.07，95 % CI [-1.67，-0.47]）和体质指数（BMI）（SMD -1.10，95 % CI [-1.74，-0.47]）。VAT (I2 = 79 %, P < 0.01)、SAT (I2 = 73 %, P < 0.01)、体重 (I2 = 82 %, P < 0.01) 和 BMI (I2 = 82 %, P < 0.01)存在异质性。VAT (P = 0.57) 和 SAT (P = 0.18) 未发现发表偏倚。GLP-1RA 治疗改善了空腹血糖 (FBG)、餐后血糖 (PPG)、血红蛋白 A1c (HbA1c)、胰岛素抵抗自律模型评估 (HOMA-IR) 和纤维化-4 (FIB-4)。这些研究结果支持将 GLP-1RAs 作为有前景的治疗药物，以解决脂肪组织分布异常和代谢功能障碍问题。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.