Effects of Glucagon-Like Peptide-1 Receptor Agonist on Bone Mineral Density and Bone Turnover Markers: A Meta-Analysis

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2024-09-23 DOI:10.1002/dmrr.3843

Hee-Ju Kim, Seo-A Choi, Min-Sun Gu, Seo-Yeong Ko, Jae-Hee Kwon, Ja-Young Han, Jae Hyun Kim, Myeong Gyu Kim

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引用次数: 0

Abstract

Aims

Glucagon-like peptide-1 receptor agonist (GLP-1RA) may promote bone formation, but conversely, they could also weaken bones due to the reduction in mechanical load associated with weight loss. However, the clinical effects in humans have not been clearly demonstrated. This meta-analysis aimed to evaluate whether GLP-1RAs affect BMD and bone turnover markers.

Material and Methods

PubMed, Embase, and Scopus were searched on June 13, 2024. The eligibility criteria were: (1) human studies, (2) receiving a GLP-1RA for more than 4 weeks, (3) an untreated control group or a placebo group, (4) reporting of at least one BMD or bone turnover marker, and (5) an RCT design. The risk of bias was assessed using the Cochrane risk of bias 2 tool. Fixed- or random-effects meta-analysis was performed according to heterogeneity.

Results

Seven studies were included in the meta-analysis. GLP-1RAs did not significantly change BMD in the femoral neck (mean difference [MD], 0.01 g/cm²; 95% CI, −0.01–0.04 g/cm²), in the total hip (MD, −0.01 g/cm²; 95% CI, −0.02–0.01 g/cm²), and in the lumbar spine (MD, 0 g/cm²; 95% CI, −0.02–0.02 g/cm²). C-terminal telopeptide of type 1 collagen (CTX), a bone resorption marker, significantly increased after GLP-1RA treatment (MD, 0.04 μg/L; 95% CI, 0.01–0.07 μg/L). GLP-1RAs did not significantly change bone formation markers such as procollagen type 1 N-terminal propeptide, bone-specific alkaline phosphatase, osteocalcin.

Conclusions

GLP-1RA did not affect BMD and bone formation markers. However, GLP-1RAs led to a significant increase in CTX.

Abstract Image

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胰高血糖素样肽-1 受体激动剂对骨矿密度和骨转换标志物的影响：元分析。

目的：胰高血糖素样肽-1 受体激动剂（GLP-1RA）可促进骨骼形成，但反过来说，由于减肥导致机械负荷减少，它们也可能削弱骨骼。然而，其对人体的临床效果尚未得到明确证实。本荟萃分析旨在评估 GLP-1RA 是否会影响 BMD 和骨转换标志物：于 2024 年 6 月 13 日检索了 PubMed、Embase 和 Scopus。资格标准为(1)人类研究；(2)接受 GLP-1RA 超过 4 周；(3)未治疗对照组或安慰剂组；(4)报告至少一种 BMD 或骨转换标志物；(5)RCT 设计。偏倚风险采用 Cochrane 偏倚风险 2 工具进行评估。根据异质性进行固定效应或随机效应荟萃分析：荟萃分析纳入了七项研究。GLP-1RA对股骨颈（平均差异[MD]，0.01 g/cm2；95% CI，-0.01-0.04 g/cm2）、全髋（MD，-0.01 g/cm2；95% CI，-0.02-0.01 g/cm2）和腰椎（MD，0 g/cm2；95% CI，-0.02-0.02 g/cm2）的BMD无明显改变。1 型胶原蛋白 C 端端肽（CTX）是一种骨吸收标记物，在 GLP-1RA 治疗后显著增加（MD，0.04 μg/L；95% CI，0.01-0.07 μg/L）。GLP-1RA并没有明显改变骨形成标志物，如1型胶原蛋白N-端肽、骨特异性碱性磷酸酶和骨钙素：结论：GLP-1RA 不影响 BMD 和骨形成标志物。结论：GLP-1RA 不影响 BMD 和骨形成标志物，但会导致 CTX 显著增加。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.