Dionysus or apollo, skeletal muscle mass changes in type 2 diabetes with sarcopenia receiving GLP-1 receptor agonist: systematic review and meta-analysis.

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Yanying Wang, Boya Lan, Shuo Zhang, Yue Mu, Jia Mi, Jing Yu, Qun Zhan, Baoling Luo, Fuyang Lin, Jia Teng, Xiuge Wang, Guanchi Yan
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引用次数: 0

Abstract

Objective: Type 2 diabetes mellitus (T2DM) increases the risk of sarcopenia, but evidence on the effects of glucagon-like peptide 1 receptor agonist (GLP-1 RA) in skeletal muscle is limited and inconsistent. The study aimed to evaluate the skeletal muscle mass of GLP-1 RA in patients with type 2 diabetes.

Methods: Randomized controlled trials of GLP-1 RA for sarcopenia with type 2 diabetes were identified by searching databases (up to July 6, 2025). Electronic databases (CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane library, Web of Science, and Google Scholar), grey literature (Open Grey and Proquest) and reference lists of included articles were searched. The I2 and τ2 statistic was used to assess the heterogeneity. The random effects model was applied regardless of the heterogeneity. Funnel plots were used to assess publication bias. The results were evaluated by calculating the risk ratio (RR), mean difference (MD), and confidence interval (CI).

Results: The study included nine randomized controlled trials with a total of 1089 participants. GLP-1 RA significantly reduced weight-related changes and fat-related changes, including body weight (BW) (MD= -2.25, 95%CI: -6.99 to 1.89 P = 0.20), body mass index (BMI) (MD= -1.83, 95%CI: -3.88 to 0.23, P < 0.01), fat mass (FM) (MD= -8.00, 95%CI: -11.93 to -4.08, P < 0.01), body fat ratio (BFR) (MD= -2.76, 95%CI: -3.65 to -1.87, P < 0.01), visceral fat area (VFA) (MD = 0.74, 95%CI: -54.93 to 56.40, P < 0.05). In muscle-related changes, lean body mass (LBM) (MD = 4.61, 95%CI: -4.19 to 13.42, P = 0.31), and skeletal muscle index (SMI) (MD = 0.59, 95% CI: -0.69 to 1.86, P = 0.19) were not significantly different.

Conclusion: GLP-1 receptor agonists, regardless of structure, have beneficial effects on body weight and fat content in type 2 diabetes with sarcopenia, but have no effect on reducing muscle mass.

Registration: PROSPERO (CRD42023473528).

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接受GLP-1受体激动剂治疗的2型糖尿病骨骼肌减少症患者的骨骼肌质量变化:系统回顾和荟萃分析。
目的:2型糖尿病(T2DM)增加骨骼肌减少的风险,但关于胰高血糖素样肽1受体激动剂(GLP-1 RA)在骨骼肌中的作用的证据有限且不一致。该研究旨在评估GLP-1 RA在2型糖尿病患者中的骨骼肌质量。方法:通过检索数据库(截至2025年7月6日)确定GLP-1 RA治疗2型糖尿病肌肉减少症的随机对照试验。检索电子数据库(中国知网、万方、维普、中国医学信息网、PubMed、EMbase、Cochrane图书馆、Web of Science、谷歌Scholar)、灰色文献(Open grey、Proquest)和收录文章的参考文献列表。采用I2和τ2统计量来评估异质性。不考虑异质性,采用随机效应模型。采用漏斗图评估发表偏倚。通过计算风险比(RR)、平均差(MD)和置信区间(CI)对结果进行评价。结果:本研究纳入9项随机对照试验,共1089名受试者。GLP-1 RA可显著降低体重相关变化和脂肪相关变化,包括体重(BW) (MD= -2.25, 95%CI: -6.99 ~ 1.89 P = 0.20)、体重指数(BMI) (MD= -1.83, 95%CI: -3.88 ~ 0.23, P)。结论:GLP-1受体激动剂不论结构如何,对2型糖尿病合并肌肉减少症患者的体重和脂肪含量有有益作用,但对减少肌肉质量无作用。报名:普洛斯彼罗(CRD42023473528)。
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来源期刊
Diabetology & Metabolic Syndrome
Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-
CiteScore
6.20
自引率
0.00%
发文量
170
审稿时长
7.5 months
期刊介绍: Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.
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