The Effects of GLP-1 Receptor Agonists on Body Composition in Patients with Type 2 Diabetes, Overweight or Obesity: A Meta-Analysis of Randomized Controlled Trials.

Aim: The objective is to evaluate the impacts of glucagon-like peptide 1 receptor agonists on body composition among patients with type 2 diabetes, overweight or obesity.

Methods: We conducted an extensive search in the PubMed, Embase, and Cochrane Library databases, scanning the literature related to GLP-1RAs from the establishment of the databases to October 15, 2024, without language restrictions. Ignoring heterogeneity, a random effects model is adopted. I² is utilized to assess the heterogeneity among studies. The weighted mean difference and 95% confidence interval are employed to evaluate the differences in outcomes. The Cochrane risk of bias assessment tool is applied to evaluate the quality of randomized controlled trials. Statistical analysis is conducted using Review Manager version 5.4.

Results: 36 randomized controlled trials were included, involving 2555 participants. The study demonstrated that GLP-1RAs conspicuously decreased fat-related outcomes, encompassing fat mass, body fat percentage, visceral fat area and subcutaneous fat area. When placebo was adopted as a control, GLP-1RAs decreased the lean mass. No significant discrepancies were detected when oral antidiabetic drugs, insulin, and lifestyle interventions were employed as controls. There was no disparity in the effect of GLP-1RAs on the lean mass percentage.

Conclusion: This study indicates that the treatment of GLP-1RAs can decrease fat mass. Lean mass loss was observed in the majority of studies, and the effect is more prominent in overweight and obese patients as well as in those with long-term treatment. However, there was no disparity in the effect of GLP-1RAs on the lean mass percentage.