基于胰高血糖素样肽 1 受体的激动剂改变身体组成的作用特征：荟萃分析

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2024-10-21 DOI:10.1111/dom.16012

Ruoyang Jiao, Chu Lin, Xiaoling Cai, Jingxuan Wang, Yuan Wang, Fang Lv, Wenjia Yang, Linong Ji

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引用次数: 0

摘要

目的：糖尿病是导致肌肉质量下降的一个独立风险因素，可能的机制包括胰岛素信号受损和慢性炎症。使用基于胰高血糖素样肽1（GLP-1）受体的激动剂可以减轻体重，这可能是脂肪和骨骼肌同时减少的结果。然而，基于 GLP-1 受体的激动剂对身体成分的调节作用尚未得到系统研究：方法：检索了从开始到 2023 年 10 月的 PubMed、EMBASE、Cochrane 研究对照试验中心注册表和 Clinicaltrial.gov。纳入了GLP-1受体激动剂或葡萄糖依赖性胰岛素多肽/GLP-1受体双重激动剂的随机对照试验，这些试验报告了身体成分的变化。结果以随机效应模型中的加权平均差（WMDs）和95%置信区间（CIs）计算：结果：共纳入了 19 项随机对照试验。与对照组相比，使用基于 GLP-1 受体的激动剂治疗的患者体内脂肪量大幅减少（WMD = -2.25 kg，95% CI -3.40 to -1.10 kg），皮下脂肪面积（WMD = -38.35 cm2，95% CI，-54.75 to -21.95 cm2）和内脏脂肪面积（WMD = -14.61 cm2，95% CI，-23.77 to -5.44 cm2）均有所减少。此外，与不使用 GLP-1 受体激动剂者相比，使用 GLP-1 受体激动剂者的瘦体重减少幅度更大（WMD = -1.02 kg，95% CI，-1.46 至 -0.57 kg），而使用 GLP-1 受体激动剂者与不使用 GLP-1 受体激动剂者的瘦体重百分比变化相当：结论：与对照组相比，GLP-1 受体激动剂使用者的脂肪量减少更多，皮下脂肪量和内脏脂肪量都有塑身效果。虽然GLP-1受体激动剂使用者的瘦体重也有较大减少，但瘦体重百分比的变化在使用者和非使用者之间不相上下。

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Characterizing body composition modifying effects of a glucagon-like peptide 1 receptor-based agonist: A meta-analysis.

Aim: Diabetes is an independent risk factor for muscle mass loss, with possible mechanisms including impaired insulin signalling and chronic inflammation. The use of a glucagon-like peptide 1 (GLP-1) receptor-based agonist could lead to weight reduction, which might result from the loss of both fat and skeletal muscle. However, the body composition-modifying effects of GLP-1 receptor-based agonists have not been systematically characterized.

Methods: PubMed, EMBASE, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from inception to October 2023. Randomized controlled trials of GLP-1 receptor agonist or glucose-dependent insulinotropic polypeptide/GLP-1 receptor dual agonist, which reported the changes of body composition, were included. The results were computed as weighted mean differences (WMDs) and 95% confidence intervals (CIs) in a random-effects model.

Results: In all, 19 randomized controlled trials were included. When compared with controls, substantial reductions in fat body mass were observed in patients using GLP-1 receptor-based agonist treatment (WMD = -2.25 kg, 95% CI -3.40 to -1.10 kg), with decrease in areas of both subcutaneous fat (WMD = -38.35 cm², 95% CI, -54.75 to -21.95 cm²) and visceral fat (WMD = -14.61 cm², 95% CI, -23.77 to -5.44 cm²). Moreover, greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users compared with non-users (WMD = -1.02 kg, 95% CI, -1.46 to -0.57 kg), while the changes in lean mass percentage were comparable between GLP-1 receptor-based agonist users and non-users.

Conclusion: Compared with the controls, GLP-1 receptor-based agonist users experienced greater reductions in fat body mass, with body shaping effects in terms of both subcutaneous fat mass and visceral fat mass. Although greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users, the changes in lean mass percentage were comparable between the users and non-users.

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.