基于胰高血糖素样肽-1受体激动剂（GLP1Ra）的疗法与双能X线吸收法（DXA）获得的肌肉骨骼健康结果：安慰剂对照试验的聚焦荟萃分析
GLP1Ra-based therapies and DXA-acquired musculoskeletal health outcomes: a focused meta-analysis of placebo-controlled trials.
作者信息
Beavers Kristen M, Cortes Tiffany M, Foy Colleen M, Dinkla Lauren, Reyes San Martin Fernando, Ard Jamy D, Serra Monica C, Beavers Daniel P
机构信息
Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA.
出版信息
Obesity (Silver Spring). 2025 Feb;33(2):225-237. doi: 10.1002/oby.24172. Epub 2024 Dec 22.
OBJECTIVE
The objective of this study was to evaluate the effect of glucagon-like peptide-1 receptor agonist (GLP1Ra)-based therapies on change in dual-energy x-ray absorptiometry (DXA)-acquired lean mass (LM) or bone mineral density (BMD).
METHODS
PubMed and Web of Science were searched from database inception through January 29, 2024, for randomized, placebo-controlled trials reporting on change in DXA-acquired LM or BMD measures associated with 12+ weeks of GLP1Ra-based treatment. Of 2618 articles, 9 trials met prespecified search criteria, with 7 reporting on change in total body LM and 2 reporting on change in BMD. For LM outcomes, a hierarchical Bayesian model was used to estimate treatment mean differences. BMD outcomes were described narratively.
RESULTS
LM was reported in a total of 659 participants (GLP1Ra-based therapies: n = 419; placebo: n = 240), with follow-up times ranging from mean (SD) 12 to 72 (33.5) weeks. At baseline, participants were aged mean (SD) 41.7 (7.6) years, and 75% were female, with BMI values ranging from 30 to 43 kg/m. Compared with placebo, GLP1Ra-based treatment was associated with significantly reduced total body weight (-6.9 kg; 95% credible interval [CI]: -10.7 to -3.0). GLP1Ra-based treatment was also associated with significantly reduced LM (-1.9 kg; 95% CI: -3.5 to -0.2).
CONCLUSIONS
Approximately 30% of body weight lost with GLP1Ra-based therapy is LM. More data are needed assessing BMD outcomes.
目的
本研究的目的是评估基于胰高血糖素样肽-1受体激动剂（GLP1Ra）的治疗对双能X线吸收法（DXA）测量的瘦体重（LM）或骨密度（BMD）变化的影响。
方法
检索PubMed和Web of Science数据库，时间从建库至2024年1月29日，查找报告与基于GLP1Ra的12周以上治疗相关的DXA测量的LM或BMD变化的随机、安慰剂对照试验。在2618篇文章中，9项试验符合预先设定的检索标准，其中7项报告了全身LM的变化，2项报告了BMD的变化。对于LM结局，使用分层贝叶斯模型估计治疗平均差异。对BMD结局进行了描述性叙述。
结果
共有659名参与者报告了LM（基于GLP1Ra的治疗：n = 419；安慰剂：n = 240），随访时间平均（标准差）为12至72（33.5）周。基线时，参与者的年龄平均（标准差）为41.7（7.6）岁，75%为女性，体重指数（BMI）值范围为30至43 kg/m²。与安慰剂相比，基于GLP1Ra的治疗与显著降低的总体重相关（-6.9 kg；95%可信区间[CI]：-10.7至-3.0）。基于GLP1Ra的治疗还与显著降低LM相关（-1.9 kg；95%CI：-3.5至-0.2）。
结论
基于GLP1Ra的治疗所减轻的体重中约30%为LM。需要更多数据来评估BMD结局。
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