Yang Yucheng, He Liyun, Han Shumeng, Yang Na, Liu Yiwen, Wang Xuechen, Li Ziyi, Ping Fan, Xu Lingling, Li Wei, Zhang Huabing, Li Yuxiu
Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Diabetes Research Center of Chinese Academy of Medical Sciences, Beijing, China.
J Diabetes. 2025 Mar;17(3):e70063. doi: 10.1111/1753-0407.70063.
To verify sex differences of GLP-1RAs for weight reduction.
We searched RCTs reporting weight change by sex from PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials registries. Meta-regression was performed to evaluate the association between weight reduction and sex differences. Subgroup analyses were stratified by individual GLP-1RA medications, dose, treatment duration, indication, type of control, background treatment, and baseline weight. The study protocol was registered (CRD42023480167).
Fourteen studies covering dulaglutide, exenatide, liraglutide, semaglutide, and retatrutide were included in this study. The meta-analysis showed that females lost more weight than males (MD 1.04 kg [95% CIs 0.70-1.38]; MD 1.69% [95% CI 0.78-2.61]). The pooled results of GLP-1RAs indicated similar results (MD 0.88 kg [95% CIs 0.67-1.09]). Meta-regression illustrated that substantial weight reduction was significantly relevant to greater gender differences (β = -0.19 [95% CIs -0.29 to -0.09]). Subgroup analysis demonstrated that indications for weight reduction increased the gender difference in weight reduction (MD 4.21 kg [95% CIs 1.75-6.67]). Background treatment, dose, duration of treatment, baseline weight, and type of control had no subgroup differences in the sex difference in weight reduction of GLP-1RAs. Dulaglutide (MD 0.88 kg [95% CIs 0.63-1.12]) and semaglutide (MD 1.04 kg [95% CIs 0.45-1.63]) showed statistically significant differences in weight reduction between males and females. No gender difference was observed in the exenatide subgroup analysis.
Females lost more weight than males when treated with GLP-1RAs for weight reduction. The sex difference in weight reduction became more pronounced as the degree of weight reduction increased. Indications for obesity could magnify this sex difference.
验证胰高血糖素样肽-1受体激动剂（GLP-1RAs）在减重方面的性别差异。
我们在PubMed、科学网、Embase、考克兰图书馆和临床试验注册库中检索了按性别报告体重变化的随机对照试验（RCTs）。进行Meta回归以评估体重减轻与性别差异之间的关联。亚组分析按个体GLP-1RA药物、剂量、治疗持续时间、适应症、对照类型、背景治疗和基线体重进行分层。研究方案已注册（CRD42023480167）。
本研究纳入了14项涉及度拉糖肽、艾塞那肽、利拉鲁肽、司美格鲁肽和雷特鲁肽的研究。Meta分析表明，女性比男性减重更多（平均差1.04千克[95%置信区间0.70 - 1.38]；平均差1.69%[95%置信区间0.78 - 2.61]）。GLP-1RAs的汇总结果显示了类似结果（平均差0.88千克[95%置信区间0.67 - 1.09]）。Meta回归表明，显著的体重减轻与更大的性别差异显著相关（β = -0.19[95%置信区间 - 0.29至 - 0.09]）。亚组分析表明，减重适应症增加了减重方面的性别差异（平均差4.21千克[95%置信区间1.75 - 6.67]）。背景治疗、剂量、治疗持续时间、基线体重和对照类型在GLP-1RAs减重的性别差异方面没有亚组差异。度拉糖肽（平均差0.88千克[95%置信区间0.63 - 1.12]）和司美格鲁肽（平均差1.04千克[95%置信区间0.45 - 1.63]）在男性和女性减重方面显示出统计学上的显著差异。艾塞那肽亚组分析未观察到性别差异。
使用GLP-1RAs进行减重治疗时，女性比男性减重更多。随着减重程度增加，减重方面的性别差异变得更加明显。肥胖适应症可能会放大这种性别差异。
