Memel Zoe, Gold Stephanie L, Pearlman Michelle, Muratore Alicia, Martindale Robert
Department of Gastroenterology, University of California San Francisco, San Francisco, California, USA.
Department of Gastroenterology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Curr Nutr Rep. 2025 Apr 28;14(1):63. doi: 10.1007/s13668-025-00649-w.
Glucagon-like peptide- 1 receptor agonists (GLP- 1 RA) are a rapidly expanding class of medications used to treat many chronic diseases. This review explores factors that may contribute to accelerated muscle loss among higher-risk patient populations and describes tailored interventions to reduce the risk of accelerated sarcopenia and frailty.
While GLP- 1 RA can result in total weight loss upwards of 25%, recent studies show that they can also lead to significant loss of lean body mass, reaching as high as 15-40% of total weight lost. This rapid and significant decline in muscle mass while taking GLP- 1 RA places certain patient populations already predisposed to sarcopenia at higher risk for muscle loss and adverse events. Currently, there is insufficient evidence delving into the impact of GLP- 1 RA on body composition among older adults, patients with chronic kidney disease, liver disease, and inflammatory bowel disease. However, research suggests that a high protein diet and resistance training may help prevent loss of muscle mass during GLP- 1 RA usage. A targeted and individualized nutrition and physical activity regimen should be instituted for each patient with a focus on optimizing protein intake and performing frequent resistance training in order to minimize loss of muscle mass while promoting the loss of fat mass. Future research should evaluate the impact of GLP- 1 RA on sarcopenia in high-risk patient populations.
胰高血糖素样肽-1受体激动剂（GLP-1 RA）是一类迅速发展的用于治疗多种慢性疾病的药物。本综述探讨了可能导致高危患者群体肌肉流失加速的因素，并描述了针对性的干预措施，以降低肌肉减少症和衰弱加速的风险。
虽然GLP-1 RA可导致体重减轻超过25%，但最近的研究表明，它们也会导致去脂体重显著减少，高达体重减轻总量的15%-40%。服用GLP-1 RA时肌肉量的这种快速且显著下降，使某些已经易患肌肉减少症的患者群体面临更高的肌肉流失和不良事件风险。目前，关于GLP-1 RA对老年人、慢性肾病患者、肝病患者和炎症性肠病患者身体成分影响的深入研究证据不足。然而，研究表明，高蛋白饮食和抗阻训练可能有助于预防GLP-1 RA使用期间的肌肉量流失。应为每位患者制定有针对性的个性化营养和体育活动方案，重点是优化蛋白质摄入量并进行频繁的抗阻训练，以尽量减少肌肉量流失，同时促进脂肪量流失。未来的研究应评估GLP-1 RA对高危患者群体肌肉减少症的影响。
