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A review of the effects of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors on lean body mass in humans

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journal contribution
posted on 04.11.2019 by Jack Sargeant, Joseph Henson, James King, Thomas Yates, Kamlesh Khunti, Melanie Davies
Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to fat mass (FM). Given the importance of skeletal muscle and lean body mass (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting the effects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associated with both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In over half of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistent with diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently, the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategies to preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.

Funding

National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC)

NIHR Collaboration for Leadership in Applied Health Research and Care–East Midlands (CLAHRC–EM)

History

School

  • Sport, Exercise and Health Sciences

Published in

Endocrinology and Metabolism

Volume

34

Issue

3

Pages

247 - 262

Publisher

Korean Endocrine Society

Version

VoR (Version of Record)

Rights holder

© Korean Endocrine Society

Publisher statement

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publication date

2019-09-26

Copyright date

2019

ISSN

2093-596X

eISSN

2093-5978

Language

en

Depositor

Dr James King. Deposit date: 1 November 2019

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