{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:24Z","timestamp":1792384884634,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Body composition changes during glucagon\u2010like peptide\u20101 (GLP\u20101)\u2010based therapy remain incompletely characterized, particularly regarding their effects on adiposity, muscle quantity, and muscle quality. We conducted a systematic review and meta\u2010analysis using a predefined physiological framework to evaluate body composition remodelling during GLP\u20101\u2010based therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, and Cochrane CENTRAL from inception through May 2026 for studies evaluating GLP\u20101 receptor agonists or dual incretin therapies reporting longitudinal body composition outcomes in adults. Outcomes were classified into adiposity, muscle quantity, muscle quality, and body weight domains. Primary analyses prioritized comparative evidence and included one physiologically coherent outcome per study and domain. Random\u2010effects meta\u2010analyses were performed using restricted maximum likelihood estimation with Hartung\u2010Knapp adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen studies met the eligibility criteria, including comparative and exploratory single\u2010arm investigations. Three comparative studies contributed to the primary adiposity meta\u2010analysis and two to the primary muscle quantity meta\u2010analysis. Comparative analyses suggested a direction toward greater reductions in adiposity during GLP\u20101\u2010based therapy. However, only three studies contributed to this analysis, and the pooled estimate was characterized by substantial between\u2010study heterogeneity and a wide confidence interval crossing the null. Evidence regarding muscle quantity was based on two comparative studies and remained highly heterogeneous and imprecise. Muscle quality outcomes could not be quantitatively synthesized because of methodological heterogeneity and incomplete variance reporting and were therefore evaluated narratively. Exploratory single\u2010arm analyses showed reductions in adiposity and body weight, whereas changes in muscle quantity varied across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current comparative evidence suggests a possible direction toward greater reductions in adiposity during GLP\u20101\u2010based therapy. However, the limited number of comparative studies, substantial between\u2010study heterogeneity, wide confidence intervals, and low to very low certainty of evidence preclude definitive conclusions regarding preferential fat loss or preservation of skeletal muscle health. Reductions in lean mass should not be interpreted as synonymous with sarcopenia, but the available evidence is also insufficient to exclude clinically relevant muscle loss in susceptible populations. These findings should therefore be considered hypothesis\u2010generating and require confirmation in adequately powered comparative studies incorporating standardized assessments of muscle quantity, muscle quality, strength, and physical performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Registration<\/jats:title>\n                    <jats:p>CRD420261411693.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71220","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:15Z","timestamp":1787018055000},"page":"9849-9860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Body Composition Remodelling During\n                    <scp>GLP<\/scp>\n                    \u20101\u2010Based Therapy: A Systematic Review and Meta\u2010Analysis Using a Hierarchical Physiological Framework"],"prefix":"10.1111","volume":"28","author":[{"given":"Maria Luizza","family":"Lopes Menezes","sequence":"first","affiliation":[{"name":"Secretariat of Health of the Federal District  Bras\u00edlia Brazil"},{"name":"School of Public Health of the Federal District  Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eduarda","family":"G\u00fcntzel Chiappa","sequence":"additional","affiliation":[{"name":"Federal University of Rio Grande do Sul  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Fuentes","family":"Kloss","sequence":"additional","affiliation":[{"name":"Health Sciences School, Faculty of Medicine Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Tuesta","sequence":"additional","affiliation":[{"name":"Exercise and Rehabilitation Sciences Institute, School of Physical Therapy Faculty of Rehabilitation Sciences, Universidad Andres Bello  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Santos","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goi\u00e1s  Goi\u00e1s Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Souza","family":"S\u00e1 Filho","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goi\u00e1s  Goi\u00e1s Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-8404","authenticated-orcid":false,"given":"Gaspar R.","family":"Chiappa","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation of Evangelical University of Goi\u00e1s  Goi\u00e1s Brazil"},{"name":"Faculty of Health Sciences Universidad Aut\u00f3noma de Chile  Santiago 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