GLP-1-derived therapies and sarcopenia: plea for a specific focus on at risk special populations

Oct 16, 2025Diabetes & metabolism

GLP-1-based treatments and muscle loss: need to focus on high-risk groups

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Caution is recommended when prescribing GLP-1-based therapies in populations with comorbidities due to potential risks of sarcopenia.

Excessive reduction in skeletal muscle mass is a concern when using GLP-1-based therapies, particularly in certain subgroups.
Older individuals and those with comorbidities such as advanced heart failure or chronic kidney disease may be at higher risk for sarcopenia.
Current literature emphasizes the need for caution, although there is a lack of hard evidence demonstrating a significantly increased risk of sarcopenia.
The benefits of GLP-1-based therapies could be mitigated by the development of sarcopenia in these at-risk populations.
Dedicated studies are urgently needed to assess the risk of sarcopenia in patients with comorbidities undergoing GLP-1-based treatment.

AI simplified

BACKGROUND: A risk of excessive reduction in skeletal muscle mass (SSM), potentially leading to sarcopenia, when using glucagon-like peptide-1 (GLP-1)-based therapies, is currently a matter of debate. While most available results are rather reassuring in the general population, sarcopenia may become a concern in some special subgroups with comorbidities known to be associated with a higher risk of sarcopenia, independently of any GLP-1-based therapy.

METHODS: An extensive literature search was done to identify studies that investigated the effects of GLP-1-based therapies on changes in SMM and sarcopenia in special populations, i.e. older people, patients with type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, and metabolic dysfunction-associated liver disease.

RESULTS: Several publications emphasized the risk of sarcopenia and recommended caution when prescribing GLP-1-based therapies in people with these comorbidities of interest. However, hard data remain scarce in the literature, without any evidence-based demonstration of a significantly increased risk of sarcopenia. Nevertheless, as old age potentiates the risk of sarcopenia, older patients with these comorbidities (especially advanced heart failure or renal disease) deserve more careful attention.

CONCLUSION: While the risk of sarcopenia associated with GLP-1-based therapies remains controversial in the general population, a higher risk in special populations with comorbidities has been repeatedly emphasized despite the lack of evidence-based data in the literature. Because these agents showed major clinical benefits in patients with such comorbidities but sarcopenia could mitigate them, there is an urgent need to implement dedicated studies with appropriate measures of sarcopenia in these special populations.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

GLP-1-derived therapies and sarcopenia: plea for a specific focus on at risk special populations

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief