Differential effects of GLP-1 receptor agonists on diabetic osteopathy in type 2 diabetes: a patient-stratified network meta-analysis

Aug 2, 2025BMC musculoskeletal disorders

Different effects of GLP-1 medicines on bone problems in type 2 diabetes patients grouped by characteristics

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Abstract

A total of 33,107 participants in 33 trials showed that GLP-1 receptor agonists may improve bone mineral density in patients with type 2 diabetes mellitus.

  • GLP-1 receptor agonists improved bone mineral density at the lumbar spine (0.052 g/cm), total hip (0.047 g/cm), and femoral neck (0.072 g/cm).
  • Bone resorption was reduced (Ξ²-CTX SMD -0.36), while markers of bone formation increased, potentially normalizing the abnormal bone remodeling seen in .
  • Long-term treatment with GLP-1 receptor agonists was associated with a 20% reduction in fracture risk (RR 0.80).
  • The effects on bone health may vary based on the type of GLP-1 receptor agonist used, patient characteristics, and duration of treatment.
  • Further studies focused specifically on bone health are needed for newer GLP-1 receptor agonist agents.

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Key numbers

0.052 g/cm
Increase in Lumbar Spine BMD
Mean increase at the lumbar spine with GLP-1 RA treatment.
20%
Fracture Risk Reduction
Long-term treatment with GLP-1 RAs associated with reduced fracture risk.
βˆ’0.41
Anti-resorptive Effect of Liraglutide
Standardized mean difference for bone resorption marker Ξ²-CTX with liraglutide.

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