Effect of glucagon-like peptide-1 receptor agonists on body weight and urinary albumin-to-creatinine ratio in patients with and without type 2 diabetes: A systematic review and meta-analysis
Abstract
ObjectiveGlucagon-like peptide-1 receptor agonists are established for weight management and cardiovascular risk reduction, with emerging evidence for kidney protection. Whether albuminuria-lowering effects extend to nondiabetic chronic kidney disease remains uncertain.MethodsWe performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided meta-analysis of randomized controlled trials comparing glucagon-like peptide-1 receptor agonists with placebo or standard care. Primary outcomes were change in body weight (kg) and percentage change in urinary albumin-to-creatinine ratio; change in estimated glomerular filtration rate was the secondary outcome. We conducted prespecified subgroup analyses (including glycemic status) and random-effects meta-regression to explore heterogeneity. Risk of bias assessment (2.0), small-study effects (funnel plot and trim-and-fill analyses), sensitivity analyses (leave-one-out and low-risk-only), and Grading of Recommendations Assessment, Development and Evaluation certainty ratings were applied.ResultsTen trials (n = 26,088) were included. Glucagon-like peptide-1 receptor agonists reduced body weight (mean difference, -5.85 kg; 95% confidence interval: -7.78 to -3.92) with a consistent direction of effect across studies despite heterogeneity. Glucagon-like peptide-1 receptor agonists lowered urinary albumin-to-creatinine ratio overall (mean difference, -27.94%; 95% confidence interval: -37.72 to -18.15). Stratified…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 26,088 participants or records.
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