Summary

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• This summary is based on the review of 39 systematic review(s)/meta-analysis(es). ^[1-39]
• In T2DM (type 2 diabetes mellitus) patients, liraglutide increased serum calcium (MD (mean difference) = 0.05, 95% CI (confidence interval) (0.01, 0.09), P = 0.002), bone alkaline phosphatase (SMD = 0.76, 95% CI (0.29, 1.24), P = 0.001), osteocalcin (SMD (standardized mean difference)= 2.04, 95% CI (0.99, 3.08), P = 0.0001), and lumbar spine BMD (SMD = 1.04, 95% CI (0.60, 1.48), P < 0.00001).
• In T2DM patients with NAFLD, significant reductions were observed in body mass index (MD = -1.06, 95% CI (-1.41, -0.70), P < 0.001), triglycerides (MD = -0.35, 95% CI (-0.61, -0.09), P = 0.0009), visceral adipose tissue (MD = -21.06, 95% CI (-34.58, -7.55), P = 0.002), and subcutaneous adipose tissue (MD = -20.53, 95% CI (-29.15, -11.90), P < 0.001).
• In prediabetic patients, GLP-1 RAs showed an increased reversion to normoglycemia (RR = 1.76, 95% CI (1.45, 2.13), P < 0.00001) and prevention of new-onset diabetes (RR = 0.28, 95% CI (0.19, 0.43), P < 0.00001), alongside reductions in HbA1c, fasting plasma glucose, body weight, waist circumference, triglycerides, and LDL (P < 0.05).
• In T2DM patients with advanced CKD or ESKD, liraglutide resulted in significant reductions in cardiothoracic ratio (SMD of -1.2%; 95% CI -2.0, -0.4), pro-BNP (SMD -335.9 pmol/L; 95% CI -438.9, -232.8), mean blood glucose (SMD -1.1 mg/dL; 95% CI -1.8, -0.3), and weight (SMD -2.2 kg; 95% CI -2.9, -1.5).
• Gastrointestinal adverse events, including nausea, vomiting, and diarrhea, occurred more frequently with liraglutide compared to placebo (P < 0.05).
• Cardiac safety concerns included worsened heart failure outcomes in diabetic patients with reduced ejection fraction and an increased heart rate (MD = 5.39; 95% CI = 3.26 to 7.52; P < 0.00001).
• In patients with advanced CKD and ESKD, there was a notably higher risk of nausea (3.8 times) and vomiting (35.7 times) with no significant increase in hypoglycemia risk.
• GLP-1RAs demonstrated significant benefits across specific populations: in T2DM with NAFLD, notable improvements in glucose metabolism, lipid and liver function, and reductions in visceral and subcutaneous fat; in prediabetes, enhanced efficacy with lifestyle modification; in advanced CKD and ESKD, improved glucose control, weight reduction, and cardiovascular benefits despite gastrointestinal side effects; for T2DM with cardiac function concerns, liraglutide improved cardiac metrics except for cardiac output and certain diastolic ratios; and in obesity and T2DM, significant body weight and BMI reductions were observed, especially relevant for overweight and obese individuals.