Liraglutide-associated body composition change: muscle mass loss and determinants
Ihsan Ayhan, Omercan Topaloglu
article (Uluslararası, Hakemli) | Yazar(lar): Ihsan Ayhan, Omercan Topaloglu | Yıl: 2026 | Dergi/Kurum: CUKUROVA MEDICAL JOURNAL | İndeks: WOS.ESCI | DOI: 10.17826/cumj.1925099 | Anahtar Kelimeler: Liraglutide, GLP-1 receptor agonist, body composition, bioelectrical impedance, fat mass, muscle mass, adverse muscle comp
Purpose: We aimed to quantify fat-mass (FM) and muscle-mass (MM) changes over six months of liraglutide therapy and to identify predictors of disproportionate MM decline.<br /> Materials and Methods: In this retrospective observational cohort, adults with overweight/obesity receiving liraglutide underwent multifrequency bioelectrical impedance analysis (BIA) at baseline and 6 months. Patients were grouped by weight reduction (<5% vs >= 5%) and, separately, by muscle trajectory using relative muscle loss (RMM), defined as the percentage of total weight loss accounted for by muscle-mass loss [RMM(%) = (muscle-mass loss divided by total weight loss) & times; 100]: RMM <25% (A1), RMM >= 25% (A2), or increased MM (A3). Outcomes included segmental and whole-body FM and MM changes, the proportion of total weight change attributable to FM or MM, and predictors of RMM >= 25% assessed using logistic regression.<br /> Results: Of 111 patients, 46 (41.4%) lost <5% and 65 (58.6%) lost >= 5% of body weight at 6 months. The >= 5% group showed larger reductions in total and regional FM and in MM across trunk and limbs (all p<0.01). Whole-body MM decreased-5.09% (Q1-Q3: -8.15 to-1.82) vs-1.30% (-4.05 to 0.83) in the <5% group (p<0.001). The fraction of total weight loss attributable to FM was higher with >= 5% loss (median 72.3%) vs <5% (57.5%), whereas MM contributed a smaller fraction (26.6% vs 42.1%); both between-group differences were not statistically significant. In muscle-trajectory analyses (A3 n=21; A1 n=29; A2 n=61), the A2 group exhibited the greatest MM decrements across segments (all p<0.001) and the highest MM/total-loss ratio (median 56.3%); by contrast, A3 gained MM and showed a negative MM/total-loss ratio (median-28.3%). >= 25% relative muscle loss was independently associated with higher baseline whole-body muscle mass and lower baseline weight and height; however, these predictors were strongly intercorrelated, and the multivariable model demonstrated moderate discrimination (AUC=0.729, 95% CI 0.634-0.823).<br /> Conclusions: Liraglutide treatment was associated predominantly with fat loss; however, a clinically meaningful subgroup experienced disproportionate muscle loss. These findings suggest that baseline body-composition phenotype may be associated with the compositional quality of weight loss and support body-composition monitoring during treatment.