Glucagon-like peptide-1 Receptor agonists (GLP-1Ras) such as liraglutide and semaglutide have been recently approved as medications for chronic weight management in people living with obesity (PwO); GLP-1 may enhance bone metabolism and improve bone quality. However, the effects of GLP-1Ras on skeletal health remain to be determined and that's the purpose of this narrative review. Nevertheless, bone consequences of intentional weight loss interventions in PwO are well known: (i) significant weight loss induced by caloric restriction and bariatric surgery results in accelerated bone turnover and bone loss, and (ii) unlike caloric restriction interventions, PwO experience a substantial deterioration in bone microarchitecture and strength associated with an increased risk of fracture after bariatric surgery especially malabsorptive procedures. Liraglutide seems to have a positive effect on bone material properties despite significant weight loss in several rodent models. However, most of positive effects on bone mineral density and microarchitecture were observed at concentration much higher than approved for obesity care in humans. No data have been reported in preclinical models with semaglutide. The current evidence of the effects of GLP-1Ra on bone health in PwO is limited. Indeed, studies on the use of GLP-1Ra mostly included patients with diabetes who were administered a dose used in this condition, did not have adequate bone parameters as primary endpoints, and had short follow-up periods. Further studies are needed to investigate the bone impact of GLP-1Ra, dual- and triple-receptor agonists for GLP-1, glucose-dependent insulin releasing polypeptide (GIP), and glucagon in PwO.

胰高血糖素样肽 1 受体激动剂 (GLP-1Ras)，例如利拉鲁肽和索马鲁肽，最近已被批准作为肥胖症患者 (PwO) 长期体重管理的药物；GLP-1可以增强骨代谢并改善骨质量。然而，GLP-1Ras 对骨骼健康的影响仍有待确定，这就是本叙述性综述的目的。然而，PwO 中有意减肥干预的骨骼后果是众所周知的：（i）热量限制和减肥手术引起的显着体重减轻导致骨转换和骨质流失加速，以及（ii）与热量限制干预不同，PwO 经历了显着的体重减轻。骨微结构和强度的恶化与减肥手术（尤其是吸收不良手术后）骨折风险增加相关。尽管在几种啮齿动物模型中体重明显减轻，但利拉鲁肽似乎对骨材料特性具有积极影响。然而，大多数对骨矿物质密度和微结构的积极影响是在远高于批准用于人类肥胖治疗的浓度下观察到的。尚未报道索马鲁肽临床前模型的数据。目前关于 GLP-1Ra 对 PwO 骨骼健康影响的证据有限。事实上，关于使用 GLP-1Ra 的研究主要包括糖尿病患者，他们接受了用于这种情况的剂量，没有足够的骨参数作为主要终点，并且随访期较短。需要进一步研究来调查 PwO 中 GLP-1Ra、GLP-1 双受体和三受体激动剂、葡萄糖依赖性胰岛素释放多肽 (GIP) 和胰高血糖素对骨骼的影响。