TOPLINE:

GLP-1 receptor agonists (GLP-1 RAs) produced meaningful weight loss in patients with cirrhosis. Although those with compensated disease did not face notable muscle loss, those with decompensated cirrhosis tended to lose significant skeletal muscle in proportion to their weight loss.

METHODOLOGY:

• GLP‑1 RAs are commonly used for diabetes and weight management in patients with cirrhosis, but they may exacerbate sarcopenia in this already vulnerable population.
• To evaluate the effects of GLP-1 RA therapy on body weight and whole-body skeletal muscle mass in patients with compensated and decompensated cirrhosis, researchers collected clinical and demographic data from 150 patients seen at the University of Alabama at Birmingham Hepatology Clinic in the United States between October 2016 and October 2025.
• The mean age of the cohort ranged from approximately 57 to 59 years, and about 37%-60% were women. Patients included had two CT scans at least 6 months apart; 57 patients (38%) received GLP-1 RAs, while 93 patients did not.
• The study measured the cross-sectional area of the psoas muscle at the third lumbar vertebra, adjusted for height, to estimate the skeletal muscle mass index and compared changes in body weight and muscle mass between GLP-1 RA users and nonusers in both compensated and decompensated cirrhosis groups.

TAKEAWAY:

• In patients with compensated cirrhosis, the use of GLP-1 RAs was associated with a significant reduction in weight compared to nonuse (P = .020), but no change in the skeletal muscle mass index was observed with or without the use of GLP-1 RAs.
• Among patients with decompensated cirrhosis, GLP-1 RA users showed a significant reduction in weight compared to nonusers (P = .026); however, the skeletal muscle mass index decreased significantly in GLP-1 RA users compared to nonusers (P = .017).
• Among patients with decompensated cirrhosis, the degree of skeletal muscle loss was correlated with the percentage of body weight loss among both GLP-1 RA users (r, 0.52; P < .001) and nonusers (r, 0.30; P = .003), with no significant difference between these correlations (P = .123).

IN PRACTICE:

“There was no notable muscle loss in compensated cirrhosis despite significant weight loss with the use of GLP1 RA. However, among patients with decompensated cirrhosis, GLP1 RA users experienced significant muscle loss compared to those not on GLP1 RA, the degree of which was correlated to the amount of weight loss,” the authors wrote.

SOURCE:

The study was led by Diep N. Edwards, of The University of Alabama at Birmingham Health System in Birmingham, Alabama. It was presented at Digestive Disease Week (DDW) 2026 in Chicago.

LIMITATIONS:

This study did not mention any limitations.

DISCLOSURES:

No disclosures or conflicts of interest were provided in the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.