The Effect of GLP-1 Receptor Agonists on Alanine Aminotransferase and Other Metabolic Parameters in Youths with Obesity: A Systematic Review and Meta-Analysis.

BACKGROUND: While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lower body mass index (BMI) in youths with obesity, less is known about their effect on metabolic parameters such as alanine aminotransferase (ALT), high-density lipoprotein, low-density lipoprotein, and hemoglobin A1c levels. We conducted a systematic review of the existing literature and a meta-analysis to determine the effect of GLP-1 RAs on metabolic parameters. METHODS: A search of the PubMed, Scopus, and Embase databases was conducted with variations of the terms GLP-1, obesity, semaglutide, exenatide, liraglutide, randomized clinical trial, adolescent, youth, and children. RESULTS: A total of 197 studies were identified, of which 6 satisfied the inclusion criteria. Four studies focused on exenatide, one on semaglutide, and one on liraglutide, with participant numbers ranging from 11 to 201 and study lengths of 12 to 68 weeks. Only BMI (-1.7, = 0.02) and ALT (-3.0, = 0.01) showed a significant treatment effect. CONCLUSIONS: Our meta-analysis suggests GLP-1 RAs improve BMI and show a modest decrease in ALT levels in youths with obesity. The clinical significance of the ALT decreases remains uncertain and warrants further examination in future trials.