Efficacy of Glucagon-Like Peptide-1 Receptor Agonists in Obese or Diabetic Patients With Obstructive Sleep Apnea Syndrome: A Meta-Analysis

CONTEXT: Results of previous studies have suggested that obstructive sleep apnea syndrome (OSAS), particularly when accompanied by obesity or diabetes, is linked to glucose metabolism disorders driven by abnormal glucagon-like peptide-1 (GLP-1) secretion. However, the efficacy of GLP-1 receptor agonists (RAs) in this population remains uncertain. OBJECTIVE: We conducted a meta-analysis to investigate the relationship between serum GLP-1 levels and OSAS, as well as the efficacy of GLP-1 RAs in treating OSAS. DATA SOURCES: The Cochrane, CINAHL, EMBASE, Google Scholar, PubMed, ScienceDirect, Web of Science, CNKI, and Wan Fang databases were searched from inception to October 1, 2024. DATA EXTRACTION: We extracted data from the included studies on serum GLP-1 levels and the apnea-hypopnea index (AHI), lowest SpO2 (LSpO2) levels, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), body weight, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP). DATA ANALYSIS: A total of 10 studies (1313 participants) were included in this analysis, comprising 4 case-control studies examining the relationship between serum GLP-1 levels and OSAS and 6 randomized controlled trials investigating the efficacy of GLP-1 RAs in patients with diabetes or obesity complicated by OSAS. Meta-analysis results indicated that compared to the non-OSAS or mild-OSAS individuals, fasting serum GLP-1 levels (mean difference [MD], -1.86 ug/L; 95% CI, -3.58 to -0.13; P = .04; I2 = 72%), and 1-hour postprandial GLP-1 levels (MD, -7.76 µg/L; 95% CI, -9.43 to -6.08; P < .00001; I2 = 49%) were significantly lower in patients with OSAS. Treatment with GLP-1 RA significantly improved the AHI (MD, -16.11 events/h; 95% CI, -26.23 to -5.99; P = .002; I2 = 96%), as well as reducing blood pressure, BMI, and FBG (P <.05). CONCLUSIONS: In patients with OSAS, serum GLP-1 levels are lower than those of healthy individuals. GLP-1 RAs may significantly reduce AHI in patients with obesity or diabetes. However, given the substantial heterogeneity among studies, the results should be interpreted with caution. Systematic Review Registration: PROSPERO registration No. CRD42024599675.