Do GLP-1 Receptor Agonists Sabotage Fat Grafts? : A Scoping Review of GLP-1 Receptor Agonist Effects on Adipocyte Biology and Implications for Autologous Fat Transfer - PubMed
3 hours ago
- #adipocyte biology
- #GLP-1 receptor agonists
- #fat grafting
- The rapid adoption of GLP-1 receptor agonists (GLP-1 RAs) for weight management is leading to increased demand for autologous fat grafting due to facial volume depletion and soft tissue deflation in patients.
- The review identifies potential mechanisms where GLP-1 RAs might interfere with fat graft survival, including adipocyte browning, enhanced lipolysis, suppression of white adipogenic differentiation, and modulation of inflammatory and angiogenic signaling.
- Specific effects noted include upregulation of UCP1 and mitochondrial uncoupling, activation of lipolysis via ATGL and HSL, and preferential commitment of adipose-derived stem cells (ASCs) toward thermogenic beige lineages.
- The off-label use of triple agonists like retatrutide in bodybuilding communities raises additional concerns due to glucagon receptor-mediated lipolysis and thermogenesis.
- No direct clinical or preclinical studies have examined fat graft outcomes in patients on incretin-based therapies, highlighting a significant gap in evidence.
- The article proposes a framework for future research and offers preliminary, mechanism-based clinical considerations for perioperative management of GLP-1 RAs in fat transfer patients, emphasizing these are hypothesis-generating rather than evidence-based guidelines.