Examining the Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists on the Human Gut Microbiome: A Systematic Review

ABSTRACT Introduction Extant literature has highlighted the role of the gut microbiome on various health conditions, including mood disorders and neurodegenerative diseases. Notwithstanding, the effects of glucagon-like peptide-1 (GLP-1) and GLP-1 receptor agonists (GLP-1RAs) on the gut microbiome have been inadequately investigated. Changes in the gut microbiome are characterized by changes in microbial abundance, microbial genomes, and microbial diversity. Herein, we conducted a comprehensive synthesis of the role of GLP-1 and GLP-1RAs on the gut microbiome. Methods Relevant articles were retrieved from OVID (MedLine, Embase, AMED, PsycInfo, JBI EBP Database), PubMed, and Web of Science from the database inception to August 19, 2024. Primary research evaluating the role of GLP-1 and GLP-1RAs on the gut microbiome were included for analysis. Results GLP-1 is associated with changes in microbial abundance, including, but not limited to Akkermansia, Sutterella, Bifidobacterium. GLP-1 was not associated with changes in microbial gene count. Additionally, dulaglutide was positively correlated to the relative abundance of Bacteroides. Similarly, liraglutide was associated with varied changes in microbial diversity, community richness. Additionally, liraglutide was associated with varied changes in microbial abundance, including, but not limited to Akkermansia, Sutterella, Bacteroides, Ruminococcus, and Actinomyces. Discussion Both GLP-1 and GLP-1RAs are associated with overlapping and discrete changes in the gut microbiome. Included studies predominantly involved persons with diabetes and were limited by sample sizes. Future research should be directed to examining how GLP-1 and GLP-1RA mediated changes in the gut microbiome may subserve potential therapeutic effects and health conditions in a more diverse population.