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Effectiveness of Combined GLP-1/GIP Dual Agonist Therapy and Structured Exercise on Skeletal Muscle Morphology, Quality, and Physical Function in Overweight and Obese Individuals

3 juni 2026 uppdaterad av: Özgül Öztürk, Acibadem University

Effectiveness of Combined GLP-1/GIP Dual Agonist Therapy and Structured Exercise on Skeletal Muscle Morphology, Quality, and Physical Function in Overweight and Obese Individuals: a Randomized Controlled Trial Protocol

This randomized controlled trial aims to investigate the effects of a 24-week home-based progressive resistance exercise program combined with tirzepatide treatment on skeletal muscle mass, muscle quality, and functional capacity in overweight and obese individuals. A total of 108 participants initiating tirzepatide therapy will be randomized to either exercise plus pharmacotherapy or pharmacotherapy alone. The primary outcome is change in thigh muscle thickness and echo intensity assessed by ultrasonography.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Pharmacologically induced weight loss with glucagon-like peptide-1 (GLP-1)/ glucose-dependent insulinotropic polypeptide (GIP) receptor agonists such as tirzepatide is associated with significant reductions in lean body mass, raising concerns regarding muscle function and long-term outcomes. Resistance exercise is the most effective intervention to preserve muscle mass during weight loss; however, evidence combining these approaches is limited.

This study is a prospective, two-center, single-blinded, randomized controlled trial designed to evaluate whether structured resistance exercise enhances muscle preservation and functional outcomes in individuals receiving tirzepatide therapy.

Studietyp

Interventionell

Inskrivning (Beräknad)

108

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • initiation of tirzepatide-based pharmacological treatment as prescribed by an endocrinology and metabolism specialist,
  • body mass index (BMI) ≥27 kg/m² and the presence of a comorbidity condition or BMI≥30 kg/m²
  • age between 18 and 65 years

Exclusion Criteria:

  • diagnosis of type 1 or type 2 diabetes mellitus
  • presence of cerebrovascular, hematological, pulmonary, rheumatological, or neurological disorders
  • current participation in a structured diet or exercise program
  • use of weight-loss medications within the past 12 months
  • history of upper or lower extremity surgery or injury within the past 6 months
  • any contraindication to resistance exercise as determined by the treating physician.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Resistance Exercise + Tirzepatide
24-week home-based progressive resistance exercise program (3 sessions/week) using elastic bands and bodyweight exercises, combined with tirzepatide treatment and general lifestyle recommendations..
Övrig: Resistance exercise
A 24-week home-based resistance exercises using elastic band and bodyweight
Övrig: Lifestyle recommendations
Lifestyle recommendations including physical activity and nutritional advice
Aktiv komparator: Tirzepatide Alone
Standard tirzepatide treatment with usual care and general lifestyle recommendations.
Övrig: Lifestyle recommendations
Lifestyle recommendations including physical activity and nutritional advice

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in muscle thickness
Tidsram: Baseline, 12 weeks, 24 weeks
Muscle thickness of the thigh (quadriceps femoris) will be assessed using a portable ultrasound and will be presented in millimeters (mm).
Baseline, 12 weeks, 24 weeks
Muscle echo intensity
Tidsram: Baseline, 12 weeks, 24 weeks
Echo intensity will be assessed via a portable muscle ultrasonography using grayscale analysis (0-255 scale) within a standardized region of interest using ImageJ software (National Institutes of Health, USA), with higher values indicating greater intramuscular fat and fibrous tissue infiltration and thus poorer muscle quality. Assessments will include quadriceps femoris.
Baseline, 12 weeks, 24 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Muscle strength (handheld dynamometer)
Tidsram: Baseline, 12 weeks, 24 weeks
Isometric muscle strength of the biceps brachii, triceps brachii, quadriceps femoris, and hamstrings will be assessed bilaterally using a Lafayette handheld dynamometer (Lafayette Instrument Company®, USA) using the make test method.
Baseline, 12 weeks, 24 weeks
Body weight
Tidsram: Baseline, 12 weeks, 24 weeks
Body weight will be assessed using bioelectrical impedance analysis and presented in kilograms (kg).
Baseline, 12 weeks, 24 weeks
Six-minute walk test
Tidsram: Baseline, 12 weeks, 24 weeks
Functional capacity will be assessed using the 6-minute walk test according to standardized procedures and the total distance will be recorded in meters.
Baseline, 12 weeks, 24 weeks
Physical activity
Tidsram: Baseline, 12 weeks, 24 weeks
Physical activity will be measured objectively using a wearable device (Garmin Vívosmart 5), time spent for light, moderate, and vigorous activity will be recorded for 7 days.
Baseline, 12 weeks, 24 weeks
Nutritional status (3-day food record)
Tidsram: Baseline, 12 weeks, 24 weeks
Dietary intake will be assessed at baseline, 12 weeks, and 24 weeks using 3-day food records (two non-consecutive weekdays and one weekend day). Prior to assessment, participants will receive standardized verbal, written, and visual instructions - including portion size estimation aids - to ensure accurate and consistent recording.
Baseline, 12 weeks, 24 weeks
Quality of life (Short Form-36)
Tidsram: Baseline, 12 weeks, 24 weeks
The Short Form-36, a validated and reliable self-reported instrument evaluating physical and mental health status across eight domains: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health will be used to determine the level of quality of life. Physical and mental sub scales are scored from 0 to 100, higher scores indicate a better quality of life.
Baseline, 12 weeks, 24 weeks
Clinical parameters (blood pressure)
Tidsram: Baseline, 12 weeks, 24 weeks
Blood pressure will be measured using a sphygmomanometer at each assessment point.
Baseline, 12 weeks, 24 weeks
Height
Tidsram: Baseline, 12 weeks, 24 weeks
Height of the participants will be assessed using a stadiometer and presented in meters.
Baseline, 12 weeks, 24 weeks
Body mass index
Tidsram: Baseline, 12 weeks, 24 weeks
Body mass index will be calculated using height and weight (kg/m^2)
Baseline, 12 weeks, 24 weeks
Body fat percentage
Tidsram: Baseline, 12 weeks, 24 weeks
Body fat percentage will be assessed using bioelectrical impedance analysis and presented in percentage (%).
Baseline, 12 weeks, 24 weeks
Fat free mass
Tidsram: Baseline, 12 weeks, 24 weeks
Fat-free mass will be assessed using bioelectrical impedance analysis and presented in kilograms.
Baseline, 12 weeks, 24 weeks
Chair stand test
Tidsram: Baseline, 12 weeks, 24 weeks
Functional capacity will be assessed using 30-second chair stand test according to standardized procedures. The number of repetitions which the participants fully raised from a chair will be recorded in numbers (n).
Baseline, 12 weeks, 24 weeks
Self-reported physical activity
Tidsram: Baseline, 12 weeks, 24 weeks
Self-reported physical activity will be determined using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Metabolic equivalent (MET) values will be calculated and participants will be categorized into inactive, moderately active, and very active based on MET values.
Baseline, 12 weeks, 24 weeks
Grip strength
Tidsram: Baseline, 12 weeks, 24 weeks
Handgrip strength will be assessed using a JAMAR dynamometer (Sammons Preston, USA) following the standardized protocol. Three maximal isometric contractions will be performed with 1-minute rest intervals, the mean of the three trials in kilograms will be used for analysis.
Baseline, 12 weeks, 24 weeks
Clinical measures (fasting glucose)
Tidsram: Baseline, 12 weeks, 24 weeks
Fasting glucose will be recorded from the medical records and will be presented in mmol/L.
Baseline, 12 weeks, 24 weeks
Clinical parameters (lipid profile)
Tidsram: Baseline, 12 weeks, 24 weeks
Total Cholesterol, LDL (Low-Density Lipoprotein) Cholesterol, HDL (High-Density Lipoprotein) Cholesterol, Triglycerides will be recorded from the medical records and presented in mmol/L.
Baseline, 12 weeks, 24 weeks
Muscle thickness
Tidsram: Baseline, 12 weeks, 24 weeks
Muscle thickness of the biceps femoris, triceps brachii, and biceps brachia will be assessed using a portable ultrasound and will be presented in millimeters (mm).
Baseline, 12 weeks, 24 weeks
Muscle echo intensity
Tidsram: Baseline, 12 weeks, 24 weeks
Echo intensity will be assessed via a portable muscle ultrasonography using grayscale analysis (0-255 scale) within a standardized region of interest using ImageJ software (National Institutes of Health, USA), with higher values indicating greater intramuscular fat and fibrous tissue infiltration and thus poorer muscle quality. Assessments will include biceps femoris, biceps brachii, and triceps brachii.
Baseline, 12 weeks, 24 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Acibadem University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 november 2026

Primärt slutförande (Beräknad)

30 november 2027

Avslutad studie (Beräknad)

1 januari 2028

Studieregistreringsdatum

Först inskickad

28 april 2026

Först inskickad som uppfyllde QC-kriterierna

21 maj 2026

Första postat (Faktisk)

27 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

4 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

3 juni 2026

Senast verifierad

1 april 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • Özgül Öztürk
  • Grant proposal submitted (Annan identifierare: Acıbadem University)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

Individual participant data (IPD) will not be shared. The study data contains personal health information. Also, data sharing may also be limited by institutional policies and data protection legislation. Findings will be reported in aggregate form.

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produkt tillverkad i och exporterad från U.S.A.

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