S1317 Effect of GLP-1 Receptor Agonists on Quality of Bowel Preparation for Colonoscopy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis
Bibliographic record
Abstract
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used to manage diabetes and obesity, but their effect on bowel preparation quality for colonoscopy is unclear. Inadequate preparation can reduce polyp detection and necessitate repeat procedures, affecting outcomes. This study evaluates the effect of GLP-1 RAs on bowel prep quality, measured by the Boston Bowel Preparation Score (BBPS), and related colonoscopy outcomes. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, and Cochrane databases for studies comparing bowel prep outcomes in GLP-1 RA users versus non-users. Eligible studies were prospective or retrospective cohorts reporting BBPS or related metrics. Statistical analysis was done using R. Risk of bias was assessed via the Newcastle-Ottawa Scale. Meta-regression analyzed the impact of age and sex on BBPS. Random-effects meta-analyses assessed BBPS, BBPS <5, BBPS <1 in any segment, inadequate bowel prep, and polyp detection rate. Results: Thirteen studies involving 167,235 patients (64,346 GLP-1 RA users; 102,889 non-users) were included. GLP-1 RA users had significantly lower BBPS (MD -0.36, 95% CI [-0.66, -0.07], P = 0.019, I² = 71.4%) and higher BBPS <1 in any segment (MD 9.03%, 95% CI [3.45, 14.61], P = 0.02, I² = 0%). No significant differences were found in BBPS <5 (MD 5.40%, 95% CI [-17.16, 27.97], P = 0.202, I² = 23.1%) or inadequate bowel prep (MD 4.00%, 95% CI [-0.41, 8.41], P = 0.068, I² = 54.0%). Polyp detection rate was higher among GLP-1 RA users (MD 6.69%, 95% CI [0.01, 13.38], P = 0.0499, I² = 0%). Despite slightly lower BBPS, the improved detection rate may reflect clinical benefit from reduced motility, less spasm, and better luminal insufflation. Meta-regression showed no significant effect of age (P = 0.5509) or sex (P = 0.5373) on BBPS. Leave-one-out sensitivity confirmed robustness (MD -0.46 to -0.35, P < 0.05). Conclusion: GLP-1 RA use is linked to mildly reduced bowel prep quality and segmental cleaning, likely due to altered gut motility. Yet, increased polyp detection suggests clinical benefit, potentially from reduced spasm and keeping the lumen better insufflated. Future studies should explore optimized prep protocols for GLP-1 RA users.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.036 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.049 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".