Cutaneous Variations in Stem-Cell Population in Those on GLP1-Receptor Agonists: A Comparative Controlled Study

BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists have been associated with cutaneous changes including accelerated skin aging and volume loss. The biological mechanisms underlying these effects remain poorly understood, with limited in vivo human data. OBJECTIVE: The aim of this study was to evaluate adipogenesis-associated cellular markers in subcutaneous adipose tissue of patients receiving GLP-1 receptor agonist therapy. METHODS: Abdominal adipose tissue biopsies from patients receiving GLP-1 receptor agonists and untreated controls were analyzed using multiplex immunofluorescence to quantify FSP1, CD90, CD105, CD73, and ERG and to characterize adipose-derived stem cells (ADSCs) and fibroblast populations. RESULTS: Baseline analysis of 10 adipose tissue samples demonstrated a statistically significant reduction in adipose-derived stem-cell counts in the GLP-1 group compared with controls (11.0 vs 44.8 cells/mm2, p = .039), representing an approximately four-fold decrease. CD90+ cell counts were also significantly lower in the GLP-1 group (p = .047). Fibroblast populations were not significantly different between groups, suggesting selective depletion of the stem-cell compartment. CONCLUSION: This is the first in vivo human study demonstrating a significant reduction in the ADSC population in patients on GLP-1 receptor agonist therapy. Selective depletion of ADSCs offers a potential mechanism for the accelerated skin aging changes in this population beyond weight loss alone.