The potential adverse effects of hypodermic glucagon-like peptide -1 receptor agonist on patients with type 2 diabetes: A population-based study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-10-22 DOI:10.1111/1753-0407.70013

Zhiyuan Cheng, Shuang Wang, Fu-rong Li, Cheng Jin, Chunbao Mo, Jing Zheng, Xia Li, Fengchao Liang, Jinkui Yang, Dongfeng Gu

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引用次数: 0

Abstract

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a class of injectable antidiabetic drugs, have shown significant efficacies in improving glycemic and weight control in patients with type 2 diabetes (T2D). However, the long-term safety of GLP-1 RAs remains insufficiently studied. This study aimed to provide real-world evidence on potential adverse outcomes associated with GLP-1 RAs use in T2D patients without major chronic diseases including impaired cardiac or renal function.

Methods

We conducted a retrospective cohort study involving 7746 T2D patients on GLP-1 RAs in Shenzhen, China. They were compared with 124 371 metformin-only users and 36 146 insulin-only users, forming two therapy control groups. GLP-1 RAs users were also further 1:2 paired with the control groups. Competing risk survival analyses were conducted to assess the incidence risks, presenting subdistributional hazard ratios (sHRs) with 95% confidence intervals (CIs) for various adverse outcomes associated with GLP-1 RAs use.

Results

Compared with metformin-only users, GLP-1 RAs use was associated with increased risks of various adverse outcomes (sHRs with 95% CIs), including pancreatitis (2.01, 1.24–3.24), acute nephritis (3.20, 2.17–4.70), kidney failure (3.73, 2.74–5.08), thyroid cancer (2.25, 1.23–4.10), and thyroid dysfunction (1.27, 1.00–1.63), respectively; Similar results were also found when compared with insulin-only users. Importantly, long-term (≥12 months) GLP-1 RAs use may further elevate the incidence risks of pancreatitis, acute nephritis, thyroid cancer, and thyroid dysfunction.

Conclusion

Compared with traditional T2D treatments, GLP-1 RAs use may be associated with increased risks of various adverse outcomes in a Chinese population. Cautions were strongly warranted in the use of GLP-1 RAs. Further validation is crucial across diverse populations.

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皮下注射胰高血糖素样肽-1 受体激动剂对 2 型糖尿病患者的潜在不良影响：一项基于人群的研究。

背景：胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）是一类可注射的抗糖尿病药物，在改善 2 型糖尿病（T2D）患者的血糖和体重控制方面具有显著疗效。然而，GLP-1 RAs 的长期安全性研究仍然不足。本研究旨在提供真实世界的证据，说明在无主要慢性疾病（包括心功能或肾功能受损）的 T2D 患者中使用 GLP-1 RAs 可能会导致的不良后果：我们在中国深圳开展了一项回顾性队列研究，涉及7746名服用GLP-1 RAs的T2D患者。他们与124 371名仅使用二甲双胍的患者和36 146名仅使用胰岛素的患者组成了两个治疗对照组。GLP-1 RAs 使用者也与对照组进一步进行了 1:2 配对。我们进行了竞争风险生存分析以评估发病风险，并给出了与使用 GLP-1 RAs 相关的各种不良后果的亚分布危险比（sHRs）及 95% 置信区间（CIs）：与仅使用二甲双胍的患者相比，使用 GLP-1 RAs 会增加各种不良后果的风险（sHRs 与 95% 置信区间），包括胰腺炎（2.01，1.24-3.24）、急性肾炎（3.20，2.胰腺炎（2.01，1.24-3.24）、急性肾炎（3.20，2.17-4.70）、肾衰竭（3.73，2.74-5.08）、甲状腺癌（2.25，1.23-4.10）和甲状腺功能障碍（1.27，1.00-1.63）。重要的是，长期（≥12个月）使用GLP-1 RAs可能会进一步提高胰腺炎、急性肾炎、甲状腺癌和甲状腺功能障碍的发病风险：结论：与传统的 T2D 治疗方法相比，在中国人群中使用 GLP-1 RAs 可能会增加各种不良后果的风险。在使用 GLP-1 RAs 时应谨慎。在不同人群中进一步验证至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.