Glucagon-like peptide-1 receptor agonists and gastrointestinal cancer risk in individuals with type 2 diabetes.

IF 8.4 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetologia Pub Date : 2025-06-05 DOI:10.1007/s00125-025-06453-z

Chia-Chih Kuo, Min-Hsiang Chuang, Chun-Hsien Li, Ya-Wen Tsai, Po-Yu Huang, Hsing-Tao Kuo, Chih-Cheng Lai

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Abstract

Aims/hypothesis: Although benefits of glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been demonstrated in treatment of type 2 diabetes and weight management, their potential role in cancer prevention remains inadequately explored.

Methods: Using the TriNetX Research Network, we conducted a retrospective cohort study comparing new users of GLP-1RAs with users of other glucose-lowering medications. Propensity score matching was performed for demographic factors, socioeconomic factors, family history, lifestyle factors and cancer risk factors. The primary outcome was the incidence of obesity-related gastrointestinal cancers, and secondary outcomes were the incidence of individual cancer types.

Results: Using adjusted HRs (aHRs), GLP-1RA use was found to be associated with a significantly lower risk of overall gastrointestinal cancer compared with all other glucose-lowering medications (insulin: aHR 0.29; 95% CI 0.23, 0.37; metformin: aHR 0.84; 95% CI 0.71, 0.99; sulfonylureas: aHR 0.71; 95% CI 0.62, 0.80; thiazolidinediones: aHR 0.86; 95% CI 0.74, 0.99; dipeptidyl peptidase-4 inhibitors: aHR 0.80; 95% CI 0.70, 0.91; sodium-glucose cotransporter-2 inhibitors: aHR 0.80; 95% CI 0.68, 0.96). The protective effect was most pronounced compared with insulin therapy, with significant risk reductions across all individual cancers.

Conclusions/interpretation: GLP-1RA use is associated with a reduced risk of gastrointestinal cancers in individuals with type 2 diabetes. These findings suggest potential cancer-protective benefits of GLP-1RAs beyond their established roles in glycaemic management and weight reduction.

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胰高血糖素样肽-1受体激动剂与2型糖尿病患者胃肠道癌风险

目的/假设：虽然胰高血糖素样肽-1受体激动剂（GLP-1RAs）在治疗2型糖尿病和控制体重方面的益处已被证实，但其在预防癌症方面的潜在作用仍未得到充分探讨。方法：利用TriNetX研究网络，我们进行了一项回顾性队列研究，比较GLP-1RAs的新使用者和其他降糖药物的使用者。对人口统计学因素、社会经济因素、家族史、生活方式因素和癌症危险因素进行倾向评分匹配。主要结局是与肥胖相关的胃肠道癌症的发病率，次要结局是个体癌症类型的发病率。结果：使用调整后的hr (aHRs)，与所有其他降糖药物相比，GLP-1RA的使用与总体胃肠道癌的风险显著降低相关(胰岛素：aHR 0.29；95% ci 0.23, 0.37；二甲双胍：aHR 0.84；95% ci 0.71, 0.99；磺脲类：aHR 0.71；95% ci 0.62, 0.80；噻唑烷二酮类：aHR 0.86；95% ci 0.74, 0.99；二肽基肽酶-4抑制剂：aHR 0.80；95% ci 0.70, 0.91；钠-葡萄糖共转运蛋白-2抑制剂：aHR 0.80；95% ci 0.68, 0.96)。与胰岛素治疗相比，这种保护作用最为明显，在所有个体癌症中都有显著的风险降低。结论/解释：GLP-1RA的使用与2型糖尿病患者胃肠道癌症风险降低相关。这些发现表明，GLP-1RAs除了在血糖管理和减肥方面的既定作用外，还有潜在的癌症保护作用。

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

Diabetologia 医学-内分泌学与代谢

CiteScore

18.10

自引率

2.40%

发文量

193

审稿时长

1 months

期刊介绍： Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.