Implications of GLP-1 Receptor Agonists on Thyroid Function and Thyroid Nodules: A Drug Target Mendelian Randomization and Cohort Study.

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-07-22 DOI:10.1016/j.eprac.2025.07.013

Zhijun Zhang, Jingyun Yang, Ling Gao

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引用次数: 0

Abstract

Objectives: GLP-1 receptor agonists are antidiabetic medications, with conflicting reports about their relationship with thyroid diseases. This study investigates their effects on thyroid function and nodules in patients with diabetes.

Methods: Mendelian randomization (MR) was conducted to examine the association between genetically proxied GLP-1 receptor agonist activity and thyroid diseases. This was followed by a cohort study involving 169 patients with diabetes, who were divided into a control group (Control group, W/O GLP-1 treatment) and a GLP-1 receptor agonist treatment group (GLP-1RAs group) based on their medication usage. Patients' thyroid function tests, thyroid nodule diameters and TI-RADS classifications were compared at baseline and after 12 months of treatment.

Results: Through MR, GLP-1 receptor agonists decrease fT4 levels within the normal range [OR (95% CI) = 0.9948 (0.9936-0.9961), P<0.001]. Cohort study showed that after treatment, the nodule diameter increased in both the Control group (0.69 vs. 0.77, p=0.004) and the GLP-1 group (0.68 vs. 0.71, p=0.019). In the GLP-1 group, the TI-RADS (2.60 vs. 2.69, p=0.007) levels increased, while the fT4 (1.26 vs. 1.17, p=0.005) levels decreased. However, linear regression did not show significant association between GLP-1 and post-treatment differences in thyroid function or thyroid nodule.

Conclusions: GLP-1 receptor agonists treatment of 12 months in patients with diabetes is considered relatively safe regarding thyroid disease although there is a potential risk for decreasing of fT4 levels and nodule growth/progression, with no clear evidence of superiority over other antidiabetic treatments.

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GLP-1受体激动剂对甲状腺功能和甲状腺结节的影响：一项药物靶向孟德尔随机和队列研究。

目的：GLP-1受体激动剂是一种降糖药物，关于其与甲状腺疾病的关系的报道相互矛盾。本研究探讨其对糖尿病患者甲状腺功能及结节的影响。方法：采用孟德尔随机化（Mendelian randomization， MR）方法，研究GLP-1受体激动剂活性与甲状腺疾病的相关性。随后进行了一项涉及169名糖尿病患者的队列研究，根据其药物使用情况将其分为对照组（对照组，W/O GLP-1治疗）和GLP-1受体激动剂治疗组（GLP-1RAs组）。在基线和治疗12个月后比较患者的甲状腺功能测试、甲状腺结节直径和TI-RADS分类。结果：通过MR， GLP-1受体激动剂使fT4水平降低在正常范围内[OR (95% CI) = 0.9948(0.9936-0.9961)]。结论：GLP-1受体激动剂治疗糖尿病患者12个月对于甲状腺疾病是相对安全的，尽管存在fT4水平降低和结节生长/进展的潜在风险，但没有明确的证据表明其优于其他降糖治疗。

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

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.