Impact of GLP-1 Receptor Agonists on Suicide Behavior: A Meta-Analysis Based on Randomized Controlled Trials

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-08-31 DOI:10.1111/1753-0407.70151

Jingqi Chen, Qiufeng Zhang, Qingping Wu, Xiaoming Zhang, Zhiyi Xiang, Sidong Zhu, Tianfu Dai, Yuexiu Si

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Abstract

Background

This meta-analysis aims to assess the association between exposure to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the incidence of suicidal behavior in patients with type 2 diabetes mellitus (T2DM)/obesity.

Methods

A comprehensive search of electronic databases, including PubMed, Web of Science, the Cochrane Library, and ClinicalTrials.gov, was conducted from the inception of the databases. The risk ratio (RR) and 95% confidence intervals (95% CI) were calculated.

Results

This meta-analysis included data from 25 randomized controlled trials (RCTs). The results indicated no significant difference in the incidence of suicidal behavior between the GLP-1 RA exposure group and the control group (RR = 0.84, 95% CI: 0.54–1.32, p = 0.46, I² = 0%). Subgroup analysis showed no significant differences in the incidence of suicidal behavior among participants with T2DM (RR = 0.74), obesity (RR = 1.07), adolescents (RR = 0.91), and adults (RR = 0.84). Additionally, no significant differences were observed between the two groups in any type of suicidal behavior, including suicidal ideation (RR = 1.04), suicide attempts (RR = 0.68), depression-related suicides (RR = 0.65), and completed suicides (RR = 1.06). There were also no significant differences between the groups for any type of GLP-1 RA, including dulaglutide (RR = 0.46), exenatide (RR = 0.98), semaglutide (RR = 0.82), lixisenatide (RR = 1.25), and liraglutide (RR = 0.92). No significant differences were observed between the exposure group and control group according to different comparators, including placebo (RR = 0.91) and others (RR = 1.08). All subgroup analyses showed p-values greater than 0.05 (two-sided tests) and I² values of 0%.

Conclusion

Our findings suggest that there is no significant association between GLP-1 RA exposure and suicidal behaviors in patients with T2DM or obesity.

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GLP-1受体激动剂对自杀行为的影响：基于随机对照试验的荟萃分析

本荟萃分析旨在评估2型糖尿病(T2DM)/肥胖患者暴露于胰高血糖素样肽-1受体激动剂（GLP-1 RAs）与自杀行为发生率之间的关系。方法从数据库建立之初，对PubMed、Web of Science、Cochrane Library和ClinicalTrials.gov等电子数据库进行全面检索。计算风险比（RR）和95%置信区间（95% CI）。结果本荟萃分析纳入了25项随机对照试验（rct）的数据。结果显示，GLP-1 RA暴露组与对照组自杀行为发生率无显著差异（RR = 0.84, 95% CI: 0.54 ~ 1.32, p = 0.46, I2 = 0%）。亚组分析显示，T2DM （RR = 0.74）、肥胖（RR = 1.07）、青少年（RR = 0.91）和成人（RR = 0.84）的自杀行为发生率无显著差异。此外，两组在自杀意念（RR = 1.04）、自杀企图（RR = 0.68）、抑郁相关自杀（RR = 0.65）和自杀完成（RR = 1.06）等任何类型的自杀行为方面均无显著差异。各组间GLP-1 RA的差异无统计学意义，包括杜拉鲁肽（RR = 0.46）、艾塞那肽（RR = 0.98）、semaglutide （RR = 0.82）、利昔那肽（RR = 1.25）和利拉鲁肽（RR = 0.92）。不同比较物，包括安慰剂组（RR = 0.91）和其他比较物（RR = 1.08），暴露组与对照组之间无显著差异。所有亚组分析显示p值大于0.05（双侧检验），I2值为0%。结论我们的研究结果表明GLP-1 RA暴露与T2DM或肥胖患者的自杀行为之间没有显著相关性。

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.