Responses to GLP-1RA in White and Black Adults With Obesity: Insights From Generalized Additive Mixed Models of EHR Data

IF 4.9 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2026-09-02 Epub Date: 2026-04-01 DOI:10.1002/oby.70180

Jordan H. Mallette, Joshua S. Speed, Seth T. Lirette, Daniel Moore, John S. Clemmer

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引用次数: 0

Abstract

Objective

This study examined racial differences in weight loss and clinical response to glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy among adults with obesity using real-world data.

Methods

We retrospectively analyzed our institution's Research Data Warehouse (RDW) containing deidentified data from electronic health records (EHRs) from adults aged 18 years and older. EHR data from the University of Mississippi Medical Center RDW were analyzed for 7214 adults (2182 White; 5032 Black) prescribed injectable GLP-1RA between 2015 and 2025. Inclusion criteria were BMI ≥ 30 kg/m² and ≥ 1 GLP-1RA. Longitudinal changes in patient data were modeled using generalized additive mixed models.

Results

At 2.5 years, White individuals experienced significantly greater body weight loss than Black individuals: −7.1% (95% CI −8.0%, −6.2%) versus −4.9% (95% CI −5.4%, −4.3%), as well as significantly larger reductions in estimated glomerular filtration rate, systolic blood pressure, and HbA1c. Semaglutide and tirzepatide were associated with the greatest improvements. Renal function decline was attenuated in both groups after therapy.

Conclusions

In a large, diverse EHR cohort, GLP-1RA therapy was associated with significant weight, glycemic, and renal benefits that were attenuated in Black adults. These findings highlight the urgent need to understand mechanisms contributing to variable GLP-1RA outcomes among different populations.

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白人和黑人肥胖成年人对GLP-1RA的反应：来自EHR数据的广义加性混合模型的见解

目的：本研究利用真实世界数据，研究了肥胖成人中胰高血糖素样肽-1受体激动剂（GLP-1RA）治疗的体重减轻和临床反应的种族差异。方法：我们回顾性分析了我们机构的研究数据仓库（RDW），其中包含来自18岁及以上成年人电子健康记录（EHRs）的未识别数据。来自密西西比大学医学中心RDW的电子病历数据分析了2015年至2025年间处方注射GLP-1RA的7214名成年人（2182名白人；5032名黑人）。纳入标准为BMI≥30 kg/m2， GLP-1RA≥1。患者数据的纵向变化采用广义加性混合模型建模。结果：在2.5年时，白人患者的体重下降幅度明显大于黑人患者：-7.1% (95% CI -8.0%, -6.2%) vs -4.9% (95% CI -5.4%, -4.3%)，并且肾小球滤过率、收缩压和HbA1c的降低幅度明显大于黑人患者。西马鲁肽和替西帕肽与最大的改善相关。两组患者治疗后肾功能下降均有所减轻。结论：在一个大型的、多样化的EHR队列中，GLP-1RA治疗与显著的体重、血糖和肾脏益处相关，但在黑人成年人中有所减弱。这些发现强调了迫切需要了解不同人群中导致GLP-1RA结果变化的机制。

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

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.