Diabetes research and clinical practice最新文献_第9页

Clinical efficacy and cost effectiveness of SGLT2i in diabetic nephropathy: a large population-based study SGLT2i治疗糖尿病肾病的临床疗效和成本效益：一项基于人群的大型研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112421

Hsuan-Hui Wang , Yi-Wen Chiu , Cheng-Yin Chung , Yu-Mei Liao , Yung-Heng Lee , Han-Ming Kuo , Hon-Yi Shi

{"title":"Clinical efficacy and cost effectiveness of SGLT2i in diabetic nephropathy: a large population-based study","authors":"Hsuan-Hui Wang , Yi-Wen Chiu , Cheng-Yin Chung , Yu-Mei Liao , Yung-Heng Lee , Han-Ming Kuo , Hon-Yi Shi","doi":"10.1016/j.diabres.2025.112421","DOIUrl":"10.1016/j.diabres.2025.112421","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy and cost-effectiveness of SGLT2i versus non-use in routine care for diabetic nephropathy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted analyzing patients diagnosed with diabetic kidney disease at three medical centers in Taiwan between 2017 and 2023. Inverse probability of treatment weighting (IPTW) minimized selection bias. The maximum follow-up period for clinical outcomes was 5.9 years, with a median duration of 2.79 years. A Markov model with a 10-year horizon, 1-year cycle, and 3 % discount rate assessed cost-effectiveness from the healthcare payer perspective.</div></div><div><h3>Results</h3><div>SGLT2i use was associated with statistically significant improvements in estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) compared to non-SGLT2i treatment (p < 0.05). Mean total cost per patient was $38,072 for the SGLT2i group and $26,567 for the non-SGLT2i group. The incremental quality-adjusted life years (QALYs) gain was 0.70, resulting in an incremental cost-effectiveness ratio (ICER) of $16,435.71/QALYs. This value was well below the established willingness-to-pay (WTP) threshold of $32,756, indicating favorable cost-effectiveness.</div></div><div><h3>Conclusions</h3><div>Although SGLT2i demonstrate favorable clinical efficacy and cost-effectiveness, National Health Insurance reimbursement for their use in diabetic nephropathy remains pending, and the potential for genitourinary infections necessitates ongoing clinical vigilance.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112421"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations between long-term metformin use, the risk of vitamin B12 deficiency, and neuropathy: An All of Us research Program study 长期使用二甲双胍、维生素B12缺乏风险和神经病变之间的关系：一项我们所有人的研究项目研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-22 DOI: 10.1016/j.diabres.2025.112424

Aryana Sepassi , Jiayuan Wang , Sophia Yankowski , Aya Enkoji , Mmeridi Okenwa , Candis M. Morello , Keri Hurley-Kim

{"title":"Associations between long-term metformin use, the risk of vitamin B12 deficiency, and neuropathy: An All of Us research Program study","authors":"Aryana Sepassi , Jiayuan Wang , Sophia Yankowski , Aya Enkoji , Mmeridi Okenwa , Candis M. Morello , Keri Hurley-Kim","doi":"10.1016/j.diabres.2025.112424","DOIUrl":"10.1016/j.diabres.2025.112424","url":null,"abstract":"<div><h3>Aims</h3><div>The primary objective of this study is to investigate the associations between long-term metformin use, vitamin B12 status, and peripheral neuropathy. Secondarily, we aim to explore the effect of time since diagnosis on the relationships between metformin use, vitamin B12 deficiency, and peripheral neuropathy.</div></div><div><h3>Methods</h3><div>A retrospective observational cross-sectional analysis was conducted using NIH’s <em>All of Us</em> database. The risk of vitamin B12 deficiency and peripheral neuropathy was compared among long-term metformin users (≥4 years), short-term users (<4 years), and non-metformin users via a series of unadjusted and adjusted logistic regression models.</div></div><div><h3>Results</h3><div>Among 14,808 adults with type 2 diabetes mellitus (T2DM), 9,136 (61.70 %) used metformin, of whom 5,609 (37.95 %) were long-term users. Following adjustment for confounders, long-term users exhibited a 67 % and 38 % higher likelihood of vitamin B12 deficiency than non-users and short-term users respectively (p < 0.001). Peripheral neuropathy prevalence was 39 % higher among long-term users compared to short-term users (p < 0.001), with a non-statistically significant difference compared to non-users.</div></div><div><h3>Conclusions</h3><div>Long-term metformin use is associated with both an increased risk of vitamin B12 deficiency and peripheral neuropathy in patients with T2DM. Providers should consider routinely assessing vitamin B12 status in long-term users, particularly when evaluating peripheral neuropathy symptoms.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112424"},"PeriodicalIF":7.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preconception and pregnancy artificially sweetened beverage consumption and its association with adverse pregnancy outcomes: findings from the Australian longitudinal study on women’s health 孕前和孕期人工加糖饮料的消费及其与不良妊娠结局的关系：澳大利亚妇女健康纵向研究的结果

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-21 DOI: 10.1016/j.diabres.2025.112422

Bereket Gebremichael , Mumtaz Begum , Tina Bianco-Miotto , Shao Jia Zhou , Zohra S. Lassi

{"title":"Preconception and pregnancy artificially sweetened beverage consumption and its association with adverse pregnancy outcomes: findings from the Australian longitudinal study on women’s health","authors":"Bereket Gebremichael , Mumtaz Begum , Tina Bianco-Miotto , Shao Jia Zhou , Zohra S. Lassi","doi":"10.1016/j.diabres.2025.112422","DOIUrl":"10.1016/j.diabres.2025.112422","url":null,"abstract":"<div><h3>Background and aim</h3><div>Exposure to artificial sweeteners has been linked to adverse health outcomes. We aimed to examine the association between preconception and pregnancy artificially sweetened beverage (ASB) consumption and adverse pregnancy outcomes.</div></div><div><h3>Methods</h3><div>We analysed data from 3,653 women from the Australian Longitudinal Study on Women’s Health (ALSWH). A generalized linear mixed model and augmented inverse probability weighting estimator were used to estimate the relative risk and average treatment effect (ATE), respectively.</div></div><div><h3>Results</h3><div>The incidence of gestational diabetes mellitus (GDM), hypertensive disorder of pregnancy (HDP), and preterm birth (PTB) in the preconception exposure group was 9.1 %, 6.7 %, and 4.3 %, while it was 8.6 %, 7.5 %, and 4.0 % in the pregnancy exposure group, respectively. The adjusted relative risk (aRR) of frequent ASB consumption (≥5 drinks/week) during pregnancy compared with none were 1.88 (95 % CI: 1.12–3.14) for GDM, 1.59 (95 % CI: 0.86–2.93) for HDP, and 1.22 (95 % CI: 0.36–3.99) for PTB. The ATE of frequent ASB intake during pregnancy compared to none was 0.06 (95 % CI: 0.01–0.11). The association between preconception ASB exposure and all outcomes remain uncertain.</div></div><div><h3>Conclusion</h3><div>Frequent ASB consumption during pregnancy is associated with a higher risk of GDM, while its association with HDP and PTB remains inconclusive.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112422"},"PeriodicalIF":7.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Excess mortality in type 1 diabetes patients in Belgium: A population based study 比利时1型糖尿病患者的高死亡率：一项基于人群的研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-21 DOI: 10.1016/j.diabres.2025.112426

Christophe de Meester, Ans Van Ginckel, Irm Vinck, Maria Eyssen, Diego Castanares-Zapatero

{"title":"Excess mortality in type 1 diabetes patients in Belgium: A population based study","authors":"Christophe de Meester, Ans Van Ginckel, Irm Vinck, Maria Eyssen, Diego Castanares-Zapatero","doi":"10.1016/j.diabres.2025.112426","DOIUrl":"10.1016/j.diabres.2025.112426","url":null,"abstract":"<div><h3>Aims</h3><div>Technological advances in the management of Type 1 diabetes (T1D) are expected to have beneficial effects on the mortality. The aim was to investigate the excess mortality and the life expectancy (LE) of adult patients with T1D living and receiving treatment in Belgium compared with the general population.</div></div><div><h3>Methods</h3><div>Patients enrolled in the multidisciplinary care programme for the self-management of diabetes mellitus during the years 2017–2021 were included. Comorbidities were identified by proxies based on health and/or medication use.</div></div><div><h3>Results</h3><div>In total 144960 patients/year (PY) were identified (2057 deaths). The standard mortality rate (95 % CI) was 1.21 (1.19;1.23), corresponding to an excess mortality rate of 3.2 deaths per 1000 PY. Renal insufficiency appeared to be the only comorbidity with a discernible effect on younger age groups. In T1D patients aged 20–50 years, LE results in a loss of 4 years of life.</div></div><div><h3>Conclusions</h3><div>Although our analysis showed a significantly lower excess mortality rate in T1D compared with older studies, a moderately increased excess risk of mortality is still shown. Given the continuous advances in diabetes treatment, it is important to perform further analyses to reassess the excess risk of mortality and to monitor this positive trend.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112426"},"PeriodicalIF":7.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimising obesity management: integrating continuous glucose monitoring with GLP-1 receptor agonists 优化肥胖管理：整合连续血糖监测与GLP-1受体激动剂

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-21 DOI: 10.1016/j.diabres.2025.112434

Pragati Gupta , Paolo Pozzilli

引用次数: 0

Association between SGLT2 inhibitor therapy and prolonged dementia-free survival in older adults with type 2 diabetes: a retrospective cohort study from Germany 来自德国的一项回顾性队列研究：SGLT2抑制剂治疗与老年2型糖尿病患者无痴呆生存期延长之间的关系

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-20 DOI: 10.1016/j.diabres.2025.112430

Theresia Sarabhai , Rebecca Zingel , Jens Bohlken , Karel Kostev

{"title":"Association between SGLT2 inhibitor therapy and prolonged dementia-free survival in older adults with type 2 diabetes: a retrospective cohort study from Germany","authors":"Theresia Sarabhai , Rebecca Zingel , Jens Bohlken , Karel Kostev","doi":"10.1016/j.diabres.2025.112430","DOIUrl":"10.1016/j.diabres.2025.112430","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 2 diabetes mellitus (T2DM) are at increased risk of dementia due to hyperglycemia, insulin resistance, and vascular dysfunction. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may have neuroprotective effects beyond glucose control, but evidence remains limited. This study aimed to assess whether SGLT2i use is associated with a lower incidence of dementia compared to dipeptidyl peptidase-4 inhibitors (DPP-4i) in older adults with T2DM.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from the IQVIA™ Disease Analyzer database in Germany. Patients aged ≥60 years with T2DM, receiving metformin and newly prescribed SGLT2i or DPP-4i (2012–2022), were included. Those with prior neurodegenerative diagnoses were excluded. Propensity score matching (1:1) and Cox proportional hazards models were used to estimate hazard ratios (HR) for dementia over five years.</div></div><div><h3>Results</h3><div>After matching, 38,140 patients were included. Dementia incidence was lower in the SGLT2i group (5.4 %) than the DPP-4i group (6.4 %) (p = 0.002). SGLT2i use was linked to a 20 % reduced dementia risk (HR: 0.80; 95 % CI: 0.70–0.93; p = 0.002), especially in patients >80 years (HR: 0.75) and males (HR: 0.77).</div></div><div><h3>Conclusions</h3><div>SGLT2i therapy was associated with a lower incidence of dementia in older adults with T2DM, particularly in men and the very elderly.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"229 ","pages":"Article 112430"},"PeriodicalIF":7.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conversational agent interventions in diabetes care: a systematic review 会话代理干预糖尿病护理：系统回顾

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-19 DOI: 10.1016/j.diabres.2025.112429

Moshe Shegal , Lin Tao Hu , Erik Friesen , Nadia Minian , Marta Maslej , Terri Rodak , Carly Whitmore , Diana Sherifali , Peter Selby , Osnat C. Melamed

{"title":"Conversational agent interventions in diabetes care: a systematic review","authors":"Moshe Shegal , Lin Tao Hu , Erik Friesen , Nadia Minian , Marta Maslej , Terri Rodak , Carly Whitmore , Diana Sherifali , Peter Selby , Osnat C. Melamed","doi":"10.1016/j.diabres.2025.112429","DOIUrl":"10.1016/j.diabres.2025.112429","url":null,"abstract":"<div><div>This systematic review aimed to evaluate the effectiveness, acceptability, and safety of conversational agent (CA) interventions in diabetes care. CAs are artificial intelligence driven tools that simulate human-like dialogue and have emerged as promising supports for self-management in chronic disease. We searched six electronic databases from inception to June 2024 and identified 16 eligible studies involving 9076 participants across 13 countries. Included studies varied in design, population, diabetes type, and intervention duration. Eleven studies assessed effectiveness, with most reporting improvements in glycemic control (e.g., HbA1c reductions of 0.3 % to 1.0 %), medication adherence, health behaviours (e.g., diet, physical activity), or mental health outcomes (e.g, anxiety). Thirteen studies examined acceptability and found that most users had positive emotional and motivational responses, though some expressed dissatisfaction with repetitive or impersonal interactions. Only four studies addressed safety, and while adverse events were rare, mechanisms such as clinical escalation protocols were inconsistently applied. Most studies were rated as weak in methodological quality, with small samples and limited use of control groups. In conclusion, CAs show promise as scalable, patient-centered tools for diabetes care. However, rigorous research is needed to better understand their clinical impact, safety, and suitability for diverse patient populations.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"228 ","pages":"Article 112429"},"PeriodicalIF":7.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A qualitative study of healthcare provider perspectives on challenges and opportunities to improve diabetes self-management practices in rural Bangladesh 一项关于改善孟加拉国农村糖尿病自我管理实践的挑战和机遇的保健提供者观点的定性研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-14 DOI: 10.1016/j.diabres.2025.112412

Hasina Akhter Chowdhury , Baki Billah , Zobaer Alam , Shamia Akther Dipa , A.K.M. Fazlur Rahman , Liaquat Ali , Anju E. Joham , Cheryce L Harrison

{"title":"A qualitative study of healthcare provider perspectives on challenges and opportunities to improve diabetes self-management practices in rural Bangladesh","authors":"Hasina Akhter Chowdhury , Baki Billah , Zobaer Alam , Shamia Akther Dipa , A.K.M. Fazlur Rahman , Liaquat Ali , Anju E. Joham , Cheryce L Harrison","doi":"10.1016/j.diabres.2025.112412","DOIUrl":"10.1016/j.diabres.2025.112412","url":null,"abstract":"<div><h3>Aims</h3><div>This qualitative study explores healthcare professionals’ perspectives on the constraints and opportunities of diabetes self-management practices among rural people with type 2 diabetes mellitus (T2DM) in Bangladesh. It also examines suggestions and preferences for future interventions to improve diabetes self-management practices (DSMP) adherence and health outcomes.</div></div><div><h3>Methods</h3><div>Semi-structured interviews with healthcare professionals that provide care to adults with T2DM in Bangladesh across tertiary, secondary and primary care settings were conducted using purposive sampling techniques. Interviews were transcribed and thematically analysed using a deductive framework based on the socio-ecological model.</div></div><div><h3>Results</h3><div>Overall, a total of 24 healthcare professionals (n = 15, local-level; n = 9, national-level) were interviewed. Four key themes emerged: healthcare system, government support and policy, patient factors, and community influences. The rural healthcare system faces major challenges, including inadequate resources, workforce shortages, and limited access to essential medications and equipment, leading to a high burden on healthcare providers. Additionally, diabetes care integration into primary health systems is minimal, compounded by cultural beliefs and fatalistic attitudes toward disease management. Healthcare professionals suggested group-based DSMP for peer support and home visits for personalised care.</div></div><div><h3>Conclusions</h3><div>The findings contribute valuable perspectives to the global discourse on DSMP in rural settings, particularly in Bangladesh and similar contexts within low- and middle-income countries (LMICs), underscoring the need for context-specific, culturally sensitive interventions.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112412"},"PeriodicalIF":7.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of diabetes-related multimorbidity among adults with diabetes 成人糖尿病患者中基于胱抑素C和肌酐的肾小球滤过率和糖尿病相关多病风险的差异

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-12 DOI: 10.1016/j.diabres.2025.112419

Fei Chen , Yang Zhang , Darui Gao , Yanyu Zhang , Shengguo Yi , Jingcui Guo , Ying Gao , Wuxiang Xie

{"title":"Difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of diabetes-related multimorbidity among adults with diabetes","authors":"Fei Chen , Yang Zhang , Darui Gao , Yanyu Zhang , Shengguo Yi , Jingcui Guo , Ying Gao , Wuxiang Xie","doi":"10.1016/j.diabres.2025.112419","DOIUrl":"10.1016/j.diabres.2025.112419","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the association of discrepancies between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFRdiff) with incident diabetes-related multimorbidity.</div></div><div><h3>Methods</h3><div>This longitudinal cohort study included 21,938 UK Biobank participants with diabetes and free of diabetes-related microvascular or macrovascular disease at baseline. eGFRdiff was calculated as both the absolute difference (eGFRabdiff) and the relative difference (eGFRrediff). Primary outcome was the incidence of any multimorbidity. Secondary outcomes included microvascular-macrovascular, microvascular, and macrovascular multimorbidity. Cox proportional hazard regression models were used to evaluate the associations between eGFRdiff and the outcomes.</div></div><div><h3>Results</h3><div>Over a median follow-up of 12.5 years, there were 2,252 cases of any multimorbidity, 1,554 cases of microvascular-macrovascular multimorbidity, 792 cases of microvascular multimorbidity, and 642 cases of macrovascular multimorbidity. Each 10 mL/min/1.73 m<sup>2</sup> decrease in eGFRabdiff was associated with 23 %, 22 %, 32 % and 23 % higher risk of any multimorbidity, microvascular-macrovascular multimorbidity, microvascular multimorbidity, and macrovascular multimorbidity, respectively. Similarly, each 10 % decrease in eGFRrediff corresponded to increase the risk of outcomes. Subgroups analyses yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Lower eGFRdiff values were independently associated with elevated diabetes-related multimorbidity risks. These findings suggest that monitoring eGFRdiff in individuals with diabetes could aid in identifying patients with high-risk multimorbidity and potentially improve clinical outcomes.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112419"},"PeriodicalIF":7.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

GLP-1 receptor agonists and risk of hepatocellular carcinoma and all-cause mortality in patients with MASLD and type 2 diabetes: a propensity score–matched population-based cohort study GLP-1受体激动剂与MASLD和2型糖尿病患者肝细胞癌和全因死亡率的风险：一项倾向评分匹配的基于人群的队列研究

IF 7.4 3区医学

Diabetes research and clinical practice Pub Date : 2025-08-11 DOI: 10.1016/j.diabres.2025.112407

Wan-Ming Chen , Hui-Ji Ng , An-Tzu Jao , Szu-Yuan Wu , Ruey-Shyang Soong

{"title":"GLP-1 receptor agonists and risk of hepatocellular carcinoma and all-cause mortality in patients with MASLD and type 2 diabetes: a propensity score–matched population-based cohort study","authors":"Wan-Ming Chen , Hui-Ji Ng , An-Tzu Jao , Szu-Yuan Wu , Ruey-Shyang Soong","doi":"10.1016/j.diabres.2025.112407","DOIUrl":"10.1016/j.diabres.2025.112407","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is increasingly driven by non-viral causes, particularly metabolic dysfunction–associated steatotic liver disease (MASLD), which commonly coexists with type 2 diabetes mellitus (T2DM). Given the strong link between T2DM and HCC and the lack of approved pharmacologic preventive strategies, agents with dual metabolic and oncologic benefits are urgently needed. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated anti-inflammatory, anti-fibrotic, and potential anti-tumor effects.</div></div><div><h3>Methods</h3><div>We conducted a multinational retrospective cohort study using the TriNetX global network to evaluate associations between GLP-1RA use and incident HCC in patients with MASLD and T2DM. Adults aged 18–90 years with both conditions were identified between 2005 and 2025. Primary outcome was incident HCC; secondary was all-cause mortality. Adjusted hazard ratios (aHRs) were estimated using Cox models.</div></div><div><h3>Results</h3><div>After matching, 152,329 patients were included in each group. GLP-1RA use was associated with lower risks of HCC (aHR, 0.64; 95% CI, 0.42–0.98) and all-cause mortality (aHR, 0.37; 95% CI, 0.36–0.38). Subgroup, sensitivity, and control analyses supported the robustness of findings.</div></div><div><h3>Conclusions</h3><div>GLP-1RA use was associated with significantly reduced risks of HCC and death in patients with MASLD and T2DM, supporting its potential for HCC chemoprevention.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"227 ","pages":"Article 112407"},"PeriodicalIF":7.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0