评估纽约市一家大型公立 NYC/hhc+ 医院中接受 glp-1 受体激动剂治疗的 HIV 群体的体重减轻情况和代谢参数

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2024-09-01 DOI:10.1016/j.ajpc.2024.100788

Natalia Nazarenko MD

{"title":"评估纽约市一家大型公立 NYC/hhc+ 医院中接受 glp-1 受体激动剂治疗的 HIV 群体的体重减轻情况和代谢参数","authors":"Natalia Nazarenko MD","doi":"10.1016/j.ajpc.2024.100788","DOIUrl":null,"url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Obesity</div></div><div><h3>Background</h3><div>Individuals living with HIV who undergo prolonged combined antiretroviral therapy (cART) may experience weight gain as a potential side effect. Many of these individuals are prescribed GLP-1 receptor agonists (RA), which are recognized for their ability to reduce weight. However, there is uncertainty regarding whether cART could serve as a confounding factor, potentially influencing the effectiveness of GLP-1 RA treatment and impeding the attainment of desired outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted, reviewing electronic medical records of 239 HIV-positive patients on GLP-1 RA. After applying criteria, 180 patients were analyzed, all on GLP-1 RA for at least 12 weeks. Multivariate logistic regression was used, assessing weight loss, BMI, HbA1c change, and association between weight loss and cART.</div></div><div><h3>Results</h3><div>Out of 180 participants, 51.67% were male and 48.33% were female, with a mean age of 58.2 (SD +/- 11.09). 82% of participants had diabetes mellitus II type (DMT2). The mean duration of GLP-1 RA treatment was 25.38 months (SD +/- 18.5). Semaglutide was used by 50.5%, liraglutide by 4%, and dulaglutide by 45.5%. Weight gain was observed in 29.4%, weight loss under 5 kg in 34.4%, 5-10 kg loss in 15%, and over 10 kg loss in 21.11%. Mean weight reduction was 2.5 kg (SD +/- 12.5), HbA1c reduction was 1.03% (SD +/- 2.3), and BMI reduction was 0.76 (SD +/- 12.4). No significant association was found between GLP duration and weight reduction. Dolutegravir/Lamivudine showed less weight reduction compared to other cART regimens (OR=0.36, CI 0.13 – 0.97, p=0.044).</div></div><div><h3>Conclusions</h3><div>We observed expected positive outcomes linked to GLP-1 RA use, leading to improvements in the metabolic profiles of individuals living with HIV on cART. Further analysis is needed to investigate the relationship between weight and improvements in metabolic parameters with different cART regimens. Additionally, it's important to examine potential sex and racial disparities in response to GLP-1 RA therapy among people living with HIV on cART.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"19 ","pages":"Article 100788"},"PeriodicalIF":4.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"EVALUATION OF WEIGHT REDUCTION AND METABOLIC PARAMETERS IN HIV COHORT UNDERGOING TREATMENT WITH GLP-1 RECEPTOR AGONISTS AT A LARGE PUBLIC NYC/HHC+ HOSPITAL IN NEW YORK CITY\",\"authors\":\"Natalia Nazarenko MD\",\"doi\":\"10.1016/j.ajpc.2024.100788\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Therapeutic Area</h3><div>Obesity</div></div><div><h3>Background</h3><div>Individuals living with HIV who undergo prolonged combined antiretroviral therapy (cART) may experience weight gain as a potential side effect. Many of these individuals are prescribed GLP-1 receptor agonists (RA), which are recognized for their ability to reduce weight. However, there is uncertainty regarding whether cART could serve as a confounding factor, potentially influencing the effectiveness of GLP-1 RA treatment and impeding the attainment of desired outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted, reviewing electronic medical records of 239 HIV-positive patients on GLP-1 RA. After applying criteria, 180 patients were analyzed, all on GLP-1 RA for at least 12 weeks. Multivariate logistic regression was used, assessing weight loss, BMI, HbA1c change, and association between weight loss and cART.</div></div><div><h3>Results</h3><div>Out of 180 participants, 51.67% were male and 48.33% were female, with a mean age of 58.2 (SD +/- 11.09). 82% of participants had diabetes mellitus II type (DMT2). The mean duration of GLP-1 RA treatment was 25.38 months (SD +/- 18.5). Semaglutide was used by 50.5%, liraglutide by 4%, and dulaglutide by 45.5%. Weight gain was observed in 29.4%, weight loss under 5 kg in 34.4%, 5-10 kg loss in 15%, and over 10 kg loss in 21.11%. Mean weight reduction was 2.5 kg (SD +/- 12.5), HbA1c reduction was 1.03% (SD +/- 2.3), and BMI reduction was 0.76 (SD +/- 12.4). No significant association was found between GLP duration and weight reduction. Dolutegravir/Lamivudine showed less weight reduction compared to other cART regimens (OR=0.36, CI 0.13 – 0.97, p=0.044).</div></div><div><h3>Conclusions</h3><div>We observed expected positive outcomes linked to GLP-1 RA use, leading to improvements in the metabolic profiles of individuals living with HIV on cART. Further analysis is needed to investigate the relationship between weight and improvements in metabolic parameters with different cART regimens. Additionally, it's important to examine potential sex and racial disparities in response to GLP-1 RA therapy among people living with HIV on cART.</div></div>\",\"PeriodicalId\":72173,\"journal\":{\"name\":\"American journal of preventive cardiology\",\"volume\":\"19 \",\"pages\":\"Article 100788\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of preventive cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666667724001569\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of preventive cardiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666667724001569","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

治疗领域肥胖症背景长期接受联合抗逆转录病毒疗法（cART）的艾滋病病毒感染者可能会出现体重增加的潜在副作用。其中许多人被处方使用 GLP-1 受体激动剂 (RA)，这种药物被认为具有减轻体重的作用。然而，目前还不确定 cART 是否会成为一个混杂因素，从而影响 GLP-1 RA 治疗的效果，阻碍预期结果的实现。在应用标准后，对 180 名患者进行了分析，所有患者均接受了至少 12 周的 GLP-1 RA 治疗。结果在 180 名参与者中，51.67% 为男性，48.33% 为女性，平均年龄为 58.2 岁（SD +/- 11.09）。82%的参与者患有 II 型糖尿病（DMT2）。GLP-1 RA的平均治疗时间为25.38个月（SD +/- 18.5）。50.5%的患者使用塞马鲁肽，4%的患者使用利拉鲁肽，45.5%的患者使用度拉鲁肽。29.4%的患者体重增加，34.4%的患者体重减轻5公斤以下，15%的患者体重减轻5-10公斤，21.11%的患者体重减轻10公斤以上。平均体重减少了 2.5 千克（SD +/-12.5），HbA1c 减少了 1.03%（SD +/-2.3），BMI 减少了 0.76（SD +/-12.4）。GLP 持续时间与体重下降之间没有明显关联。与其他 cART 方案相比，多罗替拉韦/拉米夫定的体重减轻幅度较小（OR=0.36，CI 0.13 - 0.97，p=0.044）。需要进一步分析研究体重与不同 cART 治疗方案下代谢指标改善之间的关系。此外，研究接受 cART 治疗的 HIV 感染者对 GLP-1 RA 治疗的反应中可能存在的性别和种族差异也很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

EVALUATION OF WEIGHT REDUCTION AND METABOLIC PARAMETERS IN HIV COHORT UNDERGOING TREATMENT WITH GLP-1 RECEPTOR AGONISTS AT A LARGE PUBLIC NYC/HHC+ HOSPITAL IN NEW YORK CITY

Therapeutic Area

Obesity

Background

Individuals living with HIV who undergo prolonged combined antiretroviral therapy (cART) may experience weight gain as a potential side effect. Many of these individuals are prescribed GLP-1 receptor agonists (RA), which are recognized for their ability to reduce weight. However, there is uncertainty regarding whether cART could serve as a confounding factor, potentially influencing the effectiveness of GLP-1 RA treatment and impeding the attainment of desired outcomes.

Methods

A retrospective study was conducted, reviewing electronic medical records of 239 HIV-positive patients on GLP-1 RA. After applying criteria, 180 patients were analyzed, all on GLP-1 RA for at least 12 weeks. Multivariate logistic regression was used, assessing weight loss, BMI, HbA1c change, and association between weight loss and cART.

Results

Out of 180 participants, 51.67% were male and 48.33% were female, with a mean age of 58.2 (SD +/- 11.09). 82% of participants had diabetes mellitus II type (DMT2). The mean duration of GLP-1 RA treatment was 25.38 months (SD +/- 18.5). Semaglutide was used by 50.5%, liraglutide by 4%, and dulaglutide by 45.5%. Weight gain was observed in 29.4%, weight loss under 5 kg in 34.4%, 5-10 kg loss in 15%, and over 10 kg loss in 21.11%. Mean weight reduction was 2.5 kg (SD +/- 12.5), HbA1c reduction was 1.03% (SD +/- 2.3), and BMI reduction was 0.76 (SD +/- 12.4). No significant association was found between GLP duration and weight reduction. Dolutegravir/Lamivudine showed less weight reduction compared to other cART regimens (OR=0.36, CI 0.13 – 0.97, p=0.044).

Conclusions

We observed expected positive outcomes linked to GLP-1 RA use, leading to improvements in the metabolic profiles of individuals living with HIV on cART. Further analysis is needed to investigate the relationship between weight and improvements in metabolic parameters with different cART regimens. Additionally, it's important to examine potential sex and racial disparities in response to GLP-1 RA therapy among people living with HIV on cART.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American journal of preventive cardiology Cardiology and Cardiovascular Medicine

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

76 days