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胃食管十二指肠镜检查中胰高血糖素样肽-1 受体激动剂治疗与胃残留物的关系。

Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy.

机构信息

Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan.

Division of Gastroenterology, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan.

出版信息

J Diabetes Investig. 2023 Jun;14(6):767-773. doi: 10.1111/jdi.14005. Epub 2023 Mar 15.

Abstract

AIMS/INTRODUCTION: Previous studies have reported that the glucagon-like peptide-1 receptor agonist (GLP-1RA) delays gastric emptying, and gastric emptying was assessed by the C breath test or paracetamol absorption technique. However, neither of them is clinically familiar in real-world clinical practice. The purpose of the present study was to investigate the association between GLP-1RA treatment and gastric residue in an esophagogastroduodenoscopy.

MATERIALS AND METHODS

This study was a matched pair case-control study. The study population consisted of 1,128 individuals with diabetes who had esophagogastroduodenoscopy at our clinic between July 2020 and June 2022. To account for differences in characteristics, such as age, sex, insulin treatment and glycated hemoglobin, we carried out a one-to-one nearest neighbor propensity score matching analysis between diabetes patients with and without GLP-1RA treatment. After matching, we compared the presence of gastric residue in an esophagogastroduodenoscopy by the McNemar test between patients with and without GLP-1RA treatment.

RESULTS

After the propensity score matching, we selected 205 pairs. In the propensity score-matched comparison, the proportion of gastric residue was statistically significantly higher in the GLP-1RA treatment group (0.49% vs 5.4%, P = 0.004). The details of GLP-1RA prescribed for the 11 patients with gastric residue were liraglutide once daily 1.8 mg (n = 2), dulaglutide once weekly 0.75 mg (n = 5), semaglutide once weekly 0.5 mg (n = 2) and semaglutide once weekly 1.0 mg (n = 2).

CONCLUSION

GLP-1RA treatment is associated with gastric residue in an esophagogastroduodenoscopy in patients with diabetes.

摘要

目的/引言:先前的研究报告称,胰高血糖素样肽-1 受体激动剂(GLP-1RA)可延缓胃排空,胃排空通过 13C 呼气试验或对乙酰氨基酚吸收技术进行评估。然而,在实际临床实践中,这两种方法都不被临床所熟悉。本研究旨在通过食管胃十二指肠镜检查研究 GLP-1RA 治疗与胃残留之间的关系。

材料和方法

这是一项匹配的病例对照研究。研究人群由 2020 年 7 月至 2022 年 6 月在我院接受食管胃十二指肠镜检查的 1128 名糖尿病患者组成。为了考虑年龄、性别、胰岛素治疗和糖化血红蛋白等特征的差异,我们对有和没有 GLP-1RA 治疗的糖尿病患者进行了一对一的最近邻倾向评分匹配分析。匹配后,我们通过 McNemar 检验比较了 GLP-1RA 治疗组和无 GLP-1RA 治疗组食管胃十二指肠镜检查中胃残留的存在情况。

结果

在进行倾向评分匹配后,我们选择了 205 对。在倾向评分匹配比较中,GLP-1RA 治疗组胃残留的比例明显更高(0.49%比 5.4%,P=0.004)。11 例胃残留患者所开 GLP-1RA 的详细信息为:每日 1.8mg 利拉鲁肽(n=2),每周 0.75mg 度拉糖肽(n=5),每周 0.5mg 司美格鲁肽(n=2)和每周 1.0mg 司美格鲁肽(n=2)。

结论

糖尿病患者 GLP-1RA 治疗与食管胃十二指肠镜检查中的胃残留有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3938/10204182/10d180e7197c/JDI-14-767-g001.jpg

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