Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, the Republic of Korea.
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul 06591, the Republic of Korea.
Prim Care Diabetes. 2023 Oct;17(5):460-465. doi: 10.1016/j.pcd.2023.07.006. Epub 2023 Aug 3.
Glucagon-like peptide-1 receptor agonist (GLP-1 RA) is used to treat obesity or type 2 diabetes mellitus (DM). We compared weight loss and side-effects between patients with and without DM using GLP-1 RA.
This was a retrospective cohort study based on electronic medical records. Patients were categorized into three groups: liraglutide without DM (LiRa_NL), liraglutide with DM (LiRa_DM), and lixisenatide with DM (LiXi_DM). Six-month outcomes were evaluated for weight loss, side-effect types, and onset discontinuation of GLP-1 RA.
We enrolled 356 (190 LiRa_NL, 95 LiRa_DM, and 71 LiXi_DM) patients (women, 72.5 %; mean age, 43.7 ± 12.7 years; mean body mass index, 30.7 ± 5.2 kg/m). The mean glycated hemoglobin (HbA1c) participants were 7.7 ± 2.1 %. Average weight loss was 2.9 ± 0.3 kg. The change in HbA1c was lower in the LiXi_DM group than in the LiRa_DM group (- 1.1 ± 0.2 % vs. - 0.4 ± 0.1 %, P < 0.05). The LiRa_DM group showed a more effective weight loss (- 3.0 ± 0.4 kg) than the LiXi_DM group (- 0.9 ± 0.4 kg) (P < 0.05). Approximately 30 % of the patients reported experiencing side-effects, with gastrointestinal side-effects being the most frequent (20.5 %). The median side-effect onset was 1.9 ± 0.1 months from first treatment. The rate of GLP-1 RA discontinuation was 72.8 %. Discontinuation rates due to side-effects were 75.7 %, 68.9 %, and 64.4 % in the LiRa_NL, LiRa_DM, and LiXi_DM groups, respectively.
The LiRa_NL group showed the most weight loss, although the discontinuation rate was high. Most side-effects occurred at 1-2 months. When prescribing GLP-1 RA, education concerning side-effects and discontinuation is needed to enhance treatment adherence.
胰高血糖素样肽-1 受体激动剂（GLP-1RA）用于治疗肥胖症或 2 型糖尿病（DM）。我们比较了使用 GLP-1RA 的 DM 患者和非 DM 患者之间的体重减轻和副作用。
这是一项基于电子病历的回顾性队列研究。患者分为三组：无 DM 的利拉鲁肽（LiRa_NL）、有 DM 的利拉鲁肽（LiRa_DM）和有 DM 的利西那肽（LiXi_DM）。评估了 6 个月的体重减轻、副作用类型和 GLP-1RA 开始停药情况。
共纳入 356 名（190 名 LiRa_NL、95 名 LiRa_DM 和 71 名 LiXi_DM）患者（女性，72.5%；平均年龄 43.7±12.7 岁；平均体重指数 30.7±5.2kg/m2）。参与者的平均糖化血红蛋白（HbA1c）为 7.7±2.1%。平均体重减轻 2.9±0.3kg。LiXi_DM 组的 HbA1c 变化低于 LiRa_DM 组（-1.1±0.2% vs.-0.4±0.1%，P<0.05）。LiRa_DM 组的体重减轻效果更显著（-3.0±0.4kg），LiXi_DM 组（-0.9±0.4kg）（P<0.05）。约 30%的患者报告出现副作用，胃肠道副作用最常见（20.5%）。副作用开始的中位数时间为首次治疗后 1.9±0.1 个月。GLP-1RA 停药率为 72.8%。LiRa_NL、LiRa_DM 和 LiXi_DM 组因副作用停药的比例分别为 75.7%、68.9%和 64.4%。
LiRa_NL 组体重减轻最多，但停药率较高。大多数副作用发生在 1-2 个月。在开处 GLP-1RA 时，需要对副作用和停药进行教育，以提高治疗依从性。
