胰高血糖素样肽-1 受体激动剂对糖尿病和非糖尿病患者上消化道内镜检查的影响。
Effects of glucagon-like peptide-1 receptor agonists on upper endoscopy in diabetic and nondiabetic patients.
机构信息
Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
Geisinger Commonwealth School of Medicine, Danville, Pennsylvania, USA.
出版信息
Gastrointest Endosc. 2024 Oct;100(4):745-749. doi: 10.1016/j.gie.2024.04.2900. Epub 2024 Apr 29.
BACKGROUND AND AIMS
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) promote weight loss by suppressing appetite, enhancing satiety, regulating glucose metabolism, and delaying gastric motility. We sought to determine whether GLP-1 RA use could affect medical procedures such as EGD.
METHODS
We conducted a retrospective study of 35,183 patients who underwent EGD between 2019 and 2023, 922 of whom were using a GLP-1 RAs. Data were collected regarding demographics, diabetes status, retained gastric contents during EGD, incidence of aborted EGD, and necessity for repeat EGD.
RESULTS
GLP-1 RA use was associated with a 4-fold increase in the retention of gastric contents (P < .0001), 4-fold higher rates of aborted EGD (P < .0001), and twice the likelihood of requiring repeat EGD (P = .0001), even after stratifying for the presence of diabetes.
CONCLUSIONS
GLP-1 RA use can lead to delayed gastric emptying, affecting EGD adequacy regardless of the presence of diabetes, and may warrant dose adjustment to improve the safety and efficacy of these procedures.
背景和目的
胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）通过抑制食欲、增强饱腹感、调节血糖代谢和延缓胃动力来促进体重减轻。我们旨在确定 GLP-1 RA 的使用是否会影响内镜检查等医疗程序。
方法
我们对 2019 年至 2023 年间接受内镜检查的 35183 名患者进行了回顾性研究，其中 922 名患者正在使用 GLP-1 RAs。收集的数据包括人口统计学、糖尿病状况、内镜检查时胃内残留物、内镜检查中止的发生率以及是否需要重复内镜检查。
结果
GLP-1 RA 的使用与胃内容物潴留增加 4 倍（P<0.0001）、内镜检查中止率增加 4 倍（P<0.0001）和需要重复内镜检查的可能性增加 1 倍（P=0.0001）相关，即使在分层考虑糖尿病存在的情况下也是如此。
结论
GLP-1 RA 的使用可导致胃排空延迟，无论是否存在糖尿病，都会影响内镜检查的充分性，可能需要调整剂量以提高这些程序的安全性和有效性。
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