真实世界中接受 GLP-1 受体激动剂治疗的 2 型糖尿病患者的性别差异。

Real-world sex differences in type 2 diabetes patients treated with GLP-1 receptor agonists.

机构信息

Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.

Biostatistic Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.

出版信息

Diabetes Res Clin Pract. 2024 Jun;212:111689. doi: 10.1016/j.diabres.2024.111689. Epub 2024 May 1.

DOI:10.1016/j.diabres.2024.111689

PMID:38697297

Abstract

AIMS

To evaluate the determinants of cardiovascular (CV) protection in men and women treated with glucagon-like peptide-1 receptor agonists (GLP1-RA).

METHODS

Retrospective cohort study of 550 patients (43% women), with and without established CV disease, followed at a single center after the first prescription of a GLP1-RA. We analyzed the determinants of major adverse cardiovascular events (MACE) in men and women.

RESULTS

The rate of MACE was similar between sexes. In primary prevention, among men, older age (HR 1.13, 95 % C.I. 1.05-1.22; P = 0.001) and GLP-1 RA withdrawal by time (HR 2.77, 95 % C.I. 1.15-6.68; P = 0.023) increased the HR for MACE. Among women, significant predictors of MACE were diabetes duration (HR 1.05, C.I. 1.01-1.10; P = 0.020), GLP-1 withdrawal by time (HR 2.84, 95 % C.I. 1.13-7.10; P = 0.026) and BMI at GLP-1 RA withdrawal (HR 1.08, 95 % C.I. 1.01-1.15; P = 0.026). For individuals with prior CV disease, the HR for MACE was solely impacted by GLP-1 withdrawal over time in males (HR 2.18, 95 % C.I. 1.10-4.30; P = 0.025) and by older age at GLP-1 RA initiation (HR 1.17, 95 % C.I. 1.03-1.33; P = 0.015) in females.

CONCLUSIONS

Although MACE rates were similar, the factors contributing to MACE differed by sex.

摘要

目的

评估接受胰高血糖素样肽-1 受体激动剂（GLP1-RA）治疗的男性和女性的心血管（CV）保护的决定因素。

方法

这是一项回顾性队列研究，共纳入了 550 名患者（43%为女性），这些患者在单中心接受 GLP1-RA 治疗后随访，其中部分患者患有已确诊的 CV 疾病，部分患者没有。我们分析了男性和女性中主要不良心血管事件（MACE）的决定因素。

结果

男性和女性的 MACE 发生率相似。在一级预防中，对于男性，年龄较大（HR 1.13，95%CI 1.05-1.22；P=0.001）和 GLP-1 RA 随时间停药（HR 2.77，95%CI 1.15-6.68；P=0.023）增加了 MACE 的 HR。对于女性，MACE 的显著预测因素为糖尿病病程（HR 1.05，CI 1.01-1.10；P=0.020）、GLP-1 随时间停药（HR 2.84，95%CI 1.13-7.10；P=0.026）和 GLP-1 RA 停药时的 BMI（HR 1.08，95%CI 1.01-1.15；P=0.026）。对于有既往 CV 疾病的个体，MACE 的 HR 仅受到男性中 GLP-1 随时间的停药（HR 2.18，95%CI 1.10-4.30；P=0.025）和女性中 GLP-1 RA 起始时年龄较大（HR 1.17，95%CI 1.03-1.33；P=0.015）的影响。