胰高血糖素样肽-1受体激动剂暴露与眼压变化之间的关联：胰高血糖素样肽-1受体激动剂与眼压变化
Association Between Glucagon-Like Peptide-1 Receptor Agonists Exposure and Intraocular Pressure Change: GLP-1 Receptor Agonists and Intraocular Pressure Change.
作者信息
Hallaj Shahin, Halfpenny William, Chuter Benton G, Weinreb Robert N, Baxter Sally L, Cui Qi N
机构信息
From the Viterbi Family Department of Ophthalmology, Division of Ophthalmology Informatics and Data Science (S.H., W.H., B.G.C., R.N.W., S.L.B.), Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, California, USA; Department of Medicine, Division of Biomedical Informatics (S.H., W.H., B.G.C., S.L.B.), University of California, San Diego, California, USA.
From the Viterbi Family Department of Ophthalmology, Division of Ophthalmology Informatics and Data Science (S.H., W.H., B.G.C., R.N.W., S.L.B.), Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, California, USA.
出版信息
Am J Ophthalmol. 2025 Jan;269:255-265. doi: 10.1016/j.ajo.2024.08.030. Epub 2024 Sep 3.
PURPOSE
This study evaluates the effects of glucagon-like peptide-1 receptor (GLP-1R) agonists on intraocular pressure (IOP).
DESIGN
Retrospective clinical cohort study.
METHODS
The University of California Health Data Warehouse was queried for patients exposed to GLP-1R agonists or other oral antidiabetics. A total of 1247 glaucoma surgery and treatment naïve eyes of 626 patientson GLP-1R agonists and 1083 glaucoma surgery and treatment naïve eyes of 547 patients on other oral antidiabetics were included. Index date was defined as the date of first exposure to the medication. Eyes with at least one pre-exposure and one post-exposure tonometry records within 365 days of the index date were included. Clinical and laboratory data were extracted. Eyes were excluded upon exposure to glaucoma hypotensive medication or glaucoma surgery. The primary outcome measure was ∆IOP after exposure, which was analyzed using a paired t test and generalized estimating equations (GEE) RESULTS: The median age was 66.2 years [IQR = 18.3]; 607 (51.7%) were female, and 667 (56.9%) were Caucasian. Median pre-exposure IOP, hemoglobin A1c, and body mass index were 15.2 mm Hg [IQR = 3.8], 7.5 [IQR = 2.4], and 29.8 [IQR = 9.4], respectively. A total of 776 individuals (66.1%) had diabetes, with the median number of active oral antidiabetics being 1.0 [IQR = 1.0], and 441 (37.5%) being insulin users. Several pre-exposure characteristics differed between the groups. The mean ∆IOP was -0.4 ± 2.8 mm Hg (paired t test P < .001) and -0.2 ± 3.3 mm Hg (paired t test P = .297) in the GLP-1R agonist and other antidiabetics groups, respectively. Pre-exposure IOP was the only independent predictor of ΔIOP in multivariable GEE. Sensitivity analyses yielded similar results.
CONCLUSIONS
Although GLP-1R agonists were significantly associated with a decrease in IOP in the paired analysis, they were not associated with ΔIOP in multivariable GEE. Moreover, the difference in ΔIOP between the two groups was small.
目的
本研究评估胰高血糖素样肽-1受体（GLP-1R）激动剂对眼压（IOP）的影响。
设计
回顾性临床队列研究。
方法
查询加利福尼亚大学健康数据仓库，以获取使用GLP-1R激动剂或其他口服抗糖尿病药物的患者信息。纳入了626例使用GLP-1R激动剂患者的1247只未经青光眼手术和治疗的眼睛，以及547例使用其他口服抗糖尿病药物患者的1083只未经青光眼手术和治疗的眼睛。索引日期定义为首次接触该药物的日期。纳入在索引日期365天内至少有一次接触前和一次接触后眼压测量记录的眼睛。提取临床和实验室数据。接触青光眼降压药物或接受青光眼手术后的眼睛被排除。主要结局指标是接触后的眼压变化（∆IOP），使用配对t检验和广义估计方程（GEE）进行分析。结果：中位年龄为66.2岁[四分位间距（IQR）=18.3]；607例（51.7%）为女性，667例（56.9%）为白种人。接触前眼压、糖化血红蛋白和体重指数的中位数分别为15.2 mmHg[IQR=3.8]、7.5[IQR=2.4]和29.8[IQR=9.4]。共有776例个体（66.1%）患有糖尿病，正在使用的口服抗糖尿病药物的中位数为1.0[IQR=1.0]，441例（37.5%）使用胰岛素。两组之间的一些接触前特征存在差异。GLP-1R激动剂组和其他抗糖尿病药物组的平均眼压变化分别为-0.4±2.8 mmHg（配对t检验P<.001）和-0.2±3.3 mmHg（配对t检验P=.297）。在多变量GEE中，接触前眼压是眼压变化的唯一独立预测因素。敏感性分析得出了相似的结果。
结论
虽然在配对分析中GLP-1R激动剂与眼压降低显著相关，但在多变量GEE中它们与眼压变化无关。此外，两组之间的眼压变化差异很小。
Zotero 插件