Dr Yen's Clinic, Taoyuan, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Thorax. 2024 Oct 16;79(11):1017-1023. doi: 10.1136/thorax-2023-221040.
Clinical studies have shown that glucagon-like peptide-1 receptor agonists (GLP-1 RA) can have beneficial effects on cardiopulmonary function. We conducted this longitudinal cohort study to compare the risk of cardiopulmonary outcomes and mortality between GLP-1 RA use and no use in patients with type 2 diabetes (T2D) and chronic obstructive pulmonary disease (COPD).
The study identified 8060 matched GLP-1 RA users and non-users from Taiwan's National Health Insurance Research Database from 1 January 2008 to 31 December 2019. Cox proportional hazards models were used to determine the risk of cardiopulmonary outcomes between GLP-1 RA users and non-users.
The mean follow-up time was 2.51 and 2.46 years for GLP-1 RA users and non-users, respectively. In the matched cohorts, GLP-1 RA users had a significantly lower risk of mortality (adjusted HR (aHR) 0.46, 95% CI 0.38 to 0.56), cardiovascular events (aHR 0.73, 95% CI 0.65 to 0.82), non-invasive positive pressure ventilation (aHR 0.66, 95% CI 0.47 to 0.93), invasive mechanical ventilation (aHR 0.64, 95% CI 0.51 to 0.8) and bacterial pneumonia (aHR 0.76, 95% CI 0.65 to 0.88) than GLP-1 RA non-users. The subsequent analyses for various subgroup and medication duration also showed that GLP-1 RA was associated with a significantly lower risk of mortality, cardiovascular events, ventilation support and bacterial pneumonia than non-GLP-1 RA.
This nationwide cohort study showed that GLP-1 RA had a lower risk of cardiopulmonary outcomes and all-cause mortality than non-GLP-1 RA in patients with T2D and COPD. GLP-1 RA may help manage diabetes in people with COPD.
临床研究表明,胰高血糖素样肽-1 受体激动剂(GLP-1 RA)对心肺功能有有益影响。我们进行了这项纵向队列研究,比较了 2 型糖尿病(T2D)和慢性阻塞性肺疾病(COPD)患者使用 GLP-1 RA 与不使用 GLP-1 RA 的心肺结局和死亡率的风险。
本研究从台湾全民健康保险研究数据库中确定了 2008 年 1 月 1 日至 2019 年 12 月 31 日 8060 对匹配的 GLP-1 RA 使用和未使用的患者。使用 Cox 比例风险模型确定 GLP-1 RA 使用者和未使用者之间心肺结局的风险。
GLP-1 RA 使用者和未使用者的平均随访时间分别为 2.51 年和 2.46 年。在匹配队列中,GLP-1 RA 使用者的死亡率(调整后的 HR(aHR)0.46,95%CI 0.38 至 0.56)、心血管事件(aHR 0.73,95%CI 0.65 至 0.82)、无创正压通气(aHR 0.66,95%CI 0.47 至 0.93)、有创机械通气(aHR 0.64,95%CI 0.51 至 0.8)和细菌性肺炎(aHR 0.76,95%CI 0.65 至 0.88)的风险明显低于 GLP-1 RA 未使用者。随后对各种亚组和药物持续时间的分析也表明,GLP-1 RA 与死亡率、心血管事件、通气支持和细菌性肺炎的风险明显低于非 GLP-1 RA 相关。
这项全国性队列研究表明,与非 GLP-1 RA 相比,T2D 和 COPD 患者使用 GLP-1 RA 心肺结局和全因死亡率较低。GLP-1 RA 可能有助于管理 COPD 患者的糖尿病。