Abu-Freha Naim, Yitzhak Avraham, Shirin Haim, Nevo-Shor Anat, Abu-Jaffar Jafar, Abu-Rafe Samer, Afianish Yaser, Cohen Daniel L, Bermont Anton
Gastroenterology Institute, Assuta Medical Center, Beer-Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Endoscopy. 2025 Feb;57(2):126-133. doi: 10.1055/a-2419-3875. Epub 2024 Oct 10.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) affect gastrointestinal motility, slowing gastric emptying and colonic transit. GLP-1RAs have an impact on gastric residue before endoscopy, but only limited data are available regarding its effect on the adequacy of colonic preparation. We investigated the association between GLP-1RA use and inadequate bowel preparation (IBP) for colonoscopy.
We performed a multicenter retrospective study with GLP-1RA cases matched with controls (using propensity scores for age, sex, diabetes mellitus [DM], obesity, and co-morbidities). Data on demographics, medication use, procedural indications, and colonoscopy findings were collected. IBP ("poor preparation" on Aronchik scale or Boston Bowel preparation scale <5) was the primary outcome.
4876 patients treated with GLP-1RAs were included in the analysis and compared with 4876 controls selected from 333 648 patients without GLP-1RA use. Among the GLP-1RA patients, 10% (n = 487) had IBP compared with 197 (4%) of the control group (<0.001). Subgroup analysis showed a higher rate of IBP among diabetic patients treated with GLP-1RA (284/2364 [12%]) than among diabetic patients without GLP-1RA treatment (118/2364 [5%]; <0.001). Additionally, 203/2512 nondiabetic patients treated with GLP-1RAs had IBP (8%) compared with 79 of the nondiabetic non-GLP-1RA group (3%; <0.001). On multivariate analysis, diabetes and GLP-1RA use were both found to be independent risk factors for IBP (odds ratio [OR] 1.4 and OR 2.7, respectively; both <0.001).
Our findings highlight the necessity for special attention and tailored recommendations for both diabetic and nondiabetic patients treated with GLP-1RAs in terms of colonic preparation prior to colonoscopy.
胰高血糖素样肽-1受体激动剂（GLP-1RAs）会影响胃肠动力，减缓胃排空和结肠转运。GLP-1RAs会对内镜检查前的胃残余物产生影响，但关于其对结肠准备充分性的影响的数据有限。我们研究了使用GLP-1RA与结肠镜检查肠道准备不充分（IBP）之间的关联。
我们进行了一项多中心回顾性研究，将使用GLP-1RA的病例与对照组（使用年龄、性别、糖尿病[DM]、肥胖和合并症的倾向评分）进行匹配。收集了人口统计学、用药情况、手术指征和结肠镜检查结果的数据。IBP（Aronchik量表上的“准备不佳”或波士顿肠道准备量表<5）是主要结局。
4876例接受GLP-1RAs治疗的患者纳入分析，并与从333648例未使用GLP-1RA的患者中选出的4876例对照组进行比较。在使用GLP-1RA的患者中，10%（n = 487）存在IBP，而对照组为197例（4%）（<0.001）。亚组分析显示，接受GLP-1RA治疗的糖尿病患者中IBP发生率（284/2364 [12%]）高于未接受GLP-1RA治疗的糖尿病患者（118/2364 [5%]；<0.001）。此外，2512例接受GLP-1RAs治疗的非糖尿病患者中有203例（8%）存在IBP，而非GLP-1RA非糖尿病组为79例（3%）（<0.001）。多因素分析显示，糖尿病和使用GLP-1RA均被发现是IBP的独立危险因素（优势比[OR]分别为1.4和2.7；均<0.001）。
我们的研究结果强调，对于接受GLP-1RAs治疗的糖尿病和非糖尿病患者，在结肠镜检查前的结肠准备方面需要特别关注并提供针对性建议。
