2型糖尿病患者中胰高血糖素样肽-1受体激动剂相关临床显著胆石症的相对风险：一项真实世界研究
The relative risk of clinically relevant cholelithiasis among glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus, real-world study.
作者信息
Gameil Mohammed Ali, Yousef Elshahat Ali Ahmed Mohamed, Marzouk Rehab Elsayed, Emara Mohamed H, Abdelkader Abeer H, Salama Rasha Ibrahim
机构信息
Endocrinology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
出版信息
Diabetol Metab Syndr. 2024 Dec 4;16(1):293. doi: 10.1186/s13098-024-01526-2.
BACKGROUND AND AIM
The association between biliary disorders with weight reduction enhanced by GLP-1RAs was observed frequently, nevertheless, the relative risk of the clinically relevant cholelithiasis was not specified clearly among different GLP-1RAs.
METHODS
308 patients with type 2 diabetes mellitus (T2D) were recruited and divided into 4 groups; liraglutide, dulaglutide, semaglutide, versus control group; comprised of 69, 76, 71, and 92, respectively. Clinical history, examination, laboratory, and radiology tests were implemented.
RESULTS
Cholelithiasis significantly associates GLP1-RAs (p = 0.033). Overall cholelithiasis was evident in 31.2% of our participants. Symptomatic cholelithiasis prevails in 60.4% of patients with cholelithiasis. Symptomatic complicated cholelithiasis prevailed in 33.3%; distributed in 28.1%, 28.1%, 21.9%, and 21.9% in liraglutide, semaglutide, dulaglutide, and control groups, respectively. Meanwhile, symptomatic uncomplicated cholelithiasis was observed in 27.1%; distributed in 34.6%, 30.8%, 15.4%, and 19.2% in Liraglutide, semaglutide, dulaglutide, and control groups, respectively. Asymptomatic cholelithiasis was noted in 36.8%, 21.1%, 10.5%, and 31.6% of patients with dulaglutide, semaglutide, liraglutide, and control groups, respectively. Specifically, 81.1%, 68%, and 44% of patients with liraglutide, semaglutide, and dulaglutide experienced symptomatic cholelithiasis. The relative risk of cholelithiasis was 1.2, 1.3, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 17.25, 14.69, and 10.96, respectively. The relative risk of symptomatic cholelithiasis was 1.6, 0.9, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 3.14, 16.67, and 5.56, respectively.
CONCLUSION
Liraglutide was associated with the highest risk of clinically relevant cholelithiasis than semaglutide, and dulaglutide in patients with T2D.
背景与目的
经常观察到胆汁紊乱与GLP-1受体激动剂（GLP-1RAs）所致体重减轻之间存在关联，然而，在不同的GLP-1RAs中，临床相关胆石症的相对风险并未明确界定。
方法
招募308例2型糖尿病（T2D）患者并分为4组；利拉鲁肽组、度拉鲁肽组、司美格鲁肽组与对照组；分别由69例、76例、71例和92例组成。进行了临床病史、检查、实验室及影像学检查。
结果
胆石症与GLP-1RAs显著相关（p = 0.033）。我们的参与者中31.2%有明显的胆石症。有症状的胆石症在胆石症患者中占60.4%。有症状的复杂性胆石症占33.3%；分别在利拉鲁肽组、司美格鲁肽组、度拉鲁肽组和对照组中占28.1%、28.1%、21.9%和21.9%。同时，观察到有症状的非复杂性胆石症占27.1%；分别在利拉鲁肽组、司美格鲁肽组、度拉鲁肽组和对照组中占34.6%、30.8%、15.4%和19.2%。度拉鲁肽组、司美格鲁肽组、利拉鲁肽组和对照组中无症状胆石症分别占36.8%、21.1%、10.5%和31.6%。具体而言，利拉鲁肽组、司美格鲁肽组和度拉鲁肽组中分别有81.1%、68%和44%的患者出现有症状的胆石症。利拉鲁肽、度拉鲁肽和司美格鲁肽导致胆石症的相对风险分别为1.2、1.3和1.4，造成伤害所需人数分别为17.25、14.69和10.96。利拉鲁肽、度拉鲁肽和司美格鲁肽导致有症状胆石症的相对风险分别为1.6、0.9和1.4，造成伤害所需人数分别为3.14、16.67和5.56。
结论
在2型糖尿病患者中，与司美格鲁肽和度拉鲁肽相比，利拉鲁肽与临床相关胆石症的风险最高相关。
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