Pan Ssu-Yu, Weng Chien-Hsiang, Tsai Shang-Feng, Sheen Yi-Jing, Lin Hui-Ju, Tien Peng-Tai, Lin Jun-Fu, Lin Ching-Heng, Wang I-Jong, Chou Chien-Chih
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
Ophthalmol Sci. 2025 Feb 7;5(4):100734. doi: 10.1016/j.xops.2025.100734. eCollection 2025 Jul-Aug.
To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with reduced retinal vein occlusion (RVO) risk compared with dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes mellitus (T2DM).
A multinational, retrospective cohort study.
Adults with T2DM newly prescribed GLP-1RAs or DPP-4 inhibitors between 2006 and 2023 were included in our analysis.
This study leveraged data from populations across 21 countries. Propensity score matching at a 1:1 ratio balanced age, sex, race, glycated hemoglobin (HbA1c), body mass index (BMI), estimated glomerular filtration rate, medications, and comorbidities between GLP-1RA and DPP4 inhibitor users.
We observed the occurrence of incident RVO and branch RVO (BRVO) in the overall population and in subpopulations stratified by age, sex, race, GLP-1RA type, baseline HbA1c, BMI, and diabetes duration.
Among 79 486 matched participants, GLP-1RA use is associated with a lower risk of RVO (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.54-0.98) and BRVO (HR, 0.62; 95% CI, 0.41-0.95) over 5 years compared with DPP-4 inhibitor use. This association is consistent among patients aged ≥50 years, Blacks, those prescribed human-analog GLP-1RAs, and those with baseline HbA1c ≥8%, BMI ≥30 kg/m, and diabetes duration ≥3 years.
Glucagon-like peptide-1 receptor agonist use was linked to reduced RVO and BRVO risks in patients with T2DM when compared with DPP-4 inhibitor use, particularly in high-risk populations, suggesting potential benefits of GLP-1RAs over DPP-4 inhibitors in managing ocular complications in T2DM.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估与二肽基肽酶-4（DPP-4）抑制剂相比，胰高血糖素样肽-1受体激动剂（GLP-1RAs）是否与2型糖尿病（T2DM）患者视网膜静脉阻塞（RVO）风险降低相关。
一项跨国回顾性队列研究。
纳入2006年至2023年间新开具GLP-1RAs或DPP-4抑制剂处方的成年T2DM患者进行分析。
本研究利用了来自21个国家人群的数据。以1:1的比例进行倾向得分匹配，平衡了GLP-1RA使用者和DPP-4抑制剂使用者之间的年龄、性别、种族、糖化血红蛋白（HbA1c）、体重指数（BMI）、估计肾小球滤过率、用药情况和合并症。
我们观察了总体人群以及按年龄、性别、种族、GLP-1RA类型、基线HbA1c、BMI和糖尿病病程分层的亚组中RVO和分支视网膜静脉阻塞（BRVO）的发生情况。
在79486名匹配参与者中，与使用DPP-4抑制剂相比，使用GLP-1RA在5年内发生RVO（风险比[HR]，0.73；95%置信区间[CI]，0.54 - 0.98）和BRVO（HR，0.62；95% CI，0.41 - 0.95）的风险较低。这种关联在年龄≥50岁的患者、黑人、开具人源化GLP-1RAs的患者以及基线HbA1c≥8%、BMI≥30 kg/m²和糖尿病病程≥3年的患者中一致。
与使用DPP-4抑制剂相比，使用胰高血糖素样肽-1受体激动剂与T2DM患者RVO和BRVO风险降低相关，尤其是在高危人群中，这表明GLP-1RAs在管理T2DM眼部并发症方面可能比DPP-4抑制剂更具优势。
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
