Almuammar Sarah A, Alzahrani Hani K
From the Department of Family Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi Med J. 2025 Aug;46(8):907-912. doi: 10.15537/smj.2025.46.8.20240100.
To investigate the hematological impact of Glucagon-like peptide-1 (GLP-1) analogs, specifically changes in hemoglobin and ferritin levels. Glucagon-like peptide-1 analogs, pivotal in managing type 2 diabetes mellitus (T2DM) and obesity, exhibit diverse physiological effects. While their impact on glycemic control is well-established, understanding their influence on hematological parameters remains an active area of investigation.
A cohort of 700 patients prescribed GLP-1 analogs between March 2021 and October 2022 was analyzed. Demographic data, baseline hemoglobin, ferritin levels, and subsequent measurements were collected. Statistical analyses included descriptive statistics, Wilcoxon signed-rank tests, Mann-Whitney U tests, subgroup analyses, and multivariable logistic regression.
Following GLP-1 analog initiation, a statistically significant decrease in hemoglobin levels was observed (median decrease: 0.2 g/dL), with 59 patients (8.4%) developing anemia. Ferritin levels showed no significant change. Subgroup analyses by gender and medication type revealed no significant differences in hemoglobin changes. Baseline hemoglobin demonstrated a significant inverse association with anemia development (OR=0.31, 95% CI: 0.21-0.44, <0.01).
This study contributes valuable insights into the complex interplay between GLP-1 analogs and hematological parameters. Clinicians should be aware of potential hematological effects, with baseline hemoglobin levels serving as a valuable predictor of anemia risk. Future prospective studies are warranted to deepen understanding and refine clinical strategies in the use of GLP-1 analogs.
研究胰高血糖素样肽-1(GLP-1)类似物对血液学的影响,特别是血红蛋白和铁蛋白水平的变化。GLP-1类似物在2型糖尿病(T2DM)和肥胖症的管理中起着关键作用,具有多种生理效应。虽然其对血糖控制的影响已得到充分证实,但了解其对血液学参数的影响仍是一个活跃的研究领域。
分析了2021年3月至2022年10月期间700例使用GLP-1类似物的患者队列。收集了人口统计学数据、基线血红蛋白、铁蛋白水平及后续测量值。统计分析包括描述性统计、Wilcoxon符号秩检验、Mann-Whitney U检验、亚组分析和多变量逻辑回归。
开始使用GLP-1类似物后,观察到血红蛋白水平有统计学意义的下降(中位数下降:0.2 g/dL),59例患者(8.4%)发生贫血。铁蛋白水平无显著变化。按性别和药物类型进行的亚组分析显示血红蛋白变化无显著差异。基线血红蛋白与贫血发生呈显著负相关(OR=0.31,95%CI:0.21-0.44,<0.01)。
本研究为GLP-1类似物与血液学参数之间的复杂相互作用提供了有价值的见解。临床医生应意识到潜在的血液学影响,基线血红蛋白水平可作为贫血风险的重要预测指标。未来有必要进行前瞻性研究,以加深理解并完善GLP-1类似物的临床应用策略。