葡萄糖类-1受体激活剂和胃肠道不良事件:系统性审查和元分析
Cho-Hung Chiang1, Aunchalee Jaroenlapnopparat2, Sena Cakir Colak3
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Gastroenterology
|June 11, 2025
概括
类似葡萄糖-1受体激动剂 (GLP-1RAs) 可能会增加胆结石和酸性逆流的风险. 这次元分析发现,GLP-1RA使用时,其他严重的胃肠道或胆道事件没有显著增加.
科学领域:
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
- 代谢疾病 代谢疾病
背景情况:
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 通常用于2型糖尿病 (T2DM) 和体重管理.
- 有关与GLP-1RA使用相关的潜在严重胃肠道不良事件存在担忧,但现有证据不一致.
研究的目的:
- 系统地评估GLP-1RAs与各种胃肠道和胆道不良事件之间的关联.
- 综合来自安慰剂对照随机对照试验 (RCT) 的证据,以澄清安全性.
主要方法:
- 在五个数据库中对安慰剂控制的RCT进行了系统的文献搜索.
- 包括涉及T2DM,超重/肥胖或非酒精性脂肪性肝炎 (NASH) /代谢功能障碍相关的脂肪性肝病 (MASLD) 患者的试验.
- 用随机效应模型进行了元分析,并进行了子组分析以探索风险因素.
主要成果:
- 分析包括55个RCT,其中有106,395名参与者.
- 与安慰剂相比,GLP-1RA显著增加了胆病 (胆结石) 和胃食道逆流病 (GERD) 的风险.
- 没有观察到其他胃肠道或胆道事件的显著增加,尽管子组分析表明了特定种群和配方的趋势.
结论:
- GLP-1受体激动剂与患上胆结石和GERD的风险增加有关.
- 使用GLP-1RA似乎不会显著增加其他胃肠道或胆道不良事件的风险.
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