在患有2型糖尿病的患者中,GLP-1受体激活剂和视力威胁的眼科并发症
David J Ramsey1,2,3, Bhargav Makwana4, Sourbha S Dani5
1Division of Ophthalmology, Department of Surgery, UMass Chan-Lahey School of Medicine, Burlington, Massachusetts.
JAMA network open
|August 11, 2025
概括
类似葡萄糖-1受体激动剂 (GLP-1RA) 可能会增加糖尿病视网膜病变 (DR) 的风险,但会减少危及视力的DR并发症. 患有GLP-1RA的2型糖尿病患者需要定期监测DR和相关问题.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 葡萄糖类-1受体激动剂 (GLP-1RA) 越来越多地用于2型糖尿病 (T2D).
- 据传,GLP-1RA与糖尿病视网膜病变 (DR) 和非动脉炎前部缺血性视神经病变 (NAION) 有关.
- 与GLP-1RA相关的视力威胁并发症的风险仍未得到充分研究.
研究的目的:
- 调查GLP-1 RA使用与DR,NAION或DR并发症发生率在T2D患者之间的关联.
- 评估GLP-1RA对危及视力的DR并发症的影响.
主要方法:
- 使用TrinetX数据库进行的回顾性队列研究 (2015年1月至2022年9月).
- 患有T2D的成年人 (HbA1c ≥6.5%) 的倾向性得分与GLP-1 RA用户和非用户相匹配.
- 考克斯的比例危险回归模型评估了两年后续的结果.
主要成果:
- GLP-1 RA使用与DR发病率的适度增加有关 (HR,1.07;95% CI,1.03-1.11).
- 没有观察到NAION风险的显著差异 (HR,1.26;95% CI,0.94-1.70).
- 在先前存在DR的患者中,GLP-1RA与较少的视力威胁并发症 (如玻璃体出血,新血管玻璃瘤和失明) 有关.
结论:
- 在T2D中使用GLP-1 RA与DR发病率的增加有关,但视力威胁DR并发症的减少.
- 无论之前的DR状态如何,GLP-1RA患者都需要定期查和监测T2D相关的眼睛并发症.
- 这些发现凸显了GLP-1RA和DR结果之间的复杂关系.
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