GLP-1受体激活剂和视神经或视力威胁事件的风险在2型糖尿病或心脏代谢疾病患者:随机对照试验的元分析
Hoi-Ying Li1, Tsz-Kwan Chan1, Kendrick Co Shih2
1Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
Diabetes care
|January 26, 2026
概括
葡萄糖类1受体激动剂 (GLP-1RA) 不会增加患有2型糖尿病或心脏代谢疾病的患者的视神经或视力威胁事件的风险. 这一对随机对照试验的元分析证实了它们在视力健康方面的安全性.
科学领域:
- 内分泌学 在内分泌学.
- 眼科医生 眼科 眼科
- 临床药理学 临床药理学
背景情况:
- 关于葡萄糖类1受体激动剂 (GLP-1RA) 与缺血性视神经病变 (ION) 风险之间的关联,存在相互矛盾的数据.
- 了解GLP-1RA的眼部安全概况对于治疗2型糖尿病和心脏代谢疾病的患者至关重要.
研究的目的:
- 综合随机对照试验 (RCT) 关于与GLP-1RA相关的视神经风险或视力威胁事件的证据.
- 为了评估GLP-1RA在2型糖尿病或心脏代谢疾病患者的安全性,关于视觉不良事件.
主要方法:
- 20个已发表的RCT的系统审查和元分析,涉及83,288名患有2型糖尿病或心脏代谢疾病的参与者.
- 根据系统审查和元分析 (PRISMA) 准则的首选报告项目进行了数据分析.
- 主要结局是影响视神经和/或视力的严重不良事件的组合,包括ION,并得出几率比率 (OR).
主要成果:
- GLP-1 RA使用与初级复合终点 (OR 1.20,95% CI 0.73-1.97) 的风险增加无关.
- 个别不良事件,包括ION (OR 1.50,95% CI 0.49-4.63) 和视力损失/视力障碍事件 (OR 1.08,95% CI 0.60-1.94),与GLP-1 RA使用没有显著联系.
- 分析包括240,334个患者年数据,平均随访时间为2.97年.
结论:
- 在患有2型糖尿病和心脏代谢疾病的患者中,GLP-1RA与视神经或视力威胁事件的风险增加无关.
- 在包含的RCT中,视力威胁事件被报告为不良事件,而不是预先指定的结果.
- 这项大规模的元分析支持GLP-1RA在相关患者群体中的眼睛安全性.
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