Factors associated with gastrointestinal side effects after liraglutide treatment for type 2 diabetes.
Factors associated with gastrointestinal side effects after liraglutide treatment for type 2 diabetes.
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利拉鲁肽治疗2型糖尿病后胃肠道副作用的相关因素
DOI：
10.3389/fendo.2023.1098032
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发表时间：
2023
影响因子：
5.2
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中科院分区：
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确定可预测利拉鲁肽在2型糖尿病（T2 DM）患者中的胃肠道副作用（GISE）或与之相关的风险因素。获得首次接受利拉鲁肽治疗的T2 DM患者，并将其分为无GSEA的患者和有GSEA的患者。基线变量，包括年龄，性别，体重指数（BMI），丙氨酸氨基转移酶，血清肌酐，甲状腺激素，口服降糖药和胃肠道疾病史，进行了测试，可能与GSEA的结果。将重要变量输入单变量和多变量logistic回归（前向LR）分析。受试者工作特征（ROC）曲线，以确定临床上有用的截止值。本研究共纳入254例患者（95例女性）。74例（29.13%）报告GSEA，11例（4.33%）停止治疗。单因素分析结果显示，性别、年龄、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸、α-葡萄糖苷酶抑制剂（AGI）、合并胃肠道疾病与GSEA的发生有关（均P <0.05）。在最终的回归模型中，AGI使用（校正OR=4.01，95%CI：1.90-8.45，p<0.001），胃肠道疾病（调整OR=3.29，95%CI：1.51-7.18，p=0.003），TSH（调整OR=1.79，95%CI：1.28-2.50，p=0.001）和男性（调整OR=0.19，95%CI：0.10-0.37，p<0.001）与GSEA独立相关。此外，ROC曲线分析证实，女性和男性的TSH值分别为1.33和2.30，是预测GSEA的有用阈值。本研究表明，AGI、伴随胃肠道疾病、女性和较高TSH水平的组合是T2 DM患者中利拉鲁肽治疗GSEA的独立风险因素。需要进一步的研究来阐明这些相互作用。
To identify risk factors predictive of or associated with gastrointestinal side effects (GISE) of liraglutide in patients with type 2 diabetes (T2DM). T2DM patients treated with liraglutide for the first time were obtained and grouped into patients without GSEA and patients with GSEA. Baseline variables, including age, sex, body mass index (BMI), glycemia profiles, alanine aminotransferase, serum creatinine, thyroid hormones, oral hypoglycemic drugs and history of gastrointestinal diseases, were tested for possible associations with GSEA outcome. Significant variables were entered into univariate and multivariate logistic regression (forward LR) analyses. Receiver operating characteristic (ROC) curves to determine clinically useful cutoff values. A total of 254 patients (95 female) were included in this study. 74 cases (29.13%) reported GSEA and 11 cases (4.33%) discontinued treatment. The results of univariate analyses showed that sex, age, thyroid stimulating hormone (TSH), free triiodothyronine, α-glucosidase inhibitor (AGI), and concomitant gastrointestinal diseases were associated with GSEA occurrence (all p <0.05). In the final regression model, AGI use (adjusted OR=4.01, 95%CI: 1.90-8.45, p<0.001), gastrointestinal diseases (adjusted OR=3.29, 95%CI: 1.51-7.18, p=0.003), TSH (adjusted OR=1.79, 95%CI: 1.28-2.50, p=0.001) and male sex (adjusted OR=0.19, 95%CI: 0.10-0.37, p<0.001) were independently associated with GSEA. Furthermore, ROC curve analysis confirmed that TSH values of 1.33 and 2.30 in females and males, respectively, were useful thresholds for predicting GSEA. This study suggests that the combination of AGI, concomitant gastrointestinal diseases, female sex and higher TSH levels are independent risk factors of GSEA of liraglutide treatment in patients with T2DM. Further research is warranted to elucidate these interactions.