Key result
GLP-1 receptor agonist use was associated with a significantly lower risk of all-cause mortality (aHR 0.48) compared to non-use in patients with type 2 diabetes.
Why the study?
Patients with T2D tend to have NAFLD with poorer prognosis, but the comparative effects of GLP-1 RA use on cardiovascular and liver-related outcomes in those without viral hepatitis were unclear.
Does GLP-1 RA use reduce cardiovascular and liver-related mortality in patients with type 2 diabetes?
Cohort (n=62,366)
Does GLP-1 RA use reduce cardiovascular and liver-related mortality in patients with type 2 diabetes?
Hazard Ratio: 0.48 (95% CI 0.43–0.53)
Absolute Event Rate: 5.67% vs 13.06%
p-value: p=<0.001
In a large real-world cohort of patients with type 2 diabetes, GLP-1 RA use was associated with significantly reduced risks of all-cause mortality, cardiovascular events, and liver-related death, though it did not significantly reduce the incidence of liver cirrhosis or hepatocellular carcinoma.
BACKGROUND: Patients with type 2 diabetes (T2D) tend to have nonalcoholic fatty liver disease (NAFLD) with poorer prognosis. We performed this research to compare the risks of cardiovascular diseases, cirrhosis, liver-related mortality, and cardiovascular mortality between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and no-use in patients with T2D without viral hepatitis. METHODS: From January 1, 2008, to December 31, 2018, we used propensity-score matching to identify 31,183 pairs of GLP-1 RA users and nonusers from Taiwan's National Health Insurance Research Database. Multivariable-adjusted Cox proportional hazards models were used to examine the outcomes between the study and control groups. RESULTS: The median (Q1, Q3) follow-up time for GLP-1 RA users and nonusers were 2.19 (1.35, 3.52) and 2.14 (1.19, 3.68) years, respectively. The all-cause mortality incidence rate was 5.67 and 13.06 per 1000 person-years for GLP-1 RA users and nonusers, respectively. Multivariable-adjusted analysis showed that GLP-1 RA use had significantly lower risks of all-cause mortality (aHR 0.48, 95%CI 0.43-0.53), cardiovascular events (aHR 0.92, 95%CI 0.86-0.99), cardiovascular death (aHR 0.57, 95%CI 0.45-0.72), and liver-related death (aHR 0.32, 95%CI 0.13-0.75). However, there was no significant difference in the risk of liver cirrhosis development, hepatic failure, and hepatocellular carcinoma compared to GLP-1 RA no-use. CONCLUSIONS: This nationwide cohort study showed that GLP-1 RA use was associated with a significantly lower risk of all-cause mortality, cardiovascular events, and cardiovascular death in patients with T2D among Taiwan population. More prospective studies are warranted to verify our results.
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Yen et al. (2024) conducted a cohort in Type 2 diabetes (n=62,366). Glucagon-like peptide-1 receptor agonists (GLP-1 RA) vs. No GLP-1 RA use was evaluated on All-cause mortality (aHR 0.48, 95% CI 0.43-0.53, p=<0.001). GLP-1 receptor agonist use was associated with a significantly lower risk of all-cause mortality (aHR 0.48) compared to non-use in patients with type 2 diabetes.
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