Glucagon-like peptide-1 receptor agonist use is associated with a lower risk of major adverse liver-related outcomes: a meta-analysis of observational cohort studies.

However, the impact of GLP-1RAs on the long-term risk of major adverse liver-related outcomes (MALOs) remains uncertain.

然而，GLP-1RAs对长期主要不良肝相关结果（MALOs）风险的影响仍然不确定。

We performed a meta-analysisof observational cohort studies to quantify the magnitude and direction of the association between GLP-1RA use and MALOs in people with type 2 diabetes (T2D).

我们对观察性队列研究进行了荟萃分析，以量化GLP-1RA使用与2型糖尿病（T2D）患者主要不良低血糖事件（MALOs）之间的关联程度和方向。

Methods

We systematically searched eligible cohort studies comparing GLP-1RA new users versus users of other glucose-lowering medications.

我们系统地检索了比较GLP-1RA新用户与其他降糖药物使用者的合格队列研究。

The primary outcome was the cumulative incidencerates of MALOs.

主要结果是MALOs的累积发生率。

Secondary outcomes included hepatic decompensation events, hepatocellular carcinoma (HCC) and liver-related mortality.

次要结果包括肝功能失代偿事件、肝细胞癌（HCC）和与肝相关的死亡率。

Random-effects models were used to calculate incidencerate ratios (IRRs).

使用随机效应模型来计算发病率比（IRRs）。

Results

11 retrospective cohort studies with aggregate data on 1 467 220 patients with T2D (647 903 GLP-1RA new users, 819 317 non-users) were included.

纳入了11项回顾性队列研究，这些研究汇总了1,467,220名2型糖尿病患者的资料（647,903名GLP-1RA新用户和819,317名非用户）。

GLP-1RA use was significantly associated with a lower risk of MALOs (IRR 0.71, 95% CI 0.57 to 0.88) and hepatic decompensation (IRR 0.70, 95% CI 0.52 to 0.94).

GLP-1RA的使用与较低的MALOs发生风险显著相关（IRR 0.71，95% CI 0.57至0.88）和肝功能失代偿（IRR 0.70，95% CI 0.52至0.94）。

Association with reduced risk of HCC was also observed (IRR 0.82, 95% CI 0.61 to 1.11).

与降低HCC风险的关联也被观察到（IRR 0.82，95% CI 0.61至1.11）。

Compared with other antidiabetic medications, GLP-1RAs showed superior effectiveness versus SGLT2 inhibitors in preventing MALOs (IRR 0.93, 95% CI 0.87 to 0.99), versus DPP-4 inhibitors in preventing hepatic decompensation (IRR 0.74, 95% CI 0.66 to 0.83) and versus insulin therapy in preventing HCC (IRR 0.32, 95% CI 0.13 to 0.80).

与其他抗糖尿病药物相比，GLP-1RAs在预防MALOs方面比SGLT2抑制剂更有效（IRR 0.93，95% CI 0.87至0.99），在预防肝功能失代偿方面比DPP-4抑制剂更有效（IRR 0.74，95% CI 0.66至0.83），在预防HCC方面比胰岛素治疗更有效（IRR 0.32，95% CI 0.13至0.80）。

Conclusions

GLP-1RA use is associated with a lower risk of liver-related complications and hepatic decompensation in people with T2D.

GLP-1RA的使用与2型糖尿病患者肝相关并发症和肝功能失代偿的较低风险相关。

These findings suggest a role of GLP-1RAs in preventing liver-related complications beyond their beneficial cardiometabolic effects.

这些发现表明，GLP-1RAs在预防与肝脏相关的并发症方面可能发挥作用，超出了它们对心血管代谢有益效果的范围。