| アブストラクト | BACKGROUND AND AIMS: Thiazolidinediones (TZDs) and glucagon-like peptide-1 (GLP-1) receptor agonists are potential pharmacological treatment options for patients at risk of NAFLD. Therefore, we examined the association between the risk of NAFLD and the use of TZDs and GLP-1 receptor agonists compared with the use of sulfonylureas (SUs) and insulins. Additionally, we calculated the incidence of HCC in users of TZDs and GLP-1 receptor agonists. APPROACH AND RESULTS: We conducted a population-based cohort study using primary care data from the Clinical Practice Research Datalink database (2007-2018). All patients aged >/=18 with a prescription of an oral glucose-lowering agent or GLP-1 receptor agonist were included. The first prescription defined the start of follow-up. The primary outcome was a new diagnosis of NAFLD. Cox proportional hazards regression was used to estimate HRs and 95% CIs of the primary outcome. Incidence rates of HCC were determined per 1,000 person-years for all exposures. The study identified 207,367 adults with a prescription for a glucose-lowering agent. The risk of NAFLD was lower in patients prescribed a TZD than in those prescribed an SU (adjusted HR [aHR], 0.32; 95% CI, 0.20-0.51). No difference in risk of NAFLD was observed comparing GLP-1 receptor agonist use with insulin use (aHR, 1.22; 95% CI, 0.91-1.63). CONCLUSIONS: Results of our study endorse the use of TZDs for selected patients at risk of NAFLD but do not support previous findings regarding the beneficial effect of GLP-1 receptor agonists. The low number of events in several subgroups may affect the generalizability of the current findings. |
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| 投稿日 | 2021/6/16 |
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| 投稿者 | van Dalem, Judith; Driessen, Johanna H M; Burden, Andrea M; Stehouwer, Coen D A; Klungel, Olaf H; de Vries, Frank; Brouwers, Martijn C G J |
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| ジャーナル名 | Hepatology (Baltimore, Md.) |
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| 組織名 | Department of Clinical Pharmacy & Toxicology, Maastricht University Medical;Centre+, Maastricht, the Netherlands.;CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the;Netherlands.;Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of;Pharmaceutical Sciences, Utrecht, the Netherlands.;NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht;University, Maastricht, the Netherlands.;Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical;Sciences, ETH Zurich, Zurich, Switzerland.;Department of Internal Medicine, Maastricht University Medical Centre+,;Maastricht, the Netherlands.;Department of Internal Medicine, Division of Endocrinology and Metabolic Disease,;Maastricht University Medical Centre+, Maastricht, the Netherlands. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34129693/ |
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