胰高糖素样肽-1受体激动剂与胰腺的那些事

Glucagon-like Peptide 1 Receptor Agonists and Pancreatic Safety

胰高糖素样肽1受体激动剂(glucagon-like peptide 1 receptor agonist,GLP-1 RA)在2型糖尿病(type 2 diabetes mellitus,T2DM)治疗领域得到了广泛的应用。2006年一项关于艾塞那肽引起胰腺炎的病例报道,引起了人们对GLP-1 RA胰腺安全性的质疑。然而,由于糖尿病患者发生胰腺癌和胰腺炎的风险均高于普通人群,且胰腺癌和胰腺炎也会导致糖尿病发生,这些“证据”一直饱受争议。目前,GLP-1 RA这一类药物因降糖疗效可靠,整体安全性良好,并具有减轻体重、降低收缩压、改善血脂谱等降糖外获益,其在T2DM指南中的地位不断得到提升。为进一步系统评估GLP-1 RA的胰腺安全性,本文将全面回顾GLP-1RA有关胰腺安全性的证据。

Glucagon-like peptide 1 receptor agonists(GLP-1RA)is widely applied as in the treatment of type 2 diabetes mellitus.A case report published in 2006 that exenatide induced pancreatitis has brought numerous disputes about the safety of GLP-1RA in the pancreas.However,due to a higher risk of pancreatic cancer and pancreatitis in diabetic patients,and the fact that pancreatic cancer and pancreatitis cause diabetes,these"evidences"have been controversial.Now,the status of GLP-1RA has been improving constantly in the T2DM guidelines with its reliable hypoglycemic efficacy,safety,and other benefits such as weight loss,lowering systolic blood pressure,and improving blood lipid profile.To further evaluate the pancreatic safety of GLP-1RA systematically,this review summarized the evidence about the pancreatic safety of GLP-1RA.