Beyond Glycemic Control: GLP-1 Receptor Agonists and Their Impact on Calcium Homeostasis in Real-World Patients

被引:0
作者
Alenezi, Bandar T. [1 ]
Elfezzani, Nadra [2 ]
Uddin, Rukhsana [3 ]
Patel, Hinali [4 ]
Chester, Sydney [5 ]
Abdelmaksoud, Ahmed [6 ]
Hussein, Mohammad H. [7 ]
Zaitone, Sawsan A. [8 ]
Fawzy, Manal S. [9 ,10 ]
Aiash, Hani [11 ]
Toraih, Eman A. [12 ,13 ]
机构
[1] Northern Border Univ, Fac Med, Dept Pharmacol, Ar Ar 91431, Saudi Arabia
[2] Tulane Sch Publ Hlth & Trop Med, New Orleans, LA 70112 USA
[3] Khyber Med Univ Peshawar, Women Med & Dent Coll, Abbottabad 22080, Pakistan
[4] Louisiana State Univ, Sch Med, New Orleans, LA 70112 USA
[5] Tulane Univ, Sch Med, New Orleans, LA 70112 USA
[6] Univ Calif Riverside, Dept Internal Med, Riverside, CA 92521 USA
[7] Ochsner Clin Fdn, Dept Family Med, New Orleans, LA 70112 USA
[8] Univ Tabuk, Fac Pharm, Dept Pharmacol & Toxicol, Tabuk 71491, Saudi Arabia
[9] Northern Border Univ, Fac Med, Dept Biochem, Ar Ar 91431, Saudi Arabia
[10] Northern Border Univ, Ctr Hlth Res, Ar Ar 91431, Saudi Arabia
[11] SUNY Upstate Med Univ, Syracuse, NY 13210 USA
[12] Tulane Univ, Sch Med, Dept Surg, New Orleans, LA 70112 USA
[13] Suez Canal Univ, Dept Histol & Cell Biol, Med Genet Unit, Ismailia 41522, Egypt
关键词
GLP-1R agonists; type; 2; diabetes; obesity; calcium homeostasis; propensity-matched controls; cardiovascular events; all-cause mortality; personalized treatment; long-term safety; healthcare utilization; GLUCAGON-LIKE PEPTIDE-1; BONE-MINERAL DENSITY; EXENDIN-4; LIRAGLUTIDE; METABOLISM;
D O I
10.3390/jcm13164896
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Objectives: The effect of glucagon-like peptide-1 receptor (GLP-1R) agonists on calcium homeostasis is poorly understood. This study aimed to investigate the association between GLP-1R agonist use and the risk of hypocalcemia and/or hypercalcemia, as well as other clinical outcomes. Methods: A retrospective cohort study used de-identified patient data from the TriNetX Global Collaborative Network, including 15,655 adult patients prescribed GLP-1R agonists and 15,655 propensity-matched controls. Outcomes included hypocalcemia, hypercalcemia, emergency visits, hospitalizations, cardiovascular events, and all-cause mortality. Results: GLP-1R agonist use was associated with a reduced risk of hypocalcemia (2.7% vs. 5.5%, RR 0.49, 95% CI: 0.44-0.55) but an increased risk of hypercalcemia (2.3% vs. 1.1%, RR 2.02, 95% CI: 1.69-2.42). The effect on hypocalcemia was most pronounced during the first six months of treatment. Among individual agents, tirzepatide showed the most pronounced effect, reducing hypocalcemia risk by 63% while increasing hypercalcemia risk by 85%. Semaglutide demonstrated similar effects, while dulaglutide and liraglutide showed modest effects. Furthermore, GLP-1R agonist use was associated with reduced risks of emergency visits (RR 0.57, 95% CI: 0.54-0.60), hospitalizations (RR 0.40, 95% CI: 0.36-0.44), cardiovascular events, and all-cause mortality (HR 0.27, 95% CI: 0.21-0.36). Conclusions: GLP-1R agonists exhibit a complex influence on calcium homeostasis, reducing hypocalcemia risk while increasing hypercalcemia risk. Beyond calcium regulation, these medications significantly reduce healthcare utilization, improve cardiovascular outcomes, and decrease mortality. Further research is needed to elucidate the mechanisms behind the differential effects of individual GLP-1R agonists, particularly tirzepatide, to optimize personalized treatment approaches and long-term safety.
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页数:14
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