Factors associated with gastrointestinal side effects after liraglutide treatment for type 2 diabetes

Hao Wu; Zongshi Lu; Runyao Chen; Quanfang Cai; Miaomiao Wang; Liting Zhang; Zhiming Zhu

doi:10.3389/fendo.2023.1098032

Factors associated with gastrointestinal side effects after liraglutide treatment for type 2 diabetes

Front Endocrinol (Lausanne). 2023 Jan 30:14:1098032. doi: 10.3389/fendo.2023.1098032. eCollection 2023.

Authors

Hao Wu^{1

2}, Zongshi Lu², Runyao Chen¹, Quanfang Cai¹, Miaomiao Wang¹, Liting Zhang¹, Zhiming Zhu²

Affiliations

¹ Department of Endocrinology, the 910th Hospital of Chinese People's Liberation Army, Quanzhou, China.
² Department of Hypertension and Endocrinology, Daping Hospital, Army Military Medical University, Chongqing, China.

Abstract

Aim: To identify risk factors predictive of or associated with gastrointestinal side effects (GISE) of liraglutide in patients with type 2 diabetes (T2DM).

Methods: T2DM patients treated with liraglutide for the first time were obtained and grouped into patients without GSEA and patients with GSEA. Baseline variables, including age, sex, body mass index (BMI), glycemia profiles, alanine aminotransferase, serum creatinine, thyroid hormones, oral hypoglycemic drugs and history of gastrointestinal diseases, were tested for possible associations with GSEA outcome. Significant variables were entered into univariate and multivariate logistic regression (forward LR) analyses. Receiver operating characteristic (ROC) curves to determine clinically useful cutoff values.

Results: A total of 254 patients (95 female) were included in this study. 74 cases (29.13%) reported GSEA and 11 cases (4.33%) discontinued treatment. The results of univariate analyses showed that sex, age, thyroid stimulating hormone (TSH), free triiodothyronine, α-glucosidase inhibitor (AGI), and concomitant gastrointestinal diseases were associated with GSEA occurrence (all p <0.05). In the final regression model, AGI use (adjusted OR=4.01, 95%CI: 1.90-8.45, p<0.001), gastrointestinal diseases (adjusted OR=3.29, 95%CI: 1.51-7.18, p=0.003), TSH (adjusted OR=1.79, 95%CI: 1.28-2.50, p=0.001) and male sex (adjusted OR=0.19, 95%CI: 0.10-0.37, p<0.001) were independently associated with GSEA. Furthermore, ROC curve analysis confirmed that TSH values of 1.33 and 2.30 in females and males, respectively, were useful thresholds for predicting GSEA.

Conclusion: This study suggests that the combination of AGI, concomitant gastrointestinal diseases, female sex and higher TSH levels are independent risk factors of GSEA of liraglutide treatment in patients with T2DM. Further research is warranted to elucidate these interactions.

Keywords: gastrointestinal side effects; liraglutide; risk factors; thyroid stimulating hormone; type 2 diabetes mellitus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2* / complications
Drug-Related Side Effects and Adverse Reactions*
Female
Gastrointestinal Diseases* / chemically induced
Humans
Liraglutide / adverse effects
Male
Risk Factors
Thyrotropin

Substances

Liraglutide
Thyrotropin

Grants and funding

This study was supported by the National Natural Science Foundation of China (81630015, 31900820, 81721001) and Quanzhou Science and Technology Project Foundation (Grant No. 2021N164S).