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Meta-Analysis
. 2022 Jul 11:13:927859.
doi: 10.3389/fendo.2022.927859. eCollection 2022.

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Weiting Hu  1 , Rui Song  1 , Rui Cheng  2 , Caihong Liu  3 , Rui Guo  3 , Wei Tang  2 , Jie Zhang  2 , Qian Zhao  2 , Xing Li  2 , Jing Liu  2
Affiliations
Meta-Analysis

Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials

Weiting Hu et al. Front Endocrinol (Lausanne). .

Abstract

The association between glucagon-like peptide-1 (GLP-1) receptor agonists and the risk of various kinds of thyroid disorders remains uncertain. We aimed to evaluate the relationship between the use of GLP-1 receptor agonists and the occurrence of 6 kinds of thyroid disorders. We searched PubMed (MEDLINE), EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science from database inception to 31 October 2021 to identify eligible randomized controlled trials (RCTs). We performed meta-analysis using a random-effects model to calculate risk ratios (RRs) and 95% confidence intervals (CIs). A total of 45 trials were included in the meta-analysis. Compared with placebo or other interventions, GLP-1 receptor agonists' use showed an association with an increased risk of overall thyroid disorders (RR 1.28, 95% CI 1.03-1.60). However, GLP-1 receptor agonists had no significant effects on the occurrence of thyroid cancer (RR 1.30, 95% CI 0.86-1.97), hyperthyroidism (RR 1.19, 95% CI 0.61-2.35), hypothyroidism (RR 1.22, 95% CI 0.80-1.87), thyroiditis (RR 1.83, 95% CI 0.51-6.57), thyroid mass (RR 1.17, 95% CI 0.43-3.20), and goiter (RR 1.17, 95% CI 0.74-1.86). Subgroup analyses and meta-regression analyses showed that underlying diseases, type of control, and trial durations were not related to the effect of GLP-1 receptor agonists on overall thyroid disorders (all P subgroup > 0.05). In conclusion, GLP-1 receptor agonists did not increase or decrease the risk of thyroid cancer, hyperthyroidism, hypothyroidism, thyroiditis, thyroid mass and goiter. However, due to the low incidence of these diseases, these findings need to be examined further.

Systematic review registration: PROSPERO https://www.crd.york.ac.uk/prospero/, identifier: CRD42021289121.

Keywords: GLP-1 receptor agonists; meta-analysis; randomized controlled trials; thyroid cancer; thyroid disorders.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Summary of trial selection.
Figure 2
Figure 2
Forest plot of GLP-1 receptor agonists versus comparators on risk of overall thyroid disorders. GLP-1RAs, GLP-1 receptor agonists; RR, risk ratios; CI, confidence interval.
Figure 3
Figure 3
Forest plot of specific GLP-1 receptor agonists versus comparators on risk of overall thyroid disorders. GLP-1RAs, GLP-1 receptor agonists; RR, risk ratios; CI, confidence interval.
Figure 4
Figure 4
Subgroup analyses of the effects of GLP-1 receptor agonists on the risk of overall thyroid disorders. P value calculated by χ2 statistics is shown. Statistical significance of results from meta-regression was consistent.
See this image and copyright information in PMC

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