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. 2024 Dec 4;16(1):293.
doi: 10.1186/s13098-024-01526-2.

The relative risk of clinically relevant cholelithiasis among glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus, real-world study

Mohammed Ali Gameil  1 , Elshahat Ali Ahmed Mohamed Yousef  2 , Rehab Elsayed Marzouk  3 , Mohamed H Emara  4   5 , Abeer H Abdelkader  6 , Rasha Ibrahim Salama  6
Affiliations

The relative risk of clinically relevant cholelithiasis among glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes mellitus, real-world study

Mohammed Ali Gameil et al. Diabetol Metab Syndr. .

Abstract

Background and aim: The association between biliary disorders with weight reduction enhanced by GLP-1RAs was observed frequently, nevertheless, the relative risk of the clinically relevant cholelithiasis was not specified clearly among different GLP-1RAs.

Methods: 308 patients with type 2 diabetes mellitus (T2D) were recruited and divided into 4 groups; liraglutide, dulaglutide, semaglutide, versus control group; comprised of 69, 76, 71, and 92, respectively. Clinical history, examination, laboratory, and radiology tests were implemented.

Results: Cholelithiasis significantly associates GLP1-RAs (p = 0.033). Overall cholelithiasis was evident in 31.2% of our participants. Symptomatic cholelithiasis prevails in 60.4% of patients with cholelithiasis. Symptomatic complicated cholelithiasis prevailed in 33.3%; distributed in 28.1%, 28.1%, 21.9%, and 21.9% in liraglutide, semaglutide, dulaglutide, and control groups, respectively. Meanwhile, symptomatic uncomplicated cholelithiasis was observed in 27.1%; distributed in 34.6%, 30.8%, 15.4%, and 19.2% in Liraglutide, semaglutide, dulaglutide, and control groups, respectively. Asymptomatic cholelithiasis was noted in 36.8%, 21.1%, 10.5%, and 31.6% of patients with dulaglutide, semaglutide, liraglutide, and control groups, respectively. Specifically, 81.1%, 68%, and 44% of patients with liraglutide, semaglutide, and dulaglutide experienced symptomatic cholelithiasis. The relative risk of cholelithiasis was 1.2, 1.3, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 17.25, 14.69, and 10.96, respectively. The relative risk of symptomatic cholelithiasis was 1.6, 0.9, and 1.4 in liraglutide, dulaglutide, and semaglutide with number needed to harm of 3.14, 16.67, and 5.56, respectively.

Conclusion: Liraglutide was associated with the highest risk of clinically relevant cholelithiasis than semaglutide, and dulaglutide in patients with T2D.

Keywords: Biliary; Cholelithiasis; GLP1-receptor agonists; Relevant; Type 2 diabetes mellitus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board for Clinical Research committee of Mansoura University with approval code (No. R.22.10. 1897.R1) and with the IRB committee, Al Yousif Hospital, Alkhobar, Saudi Arabia, (AYH IRB: 02/03/2023). All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and later versions.Written informed consent was approved by the IRB and signed by all participants before enrolment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Shows the frequency of various types of clinical relevance of cholelithiasis in the study groups. Out of 308 patients included in the study, cholelithiasis was detected in 96 patients. Asymptomatic cholelithiasis was encountered in 38 patients; 14, 8, 4, and 12 patients with dulaglutide, semaglutide, liraglutide, and non-GLP1-RAs users, respectively. Symptomatic uncomplicated cholelithiasis was noticed in 26 patients; 9, 8, 4, and 5 in liraglutide, semaglutide, dulaglutide, and non-GLP1RAs users, respectively. Symptomatic complicated cholelithiasis was reported in 32 patients; 9, 9, 7, and 7 in liraglutide, semaglutide, dulaglutide, and non-GLP1RAs users, respectively
See this image and copyright information in PMC

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