Effect of glucagon-like peptide-1 receptor agonists on gastric mucosal visibility during upper endoscopy in Asian patients with diabetes
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used to treat type 2 diabetes mellitus (T2DM) and obesity. Although GLP-1RAs delay gastric emptying, their impact on gastric mucosal visibility during upper endoscopy remains uncertain, especially in Asian patients. AIM To investigate the association between GLP-1RA treatment and gastric mucosal visibility during upper endoscopy in Asian patients with T2DM. METHODS The study population included Korean patients who underwent esophagogastroduodenoscopy (EGD) with concomitant GLP-1RA or dipeptidyl peptidase 4 inhibitor (DPP4i) for the treatment of T2DM. A 1:2 propensity score matching between GLP-1RA and DPP4i users resulted in 198 matched patients and 295 matched patients in each group, respectively. Gastric mucosal visibility was assessed by reviewing endoscopy images with a validated scale (POLPREP). In addition, the rates of aborted and repeat EGD and pulmonary aspiration were also assessed. RESULTS Of the 493 matched patients, mean body mass index was 26.0 kg/m2. The rate of inadequate gastric mucosal visibility (gastric POLPREP score 0 or 1) was significantly higher in GLP-1RA group than matched DPP4i group (8.6% vs 1.4%, P = 0.0007). The rates of aborted EGD and repeat EGD were also significantly higher in GLP-1RA than DPP4i group (7.6% vs 0.7% in both aborted and repeat EGD, P = 0.0011). Multivariable logistic regression revealed GLP-1RA use as an independent risk factor for both inadequate gastric mucosal visibility (odds ratio = 6.143, 95% confidence interval: 2.289, 20.318, P = 0.0008) and aborted EGD (odds ratio = 11.099, 95% confidence interval: 3.172, 63.760, P = 0.0010). Despite gastric residue, no pulmonary aspiration was reported in either group. CONCLUSION GLP-1RA use was associated with a higher risk of inadequate gastric mucosal visibility and aborted and repeat procedures during upper gastrointestinal endoscopy in Korean patients with T2DM while pulmonary aspiration was not observed.
Source: World Journal of Diabetes
Authors: Young Eun Oh, Tae-Se Kim, Sang Ah Chi, Hyun Jung Park, Yang Won Min, Hyuk Lee, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim, Byung-Hoon Min
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417261682