Video capsule endoscopy (VCE) is valuable for assessing conditions like GI bleeding, anemia, and inflammatory bowel disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are prescribed for diabetes and weight loss, with their pharmacologic effects including delayed gastric emptying. This study investigates the impact of GLP-1 RA use on VCE outcomes in patients with diabetes. This retrospective cohort study involves patients with diabetes undergoing VCE while on GLP-1 RAs matched in a 1:1 ratio with control subjects, who are not on GLP-1 RAs, based on demographics and diabetes-related factors. The primary outcome was gastric transit time in VCE studies, whereas secondary outcomes were incomplete small-bowel evaluation and small-bowel transit time. In the GLP-1 RA cohort with 68 patients, 5 (7%) experienced failure to pass the video capsule through the stomach; all control subjects passed the video capsule successfully ( = .06). GLP-1 RA patients had a longer gastric transit time (99.3 ± 134.2 minutes) compared with control subjects (25.3 ± 31.6 minutes, < .001). Multivariate analysis revealed GLP-1 RA use was associated with an increased gastric transit time by 74.5 minutes (95% confidence interval, 33.8-115.2; < .001) compared with control subjects, after adjusting for relevant factors. Sixteen GLP-1 RA patients (23.5%) experienced incomplete passage of the video capsule through the small intestine, a significantly higher rate compared with 3 patients in the control group (4.4%, < .01). GLP-1 RA use is associated with a prolonged gastric transit time and a higher rate of incomplete small-bowel evaluation during VCE. Future studies may be crucial for evaluating strategies to mitigate these effects.

中文翻译：

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糖尿病患者的胰高血糖素样肽 1 受体激动剂和胶囊内窥镜检查：一项匹配队列研究


视频胶囊内窥镜 (VCE) 对于评估胃肠道出血、贫血和炎症性肠病等疾病很有价值。胰高血糖素样肽 1 受体激动剂 (GLP-1 RA) 用于治疗糖尿病和减肥，其药理作用包括延迟胃排空。本研究调查了 GLP-1 RA 使用对糖尿病患者 VCE 结局的影响。这项回顾性队列研究涉及接受 VCE 且接受 GLP-1 RA 治疗的糖尿病患者，根据人口统计学和糖尿病相关因素，与未接受 GLP-1 RA 治疗的对照受试者以 1:1 的比例进行匹配。 VCE 研究中的主要结局是胃通过时间，而次要结局是不完整的小肠评估和小肠通过时间。在包含 68 名患者的 GLP-1 RA 队列中，5 名患者 (7%) 未能通过胃部；所有对照受试者均成功通过视频胶囊 (= .06)。与对照受试者（25.3 ± 31.6 分钟，< .001）相比，GLP-1 RA 患者的胃传输时间更长（99.3 ± 134.2 分钟）。多变量分析显示，在调整相关因素后，与对照受试者相比，GLP-1 RA 的使用与胃转运时间延长 74.5 分钟相关（95% 置信区间，33.8-115.2；< .001）。 16 名 GLP-1 RA 患者 (23.5%) 经历了视频胶囊不完全通过小肠的情况，与对照组中的 3 名患者 (4.4%, < .01) 相比，发生率明显更高。 GLP-1 RA 的使用与胃转运时间延长和 VCE 期间小肠评估不完整率较高有关。未来的研究对于评估减轻这些影响的策略可能至关重要。