GLP-1受体激动剂对2型糖尿病患者抑郁情绪和自杀念头的报告：世界卫生组织VigiBase研究
Depressed mood and suicidal thoughts reporting with GLP-1 receptor agonists in type 2 diabetes: A WHO VigiBase study.
摘要(中文译文)
关于胰高血糖素样肽-1受体激动剂（GLP-1RAs）与抑郁及自杀风险的证据仍不一致，尤其是在2型糖尿病（T2DM）合并潜在情感脆弱性的患者中。我们对WHO VigiBase（2010—2024年）进行了比例失衡分析，纳入T2DM患者。将GLP-1RAs相关的抑郁情绪和自杀意念报告与其他降糖药物进行比较。分析纳入年龄、性别、发病时间、剂量、共病抑郁及合并抗抑郁药使用。采用校正报告比值比（RORs）和Weibull时间-事件模型。使用Bradford Hill标准探讨因果关系。共识别出1,183,817例与GLP-1RA相关的不良事件。在司美格鲁肽、利拉鲁肽和替尔泊肽中观察到抑郁情绪和自杀倾向信号（校正ROR分别为2.13、1.52、1.07）及（校正ROR分别为6.76、2.43、3.39）。未发现自杀企图或自杀完成的信号。绝对报告频率较低。与其他降糖药物相比，合并抗抑郁药使用频率高2.3—5倍，共病抑郁高25%—120%。中位发病时间为96天。生存分析显示报告早期增加，随后随时间趋于稳定。对抗抑郁药使用进行校正后，关联性适度减弱。GLP-1RAs与抑郁情绪和自杀意念报告增加相关，尤其是在接受合并抗抑郁药治疗的患者中。这些发现支持以患者为中心的模型，即潜在的情感脆弱性或报告因素驱动了所报告的的情绪症状，而非统一的药物特异性效应。GLP-1RAs仍具有临床价值，但对脆弱患者早期治疗期间的精神科监测是必要的。
Abstract
Evidence regarding depression and suicidality with glucagon-like peptide-1 receptor agonists (GLP-1RAs) remains inconsistent, particularly in patients with type 2 diabetes mellitus (T2DM) and underlying affective vulnerability. We conducted a disproportionality analysis of the WHO VigiBase (2010-2024), including T2DM patients. Reports of depressed mood and suicidal thoughts associated with GLP-1RAs were compared with other glucose-lowering medications. Analyses incorporated age, sex, time-to-onset, dose, comorbid depression, and concomitant antidepressant use. Adjusted reporting odds ratios (RORs) and a Weibull time-to-event model were applied. Causality was explored using Bradford Hill criteria. A total of 1,183,817 adverse events related to GLP-1RA were identified. Depressed mood and suicidality signals were observed with semaglutide, liraglutide, and tirzepatide (adjusted ROR: 2.13, 1.52, 1.07) and (adjusted ROR: 6.76, 2.43, 3.39), respectively. No signal was identified for suicide attempts or completed suicide. Absolute reporting frequencies were low. Concomitant antidepressant use was 2.3-5 times more frequent, and comorbid depression 25%-120% higher, compared with other glucose-lowering medications. Median time-to-onset was 96 days. Survival analysis demonstrated an early increase in reporting followed by stabilization over time. Adjustment for antidepressant use modestly attenuated associations. GLP-1RAs were associated with increased reporting of depressed mood and suicidal thoughts, particularly in patients receiving concomitant antidepressants. These findings support a patient-centered model in which underlying affective vulnerability or reporting factors drive reported mood symptoms rather than a uniform drug-specific effect. GLP-1RAs remain clinically valuable, but psychiatric monitoring during early treatment in vulnerable patients is warranted.
如何引用
AMA
Mohammed Aboukaoud, Bosmat Hoch, Mark Weiser, Revital Amiaz. Depressed mood and suicidal thoughts reporting with GLP-1 receptor agonists in type 2 diabetes: A WHO VigiBase study.. Journal of affective disorders. 2026; doi:10.1016/j.jad.2026.121802.
APA
Mohammed Aboukaoud, Bosmat Hoch, Mark Weiser, Revital Amiaz (2026). Depressed mood and suicidal thoughts reporting with GLP-1 receptor agonists in type 2 diabetes: A WHO VigiBase study.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2026.121802
GB/T 7714
Mohammed Aboukaoud, Bosmat Hoch, Mark Weiser, Revital Amiaz. Depressed mood and suicidal thoughts reporting with GLP-1 receptor agonists in type 2 diabetes: A WHO VigiBase study.[J]. Journal of affective disorders, 2026 doi:10.1016/j.jad.2026.121802.
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