Article record

GLP-1受体激动剂治疗阻塞性睡眠呼吸暂停：随机对照试验的荟萃分析。

GLP-1 receptor agonists for obstructive sleep apnea: a meta-analysis of randomized controlled trials.

综述 Meta咽喉科IF 2.8Q3

文献信息

PMID	42837024
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Giulia Carvalhal 查看其他 6 位作者 Maria Meritxell Roca Mora；Gonzalo Alberto Peralta-Jiménez；Laith Ayasa；Vivian Barrera；Kavita Advani；Jafar Aljazeeri
作者单位	Federal University of Campina Grande, Paraíba, Brazil. 查看其他 9 条单位信息 International University of Catalonia, Barcelona, Spain.；Health Service of Arica and Parinacota, Arica, Chile.；Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.；Harvard Medical School, Boston, MA, USA.；Changi General Hospital, Simei, Singapore.；University of Connecticut School of Medicine, Connecticut, USA.；Medical City Hospital for Military and Security Services, Muscat, Oman. aljazeerij@upmc.edu.；Drexel University College of Medicine, Philadelphia, PA, USA. aljazeerij@upmc.edu.；University of Pittsburgh Medical Center, Harrisburg, PA, USA. aljazeerij@upmc.edu.
期刊	Sleep & breathing = Schlaf & Atmung
SCI 分区	Q3
IF	2.8
研究类型	综述 Meta · 临床
所属专科	咽喉科

中文摘要

目的： 建议所有超重和肥胖的阻塞性睡眠呼吸暂停（OSA）患者减轻体重。基于胰高血糖素样肽-1（GLP-1）受体激动剂的疗法已显示出减轻体重的临床获益，并可能改善OSA结局。我们旨在分析基于GLP-1受体激动剂的疗法在中重度OSA患者中的疗效和安全性。
方法： 我们对比较基于GLP-1受体激动剂的疗法与对照治疗成人中重度OSA的随机对照试验（RCT）进行了系统评价和荟萃分析。我们系统检索了截至2025年2月10日的电子数据库和注册库。评估的结局包括呼吸暂停低通气指数（AHI）、体重、氧减饱和度指数（ODI）、最低氧饱和度、收缩压（SBP）、舒张压（DBP）和不良事件。
结果： 共纳入6项RCT，涉及1,069名参与者，其中四项评估利拉鲁肽，两项评估替尔泊肽。与对照相比，基于GLP-1受体激动剂的疗法使AHI降低-9.99次/小时（95% CI，-16.47至-3.50；p < 0.01；I2 = 87%），体重降低-9.68 kg（95% CI，-15.84至-3.51；p < 0.01；I2 = 98%）。这些疗法还使SBP降低-4.77 mmHg（95% CI，-7.04至-2.51；p < 0.01），DBP降低-1.41 mmHg（95% CI，-2.71至-0.11；p = 0.03）。在ODI或最低氧饱和度方面未观察到显著差异。基于GLP-1受体激动剂的疗法未增加不良事件风险。
结论： 基于GLP-1受体激动剂的疗法在研究人群中降低了AHI和体重。显著的异质性限制了对合并效应量的解释。这些发现支持其在OSA综合管理中的潜在作用，但并未确立其可替代CPAP。
注册： 国际前瞻性系统评价注册库；编号：CRD42024564018；网址：https://www.crd.york.ac.uk/prospero/ 。

英文摘要

PURPOSE: Weight reduction is recommended in all overweight and obese patients with obstructive sleep apnea (OSA). Glucagon-like peptide-1 (GLP-1) receptor agonists-based therapies have demonstrated clinical benefits in reducing weight and could potentially improve OSA outcomes. We aim to analyze the efficacy and safety of GLP-1 receptor agonists-based therapies in patients with moderate-to-severe OSA.
METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared GLP-1 receptor agonists-based therapies versus control in adults with moderate-to-severe OSA. We systematically searched electronic databases and registries up to February 10, 2025. Outcomes assessed included apnea-hypopnea index (AHI), body weight, oxygen desaturation index (ODI), minimum oxygen saturation, systolic blood pressure (SBP), diastolic blood pressure (DBP), and adverse events.
RESULTS: A total of 6 RCTs involving 1,069 participants were included, four evaluating liraglutide and two tirzepatide. Compared with control, GLP-1 receptor agonist-based therapies reduced AHI by - 9.99 events/hour (95% CI, - 16.47 to - 3.50; p < 0.01; I2 = 87%) and body weight by - 9.68 kg (95% CI, - 15.84 to - 3.51; p < 0.01; I2 = 98%). These therapies also reduced SBP by -4.77 mmHg (95% CI, -7.04 to -2.51; p < 0.01), and DBP by -1.41 mmHg (95% CI, -2.71 to -0.11; p = 0.03). No significant differences were observed in ODI or minimum oxygen saturation. GLP-1 receptor agonists-based therapies did not increase the risk of adverse events.
CONCLUSION: GLP-1 receptor agonist-based therapies reduced AHI and body weight in the populations studied. Substantial heterogeneity limits interpretation of the pooled effect magnitude. These findings support their potential role within comprehensive OSA management but do not establish them as substitutes for CPAP.
REGISTRY: International Prospective Register of Systematic Reviews; No.: CRD42024564018; URL: https://www.crd.york.ac.uk/prospero/ .