FPT166
Free Paper (Tumor)
GLP-1 Receptor Agonists as a Potential Alternative Strategy to Reduce Spine-related Morbidities in Obese Population
Xuan-You Lin1, Chun-Yuan Chuang, MD2, Sung Huang Laurent Tsai, MD, MPH3,4,5,6, Kuang Yuan Goh, MD3,4, Jing-Yang Huang, PhD7,8, Chia-Wei Peng3, Wei-Bin Hsu, PhD³, James Cheng-Chung Wei, MD, PhD9,10,1 1*, Ming-Chen Hsieh, MD, PhD 12,13*, Meng- Huang Wu, MD, PhD2,4,14,*
¹School of Medicine, Taipei Medical University, Taipei, Taiwan ²Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan ³Department of Orthopedics, Taipei Medical University Hospital, 11031, Taipei, Taiwan
⁴Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, 11031, Taipei, Taiwan ⁵Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan ⁶Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan ⁷Institute of Medicine, College of medicine, Chung Shan Medical University, Taichung, Taiwan
⁸Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan ⁹Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
¹⁰Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan ¹¹Department of Nursing, Chung Shan Medical University, Taichung, Taiwan ¹²Department of Internal Medicine, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
¹³School of Medicine, China Medical University, Taichung, Taiwan ¹⁴APSS-AOSpine AP Frontier Technologies Research Study Group
Background: Spine-related morbidities are strongly influenced by obesity-related mechanical
Background: Spine-related morbidities are strongly influenced by obesity-related mechanical and inflammatory factors. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), widely used for weight management, have shown potential musculoskeletal benefits, but their association with spinal degeneration remains unclear.
Methods: We conducted a propensity score-matched active comparator new-user cohort study using the TriNetX global federated database. Adults aged 20-79 years with obesity (BMI ≥30) prescribed GLP-1 RAs or other anti-obesity medications between January 2015 and June 2024 were included. After 1:1 matching on >70 baseline covariates, 233,567 patient pairs were followed for up to 9.5 years. The primary outcome was incidence of spine-related morbidities; secondary outcomes included spinal surgery. Analyses were stratified by BMI and spinal regions.
Results: A total of 467 134 matched participants were included in this study. The mean (standard deviation) age was 49.2 (13.4) years in the GLP-1 RA group and 49.1 (14.5) years in the non-GLP-1 RA group, and 67% of all participants were women. GLP-1 RA use was associated with a reduced risk of spine-related morbidities (HR: 0.911, 95% CI: 0.897 to 0.926).
Conclusion: In this large real-world cohort, GLP-1 RA therapy was associated with reduced incidence of spine-related morbidities in obese adults, though not with surgical outcomes. These findings suggest potential region-specific and BMI-dependent protective effects of GLP-1 RAs on spinal degeneration. Prospective studies are warranted to validate these associations and clarify underlying mechanisms.