Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization

Abstract Background Glucose-lowering glucagon-like peptide-1 receptor agonists (GLP1RAs) are widely used to treat type 2 diabetes (T2D) and obesity. However, their potential benefits in pulmonary diseases remain unclear. To address this, we used Mendelian randomization (MR) analysis to assess the ca...

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Main Authors: Sijia Lai, Yaohui Feng, Lu Li, Jiayu Zhao, Zhenyu Wang, Yanli Wang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01866-7
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author Sijia Lai
Yaohui Feng
Lu Li
Jiayu Zhao
Zhenyu Wang
Yanli Wang
author_facet Sijia Lai
Yaohui Feng
Lu Li
Jiayu Zhao
Zhenyu Wang
Yanli Wang
author_sort Sijia Lai
collection DOAJ
description Abstract Background Glucose-lowering glucagon-like peptide-1 receptor agonists (GLP1RAs) are widely used to treat type 2 diabetes (T2D) and obesity. However, their potential benefits in pulmonary diseases remain unclear. To address this, we used Mendelian randomization (MR) analysis to assess the causal effects of genetically proxied GLP1RAs on chronic obstructive pulmonary disease (COPD) and related conditions, including bronchitis and asthma. Methods We selected cis-expression quantitative trait loci (cis-eQTLs) as instrumental variables to genetically proxy GLP1RAs. Summary-level data were obtained from the eQTLGen and FinnGen consortia. MR analyses were used to identify the association between genetically proxied GLP1RAs and COPD, as well as COPD-related diseases. T2D, HbA1c levels, and BMI were used as positive controls. Results After Benjamini-Hochberg correction for multiple testing, MR analyses indicated that genetically predicted GLP1RAs were significantly associated with lower risks of COPD (OR [95% CI] = 0.838 [0.74–0.948], P = 0.013), early-onset COPD (< 65 years) (OR [95% CI] = 0.751[0.622–0.906], P = 0.01), COPD-related respiratory insufficiency (OR [95% CI] = 0.720[0.55–0.944], P = 0.024), acute bronchitis (OR [95% CI] = 0.787 [0.693–0.893], P = 0.002), asthma (OR [95% CI] = 0.872 [0.782–0.973], P = 0.023), and other symptoms and signs involving the circulatory and respiratory systems (OR [95% CI] = 0.426 [0.217–0.834], P = 0.023). No significant association was observed for later-onset COPD (≥ 65 years) (OR [95% CI] = 0.921 [0.783–1.082], P = 0.315) or chronic bronchitis risk (OR [95% CI] = 0.950 [0.889–1.016], P = 0.146). Conclusions Genetically predicted GLP1RAs are associated with a lower risk of early-onset COPD, COPD-related respiratory insufficiency, acute bronchitis, and asthma. These findings highlight potential benefits of GLP1RAs in T2D patients with coexisting pulmonary diseases and support the need for further investigation in COPD management.
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spelling doaj-art-c1c236ea2d6a47dc8e1eee93bc4cab172025-08-20T03:46:15ZengBMCDiabetology & Metabolic Syndrome1758-59962025-07-011711910.1186/s13098-025-01866-7Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomizationSijia Lai0Yaohui Feng1Lu Li2Jiayu Zhao3Zhenyu Wang4Yanli Wang5Department of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityDepartment of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityDepartment of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityDepartment of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityDepartment of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityDepartment of Health Care for Cadres, Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical UniversityAbstract Background Glucose-lowering glucagon-like peptide-1 receptor agonists (GLP1RAs) are widely used to treat type 2 diabetes (T2D) and obesity. However, their potential benefits in pulmonary diseases remain unclear. To address this, we used Mendelian randomization (MR) analysis to assess the causal effects of genetically proxied GLP1RAs on chronic obstructive pulmonary disease (COPD) and related conditions, including bronchitis and asthma. Methods We selected cis-expression quantitative trait loci (cis-eQTLs) as instrumental variables to genetically proxy GLP1RAs. Summary-level data were obtained from the eQTLGen and FinnGen consortia. MR analyses were used to identify the association between genetically proxied GLP1RAs and COPD, as well as COPD-related diseases. T2D, HbA1c levels, and BMI were used as positive controls. Results After Benjamini-Hochberg correction for multiple testing, MR analyses indicated that genetically predicted GLP1RAs were significantly associated with lower risks of COPD (OR [95% CI] = 0.838 [0.74–0.948], P = 0.013), early-onset COPD (< 65 years) (OR [95% CI] = 0.751[0.622–0.906], P = 0.01), COPD-related respiratory insufficiency (OR [95% CI] = 0.720[0.55–0.944], P = 0.024), acute bronchitis (OR [95% CI] = 0.787 [0.693–0.893], P = 0.002), asthma (OR [95% CI] = 0.872 [0.782–0.973], P = 0.023), and other symptoms and signs involving the circulatory and respiratory systems (OR [95% CI] = 0.426 [0.217–0.834], P = 0.023). No significant association was observed for later-onset COPD (≥ 65 years) (OR [95% CI] = 0.921 [0.783–1.082], P = 0.315) or chronic bronchitis risk (OR [95% CI] = 0.950 [0.889–1.016], P = 0.146). Conclusions Genetically predicted GLP1RAs are associated with a lower risk of early-onset COPD, COPD-related respiratory insufficiency, acute bronchitis, and asthma. These findings highlight potential benefits of GLP1RAs in T2D patients with coexisting pulmonary diseases and support the need for further investigation in COPD management.https://doi.org/10.1186/s13098-025-01866-7GLP1RAsDrug targetMendelian randomizationChronic obstructive pulmonary disease
spellingShingle Sijia Lai
Yaohui Feng
Lu Li
Jiayu Zhao
Zhenyu Wang
Yanli Wang
Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
Diabetology & Metabolic Syndrome
GLP1RAs
Drug target
Mendelian randomization
Chronic obstructive pulmonary disease
title Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
title_full Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
title_fullStr Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
title_full_unstemmed Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
title_short Association of GLP1RAs with risk of chronic obstructive pulmonary disease: evidence from drug target Mendelian randomization
title_sort association of glp1ras with risk of chronic obstructive pulmonary disease evidence from drug target mendelian randomization
topic GLP1RAs
Drug target
Mendelian randomization
Chronic obstructive pulmonary disease
url https://doi.org/10.1186/s13098-025-01866-7
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