{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:55:29Z","timestamp":1779209729080,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The associations of glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) and outcomes among patients with obesity according to the presence of cardiovascular risk factors (metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUHO)) remain unclear. We examined the associations of GLP\u20101RAs with mortality and adverse cardiovascular events in patients with MHO and MUHO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The TriNetX network was utilized to select a cohort of patients with MHO or MUHO, and use or non\u2010use of GLP\u20101RAs with propensity score matching (1:1). Cardiovascular events were identified during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2\u2009983\u2009151 patients with obesity (512\u2009434 with MHO and 2\u2009470\u2009717 with MUHO) were included in the study. Among these, 416\u2009713 (13.9%) were GLP\u20101RA users. After propensity score matching, GLP\u20101RA use in MUHO was associated with a significantly lower risk of mortality (HR 0.580 [95% CI, 0.566\u20130.595]), ischemic stroke (HR 0.921 [0.890\u20130.953]), AF (HR 0.913 [0.888\u20130.938]) and hospitalization for HF (HR 0.925 [0.900\u20130.949]) during follow\u2010up compared with non\u2010use of GLP\u20101RA. Patients with MHO had a markedly lower risk of clinical events than those with MUHO. A trend towards a lower risk of cardiovascular events associated with GLP\u20101RA was seen among patients with MHO. There was no statistical interaction in the risk of cardiovascular outcomes with GLP\u20101RA use for MHO and MUHO patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of GLP\u20101RAs was associated with lower rates of cardiovascular events than no use in patients with MUHO. Similar but non\u2010statistically significant trends were seen in patients with MHO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16238","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T03:45:01Z","timestamp":1739245501000},"page":"2418-2429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["<scp>GLP<\/scp>\n                    \u20101 receptor agonists and cardiovascular events in metabolically healthy or unhealthy obesity"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool, John Moores University and Liverpool and Heart and Chest Hospital  Liverpool UK"},{"name":"Department of General and Specialized Surgery Sapienza University of Rome  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3190-1122","authenticated-orcid":false,"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool, John Moores University and Liverpool and Heart and Chest Hospital  Liverpool UK"},{"name":"Department of Cardiovascular &amp; Metabolic Medicine, Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Department of Medicine, University Hospital Aintree Liverpool University NHS Foundation Trust  Liverpool UK"},{"name":"Centre for Biomechanics and Rehabilitation Technologies Staffordshire University  Stoke\u2010on\u2010Trent UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gr\u00e9goire","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Service d'Endocrinologie Diab\u00e9tologie et Nutrition Centre Hospitalier Universitaire  Orl\u00e9ans France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Lochon","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Centre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours  Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaud","family":"Bisson","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Centre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours  Tours France"},{"name":"Service de Cardiologie Centre Hospitalier Universitaire  Orl\u00e9ans France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre Henri","family":"Ducluzeau","sequence":"additional","affiliation":[{"name":"Service d'Endocrinologie Diab\u00e9tologie et Nutrition, Centre Hospitalier Universitaire et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours  Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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