关于胰腺癌（PC）新使用者使用类胰高血糖素样肽-1激动剂（GLP-1As）增加风险的报告存在冲突。我们旨在探讨GLP-1A的使用是否与PC的风险增加有关。使用TriNetX进行多中心、回顾性队列研究。将2006年至2021年间首次治疗GLP-1A或二甲双胍糖尿病和/或超重和肥胖成人患者1:1匹配，使用倾向性分数匹配。使用Cox比例风险模型估计了PC的风险。共有492,760名GLP-1A组患者和918,711名二甲双胍组患者。倾向性分数匹配后，两个队列（各为370,490名患者）匹配良好。在随访期间，GLP-1A组中有351名患者和metformin组中有956名患者在延迟1年的暴露后发生了PC。类胰高血糖素样肽-1激动剂与PC发生的风险显著降低（风险比为0.47；95%置信区间为0.42-0.52）。与使用二甲双胍的类似队列的患者相比，使用GLP-1A的超重和/或糖尿病患者的PC风险较低。我们的研究结果使临床医生和担心GLP-1A与PC之间可能存在的联系的患者感到放心。版权所有©2023 Wolters Kluwer Health，Inc。保留所有权利。

There have been conflicting reports concerning an increased risk of pancreatic cancer (PC) in new users of glucagon-like peptide-1 agonists (GLP-1As). We aimed to explore whether the use of GLP-1A is associated with an increased risk of PC.A multicenter, retrospective cohort study was conducted using TriNetX. Adult patients with diabetes and/or overweight and obesity who were newly treated with GLP-1A or metformin for the first time between 2006 and 2021 were matched 1:1 using propensity score matching. The risk of PC was estimated using a Cox proportional hazards model.A total of 492,760 patients were identified in the GLP-1A and 918,711 patients in the metformin group. After propensity score matching, both cohorts (370,490 each) were well matched. During follow-up, 351 patients in the GLP-1A and 956 on metformin developed PC after an exposure lag of 1 year. Glucagon-like peptide-1 agonists was associated with a significantly lower risk of PC (hazard ratio, 0.47; 95% confidence interval, 0.42-0.52).The use of GLP-1A in patients with obesity/diabetes is associated with a lower risk of PC compared with a similar cohort of patients using metformin. Our study findings reassure clinicians and patients with apprehensions about any possible association between GLP-1A and PC.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.