Changes in glomerular filtration rate in patients with body mass index ≥35 kg/m² treated with metabolic and bariatric surgery versus GLP-1 agonist at 1-year follow-up.

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM

Obesity Science & Practice Pub Date : 2024-08-10 eCollection Date: 2024-08-01 DOI:10.1002/osp4.782

Diana Cristina Henao-Carrillo, Mayra Alejandra Jurado-Florez, Óscar Mauricio Muñoz

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Abstract

Background: Metabolic and bariatric surgery (MBS) reduces glomerular hyperfiltration. The renoprotective effects of GLP-1 analogs were derived from clinical studies in type 2 diabetes (T2D). The objective of this study was to evaluate the changes in glomerular filtration rate (GFR) over time associated with weight loss in patients with a BMI ≥ 35 kg/m² treated with liraglutide compared with patients treated with MBS.

Methods: A longitudinal study derived from a retrospective cohort of patients with BMI ≥ 35 kg/m² treated with either MBS or liraglutide 3 mg/day, with follow-up ≥1 year. Clinical variables, baseline GFR, and 1-year GFR were analyzed. A generalized estimating equation (GEE) model was used to compare changes in GFR between both groups while controlling for confounding variables.

Results: A total of 159 patients were included in the analysis. Of these, 129 patients underwent MBS (median age 60.5 years [IQR 51.8-66.6], body mass index (BMI) 40.9 kg/m2 [IQR 0.68-0.89]), and 30 patients were treated with liraglutide (median age 56 years [IQR 46-62], BMI 37.4 kg/m² [IQR 0.69-0.93]). No difference in baseline GFR or at 12 months of follow-up was found between the two interventions. GEE analysis revealed an increase of 0.32 mL/min/1.73 m² per month of follow-up. Factors associated with a greater increase in GFR were the percentage total weight loss (%TWL) (0.12 mL/min/1.73 m², p = 0.023) and baseline GFR (0.69 mL/min/1.73 m², p > 0.001) for both interventions, independent of a history of T2D.

Conclusion: In patients with BMI ≥ 35 kg/m², changes in GFR are related to %TWL and baseline GFR, regardless of the presence of diabetes or the type of intervention used.

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体重指数≥35 kg/m2患者接受代谢和减肥手术与 GLP-1 激动剂治疗后 1 年随访期间肾小球滤过率的变化。

背景：代谢和减肥手术（MBS）可降低肾小球高滤过率。GLP-1 类似物对肾脏的保护作用来自于对 2 型糖尿病（T2D）的临床研究。本研究的目的是评估体重指数（BMI）≥ 35 kg/m2、接受利拉鲁肽治疗的患者与接受MBS治疗的患者相比，肾小球滤过率（GFR）随时间推移发生的变化：这是一项纵向研究，研究对象是BMI≥35 kg/m2、接受MBS或利拉鲁肽3 mg/天治疗的患者，随访时间≥1年。对临床变量、基线 GFR 和 1 年 GFR 进行了分析。采用广义估计方程（GEE）模型比较两组患者的 GFR 变化，同时控制混杂变量：结果：共有 159 名患者被纳入分析。其中，129 名患者接受了 MBS 治疗（中位年龄 60.5 岁 [IQR：51.8-66.6]，体重指数 (BMI)：40.9 kg/m2 [IQR：0.68-0.89]），30 名患者接受了利拉鲁肽治疗（中位年龄 56 岁 [IQR：46-62]，体重指数 (BMI)：37.4 kg/m2 [IQR：0.69-0.93]）。两种干预方法的基线 GFR 和随访 12 个月时的 GFR 均无差异。GEE 分析显示，随访每月的 GFR 增加了 0.32 mL/min/1.73 m2。在两种干预方法中，与 GFR 增加幅度较大相关的因素是总减重百分比（%TWL）（0.12 mL/min/1.73 m2，p = 0.023）和基线 GFR（0.69 mL/min/1.73 m2，p > 0.001），与 T2D 病史无关：结论：对于体重指数（BMI）≥ 35 kg/m2的患者，无论是否患有糖尿病或采用何种干预措施，其肾小球滤过率的变化都与TWL%和基线肾小球滤过率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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