Effects of weight loss from oral semaglutide administration on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a retrospective analysis using propensity score matching.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2024-07-31 eCollection Date: 2024-10-01 DOI:10.1007/s13340-024-00744-3

Kazuki Aoyama, Yuya Nakajima, Shu Meguro, Kaori Hayashi

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Abstract

Background: Obesity is increasingly being recognized as a chronic disease that exacerbates type 2 diabetes and its related complications. Oral semaglutide, a novel glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated efficacy in weight loss and diabetes control in Western populations. However, in real-world clinical practice, its effectiveness in Japanese patients, who typically exhibit a leaner phenotype and unique genetic susceptibilities affecting insulin secretion, remains unclear.

Methods: We retrospectively evaluated the electronic medical records of 313 patients treated with oral semaglutide and 11,239 untreated controls at the Keio University School of Medicine. We performed propensity score matching to adjust for covariates, including age, sex, height, weight, blood pressure, blood test data, medications, and compared the cardiometabolic risk factors, including HbA1c, blood pressure, lipids, and liver function 180 days post-treatment, of both patient groups. We conducted a subgroup analysis for patients who achieved ≥ 3% weight loss.

Results: After propensity score matching, the semaglutide group demonstrated significantly better outcomes for HbA1c reduction and weight loss and improvements in systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and liver function than the control group. Subgroup analysis of patients with ≥ 3% weight loss revealed superior HbA1c improvements in the semaglutide group; however, no significant differences in other metabolic parameters, such as SBP, LDL-C, and liver function, were observed.

Conclusion: Oral semaglutide effectively improved metabolic markers in Japanese patients with type 2 diabetes, similar to that in Western populations. Weight loss itself was suggested to significantly contribute to blood pressure, lipid levels, and liver function changes.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-024-00744-3.

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日本 2 型糖尿病患者通过口服塞马鲁肽减轻体重对心脏代谢风险因素的影响：使用倾向得分匹配法进行的回顾性分析。

背景：人们日益认识到肥胖是一种慢性疾病，会加剧 2 型糖尿病及其相关并发症。口服塞马鲁肽是一种新型胰高血糖素样肽-1（GLP-1）受体激动剂，已在西方人群中证实具有减轻体重和控制糖尿病的功效。然而，在现实世界的临床实践中，该药对日本患者的疗效仍不明确，因为日本患者通常表现出较瘦弱的表型和影响胰岛素分泌的独特遗传易感性：我们回顾性评估了庆应义塾大学医学院 313 名接受口服塞马鲁肽治疗的患者和 11,239 名未接受治疗的对照组患者的电子病历。我们对两组患者的协变量（包括年龄、性别、身高、体重、血压、血液检测数据、药物）进行了倾向得分匹配调整，并比较了两组患者治疗后 180 天的心血管代谢风险因素（包括 HbA1c、血压、血脂和肝功能）。我们对体重减轻≥3%的患者进行了亚组分析：经过倾向评分匹配后，与对照组相比，塞马鲁肽组在降低 HbA1c、减轻体重以及改善收缩压 (SBP)、低密度脂蛋白胆固醇 (LDL-C) 和肝功能方面的效果明显更好。对体重减轻≥3%的患者进行的亚组分析表明，在改善HbA1c方面，塞马鲁肽组更胜一筹；然而，在其他代谢指标（如SBP、低密度脂蛋白胆固醇和肝功能）方面，未观察到显著差异：结论：口服塞马鲁肽能有效改善日本 2 型糖尿病患者的代谢指标，这与西方人群的情况类似。结论：口服塞马鲁肽能有效改善日本 2 型糖尿病患者的代谢指标，与西方人群相似。减重本身被认为对血压、血脂水平和肝功能的变化有显著促进作用：在线版本包含补充材料，可在 10.1007/s13340-024-00744-3上查阅。

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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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.