End-stage renal diseases associated with SGLT2 inhibitors versus GLP-1 receptor agonists in metabolic dysfunction-associated steatotic liver disease

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-23 DOI:10.1016/j.diabres.2025.112921

Hwa Yeon Ko , Bin Hong , Sungho Bea , Jae Hyun Bae , Young Min Cho , Yoosoo Chang , Seungho Ryu , Christopher D Byrne , Ju-Young Shin

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引用次数: 0

Abstract

Aims

To compare the renal effectiveness of SGLT2 inhibitors (SGLT2i) versus GLP-1 receptor agonists (GLP-1RA) in metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods

Using nationwide healthcare claims (2014–2023) of Korea, we constructed a cohort of MASLD patients who initiated SGLT2i or GLP-1RA. Patients were stratified on baseline status of chronic kidney disease (CKD). New-users of SGLT2i and GLP-1RA were 1:1 propensity score (PS) matched. Incidence rates (IRs) per 1,000 person-years, hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for a composite of end-stage renal diseases (ESRD).

Results

Of 333,082 MASLD patients who initiated SGLT2i or GLP-1RA, a total of 1,268 SGLT2i-GLP-1RA pairs were PS-matched in cohort with CKD, while 10,996 pairs were matched in cohort without CKD. For the cohort with CKD, SGLT2i presented 33% lower risk of ESRD compared to GLP-1RA (20.3 vs. 30.0 events per 1,000 person-years; HR 0.67, 95% CI 0.45–1.00). For the cohort without CKD, SGLT2i presented a 68% lowered risk of ESRD compared to GLP-1RA (0.9 vs. 2.5 events per 1,000 person-years; HR 0.32, 95% CI 0.19–0.53).

Conclusions

The use of SGLT2i was associated with lower risk of ESRD compared to GLP-1RA in MASLD. The protective association was presented regardless of CKD status.

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代谢功能障碍相关脂肪变性肝病中SGLT2抑制剂与GLP-1受体激动剂相关的终末期肾脏疾病

目的：比较SGLT2抑制剂（SGLT2i）与GLP-1受体激动剂（GLP-1RA）在代谢功能障碍相关脂肪变性肝病（MASLD）中的肾脏疗效。方法：使用韩国全国医疗保健索赔（2014-2023），我们构建了一个启动SGLT2i或GLP-1RA的MASLD患者队列。根据慢性肾脏疾病（CKD）的基线状态对患者进行分层。SGLT2i和GLP-1RA新使用者的倾向评分（PS）匹配为1:1。估计了终末期肾脏疾病（ESRD）的每1000人年发病率（IRs）、危险比（hr）和95%置信区间（CIs）。结果：在333,082例启动SGLT2i或GLP-1RA的MASLD患者中，有CKD的队列中有1268对SGLT2i-GLP-1RA配对，而在无CKD的队列中有10,996对配对。在CKD队列中，SGLT2i的ESRD风险比GLP-1RA低33%（每1000人年20.3 vs 30.0事件；HR 0.67, 95% CI 0.45-1.00）。对于无CKD的队列，与GLP-1RA相比，SGLT2i的ESRD风险降低68%（每1000人年0.9 vs 2.5事件；HR 0.32, 95% CI 0.19-0.53）。结论：与GLP-1RA相比，在MASLD中使用SGLT2i与较低的ESRD风险相关。无论CKD状态如何，这种保护性关联都存在。

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

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.