根据体重指数SGLT2i对2型糖尿病患者肾脏结局的影响:全国队列研究

IF 6.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Takahiro Jimba, Hidehiro Kaneko, Yuta Suzuki, Akira Okada, Tatsuhiko Azegami, Toshiyuki Ko, Katsuhito Fujiu, Hiroyuki Morita, Norifumi Takeda, Kaori Hayashi, Takashi Yokoo, Koichi Node, Issei Komuro, Hideo Yasunaga, Masaomi Nangaku, Norihiko Takeda
{"title":"根据体重指数SGLT2i对2型糖尿病患者肾脏结局的影响:全国队列研究","authors":"Takahiro Jimba, Hidehiro Kaneko, Yuta Suzuki, Akira Okada, Tatsuhiko Azegami, Toshiyuki Ko, Katsuhito Fujiu, Hiroyuki Morita, Norifumi Takeda, Kaori Hayashi, Takashi Yokoo, Koichi Node, Issei Komuro, Hideo Yasunaga, Masaomi Nangaku, Norihiko Takeda","doi":"10.1093/ehjcvp/pvae094","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To investigate the clinical significance of the modification of the kidney protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors by baseline body mass index (BMI).</p><p><strong>Methods and results: </strong>We included individuals with SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors newly prescribed for type 2 diabetes using a nationwide epidemiological cohort and performed propensity score matching (1:2). The primary outcome was the annual eGFR decline, assessed using a linear mixed-effects model, compared between individuals with SGLT2 inhibitors and DPP4 inhibitors. We investigated the interaction effect of BMI at the time of prescription using a three-knot restricted cubic spline model. We analysed 2165 individuals with SGLT2 inhibitor prescriptions and 4330 individuals with DPP4 inhibitor prescriptions. Overall, the annual decline in eGFR was less pronounced in the group treated with SGLT2 inhibitors than in those treated with DPP4 inhibitors (-1.34 mL/min/1.73 m2 vs. -1.49 mL/min/1.73 m2). The advantage of SGLT2 inhibitors in mitigating eGFR decline was augmented in the individuals with higher BMI (P-value for interaction 0.0017). Furthermore, even upon adjusting the definition of outcomes to encompass a 30 or 40% reduction in eGFR, the potential advantages of SGLT2 inhibitors over DPP4 inhibitors persisted, with a trend of augmented effects with higher BMI. This interaction effect was evident in the individuals with preserved kidney function.</p><p><strong>Conclusion: </strong>Our nationwide epidemiological study substantiated the improved kidney outcomes in the SGLT2 inhibitor users compared with the DPP4 inhibitor users across a wide range of BMI, which was pronounced for individuals with higher BMI.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"155-163"},"PeriodicalIF":6.1000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905744/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.\",\"authors\":\"Takahiro Jimba, Hidehiro Kaneko, Yuta Suzuki, Akira Okada, Tatsuhiko Azegami, Toshiyuki Ko, Katsuhito Fujiu, Hiroyuki Morita, Norifumi Takeda, Kaori Hayashi, Takashi Yokoo, Koichi Node, Issei Komuro, Hideo Yasunaga, Masaomi Nangaku, Norihiko Takeda\",\"doi\":\"10.1093/ehjcvp/pvae094\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To investigate the clinical significance of the modification of the kidney protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors by baseline body mass index (BMI).</p><p><strong>Methods and results: </strong>We included individuals with SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors newly prescribed for type 2 diabetes using a nationwide epidemiological cohort and performed propensity score matching (1:2). The primary outcome was the annual eGFR decline, assessed using a linear mixed-effects model, compared between individuals with SGLT2 inhibitors and DPP4 inhibitors. We investigated the interaction effect of BMI at the time of prescription using a three-knot restricted cubic spline model. We analysed 2165 individuals with SGLT2 inhibitor prescriptions and 4330 individuals with DPP4 inhibitor prescriptions. Overall, the annual decline in eGFR was less pronounced in the group treated with SGLT2 inhibitors than in those treated with DPP4 inhibitors (-1.34 mL/min/1.73 m2 vs. -1.49 mL/min/1.73 m2). The advantage of SGLT2 inhibitors in mitigating eGFR decline was augmented in the individuals with higher BMI (P-value for interaction 0.0017). Furthermore, even upon adjusting the definition of outcomes to encompass a 30 or 40% reduction in eGFR, the potential advantages of SGLT2 inhibitors over DPP4 inhibitors persisted, with a trend of augmented effects with higher BMI. This interaction effect was evident in the individuals with preserved kidney function.</p><p><strong>Conclusion: </strong>Our nationwide epidemiological study substantiated the improved kidney outcomes in the SGLT2 inhibitor users compared with the DPP4 inhibitor users across a wide range of BMI, which was pronounced for individuals with higher BMI.</p>\",\"PeriodicalId\":11982,\"journal\":{\"name\":\"European Heart Journal - Cardiovascular Pharmacotherapy\",\"volume\":\" \",\"pages\":\"155-163\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2025-03-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905744/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Cardiovascular Pharmacotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjcvp/pvae094\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Pharmacotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjcvp/pvae094","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

目的:通过基线体重指数(BMI)探讨钠-葡萄糖共转运蛋白-2 (SGLT2)抑制剂对肾脏保护作用的影响。方法和结果:我们纳入了使用SGLT2抑制剂或二肽基肽酶-4 (DPP4)抑制剂新开处方治疗2型糖尿病的个体,使用全国流行病学队列并进行倾向评分匹配(1:2)。主要结局是每年eGFR下降,使用线性混合效应模型进行评估,比较使用SGLT2抑制剂和DPP4抑制剂的个体。我们使用三节限制三次样条模型研究了处方时BMI的相互作用效应。我们分析了2165名服用SGLT2抑制剂的个体和4330名服用DPP4抑制剂的个体。总体而言,与DPP4抑制剂组相比,SGLT2抑制剂组eGFR的年下降幅度较小(-1.34 mL/min/1.73 m2 vs -1.49 mL/min/1.73 m2)。SGLT2抑制剂在减轻eGFR下降方面的优势在BMI较高的个体中得到增强(相互作用的p值为0.0017)。此外,即使调整了结果的定义,使eGFR降低30%或40%,SGLT2抑制剂比DPP4抑制剂的潜在优势仍然存在,并且随着BMI的升高,效果有增强的趋势。这种相互作用在保留肾功能的个体中很明显。结论:我们的全国流行病学研究证实,在广泛的BMI范围内,与DPP4抑制剂使用者相比,SGLT2抑制剂使用者的肾脏预后得到改善,这在BMI较高的个体中是明显的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.

Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.

Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.

Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.

Aims: To investigate the clinical significance of the modification of the kidney protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors by baseline body mass index (BMI).

Methods and results: We included individuals with SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors newly prescribed for type 2 diabetes using a nationwide epidemiological cohort and performed propensity score matching (1:2). The primary outcome was the annual eGFR decline, assessed using a linear mixed-effects model, compared between individuals with SGLT2 inhibitors and DPP4 inhibitors. We investigated the interaction effect of BMI at the time of prescription using a three-knot restricted cubic spline model. We analysed 2165 individuals with SGLT2 inhibitor prescriptions and 4330 individuals with DPP4 inhibitor prescriptions. Overall, the annual decline in eGFR was less pronounced in the group treated with SGLT2 inhibitors than in those treated with DPP4 inhibitors (-1.34 mL/min/1.73 m2 vs. -1.49 mL/min/1.73 m2). The advantage of SGLT2 inhibitors in mitigating eGFR decline was augmented in the individuals with higher BMI (P-value for interaction 0.0017). Furthermore, even upon adjusting the definition of outcomes to encompass a 30 or 40% reduction in eGFR, the potential advantages of SGLT2 inhibitors over DPP4 inhibitors persisted, with a trend of augmented effects with higher BMI. This interaction effect was evident in the individuals with preserved kidney function.

Conclusion: Our nationwide epidemiological study substantiated the improved kidney outcomes in the SGLT2 inhibitor users compared with the DPP4 inhibitor users across a wide range of BMI, which was pronounced for individuals with higher BMI.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
European Heart Journal - Cardiovascular Pharmacotherapy
European Heart Journal - Cardiovascular Pharmacotherapy Medicine-Cardiology and Cardiovascular Medicine
CiteScore
10.10
自引率
14.10%
发文量
65
期刊介绍: The European Heart Journal - Cardiovascular Pharmacotherapy (EHJ-CVP) is an international, peer-reviewed journal published in English, specifically dedicated to clinical cardiovascular pharmacology. EHJ-CVP publishes original articles focusing on clinical research involving both new and established drugs and methods, along with meta-analyses and topical reviews. The journal's primary aim is to enhance the pharmacological treatment of patients with cardiovascular disease by interpreting and integrating new scientific developments in this field. While the emphasis is on clinical topics, EHJ-CVP also considers basic research articles from fields such as physiology and molecular biology that contribute to the understanding of cardiovascular drug therapy. These may include articles related to new drug development and evaluation, the physiological and pharmacological basis of drug action, metabolism, drug interactions, and side effects.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信