Comparison of renal outcomes between sodium glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists
Comparison of renal outcomes between sodium glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists
复制标题
DOI：
10.1016/j.diabres.2022.109231
复制
发表时间：
2022-02-10
影响因子：
5.1
通讯作者：
Kanamori, Akira
中科院分区：
文献类型：
--
作者：
Kobayashi, Kazuo;Toyoda, Masao;Kanamori, Akira
目的：本研究旨在阐明钠-葡萄糖协同转运蛋白2抑制剂（SGLT 2 i）和胰高血糖素样肽1受体激动剂（GLP 1 Ra）如何影响日本2型糖尿病（T2 DM）患者肾功能的差异。方法：我们回顾性地建立了两个数据库，收集了神奈川医师协会会员诊所就诊的T2 DM患者。我们将肾脏复合结局定义为蛋白尿状态的进展和/或估计肾小球滤过率（eGFR）每年恶化> 15%。我们使用倾向评分匹配比较SGLT 2 i和GLP 1 Ra治疗后的患者结局。结果：SGLT 2 i治疗患者的肾脏复合结局发生率显著低于GLP 1 Ra治疗患者（分别为n = 15 [11%]和n = 27 [20%]，P = 0.001）。两组之间的eGFR年变化（mL/min/1.73 m2/年）存在显著差异（SGLT 2 i治疗患者为-1.8 [95% CI，-2.7，-0.9]，GLP 1 Ra治疗患者为-3.4 [95% CI，-4.6，-2.2]，P = 0.0049）。尿白蛋白/肌酐比值的变化是由于收缩压降低与否与治疗差异之间存在显著的相互作用（P <0. 04）。结论：SGLT 2 i治疗患者的肾脏复合结局发生率低于GLP 1 Ra治疗患者。
Aims: This study aimed to clarify the differences in how sodium glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1Ra) influence kidney function in Japanese patients with type 2 diabetes mellitus (T2DM).Methods: We retrospectively built two databases of patients with T2DM who visited the clinics of members of Kanagawa Physicians Association. We defined the renal composite outcome as either progression of albuminuria status and/or > 15% deterioration in estimated glomerular filtration rate (eGFR) per year. We used propensity score matching to compare patient outcomes after SGLT2i and GLP1Ra treatments.Results: The incidence of renal composite outcomes was significantly lower in SGLT2i-treated patients than in GLP1Ra-treated patients (n = 15 [11%] and n = 27 [20%], respectively, P = 0.001). Annual eGFR changes (mL/min/1.73 m(2)/year) between the two groups differed significantly (-1.8 [95 %CI, -2.7, -0.9] in SGLT2i-treated patients and -3.4 [95 %CI, -4.6, -2.2] in GLP1Ra-treated patients, P = 0.0049). The urine albumin-to-creatinine ratio changed owing to a significant interaction between the presence or absence of a decrease in systolic blood pressure and the difference in treatments (P < 0.04).Conclusion: Renal composite outcome incidence was lower in SGLT2i-treated patients than in GLP1Ra-treated patients.