The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease

Yuan Lin; Te Hsiung Wang; Ming Lung Tsai; Victor Chien Chia Wu; Chin Ju Tseng; Ming Shyan Lin; Yan Rong Li; Chih Hsiang Chang; Tien Shin Chou; Tzu Hsien Tsai; Ning I. Yang; Ming Jui Hung; Tien Hsing Chen

doi:10.1186/s12933-023-01793-9

The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease

Yuan Lin
, Te Hsiung Wang
, Ming Lung Tsai
, Victor Chien Chia Wu
, Chin Ju Tseng
, Ming Shyan Lin
, Yan Rong Li
, Chih Hsiang Chang
, Tien Shin Chou
, Tzu Hsien Tsai
, Ning I. Yang
, Ming Jui Hung
, Tien Hsing Chen^*

^*Corresponding author for this work

School of Traditional Chinese Medicine

Chang Gung Memorial Hospital
Chang Gung University
Tazuke Kofukai, Medical Research Institute, Kitano Hospital
Kyoto University
New Taipei Municipal Tucheng Hospital
Chia-Yi Christian Hospital

Research output: Contribution to journal › Journal Article › peer-review

37 Scopus citations

Abstract

BACKGROUND: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) have cardiovascular and renal protective effects in patients with advanced diabetic kidney disease (DKD) with an estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m 2.

METHODS: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m 2 with a first prescription for GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4is) from 2012 to 2021 (n = 125,392) were enrolled. A Cox proportional hazard model was used to assess the cardiorenal protective effects between the GLP-1RA and DDP-4i groups.

RESULTS: A total of 8922 participants [mean (SD) age 68.4 (11.5) years; 4516 (50.6%) males; GLP-1RAs, n = 759; DPP-4is, n = 8163] were eligible for this study. During a mean follow-up of 2.1 years, 78 (13%) and 204 (13.8%) patients developed composite cardiovascular events in the GLP-1RA and DPP-4i groups, respectively [hazard ratio (HR) 0.88, 95% confidence interval CI 0.68-1.13]. Composite kidney events were reported in 134 (38.2%) and 393 (44.2%) patients in the GLP-1RA and DPP-4i groups, respectively (subdistribution HR 0.72, 95% CI 0.56-0.93).

CONCLUSIONS: GLP-1RAs had a neutral effect on the composite cardiovascular outcomes but reduced composite kidney events in the patients with advanced DKD compared with DPP-4is.

Original language	English
Article number	60
Pages (from-to)	60
Journal	Cardiovascular Diabetology
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12933-023-01793-9
State	Published - 17 03 2023

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Advanced diabetic kidney disease
CV outcomes
GLP-1RA
Renal outcomes
Glucagon-Like Peptide 1
Humans
Male
Diabetes Mellitus, Type 2/complications
Kidney
Hypoglycemic Agents
Glucagon-Like Peptide-1 Receptor/agonists
Dipeptidyl-Peptidase IV Inhibitors
Diabetic Nephropathies/diagnosis
Female
Aged
Cardiovascular Diseases/diagnosis
Cohort Studies

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10.1186/s12933-023-01793-9

Cite this

Lin, Y., Wang, T. H., Tsai, M. L., Wu, V. C. C., Tseng, C. J., Lin, M. S., Li, Y. R., Chang, C. H., Chou, T. S., Tsai, T. H., Yang, N. I., Hung, M. J., & Chen, T. H. (2023). The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease. Cardiovascular Diabetology, 22(1), 60. Article 60. https://doi.org/10.1186/s12933-023-01793-9

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title = "The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease",

abstract = "BACKGROUND: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) have cardiovascular and renal protective effects in patients with advanced diabetic kidney disease (DKD) with an estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m 2. METHODS: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m 2 with a first prescription for GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4is) from 2012 to 2021 (n = 125,392) were enrolled. A Cox proportional hazard model was used to assess the cardiorenal protective effects between the GLP-1RA and DDP-4i groups. RESULTS: A total of 8922 participants [mean (SD) age 68.4 (11.5) years; 4516 (50.6\%) males; GLP-1RAs, n = 759; DPP-4is, n = 8163] were eligible for this study. During a mean follow-up of 2.1 years, 78 (13\%) and 204 (13.8\%) patients developed composite cardiovascular events in the GLP-1RA and DPP-4i groups, respectively [hazard ratio (HR) 0.88, 95\% confidence interval CI 0.68-1.13]. Composite kidney events were reported in 134 (38.2\%) and 393 (44.2\%) patients in the GLP-1RA and DPP-4i groups, respectively (subdistribution HR 0.72, 95\% CI 0.56-0.93).CONCLUSIONS: GLP-1RAs had a neutral effect on the composite cardiovascular outcomes but reduced composite kidney events in the patients with advanced DKD compared with DPP-4is.",

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author = "Yuan Lin and Wang, \{Te Hsiung\} and Tsai, \{Ming Lung\} and Wu, \{Victor Chien Chia\} and Tseng, \{Chin Ju\} and Lin, \{Ming Shyan\} and Li, \{Yan Rong\} and Chang, \{Chih Hsiang\} and Chou, \{Tien Shin\} and Tsai, \{Tzu Hsien\} and Yang, \{Ning I.\} and Hung, \{Ming Jui\} and Chen, \{Tien Hsing\}",

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day = "17",

doi = "10.1186/s12933-023-01793-9",

language = "英语",

volume = "22",

pages = "60",

journal = "Cardiovascular Diabetology",

issn = "1475-2840",

publisher = "BioMed Central Ltd",

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TY - JOUR

T1 - The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease

AU - Lin, Yuan

AU - Wang, Te Hsiung

AU - Tsai, Ming Lung

AU - Wu, Victor Chien Chia

AU - Tseng, Chin Ju

AU - Lin, Ming Shyan

AU - Li, Yan Rong

AU - Chang, Chih Hsiang

AU - Chou, Tien Shin

AU - Tsai, Tzu Hsien

AU - Yang, Ning I.

AU - Hung, Ming Jui

AU - Chen, Tien Hsing

PY - 2023/3/17

Y1 - 2023/3/17

N2 - BACKGROUND: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) have cardiovascular and renal protective effects in patients with advanced diabetic kidney disease (DKD) with an estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m 2. METHODS: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m 2 with a first prescription for GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4is) from 2012 to 2021 (n = 125,392) were enrolled. A Cox proportional hazard model was used to assess the cardiorenal protective effects between the GLP-1RA and DDP-4i groups. RESULTS: A total of 8922 participants [mean (SD) age 68.4 (11.5) years; 4516 (50.6%) males; GLP-1RAs, n = 759; DPP-4is, n = 8163] were eligible for this study. During a mean follow-up of 2.1 years, 78 (13%) and 204 (13.8%) patients developed composite cardiovascular events in the GLP-1RA and DPP-4i groups, respectively [hazard ratio (HR) 0.88, 95% confidence interval CI 0.68-1.13]. Composite kidney events were reported in 134 (38.2%) and 393 (44.2%) patients in the GLP-1RA and DPP-4i groups, respectively (subdistribution HR 0.72, 95% CI 0.56-0.93).CONCLUSIONS: GLP-1RAs had a neutral effect on the composite cardiovascular outcomes but reduced composite kidney events in the patients with advanced DKD compared with DPP-4is.

AB - BACKGROUND: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) have cardiovascular and renal protective effects in patients with advanced diabetic kidney disease (DKD) with an estimated glomerular filtration rate (eGFR) < 30 mL/min per 1.73 m 2. METHODS: In this cohort study, patients with type 2 diabetes mellitus and eGFR < 30 mL/min per 1.73 m 2 with a first prescription for GLP-1RAs or dipeptidyl peptidase 4 inhibitors (DPP-4is) from 2012 to 2021 (n = 125,392) were enrolled. A Cox proportional hazard model was used to assess the cardiorenal protective effects between the GLP-1RA and DDP-4i groups. RESULTS: A total of 8922 participants [mean (SD) age 68.4 (11.5) years; 4516 (50.6%) males; GLP-1RAs, n = 759; DPP-4is, n = 8163] were eligible for this study. During a mean follow-up of 2.1 years, 78 (13%) and 204 (13.8%) patients developed composite cardiovascular events in the GLP-1RA and DPP-4i groups, respectively [hazard ratio (HR) 0.88, 95% confidence interval CI 0.68-1.13]. Composite kidney events were reported in 134 (38.2%) and 393 (44.2%) patients in the GLP-1RA and DPP-4i groups, respectively (subdistribution HR 0.72, 95% CI 0.56-0.93).CONCLUSIONS: GLP-1RAs had a neutral effect on the composite cardiovascular outcomes but reduced composite kidney events in the patients with advanced DKD compared with DPP-4is.

KW - Advanced diabetic kidney disease

KW - CV outcomes

KW - GLP-1RA

KW - Renal outcomes

KW - Glucagon-Like Peptide 1

KW - Humans

KW - Male

KW - Diabetes Mellitus, Type 2/complications

KW - Kidney

KW - Hypoglycemic Agents

KW - Glucagon-Like Peptide-1 Receptor/agonists

KW - Dipeptidyl-Peptidase IV Inhibitors

KW - Diabetic Nephropathies/diagnosis

KW - Female

KW - Aged

KW - Cardiovascular Diseases/diagnosis

KW - Cohort Studies

UR - https://www.scopus.com/pages/publications/85150665687

U2 - 10.1186/s12933-023-01793-9

DO - 10.1186/s12933-023-01793-9

M3 - 文章

C2 - 36932379

AN - SCOPUS:85150665687

SN - 1475-2840

VL - 22

SP - 60

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

IS - 1

M1 - 60

ER -

The cardiovascular and renal effects of glucagon-like peptide 1 receptor agonists in patients with advanced diabetic kidney disease

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

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