{"title":"钠-葡萄糖共转运体抑制剂和 GLP-1 受体激动剂联合治疗对 2 型糖尿病患者肾脏的保护作用（根据之前的用药情况而定）。","authors":"Kazuo Kobayashi, Masao Toyoda, Atsuhito Tone, Daiji Kawanami, Daisuke Suzuki, Daisuke Tsuriya, Hideo Machimura, Hidetoshi Shimura, Hiroshi Takeda, Hisashi Yokomizo, Kei Takeshita, Keiichi Chin, Keizo Kanasaki, Masaaki Miyauchi, Masuo Saburi, Miwa Morita, Miwako Yomota, Moritsugu Kimura, Nobuo Hatori, Shinichi Nakajima, Shun Ito, Shunichiro Tsukamoto, Takashi Murata, Takaya Matsushita, Takayuki Furuki, Takuya Hashimoto, Tomoya Umezono, Yoshimi Muta, Yuichi Takashi, Kouichi Tamura","doi":"10.1177/14791641231222837","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.</p><p><strong>Methods: </strong>We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome.</p><p><strong>Results: </strong>The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups were 28% and 25%, respectively, with an odds ratio [95% confidence interval] of 1.14 [0.75, 1.73] (<i>p</i> = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome.</p><p><strong>Conclusion: </strong>With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"20 6","pages":"14791641231222837"},"PeriodicalIF":0.0000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725108/pdf/","citationCount":"0","resultStr":"{\"title\":\"Renoprotective effects of combination treatment with sodium-glucose cotransporter inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes mellitus according to preceding medication.\",\"authors\":\"Kazuo Kobayashi, Masao Toyoda, Atsuhito Tone, Daiji Kawanami, Daisuke Suzuki, Daisuke Tsuriya, Hideo Machimura, Hidetoshi Shimura, Hiroshi Takeda, Hisashi Yokomizo, Kei Takeshita, Keiichi Chin, Keizo Kanasaki, Masaaki Miyauchi, Masuo Saburi, Miwa Morita, Miwako Yomota, Moritsugu Kimura, Nobuo Hatori, Shinichi Nakajima, Shun Ito, Shunichiro Tsukamoto, Takashi Murata, Takaya Matsushita, Takayuki Furuki, Takuya Hashimoto, Tomoya Umezono, Yoshimi Muta, Yuichi Takashi, Kouichi Tamura\",\"doi\":\"10.1177/14791641231222837\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.</p><p><strong>Methods: </strong>We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome.</p><p><strong>Results: </strong>The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups were 28% and 25%, respectively, with an odds ratio [95% confidence interval] of 1.14 [0.75, 1.73] (<i>p</i> = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome.</p><p><strong>Conclusion: </strong>With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.</p>\",\"PeriodicalId\":93978,\"journal\":{\"name\":\"Diabetes & vascular disease research\",\"volume\":\"20 6\",\"pages\":\"14791641231222837\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725108/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes & vascular disease research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/14791641231222837\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes & vascular disease research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/14791641231222837","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Renoprotective effects of combination treatment with sodium-glucose cotransporter inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes mellitus according to preceding medication.
Aims: Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.
Methods: We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome.
Results: The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups were 28% and 25%, respectively, with an odds ratio [95% confidence interval] of 1.14 [0.75, 1.73] (p = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome.
Conclusion: With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.
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