肠促胰岛素治疗剂包括替西帕肽对2型糖尿病患者肾脏预后的影响：一项系统综述和荟萃分析

Metabolism open Pub Date : 2023-03-01 DOI:10.1016/j.metop.2023.100236

Akira Mima, Hidemasa Gotoda, Rina Lee, Ami Murakami, Ryosuke Akai, Shinji Lee

{"title":"肠促胰岛素治疗剂包括替西帕肽对2型糖尿病患者肾脏预后的影响：一项系统综述和荟萃分析","authors":"Akira Mima, Hidemasa Gotoda, Rina Lee, Ami Murakami, Ryosuke Akai, Shinji Lee","doi":"10.1016/j.metop.2023.100236","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This meta-analysis was conducted to investigate the effects of incretin-based therapeutic agents, including the latest agent tirzepatide, on renal outcomes in patients with type 2 diabetes.</p></div><div><h3>Methods</h3><p>MEDLINE (via PubMed) and Cochrane databases were searched for studies involving incretin-based therapeutic agents up to July 2022. Randomized and controlled trials comparing incretin-based therapeutic agents with placebo or other antidiabetic agents, and reporting renal outcomes were selected. The inclusion criteria were items related to the effects on albuminuria and the kidney-specific composite outcomes. A network meta-analysis was conducted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).</p></div><div><h3>Results</h3><p>Twelve trials consisting of 75,346 participants were included in this meta-analysis. Glucagon-like peptide-1 (GLP-1) receptor agonists reduced the risk of the kidney-specific composite outcome by 21% (HR 0.79, 95% CI 0.75–0.85), and worsening albuminuria by 24% (HR 0.76, 95% CI 0.71–0.82). In particular, the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide remarkably reduced the risk of the kidney-specific composite outcome by 45% (HR 0.55, 95% CI 0.40–0.77), and worsening albuminuria by 62% (HR 0.38, 95% CI 0.24–0.61).</p></div><div><h3>Conclusions</h3><p>Among incretin-based therapeutic agents, tirzepatide was associated with a significantly reduced risk of diabetic kidney disease.</p></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"17 ","pages":"Article 100236"},"PeriodicalIF":0.0000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/ec/main.PMC10009293.pdf","citationCount":"2","resultStr":"{\"title\":\"Effects of incretin-based therapeutic agents including tirzepatide on renal outcomes in patients with type 2 diabetes: A systemic review and meta-analysis\",\"authors\":\"Akira Mima, Hidemasa Gotoda, Rina Lee, Ami Murakami, Ryosuke Akai, Shinji Lee\",\"doi\":\"10.1016/j.metop.2023.100236\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This meta-analysis was conducted to investigate the effects of incretin-based therapeutic agents, including the latest agent tirzepatide, on renal outcomes in patients with type 2 diabetes.</p></div><div><h3>Methods</h3><p>MEDLINE (via PubMed) and Cochrane databases were searched for studies involving incretin-based therapeutic agents up to July 2022. Randomized and controlled trials comparing incretin-based therapeutic agents with placebo or other antidiabetic agents, and reporting renal outcomes were selected. The inclusion criteria were items related to the effects on albuminuria and the kidney-specific composite outcomes. A network meta-analysis was conducted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).</p></div><div><h3>Results</h3><p>Twelve trials consisting of 75,346 participants were included in this meta-analysis. Glucagon-like peptide-1 (GLP-1) receptor agonists reduced the risk of the kidney-specific composite outcome by 21% (HR 0.79, 95% CI 0.75–0.85), and worsening albuminuria by 24% (HR 0.76, 95% CI 0.71–0.82). In particular, the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide remarkably reduced the risk of the kidney-specific composite outcome by 45% (HR 0.55, 95% CI 0.40–0.77), and worsening albuminuria by 62% (HR 0.38, 95% CI 0.24–0.61).</p></div><div><h3>Conclusions</h3><p>Among incretin-based therapeutic agents, tirzepatide was associated with a significantly reduced risk of diabetic kidney disease.</p></div>\",\"PeriodicalId\":94141,\"journal\":{\"name\":\"Metabolism open\",\"volume\":\"17 \",\"pages\":\"Article 100236\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/ec/main.PMC10009293.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Metabolism open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589936823000087\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Metabolism open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589936823000087","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 2

摘要

背景本荟萃分析旨在研究以肠促胰岛素为基础的治疗药物，包括最新的替西帕肽，对2型糖尿病患者肾脏预后的影响。方法检索MEDLINE（通过PubMed）和Cochrane数据库中截至2022年7月涉及肠促胰岛素治疗剂的研究。选择了随机和对照试验，将肠促胰岛素治疗剂与安慰剂或其他抗糖尿病药物进行比较，并报告肾脏结果。纳入标准是与对蛋白尿的影响和肾脏特异性复合结果相关的项目。采用网络荟萃分析方法计算危险比（HR）和95%置信区间（CI）。胰高血糖素样肽-1（GLP-1）受体激动剂可将肾脏特异性复合结果的风险降低21%（HR 0.79，95%CI 0.75–0.85），并将蛋白尿恶化的风险降低24%（HR 0.76，95%CI 0.71–0.82）。特别是，双葡萄糖依赖性促胰岛素多肽（GIP）/GLP-1受体激动剂替西帕肽显著降低肾特异性复合结局的风险45%（HR 0.55，95%CI 0.40–0.77），并降低蛋白尿恶化的风险62%（HR 0.38，95%CI 0.24–0.61），替西帕肽与糖尿病肾病的风险显著降低相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

摘要图片

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Effects of incretin-based therapeutic agents including tirzepatide on renal outcomes in patients with type 2 diabetes: A systemic review and meta-analysis

Background

This meta-analysis was conducted to investigate the effects of incretin-based therapeutic agents, including the latest agent tirzepatide, on renal outcomes in patients with type 2 diabetes.

Methods

MEDLINE (via PubMed) and Cochrane databases were searched for studies involving incretin-based therapeutic agents up to July 2022. Randomized and controlled trials comparing incretin-based therapeutic agents with placebo or other antidiabetic agents, and reporting renal outcomes were selected. The inclusion criteria were items related to the effects on albuminuria and the kidney-specific composite outcomes. A network meta-analysis was conducted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

Twelve trials consisting of 75,346 participants were included in this meta-analysis. Glucagon-like peptide-1 (GLP-1) receptor agonists reduced the risk of the kidney-specific composite outcome by 21% (HR 0.79, 95% CI 0.75–0.85), and worsening albuminuria by 24% (HR 0.76, 95% CI 0.71–0.82). In particular, the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide remarkably reduced the risk of the kidney-specific composite outcome by 45% (HR 0.55, 95% CI 0.40–0.77), and worsening albuminuria by 62% (HR 0.38, 95% CI 0.24–0.61).