von Scholten Bernt Johan, Davies Melanie J, Persson Frederik, Hansen Tine W, Madsbad Sten, Endahl Lars, Jepsen Cecilie H, Rossing Peter
Steno Diabetes Center Copenhagen, Region H, Copenhagen, Denmark.
Diabetes Research Centre, University of Leicester, Leicester, UK.
J Diabetes Complications. 2017 Jul;31(7):1164-1168. doi: 10.1016/j.jdiacomp.2017.04.003. Epub 2017 Apr 11.
Weight loss-induced serum creatinine reduction may increase creatinine-based estimated glomerular filtration rate (eGFR) producing incorrect estimates of kidney function. We investigated whether weight changes in the SCALE program with liraglutide 3.0mg were associated with changes in serum creatinine.
Post hoc analysis of two 56-week, randomized, double-blind trials: SCALE Obesity and Prediabetes (n=3731, without type 2 diabetes [T2D], randomized [2:1] to liraglutide 3.0mg [n=2487] or placebo [n=1244]); SCALE Diabetes (n=846 with T2D, randomized [2:1:1] to liraglutide 3.0mg [n=423], 1.8mg [n=211, excluded from this analysis] or placebo [n=212]). NCT01272219/NCT01272232.
In SCALE Obesity and Prediabetes, mean (±SD) weight loss (baseline to week 56) with liraglutide was 8.0±6.7% (2.6±6.9% with placebo); baseline creatinine with liraglutide was 76±15μmol/L and 74±15μmol/L after 56weeks (similar across treatment groups). In SCALE Diabetes, weight loss with liraglutide was 5.9±5.5% (2.0±4.3% with placebo); baseline creatinine was 79±19μmol/L (77±16μmol/L, placebo) and 79±20μmol/L after 56weeks (76±15μmol/L, placebo). No association between changes in weight and changes in serum creatinine was observed (P≥0.05, both trials, all tests).
Moderate gradual body weight reductions observed in the SCALE program were not associated with changes in serum creatinine.
体重减轻导致血清肌酐降低可能会使基于肌酐的估计肾小球滤过率(eGFR)升高,从而对肾功能产生错误估计。我们研究了司美格鲁肽3.0mg治疗的SCALE项目中的体重变化是否与血清肌酐变化相关。
对两项为期56周的随机双盲试验进行事后分析:SCALE肥胖与糖尿病前期试验(n = 3731,无2型糖尿病[T2D],随机[2:1]分为司美格鲁肽3.0mg组[n = 2487]或安慰剂组[n = 1244]);SCALE糖尿病试验(n = 846例T2D患者,随机[2:1:1]分为司美格鲁肽3.0mg组[n = 423]、1.8mg组[n = 211,本分析中排除]或安慰剂组[n = 212])。NCT01272219/NCT01272232。
在SCALE肥胖与糖尿病前期试验中,司美格鲁肽组的平均(±标准差)体重减轻(基线至第56周)为8.0±6.7%(安慰剂组为2.6±6.9%);司美格鲁肽组的基线肌酐为76±15μmol/L,56周后为74±15μmol/L(各治疗组相似)。在SCALE糖尿病试验中,司美格鲁肽组的体重减轻为5.9±5.5%(安慰剂组为2.0±4.3%);基线肌酐为79±19μmol/L(安慰剂组为77±16μmol/L),56周后为79±20μmol/L(安慰剂组为76±15μmol/L)。未观察到体重变化与血清肌酐变化之间存在关联(两项试验所有检验的P≥0.05)。
在SCALE项目中观察到的适度渐进性体重减轻与血清肌酐变化无关。