GLP-1 受体激动剂对合并急性肾损伤的 2 型糖尿病患者的心肾结局和死亡率的影响。
GLP-1 receptor agonists' impact on cardio-renal outcomes and mortality in T2D with acute kidney disease.
机构信息
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chang Gung University College of Medicine, Taoyuan, Taiwan.
出版信息
Nat Commun. 2024 Jul 13;15(1):5912. doi: 10.1038/s41467-024-50199-y.
Previous studies have explored the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in reducing cardiovascular events in type 2 diabetes. Here we show that GLP-1 RAs are associated with lower risks of mortality, major cardiovascular events (MACEs), and major adverse kidney events (MAKEs) in type 2 diabetes patients with acute kidney disease (AKD). Utilizing global data from the TriNetX database (2002/09/01-2022/12/01) and propensity score matching, we compare 7511 GLP-1 RAs users to non-users among 165,860 AKD patients. The most common causes of AKI are sepsis (55.2%) and cardiorenal syndrome (34.2%). After a median follow-up of 2.3 years, GLP-1 RAs users exhibit reduced risks of mortality (adjusted hazard ratio [aHR]: 0.57), MACEs (aHR: 0.88), and MAKEs (aHR: 0.73). External validation in a multicenter dataset of 1245 type 2 diabetes patients with AKD supports the favorable outcomes. These results emphasize the potential of GLP-1 RAs in individualized treatment for this population.
先前的研究已经探讨了胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）在降低 2 型糖尿病患者心血管事件风险方面的作用。在这里，我们表明，在伴有急性肾损伤（AKI）的 2 型糖尿病患者中，GLP-1 RAs 与死亡率、主要心血管事件（MACEs）和主要不良肾脏事件（MAKEs）风险降低相关。我们利用来自 TriNetX 数据库（2002/09/01-2022/12/01）的全球数据和倾向评分匹配，比较了 165860 例 AKI 患者中的 7511 例 GLP-1 RA 使用者与非使用者。AKI 的最常见病因是败血症（55.2%）和心肾综合征（34.2%）。经过 2.3 年的中位随访，GLP-1 RA 使用者的死亡率（调整后的危险比[aHR]：0.57）、MACEs（aHR：0.88）和 MAKEs（aHR：0.73）风险降低。在 1245 例伴有 AKI 的 2 型糖尿病患者的多中心数据集的外部验证支持了这一有利结果。这些结果强调了 GLP-1 RAs 在该人群个体化治疗中的潜力。
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