Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?
•Disparities were found in the cardiorenal outcomes among different GLP-1RAs.•GLP-1RAs with high concentration was associated with less cardiorenal events.•Long acting GLP-1RAs was associated more improved cardiovascular outcomes.•The molecular weight of GLP-1RAs did not influence the cardiorenal ou...
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| Veröffentlicht in: | European journal of internal medicine 2023-03, Vol.109, p.79-88 |
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| creator | Bai, Shuzhen Lin, Chu Jiao, Ruoyang Cai, Xiaoling Hu, Suiyuan Lv, Fang Yang, Wenjia Zhu, Xingyun Ji, Linong |
| description | •Disparities were found in the cardiorenal outcomes among different GLP-1RAs.•GLP-1RAs with high concentration was associated with less cardiorenal events.•Long acting GLP-1RAs was associated more improved cardiovascular outcomes.•The molecular weight of GLP-1RAs did not influence the cardiorenal outcomes.
Disparities were found in the cardiovascular and renal outcomes among different glucagon-like peptide 1 receptor agonist (GLP-1RA) subtypes. However, whether the characteristics of GLP-1RA itself are associated with these disparities remains unclear.
To assess the association between the steady-state concentration, duration of action, or molecular weight of GLP-1RA and the risks of cardiovascular and renal outcomes in patients with type 2 diabetes (T2D).
PubMed, MEDLINE, EMBASE, Cochrane and Clinicaltrial.gov from inception to April 2022.
Randomized controlled trials (RCTs) investigating GLP-1RAs in patients with T2D were included.
Literature screening and data extraction were performed independently by 2 researchers. The outcomes were computed as odds ratio (OR) and its 95% confidence interval (CI). Subgroup analyses were conducted according to steady-state concentration, duration of action and molecular weight of GLP-1RAs.
Primary outcomes were major adverse cardiovascular events (MACE), composite renal outcome and all-cause mortality.
In all, 61 RCTs were included. When compared with non-GLP-1RA agents, GLP-1RAs with high steady-state concentration were associated with greater risk reduction in MACE (p for subgroup difference = 0.01) and the composite renal outcome (p for subgroup difference = 0.008) in patients with T2D. Greater risk reductions in MACE between GLP-1RA users versus non-GLP-RA users were observed in long acting stratum when compared with short acting stratum (p for subgroup difference = 0.04) in patients with T2D. The molecular weight of GLP-1RAs was not associated with the risk of cardiovascular and renal outcomes.
GLP-1RAs with high steady-state concentrations might be associated with greater risk reductions in cardiovascular and renal outcomes in patients with T2D. Long acting GLP-1RAs might outperform short acting ones in reducing the risk of cardiovascular outcomes. These findings provided new insights for guiding the clinical applications of GLP-1RAs in patients with T2D. |
| doi_str_mv | 10.1016/j.ejim.2023.01.008 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2764444062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0953620523000122</els_id><sourcerecordid>2764444062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c307t-b3c170d125f3a69a1743e74b5decb553096cbfddb7ac666d21d27ca34a7929203</originalsourceid><addsrcrecordid>eNp9kVGL1DAQx4Mo3nr6BXyQPPpwXSdJm7YgyHHoebCgiD6HaTJ1s7TNmqR37Gfxy9qlp4_Oywwz__8fhh9jrwVsBQj97rClgx-3EqTagtgCNE_YRjR1W0Ajm6dsA22lCi2humAvUjoAiBpAPWcXSmvZNLLcsN93iec98ZQJ3alIGTNxGyZLU46YfZiuuJvXiYeeo113IfIxDGTnASN_IP9zn8_n293XQny75phSsH7JcvzB5z23GJ0P95hWA06OR5pw4GHONoyUuJ94Ph2JS-48dpQpfXjJnvU4JHr12C_Zj08fv998LnZfbu9urneFVVDnolN2-csJWfUKdYuiLhXVZVc5sl1VKWi17Xrnuhqt1tpJ4WRtUZVYt7KVoC7Z2zX3GMOvmVI2o0-WhgEnCnMystblUqDlIpWr1MaQUqTeHKMfMZ6MAHOGYg7mDMWcoRgQZoGymN485s_dSO6f5S-FRfB-FdDy5b2naJL1tDBwPpLNxgX_v_w_rGafjQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2764444062</pqid></control><display><type>article</type><title>Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Bai, Shuzhen ; Lin, Chu ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Zhu, Xingyun ; Ji, Linong</creator><creatorcontrib>Bai, Shuzhen ; Lin, Chu ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Zhu, Xingyun ; Ji, Linong</creatorcontrib><description>•Disparities were found in the cardiorenal outcomes among different GLP-1RAs.•GLP-1RAs with high concentration was associated with less cardiorenal events.•Long acting GLP-1RAs was associated more improved cardiovascular outcomes.•The molecular weight of GLP-1RAs did not influence the cardiorenal outcomes.
Disparities were found in the cardiovascular and renal outcomes among different glucagon-like peptide 1 receptor agonist (GLP-1RA) subtypes. However, whether the characteristics of GLP-1RA itself are associated with these disparities remains unclear.
To assess the association between the steady-state concentration, duration of action, or molecular weight of GLP-1RA and the risks of cardiovascular and renal outcomes in patients with type 2 diabetes (T2D).
PubMed, MEDLINE, EMBASE, Cochrane and Clinicaltrial.gov from inception to April 2022.
Randomized controlled trials (RCTs) investigating GLP-1RAs in patients with T2D were included.
Literature screening and data extraction were performed independently by 2 researchers. The outcomes were computed as odds ratio (OR) and its 95% confidence interval (CI). Subgroup analyses were conducted according to steady-state concentration, duration of action and molecular weight of GLP-1RAs.
Primary outcomes were major adverse cardiovascular events (MACE), composite renal outcome and all-cause mortality.
In all, 61 RCTs were included. When compared with non-GLP-1RA agents, GLP-1RAs with high steady-state concentration were associated with greater risk reduction in MACE (p for subgroup difference = 0.01) and the composite renal outcome (p for subgroup difference = 0.008) in patients with T2D. Greater risk reductions in MACE between GLP-1RA users versus non-GLP-RA users were observed in long acting stratum when compared with short acting stratum (p for subgroup difference = 0.04) in patients with T2D. The molecular weight of GLP-1RAs was not associated with the risk of cardiovascular and renal outcomes.
GLP-1RAs with high steady-state concentrations might be associated with greater risk reductions in cardiovascular and renal outcomes in patients with T2D. Long acting GLP-1RAs might outperform short acting ones in reducing the risk of cardiovascular outcomes. These findings provided new insights for guiding the clinical applications of GLP-1RAs in patients with T2D.</description><identifier>ISSN: 0953-6205</identifier><identifier>EISSN: 1879-0828</identifier><identifier>DOI: 10.1016/j.ejim.2023.01.008</identifier><identifier>PMID: 36628824</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cardiovascular ; Cardiovascular Diseases - prevention & control ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - complications ; Glucagon-like peptide-1 receptor ; Glucagon-Like Peptide-1 Receptor - agonists ; Humans ; Hypoglycemic Agents - adverse effects ; Kidney ; Molecular Weight ; Renal</subject><ispartof>European journal of internal medicine, 2023-03, Vol.109, p.79-88</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-b3c170d125f3a69a1743e74b5decb553096cbfddb7ac666d21d27ca34a7929203</cites><orcidid>0000-0002-7881-0543</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejim.2023.01.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36628824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bai, Shuzhen</creatorcontrib><creatorcontrib>Lin, Chu</creatorcontrib><creatorcontrib>Jiao, Ruoyang</creatorcontrib><creatorcontrib>Cai, Xiaoling</creatorcontrib><creatorcontrib>Hu, Suiyuan</creatorcontrib><creatorcontrib>Lv, Fang</creatorcontrib><creatorcontrib>Yang, Wenjia</creatorcontrib><creatorcontrib>Zhu, Xingyun</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><title>Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?</title><title>European journal of internal medicine</title><addtitle>Eur J Intern Med</addtitle><description>•Disparities were found in the cardiorenal outcomes among different GLP-1RAs.•GLP-1RAs with high concentration was associated with less cardiorenal events.•Long acting GLP-1RAs was associated more improved cardiovascular outcomes.•The molecular weight of GLP-1RAs did not influence the cardiorenal outcomes.
Disparities were found in the cardiovascular and renal outcomes among different glucagon-like peptide 1 receptor agonist (GLP-1RA) subtypes. However, whether the characteristics of GLP-1RA itself are associated with these disparities remains unclear.
To assess the association between the steady-state concentration, duration of action, or molecular weight of GLP-1RA and the risks of cardiovascular and renal outcomes in patients with type 2 diabetes (T2D).
PubMed, MEDLINE, EMBASE, Cochrane and Clinicaltrial.gov from inception to April 2022.
Randomized controlled trials (RCTs) investigating GLP-1RAs in patients with T2D were included.
Literature screening and data extraction were performed independently by 2 researchers. The outcomes were computed as odds ratio (OR) and its 95% confidence interval (CI). Subgroup analyses were conducted according to steady-state concentration, duration of action and molecular weight of GLP-1RAs.
Primary outcomes were major adverse cardiovascular events (MACE), composite renal outcome and all-cause mortality.
In all, 61 RCTs were included. When compared with non-GLP-1RA agents, GLP-1RAs with high steady-state concentration were associated with greater risk reduction in MACE (p for subgroup difference = 0.01) and the composite renal outcome (p for subgroup difference = 0.008) in patients with T2D. Greater risk reductions in MACE between GLP-1RA users versus non-GLP-RA users were observed in long acting stratum when compared with short acting stratum (p for subgroup difference = 0.04) in patients with T2D. The molecular weight of GLP-1RAs was not associated with the risk of cardiovascular and renal outcomes.
GLP-1RAs with high steady-state concentrations might be associated with greater risk reductions in cardiovascular and renal outcomes in patients with T2D. Long acting GLP-1RAs might outperform short acting ones in reducing the risk of cardiovascular outcomes. These findings provided new insights for guiding the clinical applications of GLP-1RAs in patients with T2D.</description><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Glucagon-like peptide-1 receptor</subject><subject>Glucagon-Like Peptide-1 Receptor - agonists</subject><subject>Humans</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Kidney</subject><subject>Molecular Weight</subject><subject>Renal</subject><issn>0953-6205</issn><issn>1879-0828</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kVGL1DAQx4Mo3nr6BXyQPPpwXSdJm7YgyHHoebCgiD6HaTJ1s7TNmqR37Gfxy9qlp4_Oywwz__8fhh9jrwVsBQj97rClgx-3EqTagtgCNE_YRjR1W0Ajm6dsA22lCi2humAvUjoAiBpAPWcXSmvZNLLcsN93iec98ZQJ3alIGTNxGyZLU46YfZiuuJvXiYeeo113IfIxDGTnASN_IP9zn8_n293XQny75phSsH7JcvzB5z23GJ0P95hWA06OR5pw4GHONoyUuJ94Ph2JS-48dpQpfXjJnvU4JHr12C_Zj08fv998LnZfbu9urneFVVDnolN2-csJWfUKdYuiLhXVZVc5sl1VKWi17Xrnuhqt1tpJ4WRtUZVYt7KVoC7Z2zX3GMOvmVI2o0-WhgEnCnMystblUqDlIpWr1MaQUqTeHKMfMZ6MAHOGYg7mDMWcoRgQZoGymN485s_dSO6f5S-FRfB-FdDy5b2naJL1tDBwPpLNxgX_v_w_rGafjQ</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Bai, Shuzhen</creator><creator>Lin, Chu</creator><creator>Jiao, Ruoyang</creator><creator>Cai, Xiaoling</creator><creator>Hu, Suiyuan</creator><creator>Lv, Fang</creator><creator>Yang, Wenjia</creator><creator>Zhu, Xingyun</creator><creator>Ji, Linong</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7881-0543</orcidid></search><sort><creationdate>202303</creationdate><title>Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?</title><author>Bai, Shuzhen ; Lin, Chu ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Zhu, Xingyun ; Ji, Linong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-b3c170d125f3a69a1743e74b5decb553096cbfddb7ac666d21d27ca34a7929203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiovascular</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Glucagon-like peptide-1 receptor</topic><topic>Glucagon-Like Peptide-1 Receptor - agonists</topic><topic>Humans</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Kidney</topic><topic>Molecular Weight</topic><topic>Renal</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bai, Shuzhen</creatorcontrib><creatorcontrib>Lin, Chu</creatorcontrib><creatorcontrib>Jiao, Ruoyang</creatorcontrib><creatorcontrib>Cai, Xiaoling</creatorcontrib><creatorcontrib>Hu, Suiyuan</creatorcontrib><creatorcontrib>Lv, Fang</creatorcontrib><creatorcontrib>Yang, Wenjia</creatorcontrib><creatorcontrib>Zhu, Xingyun</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bai, Shuzhen</au><au>Lin, Chu</au><au>Jiao, Ruoyang</au><au>Cai, Xiaoling</au><au>Hu, Suiyuan</au><au>Lv, Fang</au><au>Yang, Wenjia</au><au>Zhu, Xingyun</au><au>Ji, Linong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?</atitle><jtitle>European journal of internal medicine</jtitle><addtitle>Eur J Intern Med</addtitle><date>2023-03</date><risdate>2023</risdate><volume>109</volume><spage>79</spage><epage>88</epage><pages>79-88</pages><issn>0953-6205</issn><eissn>1879-0828</eissn><abstract>•Disparities were found in the cardiorenal outcomes among different GLP-1RAs.•GLP-1RAs with high concentration was associated with less cardiorenal events.•Long acting GLP-1RAs was associated more improved cardiovascular outcomes.•The molecular weight of GLP-1RAs did not influence the cardiorenal outcomes.
Disparities were found in the cardiovascular and renal outcomes among different glucagon-like peptide 1 receptor agonist (GLP-1RA) subtypes. However, whether the characteristics of GLP-1RA itself are associated with these disparities remains unclear.
To assess the association between the steady-state concentration, duration of action, or molecular weight of GLP-1RA and the risks of cardiovascular and renal outcomes in patients with type 2 diabetes (T2D).
PubMed, MEDLINE, EMBASE, Cochrane and Clinicaltrial.gov from inception to April 2022.
Randomized controlled trials (RCTs) investigating GLP-1RAs in patients with T2D were included.
Literature screening and data extraction were performed independently by 2 researchers. The outcomes were computed as odds ratio (OR) and its 95% confidence interval (CI). Subgroup analyses were conducted according to steady-state concentration, duration of action and molecular weight of GLP-1RAs.
Primary outcomes were major adverse cardiovascular events (MACE), composite renal outcome and all-cause mortality.
In all, 61 RCTs were included. When compared with non-GLP-1RA agents, GLP-1RAs with high steady-state concentration were associated with greater risk reduction in MACE (p for subgroup difference = 0.01) and the composite renal outcome (p for subgroup difference = 0.008) in patients with T2D. Greater risk reductions in MACE between GLP-1RA users versus non-GLP-RA users were observed in long acting stratum when compared with short acting stratum (p for subgroup difference = 0.04) in patients with T2D. The molecular weight of GLP-1RAs was not associated with the risk of cardiovascular and renal outcomes.
GLP-1RAs with high steady-state concentrations might be associated with greater risk reductions in cardiovascular and renal outcomes in patients with T2D. Long acting GLP-1RAs might outperform short acting ones in reducing the risk of cardiovascular outcomes. These findings provided new insights for guiding the clinical applications of GLP-1RAs in patients with T2D.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36628824</pmid><doi>10.1016/j.ejim.2023.01.008</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7881-0543</orcidid></addata></record> |
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| ispartof | European journal of internal medicine, 2023-03, Vol.109, p.79-88 |
| issn | 0953-6205 1879-0828 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2764444062 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Cardiovascular Cardiovascular Diseases - prevention & control Diabetes mellitus Diabetes Mellitus, Type 2 - complications Glucagon-like peptide-1 receptor Glucagon-Like Peptide-1 Receptor - agonists Humans Hypoglycemic Agents - adverse effects Kidney Molecular Weight Renal |
| title | Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes? |
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