Effects of Tirzepatide Versus Insulin Glargine on Cystatin C-Based Kidney Function: A SURPASS-4 Post Hoc Analysis

被引：29

作者：

Heerspink, Hiddo J. L. ^{[1
,2
]}

Sattar, Naveed ^{[3
]}

Pavo, Imre ^{[4
]}

Haupt, Axel ^{[4
]}

Duffin, Kevin L. ^{[4
]}

Yang, Zhengyu ^{[4
]}

Wiese, Russell J. ^{[4
]}

Wilson, Jonathan M. ^{[4
]}

Hemmingway, Andrea ^{[4
]}

Cherney, David Z. I. ^{[5
]}

Tuttle, Katherine R. ^{[6
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands

[2] George Inst Global Hlth, Sydney, NSW, Australia

[3] Univ Glasgow, Sch Cardiovasc & Metab Hlth, Glasgow City, Scotland

[4] Eli Lilly & Co, Indianapolis, IN USA

[5] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Dept Med,Div Nephrol, Toronto, ON, Canada

[6] Univ Washington, Providence Hlth Care, Spokane, WA USA

来源：

DIABETES CARE | 2023年 / 46卷 / 08期

关键词：

CREATININE;

D O I：

10.2337/dc23-0261

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVETirzepatide reduces HbA(1c) and body weight, and creatinine-based estimated glomerular filtration rate (eGFR) decline. Unlike creatine-derived eGFR (eGFR-creatinine), cystatin C-derived eGFR (eGFR-cystatin C) is unaffected by muscle mass changes. We assessed effects of tirzepatide on eGFR-creatinine and eGFR-cystatin C. RESEARCH DESIGN AND METHODSOur primary outcome was eGFR change from baseline at 52 weeks with pooled tirzepatide (5, 10, and 15 mg) and titrated insulin glargine in adults with type 2 diabetes and high cardiovascular risk (SURPASS-4). RESULTSLeast squares mean (SE) eGFR-creatinine (mL/min/1.73 m(2)) changes from baseline with tirzepatide and insulin glargine were -2.5 (0.38) and -3.9 (0.38) (between-group difference, 1.4 [95% CI 0.3-2.4]) and -3.5 (0.37) and -5.3 (0.37) (between-group difference, 1.8 [95% CI 0.8-2.8]) for eGFR-cystatin C. Baseline, 1-year, and 1-year change from baseline values significantly correlated between eGFR-cystatin C and eGFR-creatinine. Measures of eGFR changes did not correlate with body weight changes. CONCLUSIONSTirzepatide slows the eGFR decline rate, supporting a kidney-protective effect.

引用

页码：1501 / 1506

页数：7

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