Endocrinology and Metabolism

Original Articles

Thyroid Big Data Articles (National Health Insurance Service Database)
Graves’ Disease and the Risk of End-Stage Renal Disease: A Korean Population-Based Study: Yoon Young Cho, Bongseong Kim, Dong Wook Shin, Hye Ryoun Jang, Bo-Yeon Kim, Chan-Hee Jung, Jae Hyeon Kim, Sun Wook Kim, Jae Hoon Chung, Kyungdo Han, Tae Hyuk Kim; Endocrinol Metab. 2022;37(2):281-289. Published online April 6, 2022; DOI: https://doi.org/10.3803/EnM.2021.1333

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Background
Hyperthyroidism is associated with an increased glomerular filtration rate (GFR) in the hyperdynamic state, which is reversible after restoring euthyroidism. However, long-term follow-up of renal dysfunction in patients with hyperthyroidism has not been performed.
Methods
This was a retrospective cohort study using the Korean National Health Insurance database and biannual health checkup data. We included 41,778 Graves’ disease (GD) patients and 41,778 healthy controls, matched by age and sex. The incidences of end-stage renal disease (ESRD) were calculated in GD patients and controls. The cumulative dose and duration of antithyroid drugs (ATDs) were calculated for each patient and categorized into the highest, middle, and lowest tertiles.
Results
Among 41,778 GD patients, 55 ESRD cases occurred during 268,552 person-years of follow-up. Relative to the controls, regardless of smoking, drinking, or comorbidities, including chronic kidney disease, GD patients had a 47% lower risk of developing ESRD (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.37 to 0.76). In particular, GD patients with a higher baseline GFR (≥90 mL/min/1.73 m2; HR, 0.33; 95% CI, 0.11 to 0.99), longer treatment duration (>33 months; HR, 0.31; 95% CI, 0.17 to 0.58) or higher cumulative dose (>16,463 mg; HR, 0.29; 95% CI, 0.15 to 0.57) of ATDs had a significantly reduced risk of ESRD.
Conclusion
This was the first epidemiological study on the effect of GD on ESRD, and we demonstrated that GD population had a reduced risk for developing ESRD.

Citations

Citations to this article as recorded by

Renal function changes in patients with subclinical hyperthyroidism: a novel postulated mechanism
Magdy Mohamed Allam, Hanaa Tarek El-Zawawy, Tarek Hussein El-Zawawy
Endocrine.2023; 82(1): 78. CrossRef
Effect of Hyperthyroidism on Preventing Renal Insufficiency
Tae Yong Kim
Endocrinology and Metabolism.2022; 37(2): 220. CrossRef
Effects and Clinical Value of Peritoneal Dialysis on Water and Water Balance, Adverse Reactions, Quality of Life, and Clinical Prognosis in Patients with Decompensated Chronic Nephropathy: A Systematic Review and Meta-Analysis
Xichao Wang, Miaomiao Zhang, Na Sun, Wenxiu Chang, Gang Chen
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef

Clinical Study
Comparative Renal Effects of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Individual Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis: Jae Hyun Bae, Eun-Gee Park, Sunhee Kim, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim; Endocrinol Metab. 2021;36(2):388-400. Published online March 31, 2021; DOI: https://doi.org/10.3803/EnM.2020.912

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359 Download
13 Web of Science
16 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
To compare the renal effects of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors on individual outcomes in patients with type 2 diabetes.
Methods
We searched electronic databases (MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials) from inception to June 2019 to identity eligible randomized controlled trials of DPP-4 inhibitors or SGLT2 inhibitors that reported at least one kidney outcome in patients with type 2 diabetes. Outcomes of interest were microalbuminuria, macroalbuminuria, worsening nephropathy, and end-stage kidney disease (ESKD). We performed an arm-based network meta-analysis using Bayesian methods and calculated absolute risks and rank probabilities of each treatment for the outcomes.
Results
Seventeen studies with 87,263 patients were included. SGLT2 inhibitors significantly lowered the risks of individual kidney outcomes, including microalbuminuria (odds ratio [OR], 0.64; 95% credible interval [CrI], 0.41 to 0.93), macroalbuminuria (OR, 0.48; 95% CrI, 0.24 to 0.72), worsening nephropathy (OR, 0.65; 95% CrI, 0.44 to 0.91), and ESKD (OR, 0.65; 95% CrI, 0.46 to 0.98) as compared with placebo. However, DPP-4 inhibitors did not lower the risks. SGLT2 inhibitors were considerably associated with higher absolute risk reductions in all kidney outcomes than DPP-4 inhibitors, although the benefits were statistically insignificant. The rank probabilities showed that SGLT2 inhibitors were better treatments for lowering the risk of albuminuria and ESKD than placebo or DPP-4 inhibitors.
Conclusion
SGLT2 inhibitors were superior to DPP-4 inhibitors in reducing the risk of albuminuria and ESKD in patients with type 2 diabetes.

Citations

Citations to this article as recorded by

Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2024; 20(2): 212. CrossRef
Ipragliflozin and sitagliptin differentially affect lipid and apolipoprotein profiles in type 2 diabetes: the SUCRE study
Mototsugu Nagao, Jun Sasaki, Kyoko Tanimura-Inagaki, Ichiro Sakuma, Hitoshi Sugihara, Shinichi Oikawa
Cardiovascular Diabetology.2024;[Epub] CrossRef
Comparative Effect of Glucose-Lowering Drugs for Type 2 Diabetes Mellitus on Stroke Prevention: A Systematic Review and Network Meta-Analysis
Ji Soo Kim, Gyeongsil Lee, Kyung-Il Park, Seung-Won Oh
Diabetes & Metabolism Journal.2024; 48(2): 312. CrossRef
Therapy of Type 2 Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Experimental and Clinical Endocrinology & Diabetes.2024;[Epub] CrossRef
Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2023; 19(5): 658. CrossRef
Renoprotective Effect of Thai Patients with Type 2 Diabetes Mellitus Treated with SGLT-2 Inhibitors versus DPP-4 Inhibitors: A Real-World Observational Study
Apichaya Chanawong, Suriyon Uitrakul, Supatcha Incomenoy, Natnicha Poonchuay, Rizky Abdulah
Advances in Pharmacological and Pharmaceutical Sciences.2023; 2023: 1. CrossRef
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Daijin Huang, Yumei Li, Jing Ye, Chang Liu, Dongyan Shen, Yunhui Lv
Medicine.2023; 102(52): e36298. CrossRef
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Pavel Weber, Hana Meluzínová, Dana Weberová
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Hongwei Cao, Tao Liu, Li Wang, Qiuhe Ji
Diabetes, Obesity and Metabolism.2022; 24(8): 1448. CrossRef
Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2022; 18(5): 623. CrossRef
Significant reduction in chronic kidney disease progression with sodium‐glucose cotransporter‐2 inhibitors compared to dipeptidyl peptidase‐4 inhibitors in adults with type 2 diabetes in a UK clinical setting: An observational outcomes study based on inte
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Diabetes, Obesity and Metabolism.2022; 24(11): 2138. CrossRef
Therapy of Type 2 Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Experimental and Clinical Endocrinology & Diabetes.2022; 130(S 01): S80. CrossRef
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Chan-Hee Jung
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Diabetes
Effects of Dipeptidyl Peptidase-4 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis: Jae Hyun Bae, Sunhee Kim, Eun-Gee Park, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim; Endocrinol Metab. 2019;34(1):80-92. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.80

7,532 View
264 Download
36 Web of Science
38 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background

To investigate the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal outcomes in patients with type 2 diabetes.

Methods

MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched to identify randomized controlled trials (RCTs) of DPP-4 inhibitors from inception to September 2017. We selected eligible RCTs comparing DPP-4 inhibitors with placebo or other antidiabetic agents and reporting at least one renal outcome. A meta-analysis was conducted to calculate standardized mean differences, weighted mean differences (WMDs), relative risks (RRs), and 95% confidence intervals (CIs) for each renal outcome.

Results

We included 23 RCTs with 19 publications involving 41,359 patients. Overall changes in urine albumin-to-creatinine ratio were comparable between DPP-4 inhibitors and controls (P=0.150). However, DPP-4 inhibitors were associated with significantly lower risk of incident microalbuminuria (RR, 0.89; 95% CI, 0.80 to 0.98; P=0.022) and macroalbuminuria (RR, 0.77; 95% CI, 0.61 to 0.97; P=0.027), as well as higher rates of regression of albuminuria (RR, 1.22; 95% CI, 1.10 to 1.35; P<0.001) compared with controls. Although DPP-4 inhibitors were associated with small but significantly lower estimated glomerular filtration rate (WMD, −1.11 mL/min/1.73 m²; 95% CI, −1.78 to −0.44; P=0.001), there was no difference in the risk of end-stage renal disease between two groups (RR, 0.93; 95% CI, 0.76 to 1.14; P=0.475).

Conclusion

DPP-4 inhibitors had beneficial renal effects mainly by reducing the risk of development or progression of albuminuria compared with placebo or other antidiabetic agents.

Citations

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