부산대학교 도서관

Background Prior research suggests clinical effects of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) are mediated by changes in glycated hemoglobin, body weight, systolic blood pressure, hematocrit, and urine albumin‐creatinine ratio. We aimed to confirm these findings using a meta‐analytic approach. Methods and Results We updated a systematic review of 9 GLP‐1RA and 13 SGLT2i trials and summarized longitudinal mediator data. We obtained hazard ratios (HRs) for cardiovascular, renal, and mortality outcomes. We performed linear mixed‐effects modeling of LogHRs versus changes in potential mediators and investigated differences in meta‐regression associations among drug classes using interaction terms. HRs generally became more protective with greater glycated hemoglobin reduction among GLP‐1RA trials, with average HR improvements of 20% to 30%, reaching statistical significance for major adverse cardiovascular events (ΔHR, 23%; P=0.02). Among SGLT2i trials, associations with HRs were not significant and differed from GLP1‐RA trials for major adverse cardiovascular events (Pinteraction=0.04). HRs for major adverse cardiovascular events, myocardial infarction, and stroke became less efficacious (ΔHR, −15% to −34%), with more weight loss for SGLT2i but not for GLP‐1RA trials (ΔHR, 4%−7%; Pinteraction