ArticleInternational urology and nephrology2026
Comparison of SGLT-2i and GLP-1RA on cardiovascular and renal outcomes in elderly patients with T2DM: a single-center retrospective cohort study.
Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWhile SGLT-2i and GLP-1RA show cardiorenal benefits, their comparative efficacy in elderly type 2 diabetes mellitus (T2DM) patients remains uncertain. This study aimed to compare SGLT-2i and GLP-1RA on cardiovascular and renal outcomes in elderly T2DM patients.
methodsThis retrospective study analyzed 1,015 propensity score-matched elderly T2DM patients (SGLT-2i group: n = 583; GLP-1RA group: n = 432). Medical records were collected to assess cardiovascular/renal outcomes, glycemic parameters [(fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPBG), homeostatic model assessment of insulin resistance (HOMA-IR), and hemoglobin A1c (HbA1c)], body mass index (BMI), and adverse reactions. A Cox regression model was constructed to analyze the impact of SGLT-2i and GLP-1RA on 3-point major adverse cardiovascular events (3P-MACE: non-fatal myocardial infarction, stroke, and cardiovascular death) and adverse renal outcomes (persistent decline in eGFR by 40%, end-stage renal disease, or death due to renal disease) across subgroups.
resultsThe two groups were similar in baseline clinical characteristics. The risk of 3P-MACE was not markedly different between the SGLT-2i and GLP-1RA groups (P = 0.071), while SGLT-2i demonstrated a superior performance in reducing the risk of composite adverse renal outcomes (P = 0.014). Both groups achieved significant glycemic improvements and BMI reduction at 24 months post-treatment (all P < 0.05), with greater BMI reduction in GLP-1RA (P < 0.05). The two groups did not differ markedly in overall adverse events (P > 0.05). No marked differences were found in 3P-MACE or adverse renal composite outcomes across the predefined subgroups (all P > 0.05).
conclusionIn elderly T2DM patients, SGLT-2i and GLP-1RA contributed to similar cardiovascular outcomes, but SGLT-2i was associated with a lower risk of composite adverse renal outcomes.
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