Evidence map›Paper›PMID 40920377›Full record

ArticleJAMA network open2025

GLP-1 RAs and Cardiovascular and Kidney Outcomes by Body Mass Index in Type 2 Diabetes.

Tien-Hsing Chen, En-Hao Hu, Dong-Yi Chen, Yuan Lin, Tien-Shin Chou, Ming-Shyan Lin, Ning-I Yang, Chao-Yung Wang, Ming-Jui Hung, Ming-Lung Tsai

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Observational
  2. Cardiorenal outcomes of weight loss interventions in people with CKD and type 2 diabetes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tien-Hsing ChenDivision of Cardiology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
En-Hao HuDepartment of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Dong-Yi ChenDivision of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Yuan LinDepartment of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Tien-Shin ChouDivision of Gastroenterology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Ming-Shyan LinDivision of Cardiology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
Ning-I YangDivision of Cardiology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Chao-Yung WangDivision of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Ming-Jui HungDivision of Cardiology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Ming-Lung TsaiDivision of Cardiology, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The cardiovascular benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may vary by body mass index (BMI), but evidence on BMI-specific outcomes remains limited. Objective: To investigate the associations of GLP-1 RA use with cardiovascular and kidney outcomes across BMI categories in patients with type 2 diabetes. Design, Setting, and Participants: This retrospective cohort study used the Chang Gung Research Database, a clinical dataset covering multiple hospitals in Taiwan. Patients with type 2 diabetes who received GLP-1 RAs or dipeptidyl peptidase-4 (DPP-4) inhibitors between 2011 and 2022 were identified. DPP-4 inhibitors were selected as the comparator due to their widespread use as a second-line oral hypoglycemic agent and their relatively neutral cardiovascular and kidney effects reported in previous studies. Propensity score matching was applied separately within BMI categories less than 25 and 25 or greater using a comprehensive set of demographic, clinical, and biochemical variables to balance baseline characteristics between treatment groups. The analysis was conducted from December 15, 2023, to July 5, 2024. Exposures: Initiation of GLP-1 RAs compared with DPP-4 inhibitors. Main Outcomes and Measures: Primary outcomes included major adverse cardiovascular events (MACE; defined as cardiovascular death, myocardial infarction, ischemic stroke, or hospitalization for heart failure) and composite kidney outcomes (defined as estimated glomerular filtration rate decline ≥50% or progression to dialysis). Results: Among 97 156 patients with diabetes identified, a total of 7200 matched patients (mean [SD] age, 57.4 [14.2] years; 7473 [51.9%] female) were included (1841 pairs with BMI <25 and 5359 pairs with BMI ≥25). Among patients with BMI 25 or greater, GLP-1 RAs were associated with lower risks of cardiovascular death (hazard ratio [HR], 0.62; 95% CI, 0.46-0.83) and hospitalization for heart failure (subdistribution HR, 0.77; 95% CI, 0.62-0.94). Kidney outcomes were consistent across BMI strata. Restricted cubic spline analysis revealed increasing cardiovascular benefit associated with GLP-1 RAs among patients with higher BMI. Conclusions and Relevance: In this cohort study of patients with type 2 diabetes, GLP-1 RAs use was associated with BMI-dependent cardiovascular benefits and consistent kidney protection, suggesting the importance of BMI stratification in guiding treatment decisions.

Indexed as

Body Mass IndexCardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsAgedDipeptidyl-Peptidase IV InhibitorsFemaleHumansMaleMiddle AgedRetrospective StudiesTaiwanDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic Agents

Identifiers

PMID40920377
PMCPMC12418133

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.