Effects of GLP-1 Receptor Agonists on the Risk of Cardiovascular Events and Serum ApoB/ApoA1 Ratio in Patients with Diabetic Kidney Disease
YU Ping
AN Yan
DONG Xuejie
ZHU Wei
Abstract：Objective: To investigate the relationship between serum apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) and major adverse cardiovascular events (MACE) in patients with diabetic kidney disease (DKD) after treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA). Methods: A retrospective analysis was conducted on data from 154 DKD patients admitted to our hospital between January 2022 and June 2023. The patients were divided into an observation group (52 cases) receiving metformin combined with GLP-1 RA and a control group (102 cases) receiving only metformin. The occurrence of major adverse cardiovascular events (MACEs), including cardiovascular death, non-fatal myocardial infarction, new-onset heart failure, refractory angina pectoris, and stent thrombosis, was observed and compared during follow-up. The effects of ApoB/ApoA1 and GLP-1 RA treatment on ApoB/ApoA1 levels were analyzed. Clinical data of all patients were collected, and univariate and logistic regression analyses were used to identify independent predictive factors for MACE in DKD patients. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and ApoB/ApoA1 in predicting MACE in DKD patients. Results: The incidence of MACE in the observation group was 11.5% (6/52), which was lower than that in the control group at 22.5% (23/102). Compared with the control group, the risk of MACE in the observation group was reduced by 48.89% [HR=0.51, 95%CI (0.34, 0.77), P<0.05]. The levels of TC, LDL-C, and ApoB/ApoA1 in the observation group were lower than those in the control group, with statistically significant differences (P<0.05). LDL-C and ApoB/ApoA1 were independent predictors of MACE in DKD patients (P<0.05). The area under the ROC curve (AUC) for ApoB/ApoA1 was 0.923, while that for LDL-C was 0.774. Conclusion: GLP-1 RA treatment can reduce the risk of MACE in DKD patients, and ApoB/ApoA1 may serve as a predictive indicator for assessing MACE risk in DKD patients.
Keywords：diabetic kidney diseaseglucagon-like peptide-1 receptor agonistmajor adverse cardiovascular eventsapolipoprotein B/apolipoprotein A1 ratioinfluencing factor
Publication Date：2025-06-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1723-1726 )