Sodium-glucose cotransporter 2 inhibitors and cardiovascular events among patients with type 2 diabetes and low-to-normal body mass index: a nationwide cohort study
Authors' conclusion
The protective effect of SGLT2 inhibitors on cardiovascular events among patients with type 2 diabetes appeared to decrease with lower BMI and was not significant among patients with low-to-normal BMI (< 25.0 kg/m2). These findings suggest the importance of considering BMI when initiating SGLT2 inhibitors.
Study context
- Population
- Working-age patients with T2D in Japan, insurance claims and health screening records, April 2015–March 2022; 17.3% female, 31.0% with body mass index (BMI) <25.0 kg/m²matched cohort
- Participants
- 139,783 vs 139,783
- Exposure
- SGLT2i vs DPP-4i
- SGLT2 inhibitorsn = 139,783
- DPP4 inhibitorsn = 139,783reference
- Outcome
- Composite of:
- All-cause death
- MI
- Stroke
- HF
- Follow-up
- Median 24 months
Methodological detailsnationwide, matched, stratified by BMI category
- Nationwide
- Matched
- Stratified by BMI category
Main finding
As reported in the abstract
SGLT2i vs DPP-4iHazard ratio (95% CI)
Whole population
0.92(0.89–0.96)
BMI <20.0 kg/m²
1.08(0.80–1.46)
BMI 20.0-22.4 kg/m²
1.04(0.90–1.20)
BMI 22.5-24.9 kg/m²
0.92(0.84–1.01)
- Primary outcome occurred in participants overall
- 2.9% (n = 8,165)
Observational data: associations, not effects.
Original publication
Sodium-glucose cotransporter 2 inhibitors and cardiovascular events among patients with type 2 diabetes and low-to-normal body mass index: a nationwide cohort study. Cardiovasc Diabetol. Published 22 October 2024. doi:10.
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