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논문분류	춘계학술대회 초록집
제목	Disparities in Cardiovascular Outcomes of GLP-1 Receptor Agonists by Sex, BMI, and Renal Function in Type 2 Diabetes: A Meta-Analysis
저자	Noha Hammad
출판정보	2026; 2026(1):
키워드	GLP-1 receptor agonists, type 2 diabetes, major adverse cardiovascular events (MACE), renal function, estimated glomerular filtration rate
초록	Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce cardiovascular risk in patients with type 2 diabetes (T2D). However, whether these benefits vary by sex, body mass index (BMI), or renal function remains unclear. Methods: This meta-analysis followed PRISMA and Cochrane Handbook guidelines. PubMed, Web of Science, Scopus, and Cochrane CENTRAL were searched through November 2025 for placebo-controlled randomized controlled trials evaluating GLP-1RAs in adults with T2D. Eligible studies reported major adverse cardiovascular events (MACE) stratified by sex, BMI, and/or estimated glomerular filtration rate (eGFR). Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analyses were conducted by sex, BMI (>30 vs ≤30 kg/m²), and renal function (eGFR ≥60 vs <60 mL/min/1.73 m²). Results: Nine RCTs including 67,718 participants (34,560 GLP-1RA; 33,158 placebo) with follow-up ranging from 1.3 to 5.4 years were analyzed. The mean age was 64.3 ± 7.9 years. GLP-1RAs significantly reduced MACE in both males (RR 0.89, 95% CI 0.85–0.95) and females (RR 0.84, 95% CI 0.87–0.91), with a greater relative reduction observed in women. Significant benefit was also seen in patients with BMI >30 kg/m² (RR 0.87, 95% CI 0.82–0.92) and BMI ≤30 kg/m² (RR 0.86, 95% CI 0.75–0.98). By renal function, GLP-1RAs reduced MACE in patients with eGFR ≥60 mL/min/1.73 m² (RR 0.87, 95% CI 0.89–0.94), whereas the effect was not statistically significant in those with eGFR <60 mL/min/1.73 m² (RR 0.88, 95% CI 0.77–1.01). Conclusion: GLP-1RAs significantly reduce cardiovascular events in T2D, with consistent benefits across sex and BMI subgroups. However, cardiovascular protection may be attenuated in patients with impaired renal function, underscoring the need for individualized risk assessment.
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