Evidence map›Paper›PMID 40296191›Full record

ArticleDiabetes, obesity & metabolism2025

Association between the body mass index and risk of cardiovascular events in sodium-glucose cotransporter 2 inhibitor users compared with dipeptidyl-peptidase 4 inhibitor users: A nationwide cohort study in Korea.

Hwa Yeon Ko, Kyungyeon Jung, Yongtai Cho, Sungho Bea, Jae Hyun Bae, Young Min Cho, Sang Youl Rhee, Ju-Young Shin

Abstract readComparative Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Heart failure with preserved ejection fraction: current insights and emerging therapeutic directions.The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2026
    Review
  2. Article
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

8 authors.

Hwa Yeon KoSchool of Pharmacy, Sungkyunkwan University, Suwon, South Korea.ORCID 0000-0001-5297-8826
Kyungyeon JungDepartment of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea.ORCID 0009-0002-0990-9360
Yongtai ChoSchool of Pharmacy, Sungkyunkwan University, Suwon, South Korea.ORCID 0000-0003-3303-7881
Sungho BeaSchool of Pharmacy, Sungkyunkwan University, Suwon, South Korea.ORCID 0000-0003-2622-6553
Jae Hyun BaeDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.ORCID 0000-0002-1384-6123
Young Min ChoDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.ORCID 0000-0002-2331-6126
Sang Youl RheeDepartment of Digital Health, Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, South Korea.ORCID 0000-0003-0119-5818
Ju-Young ShinSchool of Pharmacy, Sungkyunkwan University, Suwon, South Korea.ORCID 0000-0003-1010-7525

Funding

Ministry of Food and Drug Safety 23212MFDS230Ministry of Food and Drug Safety RS-2024-00332632
6 · The paper itself

Abstract

aimsThere is limited evidence regarding whether obesity modifies the association between the use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and the risk of cardiovascular events. We assessed whether baseline body mass index (BMI) modifies the association between SGLT2i use and the risk of major adverse cardiovascular events (MACE) and heart failure (HF) in patients with type 2 diabetes (T2D). MATERIALS AND

methodsWe used the nationwide claims data of Korea (September 2014-December 2022) to construct an active-comparator, new-user cohort of patients with T2D stratified by the Asian BMI categories: normal weight, 18.5-23 kg/m

resultsNew-users of SGLT2i and DPP4i were PS-matched in a 1:1 ratio (n = 231 332 pairs; normal weight, 21 285 pairs; overweight, 35 372 pairs; and obesity, 174 675 pairs). The overall HR for the risk of MACE with SGLT2i versus DPP4i use was 0.90 (95% CI: 0.86-0.95), with no evidence of effect modification by baseline BMI (p for homogeneity = 0.27). The risk of HHF decreased in the overall cohort (HR: 0.53, 95% CI: 0.44-0.64), as well as in the obesity (HR: 0.47, 95% CI: 0.37-0.58) and overweight (HR: 0.49, 95% CI: 0.31-0.78) groups but not in the normal-weight (HR: 0.88, 95% CI: 0.59-1.31) group, with evidence of effect modification by the BMI (p for homogeneity = 0.01).

conclusionsThe association between SGLT2i use and the risk of MACE and HHF was significant in patients with obesity. Baseline BMI was an effect modifier in the association between SGLT2i use and the risk of HHF, with a more pronounced association observed with increasing BMI and with no significant effect modification of the association noted in patients with normal weight.

Indexed as

Body Mass IndexCardiovascular DiseasesDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsObesitySodium-Glucose Transporter 2 InhibitorsAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedRepublic of KoreaRisk FactorsDipeptidyl-Peptidase IV InhibitorsSodium-Glucose Transporter 2 Inhibitorsbody mass indexheart failuremajor adverse cardiovascular eventsSGLT2 inhibitors

Identifiers

PMID40296191
PMCPMC12146473

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Registered trials

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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 OpenQuestion graph.