{"doi":"10.1111/dom.70054","title":"Cardiovascular and kidney outcomes of <scp>GLP</scp> ‐1 receptor agonists in adults with obesity: A target trial emulation study","abstract":"AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) provide cardiovascular and renal benefits in type 2 diabetes, but their real-world effects in individuals with obesity without diabetes are unclear. This study aimed to evaluate the cardiovascular and kidney outcomes of GLP-1RAs versus other anti-obesity medications (AOMs) in adults with obesity. MATERIALS AND METHODS: This target trial emulation used TriNetX electronic health records (July 2021-May 2025) to identify adults with obesity and no diabetes history who initiated GLP-1RAs (liraglutide, semaglutide, or tirzepatide) or other AOMs. Outcomes included major adverse cardiovascular events (MACE), major adverse kidney events (MAKE), all-cause mortality, mental health conditions, and safety outcomes. Propensity score matching (1:1) balanced baseline characteristics; Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: The study included 140 169 matched pairs of GLP-1RA and AOM initiators. Mean follow-up was 392 days for GLP-1RA users and 564 days for AOM users. Compared to AOMs, GLP-1RA use was associated with lower risks of MACE (HR, 0.76; 95% CI, 0.72-0.81), MAKE (HR, 0.64; 95% CI, 0.55-0.74), and all-cause mortality (HR, 0.49; 95% CI, 0.42-0.57). Mental health outcomes also improved, with reduced risks of depression (HR, 0.63), suicidal ideation/attempt (HR, 0.42), and substance use disorder (HR, 0.58). GLP-1RAs were not associated with increased risks of acute pancreatitis (HR, 1.17), hypoglycemia (HR, 1.08), or gastrointestinal symptoms (HR, 0.99). CONCLUSIONS: Among adults with obesity but without diabetes, GLP-1RA use was associated with reduced cardiovascular, kidney, mortality, and mental health risks compared to other AOMs.","journal":"Diabetes Obesity and Metabolism","year":2025,"id":514016,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9276,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1375867,"name":"Yiwen Lu","orcid":"0009-0000-9591-2261","position":1,"is_corresponding":false},{"id":1163291,"name":"Bingyu Zhang","orcid":"0000-0001-7176-249X","position":2,"is_corresponding":false},{"id":1218240,"name":"Ting Zhou","orcid":"0000-0003-3392-2979","position":3,"is_corresponding":false},{"id":1093138,"name":"Dazheng Zhang","orcid":"0000-0002-1431-0785","position":4,"is_corresponding":false},{"id":1163292,"name":"Jiajie Chen","orcid":"0009-0008-7402-6883","position":5,"is_corresponding":false},{"id":235491,"name":"Yong Chen","orcid":"0009-0001-0019-6889","position":6,"is_corresponding":false},{"id":281593,"name":"David A. Asch","orcid":"0000-0002-7970-286X","position":8,"is_corresponding":false},{"id":545934,"name":"Huilin Tang","orcid":"0000-0002-5814-6657","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:48:23.284782Z","pmid":"40874398","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}