490-P: Renal Effects of Metformin in Type 1 Diabetes (T1D): The REMOVAL Trial
Bibliographic record
Abstract
Aims: In REMOVAL (NCT01483560), metformin attenuated decline in estimated glomerular filtration rate (eGFR) using the creatinine-based Modified Diet in Renal Disease (MDRD) equation in adults with T1D. We now report the effects of metformin vs. placebo on: (i) eGFR by CKD-EPI; and (ii) microalbuminuria (albumin: creatinine ratio, ACR). Methods: In 428 participants (mean age 55 years; HbA1c 8.0%; BP 130/72mmHg; eGFR 92 ml/min/1.73m2, 69% on ACE inhibitors/ARBs), CKD-EPI was derived separately from creatinine and cystatin C (annual). ACR was measured on annual first morning void. Treatment effects were compared by ANCOVA for continuous data (adjusted for baseline) and Cox Regression for incident microalbuminuria. Results: Mean baseline eGFR by CKD-EPI was 90 ml/min/1.73m2 by creatinine and 96 ml/min/1.73m2 by cystatin C. Decline in eGFR over 3 years was attenuated by metformin vs. placebo when CKD-EPI was derived from creatinine and cystatin C. There was no effect on ACR but confidence intervals were wide (Table). Conclusions: Deriving eGFR from other biomarkers/equations does not alter the conclusion that metformin has a potentially beneficial effect on eGFR in T1D; its effect on ACR requires further study. Disclosure J.G. Timmons: None. N. Greenlaw: None. C.D. Stehouwer: None. M. Brouwers: None. N. Chaturvedi: Consultant; Self; AstraZeneca. A.D. Hughes: Advisory Panel; Spouse/Partner; AstraZeneca. I. Hramiak: Consultant; Self; Medtronic, Novo Nordisk Inc. Research Support; Self; Eli Lilly and Company, PHRI Population Health Research Institute, Sanofi. Speaker’s Bureau; Self; Boehringer Ingelheim (Canada) Ltd., Merck & Co., Inc. Other Relationship; Self; AstraZeneca, Bristol-Myers Squibb, Insulet Corporation. A. Jenkins: Advisory Panel; Self; Abbott, Medtronic. Research Support; Self; Abbott, GlySens Incorporated, Medtronic, Sanofi-Aventis. P. Welsh: Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Roche Diagnostics. N. Sattar: Advisory Panel; Self; Amgen, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S, Pfizer Inc., Sanofi. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. H.M. Colhoun: Advisory Panel; Self; AstraZeneca, Eli Lilly and Company, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Regeneron Pharmaceuticals, Sanofi-Aventis. Research Support; Self; AstraZeneca, Eli Lilly and Company, Novo Nordisk Inc., Novo Nordisk Inc., Pfizer Inc., Regeneron Pharmaceuticals, Sanofi-Aventis. Speaker’s Bureau; Self; Eli Lilly and Company, Regeneron Pharmaceuticals, Sanofi. Stock/Shareholder; Self; Bayer AG, Roche Pharma. Other Relationship; Self; Eli Lilly and Company, Sanofi. P. Rossing: Advisory Panel; Self; Sanofi. Consultant; Self; Astellas Pharma Inc., AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim International GmbH, Gilead Sciences, Inc., Novo Nordisk A/S. Research Support; Self; Novo Nordisk A/S. Speaker’s Bureau; Self; Eli Lilly and Company. Stock/Shareholder; Self; Novo Nordisk A/S. J.R. Petrie: Advisory Panel; Self; Novo Nordisk A/S. Consultant; Self; Advanced Clinical Intelligence, IQVIA. Research Support; Self; AstraZeneca, Janssen Pharmaceuticals, Inc. Speaker’s Bureau; Self; Merck KGaA, Novo Nordisk A/S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".