Bulum Tomislav
Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Dugi dol 4a, 10000 Zagreb, Croatia.
Medical School, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia.
Biomedicines. 2022 Oct 15;10(10):2586. doi: 10.3390/biomedicines10102586.
Diabetes mellitus is the leading cause of chronic kidney disease, and about 30-40% of patients with diabetes will develop kidney disease. Incretin hormones have received attention during the past three decades not only as a pharmacotherapy for the treatment of type 2 diabetes, but also for their cardiorenometabolic effects. The main incretins are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). Additional to the pancreas, receptors for GLP-1 are widely distributed in various organs, causing positive effects on endothelial function and vascular atherogenesis. Along with glycemic control and weight reduction, GLP-1 receptor agonists also strongly improve cardiovascular and renal outcomes in patients with type 2 diabetes. Recently, a dual GIP and GLP-1 receptor agonist has been approved for the treatment of type 2 diabetes. Compared to GLP-1 receptor agonist semaglutide, dual GIP and GLP-1 receptor agonist tirzepatide showed a superior reduction in hemoglobin A1c and body weight. Preliminary results also suggest that tirzepatide improves kidney outcomes in adults with type 2 diabetes with increased cardiovascular risk. In this review, we present the nephroprotective properties of dual GIP and GLP-1 receptor agonists as a new drug to treat type 2 diabetes.
糖尿病是慢性肾脏病的主要病因，约30%-40%的糖尿病患者会发展为肾脏疾病。在过去三十年中，肠促胰岛素不仅作为治疗2型糖尿病的药物疗法受到关注，还因其对心脏、肾脏和代谢的影响而受到关注。主要的肠促胰岛素是胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）。除胰腺外，GLP-1受体广泛分布于各个器官，对内皮功能和血管动脉粥样硬化产生积极影响。除了控制血糖和减轻体重外，GLP-1受体激动剂还能显著改善2型糖尿病患者的心血管和肾脏结局。最近，一种GIP和GLP-1双重受体激动剂已被批准用于治疗2型糖尿病。与GLP-1受体激动剂司美格鲁肽相比，GIP和GLP-1双重受体激动剂替尔泊肽在降低糖化血红蛋白和体重方面表现更优。初步结果还表明，替尔泊肽可改善心血管风险增加的2型糖尿病成年患者的肾脏结局。在本综述中，我们阐述了GIP和GLP-1双重受体激动剂作为一种治疗2型糖尿病的新药的肾脏保护特性。
