Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO.
University of Miami Miller School of Medicine, Miami, FL.
Diabetes Care. 2024 Jun 1;47(6):1056-1064. doi: 10.2337/dc23-2356.
We evaluated baseline characteristics of participants with early-onset type 2 diabetes (T2D) from the SURPASS program and tirzepatide's effects on glycemic control, body weight (BW), and cardiometabolic markers.
This post hoc analysis compared baseline characteristics and changes in mean HbA1c, BW, waist circumference (WC), lipids, and blood pressure (BP) in 3,792 participants with early-onset versus later-onset T2D at week 40 (A Study of Tirzepatide [LY3298176] in Participants With Type 2 Diabetes Not Controlled With Diet and Exercise Alone [SURPASS-1] and A Study of Tirzepatide [LY3298176] Versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Participants With Type 2 Diabetes [SURPASS-2]) or week 52 (A Study of Tirzepatide [LY3298176] Versus Insulin Degludec in Participants With Type 2 Diabetes [SURPASS-3]). Analyses were performed by study on data from participants while on assigned treatment without rescue medication in case of persistent hyperglycemia.
At baseline in SURPASS-2, participants with early-onset versus later-onset T2D were younger with longer diabetes duration (9 vs. 7 years, P < 0.001) higher glycemic levels (8.5% vs. 8.2%, P < 0.001), higher BW (97 vs. 93 kg, P < 0.001) and BMI (35 vs. 34 kg/m2, P < 0.001), and a similarly abnormal lipid profile (e.g., triglycerides 167 vs. 156 mg/dL). At week 40, similar improvements in HbA1c (-2.6% vs. -2.4%), BW (-14 vs. -13 kg), WC (-10 vs. -10 cm), triglycerides (-26% vs. -24%), HDL (7% vs. 7%), and systolic BP (-6 vs. -7 mmHg) were observed in both subgroups with tirzepatide.
Despite younger age, participants with early-onset T2D from the SURPASS program had higher glycemic levels and worse overall metabolic health at baseline versus those with later-onset T2D. In this post hoc analysis, similar improvements in HbA1c, BW, and cardiometabolic markers were observed with tirzepatide, irrespective of age at T2D diagnosis. Future studies are needed to determine long-term outcomes of tirzepatide in early-onset T2D.
我们评估了 SURPASS 项目中早发性 2 型糖尿病（T2D）患者的基线特征，以及替西帕肽对血糖控制、体重（BW）、心血管代谢标志物的影响。
这项事后分析比较了在第 40 周（一项研究替西帕肽[LY3298176]在饮食和运动单独控制不佳的 2 型糖尿病患者中的疗效[SURPASS-1]和一项替西帕肽[LY3298176]与每周一次司美格鲁肽作为 2 型糖尿病患者二甲双胍附加治疗的疗效比较研究[SURPASS-2]）或第 52 周（一项替西帕肽[LY3298176]与 2 型糖尿病患者甘精胰岛素的疗效比较研究[SURPASS-3]）时，3792 名早发性和晚发性 T2D 患者的基线特征以及平均 HbA1c、BW、腰围（WC）、血脂和血压（BP）的变化。分析基于研究数据，在出现持续性高血糖的情况下，对接受指定治疗而无抢救药物的患者进行分析。
在 SURPASS-2 中，与晚发性 T2D 患者相比，早发性 T2D 患者的基线特征为年龄更小（9 岁 vs. 7 岁，P < 0.001）、血糖水平更高（8.5% vs. 8.2%，P < 0.001）、BW 更高（97 公斤 vs. 93 公斤，P < 0.001）和 BMI 更高（35 公斤/平方米 vs. 34 公斤/平方米，P < 0.001），且血脂谱同样异常（如，甘油三酯 167 毫克/分升 vs. 156 毫克/分升）。在第 40 周时，替西帕肽治疗组两组患者的 HbA1c（-2.6% vs. -2.4%）、BW（-14 公斤 vs. -13 公斤）、WC（-10 厘米 vs. -10 厘米）、甘油三酯（-26% vs. -24%）、高密度脂蛋白（7% vs. 7%）和收缩压（-6 毫米汞柱 vs. -7 毫米汞柱）均有类似的改善。
尽管年龄较小，但与晚发性 T2D 患者相比，SURPASS 项目中的早发性 T2D 患者在基线时血糖水平更高，整体代谢健康状况更差。在这项事后分析中，替西帕肽治疗可使 HbA1c、BW 和心血管代谢标志物得到类似的改善，与 T2D 的发病年龄无关。需要进一步的研究来确定替西帕肽在早发性 T2D 中的长期疗效。
