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弥合 GLP1 受体激动剂与心血管结局之间的差距:替西帕肽的作用证据。

Bridging the gap between GLP1-receptor agonists and cardiovascular outcomes: evidence for the role of tirzepatide.

机构信息

Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

Cardiovasc Diabetol. 2024 Jul 10;23(1):242. doi: 10.1186/s12933-024-02319-7.

DOI:10.1186/s12933-024-02319-7
PMID:38987789
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11238498/
Abstract

Tirzepatide is a new drug targeting glucagon-like peptide 1(GLP1) and gastric inhibitory polypeptide (GIP) receptors. This drug has demonstrated great potential in improving the clinical outcomes of patients with type 2 diabetes. It can lead to weight loss, better glycemic control, and reduced cardiometabolic risk factors. GLP1 receptor agonists have been proven effective antidiabetic medications with possible cardiovascular benefits. Even though they have been proven to reduce the risk of major adverse cardiovascular events, their effectiveness in treating heart failure is unknown. Unlike traditional GLP1 receptor agonists, tirzepatide is more selective for the GIP receptor, resulting in a more balanced activation of these receptors. This review article discusses the possible mechanisms tirzepatide may use to improve cardiovascular health. That includes the anti-inflammatory effect, the ability to reduce cell death and promote autophagy, and also its indirect effects through blood pressure, obesity, and glucose/lipid metabolism. Additionally, tirzepatide may benefit atherosclerosis and lower the risk of major adverse cardiac events. Currently, clinical trials are underway to evaluate the safety and efficacy of tirzepatide in patients with heart failure. Overall, tirzepatide's dual agonism of GLP1 and GIP receptors appears to provide encouraging cardiovascular benefits beyond glycemic control, offering a potential new therapeutic option for treating cardiovascular diseases and heart failure.

摘要

替尔泊肽是一种新型的胰高血糖素样肽 1(GLP1)和胃抑制多肽 (GIP) 受体靶向药物。该药在改善 2 型糖尿病患者的临床结局方面显示出巨大潜力。它可以导致体重减轻、更好的血糖控制和减少心血管代谢危险因素。GLP1 受体激动剂已被证明是有效的抗糖尿病药物,可能对心血管有益。尽管它们已被证明可降低主要不良心血管事件的风险,但它们在治疗心力衰竭方面的效果尚不清楚。与传统的 GLP1 受体激动剂不同,替尔泊肽对 GIP 受体更具选择性,从而更平衡地激活这些受体。这篇综述文章讨论了替尔泊肽可能用于改善心血管健康的潜在机制。其中包括抗炎作用、减少细胞死亡和促进自噬的能力,以及通过血压、肥胖和葡萄糖/脂质代谢的间接作用。此外,替尔泊肽可能有益于动脉粥样硬化并降低主要不良心脏事件的风险。目前,正在进行临床试验以评估替尔泊肽在心力衰竭患者中的安全性和疗效。总体而言,替尔泊肽对 GLP1 和 GIP 受体的双重激动作用似乎提供了除血糖控制之外令人鼓舞的心血管益处,为治疗心血管疾病和心力衰竭提供了一种潜在的新治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf65/11238498/28bee57c9d8f/12933_2024_2319_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf65/11238498/28bee57c9d8f/12933_2024_2319_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf65/11238498/28bee57c9d8f/12933_2024_2319_Fig1_HTML.jpg

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本文引用的文献

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The current landscape for diabetes treatment: Preventing diabetes-associated CV risk.当前糖尿病治疗领域全景:预防糖尿病相关心血管风险。
Atherosclerosis. 2024 Jul;394:117560. doi: 10.1016/j.atherosclerosis.2024.117560. Epub 2024 Apr 23.
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Glycemic control and clinical outcomes in diabetic patients with heart failure and reduced ejection fraction: insight from ventricular remodeling using cardiac MRI.使用心脏 MRI 评估心室重构:糖尿病合并射血分数降低心力衰竭患者的血糖控制与临床结局。
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Safety of native glucose-dependent insulinotropic polypeptide in humans.
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Role of Residual Inflammation as a Risk Factor Across Cardiovascular-Kidney-Metabolic (CKM) Syndrome: Unpacking the Burden in People with Type 2 Diabetes.残余炎症作为心血管-肾脏-代谢(CKM)综合征危险因素的作用:剖析2型糖尿病患者的负担
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A different perspective on studying stroke predictors: joint models for longitudinal and time-to-event data in a type 2 diabetes mellitus cohort.关于研究中风预测因素的不同视角:2型糖尿病队列中纵向数据和事件发生时间数据的联合模型
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Biotechnology Revolution Shaping the Future of Diabetes Management.生物技术革命塑造糖尿病管理的未来。
Biomolecules. 2024 Dec 7;14(12):1563. doi: 10.3390/biom14121563.
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Weight Loss Therapies and Hypertension Benefits.减肥疗法与高血压益处。
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