Department of Diabetes, Metabolism and Endocrinology, Kawasaki Medical School, Kurashiki, Japan.
Diabetes Obes Metab. 2024 Dec;26(12):5982-5994. doi: 10.1111/dom.15972. Epub 2024 Sep 30.
Tirzepatide, a dual agonist of glucagon-like peptide receptor and glucose-dependent insulinotropic polypeptide receptor, is expected to exhibit high clinical efficacy in obese type 2 diabetic patients. We evaluated the effects of tirzepatide on pancreatic β-cells and the liver, an insulin-target organ, in a mouse model of obese type 2 diabetes mellitus.
Obese type 2 diabetic db/db mice (BKS.Cg-/+ Leprdb/+ Leprdb/Jcl*) were used in this study. Starting at 7 weeks of age, mice were treated with tirzepatide (30 nmol/kg, subcutaneous injection twice a week) or semaglutide (200 nmol/kg, subcutaneous injection twice a week). The control group received phosphate-buffered saline (40-50 μL/subcutaneous injection twice a week). After 4 weeks of drug administration, pancreatic β-cells and the liver were removed and examined.
Compared to the control group, blood glucose and body weight were significantly reduced in the group that received either tirzepatide or semaglutide (p < 0.001 and p < 0.05, respectively). Fasting insulin was significantly higher in the semaglutide and tirzepatide groups compared to the control group (p < 0.001). β-Cell mass and quality of insulin granules in β-cells similarly increased in the semaglutide and tirzepatide groups compared to the control group (p < 0.05 and p < 0.001, respectively). The fat staining area in the liver in oil red O staining and the liver-spleen ratio in computed tomography showed improvement only in the tirzepatide group (p < 0.001 and p < 0.005, respectively). Liver macrophage M1/M2 ratio similarly improved with semaglutide and tirzepatide (p < 0.05).
Tirzepatide and semaglutide exhibited similar potent glucose-lowering effects. At concentrations used in the present experiments, tirzepatide exhibited more beneficial effects on β-cell-related gene expression, insulin granule count and glucose-stimulated insulin secretion compared to semaglutide. In addition, tirzepatide exhibited a stronger favourable effect on hepatic fat deposition and improved inflammation in the liver. This is the first report showing that tirzepatide, a novel diabetes drug, exhibits a superior effect on pancreatic β-cells and the liver of obese type 2 diabetic mice.
胰高血糖素样肽受体和葡萄糖依赖性胰岛素释放多肽受体双重激动剂替西帕肽有望在肥胖 2 型糖尿病患者中表现出较高的临床疗效。我们在肥胖 2 型糖尿病小鼠模型中评估了替西帕肽对胰岛β细胞和作为胰岛素靶器官的肝脏的作用。
本研究使用肥胖 2 型糖尿病 db/db 小鼠(BKS.Cg-/+Leprdb/+Leprdb/Jcl*)。从 7 周龄开始,小鼠每周两次接受替西帕肽(30nmol/kg,皮下注射)或司美格鲁肽(200nmol/kg,皮下注射)治疗。对照组接受磷酸盐缓冲盐水(40-50μL/皮下注射,每周两次)。给药 4 周后,取出胰腺β细胞和肝脏进行检查。
与对照组相比,接受替西帕肽或司美格鲁肽治疗的两组血糖和体重均显著降低(p<0.001 和 p<0.05)。空腹胰岛素在司美格鲁肽和替西帕肽组均显著高于对照组(p<0.001)。与对照组相比,司美格鲁肽和替西帕肽组β细胞质量和胰岛素颗粒质量均显著增加(p<0.05 和 p<0.001)。油红 O 染色的肝脏脂肪染色面积和计算机断层扫描的肝脾比值仅在替西帕肽组改善(p<0.001 和 p<0.005)。司美格鲁肽和替西帕肽组肝巨噬细胞 M1/M2 比值也有所改善(p<0.05)。
替西帕肽和司美格鲁肽均表现出类似的强效降血糖作用。在本实验中使用的浓度下,与司美格鲁肽相比,替西帕肽对与β细胞相关的基因表达、胰岛素颗粒计数和葡萄糖刺激的胰岛素分泌具有更有益的作用。此外,替西帕肽对肝脏脂肪沉积和改善肝脏炎症有更强的有利作用。这是首次报道新型糖尿病药物替西帕肽对肥胖 2 型糖尿病小鼠的胰岛β细胞和肝脏具有更好的作用。