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替尔泊肽治疗的超重或肥胖中国人2型糖尿病10年风险预测:SURMOUNT-CN试验的事后分析

Predicting 10-year risk of type 2 diabetes in Chinese people with overweight or obesity treated with Tirzepatide: Post hoc analysis of SURMOUNT-CN trial.

作者信息

Zhao Lin, Tao Feng, Cheng Zhifeng, Lu Yibing, Liu Ming, Chen Hong, Zhang Min, Yang Yang, Song Xiang, Sun Yuzi, Ma Xiao, Si Si, Zhang Hanxi, Li Xiaoying

机构信息

Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Endocrinology, Shanghai Traditional Chinese Medicine Hospital, Shanghai, China.

出版信息

Diabetes Obes Metab. 2025 Aug;27(8):4118-4125. doi: 10.1111/dom.16439. Epub 2025 May 6.

Abstract

AIM

To assess the association of tirzepatide use with a 10-year predicted risk of type 2 diabetes (T2D) among Chinese participants with obesity or overweight from the SURMOUNT-CN trial.

MATERIALS AND METHODS

In this post hoc analysis, the QDiabetes-2018 risk engine was used to calculate the 10-year predicted T2D risk at baseline, week 24 and week 52 among SURMOUNT-CN participants randomized to receive tirzepatide 10 mg, 15 mg or placebo. A mixed model for repeated measures was used to compare mean predicted risk changes from baseline to weeks 24 and 52 between tirzepatide and placebo. Subgroup analyses were conducted by baseline body weight mass index (BMI) status and baseline prediabetes status.

RESULTS

Demographic and baseline clinical characteristics were similar among tirzepatide10 mg (n = 59), 15 mg (n = 53) and placebo (n = 57). From baseline to week 52, the least square (LS) mean predicted T2D risk changed from 5.3% to 1.2% for tirzepatide 10 mg, from 4.9% to 1.0% for tirzepatide 15 mg and from 5.8% to 4.5% for placebo. The difference in LS mean risk change from baseline to week 52 was significant between both tirzepatide 10 mg (-3.2%, 95% confidence interval [CI]: -4.2%, -2.2%) and 15 mg (-3.4%, 95% CI: -4.4%, -2.4%) and placebo. Significantly greater predicted risk reductions for tirzepatide than placebo were observed in all subgroups.

CONCLUSION

Tirzepatide was associated with significantly reduced predicted 10-year risk of T2D among SURMOUNT-CN participants with obesity or overweight, irrespective of baseline BMI and prediabetes status.

摘要

目的

在SURMOUNT-CN试验中,评估替尔泊肽的使用与中国肥胖或超重参与者10年2型糖尿病(T2D)预测风险之间的关联。

材料与方法

在这项事后分析中,使用QDiabetes-2018风险引擎计算SURMOUNT-CN试验中随机接受10毫克、15毫克替尔泊肽或安慰剂的参与者在基线、第24周和第52周时10年T2D预测风险。采用重复测量混合模型比较替尔泊肽组和安慰剂组从基线到第24周和第52周的平均预测风险变化。根据基线体重指数(BMI)状态和基线糖尿病前期状态进行亚组分析。

结果

10毫克替尔泊肽组(n = 59)、15毫克替尔泊肽组(n = 53)和安慰剂组(n = 57)的人口统计学和基线临床特征相似。从基线到第52周,10毫克替尔泊肽组的最小二乘(LS)平均预测T2D风险从5.3%降至1.2%,15毫克替尔泊肽组从4.9%降至1.0%,安慰剂组从5.8%降至4.5%。10毫克替尔泊肽组(-3.2%,95%置信区间[CI]:-4.2%,-2.2%)和15毫克替尔泊肽组(-3.4%,95%CI:-4.4%,-2.4%)与安慰剂组相比,从基线到第52周的LS平均风险变化差异均具有统计学意义。在所有亚组中,均观察到替尔泊肽组的预测风险降低幅度显著大于安慰剂组。

结论

在SURMOUNT-CN试验中,无论基线BMI和糖尿病前期状态如何,替尔泊肽与肥胖或超重参与者显著降低的10年T2D预测风险相关。

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