Wen Yi, Lemen Deven, Lin Yanzhu, Chen Yan Q, Regmi Ajit, Roell William C, Thomas Melissa K, Hartman Mark L, Coskun Tamer, Milicevic Zvonko, Haupt Axel, Ruotolo Giacomo, Konrad Robert J
Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA.
Diabetes Obes Metab. 2025 Oct;27(10):5985-5995. doi: 10.1111/dom.16661. Epub 2025 Jul 29.
AIMS: The aim of this study was to determine if retatrutide, a triple agonist of glucose-dependent insulinotropic polypeptide (GIP) receptor, glucagon-like peptide 1 (GLP-1) receptor and glucagon (GCG) receptor, may lower serum triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) levels in part by decreasing circulating concentrations of the angiopoietin-like protein 3/8 complex (ANGPTL3/8). MATERIALS AND METHODS: In post-hoc analyses of two phase 2 retatrutide trials, concentrations of ANGPTL3/8, ANGPTL4/8 complex (ANGPTL4/8), ANGPTL3 and ANGPTL4 were measured using dedicated immunoassays to determine percent changes from baseline. Correlations of ANGPTL protein and complex levels with lipid and metabolic parameters at baseline were analysed. Correlations of the changes in ANGPTL protein and complex levels versus the changes in lipid and metabolic parameters at study endpoints were also analysed. Direct effects of retatrutide itself, GIP, GLP-1, GCG and a GCG receptor (GCGR) antagonist antibody on ANGPTL3/8 secretion were studied in vitro using primary human hepatocytes. RESULTS: ANGPTL3/8 reductions were observed with 8 and 12 mg retatrutide doses in participants with type 2 diabetes, and with 1, 4, 8 and 12 mg retatrutide doses in participants with obesity or overweight but without diabetes. In both cases, ANGPTL3/8 decreases paralleled retatrutide-induced reductions in TG and LDL-C. In primary human hepatocytes, both glucagon and retatrutide decreased ANGPTL3/8 secretion, and these reductions were blocked with the GCGR antagonist antibody. CONCLUSIONS: Together, these results suggest that the GCGR agonism of retatrutide could lead to reduced circulating ANGPTL3/8 concentrations, which may then contribute to decreases in TG and LDL-C levels.
目的:本研究旨在确定葡萄糖依赖性促胰岛素多肽(GIP)受体、胰高血糖素样肽1(GLP-1)受体和胰高血糖素(GCG)受体的三联激动剂retatrutide是否可部分通过降低血管生成素样蛋白3/8复合物(ANGPTL3/8)的循环浓度来降低血清甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平。 材料与方法:在两项retatrutide 2期试验的事后分析中,使用专用免疫测定法测量ANGPTL3/8、ANGPTL4/8复合物(ANGPTL4/8)、ANGPTL3和ANGPTL4的浓度,以确定相对于基线的百分比变化。分析了基线时ANGPTL蛋白和复合物水平与脂质和代谢参数的相关性。还分析了研究终点时ANGPTL蛋白和复合物水平的变化与脂质和代谢参数变化的相关性。使用原代人肝细胞在体外研究了retatrutide本身、GIP、GLP-1、GCG和GCG受体(GCGR)拮抗剂抗体对ANGPTL3/8分泌的直接影响。 结果:在2型糖尿病患者中,8毫克和12毫克retatrutide剂量可降低ANGPTL3/8水平;在肥胖或超重但无糖尿病的患者中,1毫克、4毫克、8毫克和12毫克retatrutide剂量均可降低ANGPTL3/8水平。在这两种情况下,ANGPTL3/8的降低与retatrutide诱导的TG和LDL-C降低平行。在原代人肝细胞中,胰高血糖素和retatrutide均降低了ANGPTL3/8的分泌,而这些降低被GCGR拮抗剂抗体阻断。 结论:总之,这些结果表明retatrutide的GCGR激动作用可能导致循环ANGPTL3/8浓度降低,进而可能有助于降低TG和LDL-C水平。
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