The Ulutas Medical Journal p-ISSN 2149-0430 e-ISSN 2149-388X

The Ulutas Medical Journal · ISSN 2149-0430 (印刷版), 2149-388X (在线版) · https://www.ulutasmedicaljournal.com/?mno=254988

短篇通讯 · 开放获取

GLP-1 肥胖和心力衰竭患者的作用

标题、摘要和全文为机器翻译。 英文原文

  • Kevan English1
  • Christine Uwibambe2
  1. Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States ROR
  2. Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, United States ROR
下载 PDF (328.1 KB) 引用方式 doi:10.5455/umj.20250429034140

摘要

肥胖是心脏衰竭的一个众所周知的风险因素,保留了喷出分数(HFpEF). 通过最近的临床试验,已经证明,类似葡萄糖的肽-1和依赖葡萄糖的胰氨酸多肽(GIP)受体激动剂可以降低肥胖症和HFpEF患者的死亡率,改善症状. 根据新的现有数据,我们建议改变全球医生的临床做法。 现在有证据支持在肥胖患者和高血压和高血压患者中启动GLP-1/GIP激动剂。 这份简短的通报回顾了一些关于GLP-1/GIP激动剂的最新数据,这些数据支持了他们对肥胖和心脏衰竭患者的临床症状.

关键词

全文

全文为机器翻译；以英文原文为准。 英文原文

肥胖是已知的心脏衰竭风险因素,保留了弹射分数(HFpEF) (1)这些患者中有许多最终由于粘膜消化会诱发系统性的炎症状态,导致心肌功能明显失调,通过心肌吞噬组织的发炎过渡,可能转录到心肌中. (1, 2)产生循环体积膨胀和压力超载,导致心血管-肾脏末端器官损伤 (1–3)Tirzepatide是葡萄糖类肽-1(GLP-1)和葡萄糖依赖性胰腺多肽(GIP)受体的双激动剂,在新英格兰医学杂志最近出版的SUMMIT试验中被证明具有显著的心血管效益. (4). 在此次国际双盲、随机、安慰剂控制的试验中,731名HFpEF和肥胖患者(由至少30人的身体质量指数(BMI)定义)至少获得t(每周一次最多15毫克)或安慰剂,为期52周。 分配的团体比例为1:1。

两个主要的终点是心血管病死或心力衰竭事件恶化,堪萨斯市心肺病问卷临床总结分数(KCCQ-CSS;分数在0到100之间,高分显示生活质量更好)从基线变为52周. 结果显示,安慰剂的56名患者(危险比率,0.62;95%的置信间隔,0.41–095;p=0.026)和tirzepatide组的36名患者(9.9%)因心血管原因死亡或心力衰竭事件恶化。 在52周时,KCCQ-CSS的平均变化是19.5±1.2,而安慰剂组的平均变化是12.7±1.3。 研究最终得出结论,与安慰剂相比,tirzepatide降低了心血管疾病导致死亡或心力衰竭事件恶化的风险,改善了HFpEF和肥胖患者的健康状况.

还进行了另外两次试验,两次试验都评价了高血压和肥胖症患者使用血浆(GLP-1激动剂)的情况。 在STEP-HFpEF临床试验中,529名HFpEF和肥胖症患者(由30个或以上的BMI定义)被随机分配接受一次每周一次的溶解(2.4毫克)或安慰剂,为期52周 (5)。两个主要终点是体重变化和KCCQ-CSS基准变化。 研究显示,与安慰剂相比,用麻黄素进行治疗可以使症状和局限性得到更大幅度的减少,锻炼功能得到更大的改善,体重减少也更大. 同样,在STEP-HFpEF糖尿病试验中,肥胖病人、HFpEF病人和2型糖尿病患者中,与安慰剂1年相比,麻黄素导致生理限制和心力衰竭相关症状减少更多,体重减少更多。 (6)这些临床研究最终表明,GLP-1激动剂在患有肥胖症的心脏衰竭患者中发挥着作用。 虽然t基pat基pat基pat基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide基ide 血浆体积的扩大和有利于HFpEF致病的炎症反应 (7–10)在执业的临床医生中,我们建议考虑对有记录的HFpEF和肥胖症患者开具GLP-1激动剂的处方,因为有可能改善症状和增加死亡率。 对这些审判的一个重大限制是BMI标准(将至少30个BMI定为资格标准)。 因此,需要进行进一步研究,以评估GLP-1/GIP激动剂对体重指数低于30的患者的作用。

声明

作者贡献（CRediT）
所有作者对全部 14 项 CRediT 角色贡献均等（Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing）。
资助

None of the authors received any financial grant that could be considered a potential conflict of interest regarding this manuscript or its submission.

利益冲突
The authors declare no relevant conflicts of interest for this article. None of the authors received any financial grant that could be considered a potential conflict of interest regarding this manuscript or its submission.
伦理批准
Ethics approval details were not reported in the published version of this article.
数据可用性
A data availability statement was not reported in the published version of this article.

参考文献 (10)

10 条参考文献中有 9 条已链接 DOI。

  1. Aryee EK, Ozkan B, Ndumele CE. Heart Failure and Obesity: The Latest Pandemic. Prog Cardiovasc Dis. 2023; 78:43-48 DOI Crossref PubMed Google Scholar
  2. Benn M, Marott SCW, Tybjærg -Hansen A, Nordestgaard BG. Obesity increases heart failure incidence and mortality: observational and Mendelian randomization studies totalling over 1 million individuals. Cardiovasc Res. 2023; 118(18):3576-3585 PubMed Google Scholar
  3. Miller WL, Sorimachi H, Grill DE, Fischer K, Borlaug BA. Contributions of cardiac dysfunction and volume status to central haemodynamics in chronic heart failure. Eur J Heart Fail. 2021; 23(7):1097-1105 DOI Crossref PubMed Google Scholar
  4. Packer M, Zile MR, Kramer CM, Baum SJ, Litwin SE, Menon V, Ge J, Weerakkody GJ, Ou Y, Bunck MC, Hurt KC, Murakami M, Borlaug BA; SUMMIT Trial Study Group. Tirzepatide for Heart Failure with Preserved Ejection GLP-1 Agonists in Obesity and Heart Failure Kevan English and Christine Uwibambe Fraction and Obesity. N Engl J Med. 2025; 392(5):427- DOI Crossref PubMed Google Scholar
  5. Kosiborod MN, Abildstrøm SZ, Borlaug BA, Butler J, Rasmussen S, Davies M, Hovingh GK, Kitzman DW, Lindegaard ML, Møller DV, Shah SJ, Treppendahl MB, Verma S, Abhayaratna W, Ahmed FZ, Chopra V, Ezekowitz J, Fu M, Ito H, Lelonek M, Melenovsky V, Merkely B, Núñez J, Perna E, Schou M, Senni M, Sharma K, Van der Meer P, von Lewinski D, Wolf D, Petrie MC; STEP-HFpEF Trial Committees and Investigators. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. 2023; 389(12):1069-1084 DOI Crossref PubMed Google Scholar
  6. Kosiborod MN, Petrie MC, Borlaug BA, Butler J, Davies MJ, Hovingh GK, Kitzman DW, Møller DV, Treppendahl MB, Verma S, Jensen TJ, Liisberg K, Lindegaard ML, Abhayaratna W, Ahmed FZ, Ben-Gal T, Chopra V, Ezekowitz JA, Fu M, Ito H, Lelonek M, Melenovský V, Merkely B, Núñez J, Perna E, Schou M, Senni M, Sharma K, van der Meer P, Von Lewinski D, Wolf D, Shah SJ; STEP-HFpEF DM Trial Committees and Investigators. Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes. N Engl J Med. 2024; 390(15):1394-1407 DOI Crossref PubMed Google Scholar
  7. Nauck MA, D'Alessio DA. Tirzepatide, a dual GIP/GLP-1 receptor co-agonist for the treatment of type 2 diabetes with unmatched effectiveness regrading glycaemic control and body weight reduction. Cardiovasc Diabetol. 2022; 21(1):169 DOI Crossref PubMed Google Scholar
  8. Pratley RE, Tuttle KR, Rossing P, Rasmussen S, Perkovic V, Nielsen OW, Mann JFE, MacIsaac RJ, Kosiborod MN, Kamenov Z, Idorn T, Hansen MB, Hadjadj S, Bakris G, Baeres FMM, Mahaffey KW; FLOW Trial Committees and Investigators. Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW Trial. J Am Coll Cardiol. 2024; 84(17):1615-1628 DOI Crossref PubMed Google Scholar
  9. Solomon SD, Ostrominski JW, Wang X, Shah SJ, Borlaug BA, Butler J, Davies MJ, Kitzman DW, Verma S, Abildstrøm SZ, Nygaard Einfeldt M, Rasmussen S, Abhayaratna WP, Ahmed FZ, Ben-Gal T, Chopra V, Ito H, Merkely B, Núñez J, Senni M, van der Meer P, Wolf D, Petrie MC, Kosiborod MN; STEP-HFpEF Trial Committees and Investigators. Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure. J Am Coll Cardiol. 2024 Oct 22;84(17):1587-1602. doi: 10.1016/j.jacc.2024.08.021. Epub 2024 Aug 30. Erratum in: J Am Coll Cardiol. 2025; 85(9):967-968 DOI Crossref PubMed Google Scholar
  10. Liu QK. Mechanisms of action and therapeutic applications of GLP-1 and dual GIP/GLP-1 receptor agonists. Front Endocrinol (Lausanne). 2024; 15:1431292 DOI Crossref PubMed Google Scholar

阅读全文

在此打开 PDF

正在加载 PDF…

若 PDF 未在此显示，请使用上方的下载按钮。

如何引用本文

English K, Uwibambe C. Role for GLP-1 Agonists in Patients with Obesity and Heart Failure with Preserved Ejection Fraction. Ulutas Med J. 2025;11(2):22-24. doi:10.5455/umj.20250429034140

English, K., & Uwibambe, C. (2025). Role for GLP-1 Agonists in Patients with Obesity and Heart Failure with Preserved Ejection Fraction. The Ulutas Medical Journal, 11(2), 22–24. https://doi.org/10.5455/umj.20250429034140

English, K. and Uwibambe, C. (2025) 'Role for GLP-1 Agonists in Patients with Obesity and Heart Failure with Preserved Ejection Fraction', The Ulutas Medical Journal, 11(2), pp. 22–24. doi: 10.5455/umj.20250429034140.

RIS (EndNote, Zotero) BibTeX JATS XML
在您的网站中嵌入本文

将此代码粘贴到您的页面。卡片显示标题、作者和 DOI，并链接回本文。

报告不一致
投稿 联系我们