Irshad Khan, Sarasa Meenakshi, Md Abubakar, Nitesh Kumar, Vinod L Gaikwad, Amita Rai, Krishna Murti
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引用次数: 0
Abstract
Introduction: Metabolic diseases, including type 2 diabetes mellitus (T2DM), obesity, dyslipidemia, Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), and obstructive sleep apnoea (OSA), are characterized by a complex and interconnected pathophysiological syndrome. These conditions involve insulin resistance, chronic inflammation, and disturbances in energy homeostasis. Typically, they affect multiple organs and require comprehensive treatment.
Objective: This narrative review examines the multi-organ effects of tirzepatide, a new dual agonist of the glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Tirzepatide possesses innovative therapeutic properties and targets multiple metabolic pathways. The review incorporates peer-reviewed sources, including clinical trials, preclinical studies, and specialist reviews. Emphasis is placed on tirzepatide's physiological effects on pancreatic β-cells, adipose tissue, the liver, the gastrointestinal tract, the cardiovascular system, the kidneys, the brain, and gut microbiota.
Key insights: Tirzepatide is a dual receptor agonist that increases insulin levels, decreases glucagon levels, slows gastric emptying, and promotes feelings of fullness, contributing to significant weight loss. Recent preclinical studies have shown that tirzepatide can also alter gut microbiota composition, leading to increased Bacteroidetes and decreased Firmicutes. Additionally, tirzepatide has been shown to enhance intestinal barrier integrity. Clinical trial programs, such as SURPASS and SURMOUNT, have demonstrated that tirzepatide provides improved glycemic control and weight loss compared to current treatments. Other benefits include improvements in lipid profiles, reduced hepatic steatosis, and potential protection for the heart and kidneys.
Conclusion: Tirzepatide is a multi-organ integrator with a therapeutic effect extending beyond glucose regulation. It can influence bowel hormones, improve metabolic parameters, and facilitate communication between different organs, making it a promising treatment for metabolic disorders. However, its broader clinical applications need to be confirmed through additional real-life studies and extended evaluations.
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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