Hiddo J L Heerspink, Allon N Friedman, Petter Bjornstad, Daniel H van Raalte, David Cherney, Dachuang Cao, Luis-Emilio Garcia-Pérez, Adam Stefanski, Ibrahim Turfanda, Mathijs C Bunck, Imane Benabbad, Ryan Griffin, Carolina Piras de Oliveira
{"title":"替西肽治疗伴有或不伴有2型糖尿病的肥胖患者的肾脏参数。","authors":"Hiddo J L Heerspink, Allon N Friedman, Petter Bjornstad, Daniel H van Raalte, David Cherney, Dachuang Cao, Luis-Emilio Garcia-Pérez, Adam Stefanski, Ibrahim Turfanda, Mathijs C Bunck, Imane Benabbad, Ryan Griffin, Carolina Piras de Oliveira","doi":"10.1681/ASN.0000000764","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tirzepatide, a once-weekly, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, showed kidney protective effects in people with type 2 diabetes at high cardiovascular disease risk. In this post hoc analysis of the SURMOUNT-1 and SURMOUNT-2 trials, we assessed the association of tirzepatide use with kidney function parameters in people with overweight/obesity with or without type 2 diabetes.</p><p><strong>Methods: </strong>In SURMOUNT-1, participants with overweight or obesity without type 2 diabetes were randomized to tirzepatide 5 mg, 10 mg, and 15 mg or placebo. In SURMOUNT-2, participants with type 2 diabetes were randomized to tirzepatide 10 mg and 15 mg or placebo. For this analysis, all tirzepatide groups were pooled in each trial. Assessments included change from baseline to week 72 for urine albumin-to-creatinine ratio (UACR) and eGFR. eGFR was assessed using creatinine-based eGFR (Cr-eGFR), cystatin-C-based-eGFR (Cys-C-eGFR), and creatinine-cystatin-C-based eGFR (Cr-Cys-C-eGFR).</p><p><strong>Results: </strong>In SURMOUNT-1 (N=2539) and SURMOUNT-2 (N=938) median [25th to 75th percentile] baseline UACR was 6.0 [4.0, 11.0] mg/g and 13.0 [6.0, 35.1] mg/g, respectively. UACR estimated difference for tirzepatide vs. placebo, at week 72 was -8.4% (95% confidence interval [CI], -14.7 to -1.6) for SURMOUNT-1 and -31.1% (95% CI, -40.9 to -19.7) for SURMOUNT-2. The UACR change was more pronounced among participants with baseline UACR ≥30 mg/g with placebo-corrected changes from baseline at week 72 of -42.3% (95% CI, -60.8 to -15.0) in SURMOUNT-1 and -55.2% (95% CI, -68.5 to -36.4) in SURMOUNT-2, respectively. In SURMOUNT-1, tirzepatide was associated with increased eGFR based on Cys-C-eGFR or Cr-Cys-C-eGFR estimation equations, with mean differences versus placebo at week 72 of 3.2 ml/min per 1.73 m2 (95% CI, 2.1-4.3) and 1.9 ml/min per 1.73 m2 (95% CI, 0.9 to 2.9), respectively. In SURMOUNT-2 at week 72, increases in both tirzepatide and placebo groups were observed for Cys-C or Cr-Cys-C-eGFR, with no between-group differences.</p><p><strong>Conclusions: </strong>In participants with obesity/overweight with or without type 2 diabetes, tirzepatide was associated with reduced albuminuria without adverse changes in eGFR.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Kidney Parameters with Tirzepatide in Obesity with or without Type 2 Diabetes.\",\"authors\":\"Hiddo J L Heerspink, Allon N Friedman, Petter Bjornstad, Daniel H van Raalte, David Cherney, Dachuang Cao, Luis-Emilio Garcia-Pérez, Adam Stefanski, Ibrahim Turfanda, Mathijs C Bunck, Imane Benabbad, Ryan Griffin, Carolina Piras de Oliveira\",\"doi\":\"10.1681/ASN.0000000764\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tirzepatide, a once-weekly, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, showed kidney protective effects in people with type 2 diabetes at high cardiovascular disease risk. In this post hoc analysis of the SURMOUNT-1 and SURMOUNT-2 trials, we assessed the association of tirzepatide use with kidney function parameters in people with overweight/obesity with or without type 2 diabetes.</p><p><strong>Methods: </strong>In SURMOUNT-1, participants with overweight or obesity without type 2 diabetes were randomized to tirzepatide 5 mg, 10 mg, and 15 mg or placebo. In SURMOUNT-2, participants with type 2 diabetes were randomized to tirzepatide 10 mg and 15 mg or placebo. For this analysis, all tirzepatide groups were pooled in each trial. Assessments included change from baseline to week 72 for urine albumin-to-creatinine ratio (UACR) and eGFR. eGFR was assessed using creatinine-based eGFR (Cr-eGFR), cystatin-C-based-eGFR (Cys-C-eGFR), and creatinine-cystatin-C-based eGFR (Cr-Cys-C-eGFR).</p><p><strong>Results: </strong>In SURMOUNT-1 (N=2539) and SURMOUNT-2 (N=938) median [25th to 75th percentile] baseline UACR was 6.0 [4.0, 11.0] mg/g and 13.0 [6.0, 35.1] mg/g, respectively. UACR estimated difference for tirzepatide vs. placebo, at week 72 was -8.4% (95% confidence interval [CI], -14.7 to -1.6) for SURMOUNT-1 and -31.1% (95% CI, -40.9 to -19.7) for SURMOUNT-2. The UACR change was more pronounced among participants with baseline UACR ≥30 mg/g with placebo-corrected changes from baseline at week 72 of -42.3% (95% CI, -60.8 to -15.0) in SURMOUNT-1 and -55.2% (95% CI, -68.5 to -36.4) in SURMOUNT-2, respectively. In SURMOUNT-1, tirzepatide was associated with increased eGFR based on Cys-C-eGFR or Cr-Cys-C-eGFR estimation equations, with mean differences versus placebo at week 72 of 3.2 ml/min per 1.73 m2 (95% CI, 2.1-4.3) and 1.9 ml/min per 1.73 m2 (95% CI, 0.9 to 2.9), respectively. In SURMOUNT-2 at week 72, increases in both tirzepatide and placebo groups were observed for Cys-C or Cr-Cys-C-eGFR, with no between-group differences.</p><p><strong>Conclusions: </strong>In participants with obesity/overweight with or without type 2 diabetes, tirzepatide was associated with reduced albuminuria without adverse changes in eGFR.</p>\",\"PeriodicalId\":17217,\"journal\":{\"name\":\"Journal of The American Society of Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":10.3000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of The American Society of Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1681/ASN.0000000764\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of The American Society of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1681/ASN.0000000764","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Kidney Parameters with Tirzepatide in Obesity with or without Type 2 Diabetes.
Background: Tirzepatide, a once-weekly, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, showed kidney protective effects in people with type 2 diabetes at high cardiovascular disease risk. In this post hoc analysis of the SURMOUNT-1 and SURMOUNT-2 trials, we assessed the association of tirzepatide use with kidney function parameters in people with overweight/obesity with or without type 2 diabetes.
Methods: In SURMOUNT-1, participants with overweight or obesity without type 2 diabetes were randomized to tirzepatide 5 mg, 10 mg, and 15 mg or placebo. In SURMOUNT-2, participants with type 2 diabetes were randomized to tirzepatide 10 mg and 15 mg or placebo. For this analysis, all tirzepatide groups were pooled in each trial. Assessments included change from baseline to week 72 for urine albumin-to-creatinine ratio (UACR) and eGFR. eGFR was assessed using creatinine-based eGFR (Cr-eGFR), cystatin-C-based-eGFR (Cys-C-eGFR), and creatinine-cystatin-C-based eGFR (Cr-Cys-C-eGFR).
Results: In SURMOUNT-1 (N=2539) and SURMOUNT-2 (N=938) median [25th to 75th percentile] baseline UACR was 6.0 [4.0, 11.0] mg/g and 13.0 [6.0, 35.1] mg/g, respectively. UACR estimated difference for tirzepatide vs. placebo, at week 72 was -8.4% (95% confidence interval [CI], -14.7 to -1.6) for SURMOUNT-1 and -31.1% (95% CI, -40.9 to -19.7) for SURMOUNT-2. The UACR change was more pronounced among participants with baseline UACR ≥30 mg/g with placebo-corrected changes from baseline at week 72 of -42.3% (95% CI, -60.8 to -15.0) in SURMOUNT-1 and -55.2% (95% CI, -68.5 to -36.4) in SURMOUNT-2, respectively. In SURMOUNT-1, tirzepatide was associated with increased eGFR based on Cys-C-eGFR or Cr-Cys-C-eGFR estimation equations, with mean differences versus placebo at week 72 of 3.2 ml/min per 1.73 m2 (95% CI, 2.1-4.3) and 1.9 ml/min per 1.73 m2 (95% CI, 0.9 to 2.9), respectively. In SURMOUNT-2 at week 72, increases in both tirzepatide and placebo groups were observed for Cys-C or Cr-Cys-C-eGFR, with no between-group differences.
Conclusions: In participants with obesity/overweight with or without type 2 diabetes, tirzepatide was associated with reduced albuminuria without adverse changes in eGFR.
期刊介绍：
The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews.
Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication.
JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.
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