chiglitazar（一种泛ppar激动剂）对2型糖尿病患者代谢功能障碍相关脂肪变性肝病的影响：一项现实世界研究

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-06-21 DOI:10.1016/j.diabet.2025.101680

Yijiong Tan , Wenjun Qu , Jiehua Zhao , Yunqin Ma , Qidi Zhang , Hong Gao , Qin Zhen , Yufan Wang , Yongde Peng , Fang Liu , Nengguang Fan

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引用次数: 0

摘要

目的：在现实世界的临床环境中，评估新型泛ppar激动剂chiglitazar对2型糖尿病（T2D）患者代谢功能障碍相关脂肪变性肝病（MASLD）的疗效。材料和方法：这项前瞻性队列研究纳入了接受齐列他或其他降糖药物治疗24周的t2dm MASLD患者。为了尽量减少选择偏差，采用1:1倾向评分匹配（PSM）。主要结果是控制衰减参数（CAP，测量肝脏脂肪变性）和肝脏硬度测量（LSM，评估纤维化）的变化。次要结局包括血糖参数和肝酶。结果：共纳入235例T2D患者（使用吉列他者40例，非使用吉列他者195例），1:1 PSM后得到31对配对。从基线到24周的CAP调整后平均降低，奇格列扎组（-28.38 dB/m [95% CI: -36.11;-20.65]）显著高于非奇格列扎组（-16.74 dB/m[-24.47;-9.01]），组间差异为-11.64 dB/m （-22.38;-0.90, P = 0.038）。两组间LSM变化相似（LS均值差异：-0.11 [-1.04;0.82],P = 0.813）。亚组分析表明，chiglitazar的有益效果在性别、年龄、体重指数和同时使用SGLT-2抑制剂或GLP-1受体激动剂等变量中是一致的（相互作用的P均为0.05）。结论：Chiglitazar给药与T2D合并MASLD患者CAP值的显著降低相关，提示其作为两种情况的双重治疗方法的潜力。

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The impact of chiglitazar, a pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease in patients with type 2 diabetes: a real-world study

Aim

To evaluate the efficacy of chiglitazar, a novel pan-PPAR agonist, on metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes (T2D) in a real-world clinical setting.

Materials and methods

This prospective cohort study included T2D patients with MASLD who received either chiglitazar or other glucose-lowering medications over a 24-week period. To minimize selection bias, 1:1 propensity score matching (PSM) was implemented. The primary outcomes were changes in controlled attenuation parameter (CAP, measuring hepatic steatosis) and liver stiffness measurement (LSM, assessing fibrosis). Secondary outcomes included glycemic parameters and liver enzymes.

Results

A total of 235 T2D patients were enrolled (40 chiglitazar users, 195 non-chiglitazar users), and 31 matched pairs were derived after 1:1 PSM. The adjusted mean reduction in CAP from baseline to 24 weeks was significantly greater in the chiglitazar group (-28.38 dB/m [95 % CI:36.11;-20.65]) compared to the non-chiglitazar group (-16.74 dB/m [-24.47;-9.01]), with a between-group difference of -11.64 dB/m (-22.38;-0.90, P = 0.038). LSM changes were similar between groups (difference in LS mean:0.11 [-1.04;0.82], P = 0.813). Subgroup analyses indicated that the beneficial effect of chiglitazar was consistent across variables such as sex, age, body mass index, and concomitant use of SGLT-2 inhibitors or GLP-1 receptor agonists (all P for interaction > 0.05).

Conclusions

Chiglitazar administration is associated with a significant reduction in CAP values in T2D patients with MASLD, suggesting its potential as a dual therapeutic approach for both conditions.

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.