Effect of Semaglutide and Tirzepatide on LDL and VLDL Levels in Adults With Type 1 and Type 2 Diabetes: A Comparative Study in Men and Women.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i12.2351Cuvinte cheie:
Semaglutide; Tirzepatide, LDL cholesterol, VLDL cholesterol, Type 1 diabetes;, Type 2 diabetes, Incretin therapy, DyslipidemiaRezumat
Background:
Dyslipidemia remains a major cardiovascular risk driver in diabetes, and incretin-based therapies can influence lipoprotein metabolism beyond glucose lowering.
Objectives:
To compare 24-week changes in LDL-C and VLDL-C between semaglutide and tirzepatide, and to evaluate differences by diabetes type and sex.
Methods:
This prospective comparative study was conducted at KIMS & RF, Amalapuram, Andhra Pradesh, India (January–December 2024). One hundred adults with type 1 or type 2 diabetes were allocated to once-weekly semaglutide (n=50) or tirzepatide (n=50) and followed for 24 weeks. Fasting LDL-C and VLDL-C were assessed at baseline and week 24, and changes were compared between groups with stratified analyses by diabetes type and sex.
Results:
The mean age of the participants was 52.6 ± 10.8 years. Men constituted 52.0% and women 48.0% of the study population. Type 2 diabetes was present in 80.0%, while type 1 diabetes was present in 20.0%. Both treatment groups showed significant reductions in lipid levels at 24 weeks. Tirzepatide produced a greater reduction in low-density lipoprotein cholesterol than semaglutide (−30.9 mg/dL vs. −18.5 mg/dL) and a greater reduction in very-low-density lipoprotein cholesterol (−13.3 mg/dL vs. −7.5 mg/dL). Lipid improvement was more marked in type 2 diabetes than in type 1 diabetes. Reductions were observed in both men and women, without a meaningful sex-by-treatment interaction.
Conclusion:
Over 24 weeks, semaglutide and tirzepatide improved LDL-C and VLDL-C in adults with diabetes, with consistently greater lipid lowering observed with tirzepatide across diabetes type and sex strata.
Recommendations:
Tirzepatide may be preferred when lipid risk reduction is a priority in adults with diabetes. Routine lipid monitoring should accompany incretin therapy. Longer, multicenter trials are recommended to confirm durability, cardiovascular outcomes, and safety across diverse diabetic populations.
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