【摘要】 胰高血糖素样肽1(GLP-1)受体激动剂是一类新型降糖药物，兼具降脂和心血管保护作用，利拉鲁肽和司美格鲁肽是其代表药物。本文基于系统的文献检索，综述了利拉鲁肽和司美格鲁肽直接作用于肝肾（调控自噬、关键脂质代谢通路、胆固醇逆向转运等途径）、直接作用于脂肪组织（影响脂肪细胞增殖与分化、脂质代谢蛋白表达及基因转录）、通过中枢神经系统激活交感神经通路、调节肠道微生物群等降脂机制，还总结了其在2型糖尿病（T2DM）、超重等人群中的临床降脂证据。上述内容表明，GLP-1受体激动剂可通过作用于多个组织或系统而发挥降脂作用，为深入阐明此类药物在血脂调节中的分子机制及挖掘潜在的临床应用新思路提供了重要依据。更多还原

【Abstract】 Glucagon-like peptide-1(GLP-1) receptor agonists are a novel class of antidiabetic drugs that also possess lipidlowering and cardiovascular protective effects, with liraglutide and semaglutide being their representative medications. Based on a systematic literature search, this review summarizes the lipid-lowering mechanisms by which liraglutide and semaglutide exert direct effects on the liver and kidney(regulating autophagy, key lipid metabolism pathways, reverse cholesterol transport, etc.), direct actions on adipose tissue(affecting adipocyte proliferation and differentiation, expression of lipid metabolism proteins, and gene transcription), activation of sympathetic pathways through the central nervous system, and modulation of the gut microbiota. Additionally, it summarizes the clinical evidence of their lipid-lowering effects in populations with type 2 diabetes mellitus, overweight individuals, and others. These findings indicate that GLP-1 receptor agonists exert lipid-lowering effects by acting on multiple tissues or systems, providing crucial evidence for further elucidating the molecular mechanisms of these drugs in lipid regulation and exploring potential new ideas for their clinical applications.更多还原