司美格鲁肽真的能减少心脏病发作、中风和心血管死亡吗？
是的，证据充分且一致。规模最大、最具决定性的研究——SELECT试验——纳入了17604名超重或肥胖、已确诊心血管疾病但无糖尿病的受试者。在近40个月的平均随访期内，每周服用一次司美格鲁肽（2.4毫克）的受试者，其心血管死亡、非致命性心脏病发作或非致命性卒中的复合终点风险较安慰剂组降低20%（6.5%对比8.0%）[2]。这一获益在所有亚组中均得到体现，包括伴有或不伴有心力衰竭的患者[1]。
这些发现得到了其他大型试验的进一步证实。在2型糖尿病患者中，SOUL试验（涉及9650名参与者）发现，口服司美格鲁肽可使主要不良心血管事件（MACE）降低14%（12.0% vs. 13.8%）[8]。一项纳入50项试验、涵盖近5.5万名参与者的大型荟萃分析证实，司美格鲁肽可使全因死亡率降低15%，心脏病发作风险降低23%[5]。另一项包含四项随机对照试验（共27617名参与者）的荟萃分析显示，MACE风险降低了19%[4]。这些证据并非仅来自单一研究或特定人群，而是在不同剂型（注射剂和口服剂）以及不同患者群体（伴或不伴糖尿病）中均得到重复验证。
心血管获益仅仅来自减重，还是司美格鲁肽另有作用？
减肥是故事的重要部分，但并非全部。在SELECT试验中，服用司美格鲁肽的参与者两年内平均减重9.4%，而安慰剂组仅为0.9%[6]。然而，对SUSTAIN-6试验（该试验研究司美格鲁肽在2型糖尿病中的作用）的事后分析发现，减重幅度并不能预测心血管事件的减少[3]。这表明司美格鲁肽对心脏的益处部分源于其他机制，例如改善血压、胆固醇和炎症[7]。该药物还将糖尿病及糖尿病前期的发生风险降低了70%以上[7]，这本身就能降低长期心血管风险。
简而言之，虽然减重是令人欣喜且重要的效果，但司美格鲁肽似乎对心脏和血管具有直接的保护作用。关键点在于：即使体重仅适度下降的人群，该药物依然有效。
有哪些缺点？副作用是否值得？
主要缺点在于耐受性。在SELECT试验中，服用司美格鲁肽的受试者中有16.6%因副作用停药，而安慰剂组为8.2%[2]。最常见的副作用是胃肠道反应——恶心、呕吐和腹泻——这些症状通常是暂时性的，但严重时可能导致停药[5]。一项荟萃分析发现，司美格鲁肽使恶心风险增加两倍，呕吐风险增加三倍[5]。这些副作用虽不严重，但可能令人非常不适。
然而，代价是总体严重不良事件显著减少。同一项荟萃分析显示，司美格鲁肽可将任何严重不良事件的风险降低7%[5]。在SELECT试验中，司美格鲁肽组在所有体重指数类别中的严重不良事件发生率均低于安慰剂组[6]。因此，尽管胃肠道副作用很常见，但该药物能降低心脏病发作和中风等更严重后果的风险。是否使用司美格鲁肽，应在医生指导下权衡个体的心血管风险与对胃肠道副作用的耐受性后决定。
关于这些来源
该回答基于8篇经同行评审的研究——发表于2023年至2026年间，其中7篇为2024年及以后发表，3篇发表于Q1期刊，总被引次数达2745次——这些研究是从15篇通过质量筛选的文献中选出的最具相关性的成果，而后者又源自从超过5亿篇论文的数据库中检索到的56篇论文。
本文引用的文献
1
司美格鲁肽对肥胖合并心力衰竭患者的心血管结局影响：SELECT试验的预设分析
在SELECT试验预设分析（共17,604名参与者）中，司美格鲁肽使心力衰竭患者的主要不良心血管事件（MACE）风险降低28%，并使复合心力衰竭终点风险降低21%，且该获益与射血分数亚型无关。
2024 · John Deanfield, Subodh Verma, Benjamin M Scirica, Steven E Kahn, Scott S Emerson, Donna Ryan, Ildiko Lingvay, Helen M Colhoun, Jorge Plutzky, Mikhail N Kosiborod, G Kees Hovingh, Søren Hardt-Lindberg, Ofir Frenkel, Peter E Weeke, Søren Rasmussen, Assen Goudev, Chim C Lang, Miguel Urina-Triana, Mikko Pietilä, A Michael Lincoff, Mitsunori Abe, Rajpal K Abhaichand, Walter P Abhayaratna, Atul Abhyankar, Imran B Zainal Abidin, Hiba Abou Assi, Jose L Accini Mendoza, Mine Adas, John M Agaiby, Devendra K Agarwal, Maher Agha, Azazuddin Ahmed, Petteri Ahtiainen, Elmar Aigner, Naik Ajay, Norsiah Ali, Amer Al-Karadsheh, Roy Allison, Dale C Allison, Diana Alpenidze, Yuksel Altuntas, Ayham Al-Zoebi, Roy Ambuj, John Amerena, Robert J Anderson, Toshiaki Ando, Robert Andrews, Elizaveta Antonova, Karl-Friedrich Appel, Flávia B Arantes, Mustafa Araz, Yaron Arbel, José L Arenas León, Georgia Argyrakopoulou, Mehrdad Ariani, Maria A Arias Mendoza, Ahmed A Arif, Jaspal Arneja, Vanita R Aroda, Louis J Aronne, Margaret Arstall, Njaimeh Asamoah, Milika Asanin, Hanid Audish, Rodica Avram, Aysha Badat, Corin V Badiu, Wa'el Bakdash, Okan S Bakiner, Vuyokazi N Bandezi, Liew H Bang, Sandeep Bansal, Marietta Baranyai, Olga Barbarash, Mark Barber, Otis Barnum, Gilles Barone Rochette, Amir Bashkin, Seth Baum, Harold E Bays, Alberto E Bazzoni Ruiz, Maciej Beckowski, Yaswin Beerachee, Srikanth Bellary, Lidia Belousova, Martin Berk, Marc Bernstein, Cesare Berra, Isaac Beshay, Ajit Bhagwat, Arti Bhan, William C Biggs, Liana Billings, Fahed Bitar, Bradley Block, Simona Bo, Pawel Bogdanski, Olga O Bolshakova, Alla A Boshchenko, Hayden Bosworth, Rodrigo Botero Lopez, Morten Bôttcher, Ronald Bourgeois, Donald Brautigam, Cristian F Breton, Andrew Broadley, Andrew P Brockmyre, Steven K Brodie, Marco Bucci, Hrvoje Budincevic, Matthew J Budoff, Barry Buffman, Nediljka Buljubasic, Supawan Buranapin, Lesley Burgess, Bartolomé Burguera, Olena Buriakovska, Silvio Buscemi, Robert Busch, John B Buse, Robert Buynak, Maria Byrne, Elena Caceaune, Alberto J Cadena Bonfanti, Cornell V Calinescu, Robert S Call, Silvija Canecki Varzic, Kevin Cannon, Matt Capehorn, Bertrand Cariou, Jeffrey Carr, Rodolfo Carrillo-Jimenez, Marcelo Casas, Almudena Castro, Ahmet Celik, Cintia Cercato, Ondrej Cermak, James Y Cha, Carolina Chacon, Tira Chaicha-Brom, Sandeep Chandra, Mohamed Chettibi, Julia Chevts, Johann Christopher, Witold Chrustowski, Adriana Cif, Rebecca Clark, Wayne Clark, Piers Clifford, Kathleen Coetzee, Giulia Cogni, Anna Maria Colao, David M Colquhoun, Mauricio Concha, Jonathan Condit, Christian Constance, Ciprian Constantin, Silviana Constantinescu, Clive Corbett, George M Cornett, Marcelo Correia, Fiorenzo Cortinovis, Dana Cosma, Steven Creely, David Cross, Brian Curtis, Wojciech Czochra, Nizar Y Daboul, Selcuk Dagdelen, Ronald D'agostino, Cuong Dang, Sudip Datta, Ashwini K Davuluri, Saleem Y Dawood, Douwe M De Jong, Carmen De La Cuesta, Manuel O De Los Rios Ibarra, Carmen De Pablo, Michel De Pauw, Alexander Dela Llana, Maja Delibasic, Diana Delic-Brkljacic, Thibaud Demicheli, Ralf J Denger, Devang Desai, Piyush Desai, Cyrus V Desouza, Dror Dicker, Nemanja Djenic, Simon Dobson, Masayuki Doi, Jesse A Doran, Reinhart Dorman, Francesco Dotta, Carl E Dukes, Ernesto Duronto, Ronen Durst, Irina V Dvoryashina, Iftikhar O Ebrahim, Holger Eggebrecht, Kenneth Egstrup, Elif I Ekinci, Björn Eliasson, Ken Eliasson, Georgiana Enache, Dan Enculescu, Patrick English, Polina Ermakova, Olga Ershova, Hirotaka Ezaki, Marat Ezhov, Eduardo Farias, Javier M Farias, Pedro S Farsky, Daniel Ferreira, Pierre Filteau, Matthew P Finneran, Eric M Folkens, Alberto G Fonseca, Luisa Fonseca, Steven Fordan, Nyda Fourie, Sara França, Denise R Franco, Edward Franek, Keith Friedman, Lucia Frittitta, Michael Froer, Krunoslav Fuckar, Kenshi Fujii, Ryoko Fujita, Yasushi Fukushima, Mohamed Fulat, Mahesh Fulwani, Grzegorz Gajos, Albert Galyavich, Michael L Gambill, Dheeraj Gandotra, Gandy Winston, Pedro A Garcia Hernandez, Raymundo García Reza, Naveen Garg, Sandeep Garg, William T Garvey, Juan C Garza, Blandine Gatta-Cherifi, Valeri Gelev, Steven A Geller, Jeffrey G Geohas, Borislav Georgiev, Adline Ghazi, Matthew P Gilbert, Olga Gilinskaya, Gunnar Gislason, Dilek Gogas Yavuz, Olga González Albarrán, Ivan G Gordeev, Sidney C Gorton, Tone Gretland Valderhaug, Bjorn Groenemeijer, Ibrahim Gul, Lars Gullestad, Irina Gurieva, Galina N Guseva, Andreas Hagenow, Martin Haluzik, Sigrun Halvorsen, Naima Hammoudi, Keiichi Hanaoka, Nicolae Hancu, Ursula Hanusch, Kathleen Harris, Barry Harris, Michael Hartleib, Aaron N Hartman, Yoshiki Hata, Brian Heimer, Lee Herman, William Herzog, Eric Hewitt, Peter Heymer, Shirish Hiremath, Joeran Hjelmesaeth, Rasmus Geir Høgalmen, Hans Olav Høivik, Helene Holmer, Olha Horoshko, Patricia M Houser, Jens D Hove, I-Chang Hsieh, Jean-Sébastien Hulot, Zanariah Hussein, Tetiana Ilashchuk, Erkki Ilveskoski, Irina Ipatko, Ali Iranmanesh, Tsuyoshi Isawa, Moises Issa, Bruce Iteld, Takamasa Iwasawa, Danish Jabbar, Richard A Jackson, Ewart Jackson-Voyzey, Stephan Jacob, Naseem A Jaffrani, Michael F Jardula, Ania Jastreboff, Svend E Jensen, Terri Jerkins, Silvia A Jimenez-Ramos, Sawhney Jitendra Pal Singh, Wallace Johnson, John M Joyce, Malgorzata Jozefowska, Prakash Jugnundan, Wolfgang Jungmair, Jaroslaw Jurowiecki, Toshiaki Kadokami, Dhiman Kahali, Gerd Kahrmann, Sergio E Kaiser, Piotr Kalmucki, Mehmet Kanadasi, David Kandath, Grzegorz Kania, J Kannan, Cornelia Kapp, Agnieszka Karczmarczyk, Athanasios Kartalis, Susanne Kaser, Sazzli Shahlan Kasim, Richard Kastelic, Toshiaki Kato, Tzvetana Katova, Upendra Kaul, Alexandra Kautzky-Willer, Masahiro Kawanishi, Meral Kayikcioglu, Elena E Kazakova, Philip Keeling, Hans-Peter Kempe, Dean J Kereiakes, Mathieu Kerneis, Tiina Keski-Opas, Suhail Khadra, Larisa Khaisheva, Marina Kharakhulakh, Tatiana Khlevchuk, Jeffrey Khoo, Songsak Kiatchoosakun, Noriyuki Kinoshita, Masaharu Kinoshita, Ryoji Kitamura, Arihiro Kiyosue, Irina Klavina, Eric J Klein, Zdenek Klimsa, David Klonoff, Eric Klug, Zhanna Kobalava, Satoshi Kodera, Tokushi Koga, Alexander Kokkinos, Pavel Koleckar, László Könyves, Michael J Koren, Adrian P Kormann, Karam Kostner, Kristin Kreutzmann, Saravanan Krishinan, Sathya S Krishnasamy, Inga Krivosheeva, Ivan Kruljac, Ted Kubicki, Ladislav Kuchar, Monika Kujawiak, Hideyuki Kunishige, Melinda Kurtinecz, Hugo R Kurtz Lisboa, Mykola Kushnir, Yulian Kyyak, Arija Lace, Timo Lakka, Nebojsa Lalic, Katarina Lalic, Vaia Lambadiari, Leonidas Lanaras, Chim Lang, Marie-France Langlois, Joseph Lash, Gustavs Latkovskis, David Lau, José Roberto Lazcano Soto, Carel Le Roux, Gilbert N Ledesma, Li Yuan Lee, Thung-Lip Lee, Kelvin Lee, Michael Lehrke, Silmara O Leite, Agata Leksycka, Thomas Lenzmeier, Frida Leonetti, Viktoriia Leonidova, Norman Lepor, Melissa Leung, Olena Levchenko, Peter Levins, Louis J Levy, Matthew Lewis, Evangelos Liberopoulos, Idit Liberty, Carl-Johan Lindholm, Ales Linhart, Ming-En Liu, Jenny Liu, Holly Lofton, Timothy Logemann, Johannes J Lombaard, Landman Lombard, Richard Lorraine, Charles F Lovell, Bernhard Ludvik, Monika Lukaszewicz, Géza Lupkovics, Steven Lupovitch, Sirona Lupu, Mary Lynch, Zoreslava Lysak, Tatyana A Lysenko, Hajime Maeda, Itaru Maeda, Michael Mæng, Ajay U Mahajan, Vincent Maher, Lilia N Maia, Ellen M Makotoko, Alexis Malavazos, Jan Malecha, Emilia Malicherova, Mamoru Manita, Edoardo Mannucci, Viacheslav Mareev, Liliana Marin, Tatiana Markova, Steven P Marso, F.M.A.C. Martens, Cuper Martinez, Carlos A Martinez Cano, Cristina Martins, Luis Masmiquel Comas, Takashi Matsumoto, Kenneth Mcdonald, Barbara Mcgowan, Frank Mcgrew, Barry K Mclean, David D Mcpherson, Juan Francisco Merino Torres, Peter Meyers, Sebastian Meyhöfer, Pedro Mezquita Raya, Maria Milanova, Davor Milicic, Gary Miller, Richard E Mills, Nicoleta M Mîndrescu, Geltrude Mingrone, Dotska A Minkova, Marco Mirani, Alexander Miras, Cristina V Mistodie, Satoru Mitomo, Sanjay Mittal, Taiji Miyake, Naomasa Miyamoto, David Molony, Pedro Monteiro, Thomas Mooe, Naeem Moosa, Cristobal Morales Portillo, Enrique C Morales Villegas, Emily J Morawski, Claire Morbey, Robert P Morin, Kuniaki Morisaki, Magdalena Morosanu, Ofri Mosenzon, Yuriy Mostovoy, Iqbal Munir, Fabrizio Muratori, Ryan Murray, Avinash Murthy, Min Myint, Galyna Myshanych, Valerica Nafornita, Takuya Nagano, Sunil Nair, Samer N Nakhle, Masahiro Natsuaki, Bindu M Nayak, Djamel Eddine Nibouche, Stephen Nicholls, José C Nicolau, Georgiana Nicolescu, Peter Nierop, Leo Niskanen, George Ntaios, Ottar Kjell Nygård, Joshua B Oaks, Andrey Obrezan, Philip O'donnell, Mitsutoshi Oguri, Abdurrahman Oguzhan, Fumiki Oh, Mitsuru Ohsugi, Yoshio Okada, Hideki Okayama, Adriana Onaca, Haruhiko Onaka, Patrick Oneil, Tiong Kiam Ong, Stephen Ong, Yasuhiro Ono, Paul J Opsahl, Lucyna Ostrowska, Alejandra Oviedo, Oner Ozdogan, Ebru Ozpelit, Emmanouil Pagkalos, Uberto Pagotto, Dénes Páll, Amritanshu- Shekhar Pandey, Oleksandr Parkhomenko, Krishna Malakondareddy Parvathareddy, Minesh B Patel, Sotirios Patsilinakos, Neil Paul, Sue Pedersen, Isabel Pereira, Edward Scott Pereira, Paula Perez Terns, Elba A Perez-Vargas, Yulia Pergaeva, Alexander Perkelvald, Andrey B Peskov, Jonathan Peter, Karina Peters, Catherine Petit, Ivo Petrov, Athena Philis-Tsimikas, Fausto Pinto, Annamária Piros, Dilok Piyayotai, Dmitriy Platonov, Paul Poirier, Lavinia Pop, Bogdan Popa, Rodica Pop-Busui, John Poremba, Alejandro Porto, Arman Postadzhiyan, Ramesh B Pothineni, Ranganatha P Potu, Talessa Powell, Kerkar G Prafulla, Rudolf Prager, Zhulieta R Prakova-Teneva, Richard E Pratley, Hermione Price, Grazyna Pulka, John Pullman, Zelda E Punt, Raman S Purighalla, Peter Purnell, Mansoor Qureshi, Remi Rabasa-Lhoret, Marina A Raikhel, Gita Rancane, Harpal Randeva, Neda Rasouli, Delia V Reurean Pintilei, Ciro R Reyes, Inga Rezgale, Eva Rice, Thaddeus H Riley, Joseph A Risser, Arsen Ristic, Margarita Rivas Fernández, David Robbins, Yves Robitaille, Helena W Rodbard, Jaime A Rodriguez Plazas, T.J. Römer, Glenn Rosen, Dr Azhari Rosman, Paulo Rossi, Leonid Rudenko, Omari Ruffin, Anwar Irawan Ruhani, Nikolay Runev, Dmitriy Ruyatkin, Alen Ruzic, Vyacheslav V Ryabov, Lars Rydén, Suraj Saggar, Tomohiro Sakamoto, Tim Salter, Aditya K Samal, Yulia Samoilova, Hugo D Sanabria, Seda Sancak, Renee Sangrigoli, Nakarin Sansanayudh, Ferruccio Santini, José F Saraiva, Ruslan Sardinov, William Sargeant, Ramazan Sari, Airani Sathananthan, Thozhukat Sathyapalan, Atsushi Sato, Joachim Sauter, Paolo Sbraccia, J. Schaap, Thomas Schaum, François Schiele, John Scott, Gabriella Segal Lieberman, Alexander Segner, Roxy Senior, Marina Y Sergeeva-Kondrachenko, Harvey Serota, Pierre Serusclat, Rishi Sethi, Manoj K Shah, Neerav Shah, Sergey Shalaev, Raj Sharma, Sumeet Sharma, Oksana Shaydyuk, Heidi C Shea, Michael Shechter, Naim Shehadeh, Mitra Shirazi, Yshay Shlesinger, Ayham Shneker, Elena Shutemova, Gerasimos Siasos, Imran A Siddiqui, Jennifer Sidey, Felix Sigal, Iveta Sime, Narendra Singh, Elias Siraj, Kanagaratnam Sivalingam, Grzegorz Skoczylas, Stephen K Smith, Olga Smolenskaya, Brian Snyder, Yael Sofer, C.W. Sofley, Royce Solano, Yusuf A Sonmez, Maxim Sorokin, Alfonso Soto González, Carlos Sotolongo, Joseph Soufer, Ozlem Soyluk Selcukbiricik, Tamara Spaic, Douglas Spriggs, Seamus Sreenan, Hans-Detlev Stahl, Kimon Stamatelopoulos, Mykola Stanislavchuk, Goran Stankovic, Josef Stasek, Gabriel Steg, Joerg Steindorf, Dominique Stephan, John Stewart, Christopher Still, Francois St-Maurice, Barbara Stogowska-Nikiciuk, Jeff Stoker, Edita Stokic, Anna Strzelecka, Kerstin Sturm, Atsushi Sueyoshi, Toshiyuki Sugiura, Senan Sultan, Lyudmila A Suplotova, Arisara Suwanagool, Sompongse Suwanwalaikorn, Tatiana Sveklina, Neil Swanson, Henk Swart, Bradley P Swenson, Ewa Szyprowska, Graeme Tait, Róbert Takács, Yuzo Takeuchi, Aparna Tamirisa, Hideki Tanaka, Danijela Tatovic, Guy Tellier, Hiroki Teragawa, Dace Teterovska, Nihal Thomas, Jean-Francois Thuan, Francisco Tinahones, Snezhanka Tisheva-Gospodinova, Cristina Toarba, Liudmyla Todoriuk, Mariya Tokmakova, Serena Tonstad, Hermann Toplak, Henry Tran, Devjit Tripathy, Aliaksandr Trusau, Nqoba Tsabedze, Elias Tsougos, George M Tsoukas, Dario Tuccinardi, Mazhar M Tuna, Luiz A Turatti, Konstantinos Tziomalos, Chesda Udommongkol, Osamu Ueda, Olavi Ukkola, Mustafa Unubol, Dorothea Urbach, Miguel A Urina Triana, Lisa Usdan, Bijay Vaidya, Noah Vale, Gerald Vallieres, Andre P Van Beek, Philippe Van De Borne, Eugene Van Der Walt, C. Van Der Zwaan, Elane Van Nieuwenhuizen, Louis Van Zyl, Philippe Vanduynhoven, Kiron Varghese, Svetla P Vasileva, Dobrin Vassilev, Prin Vathesatogkit, Valentyna Velychko, Chris Vercammen, Bruno Verges, Jan Verwerft, Alica Vesela, Nadezhda G Veselovskaya, Roberto Vettor, Irina Veze, Vinod Vijan, Ram Vijayaraghavan, Adriana Villarino, Royce Vincent, Oksana Vinogradova, Victor Vishlitzky, Adrian Vlad, Ionela Mihaela Vladu, Anthony Vo, Charlotte Von Engelhardt, Candy Von Münchhausen, Olga Vorobyeva, T. Vossenberg, Mathias Vrolix, Marjana Vukicevic, Ivan Vyshnyvetskyy, Shahid Wadvalla, Jan Wagner, John Wakeling, James Wallace, Wan Mohd Izani Wan Mohamed, Gurpreet S Wander, Kathleen Ward, Mark L Warren, Atsuyuki Watanabe, Bruce Weber, Howard Weintraub, John Weisnagel, James Welker, Ulrich Wendisch, Howard S Wenocur, Craig Wierum, John Wilding, Maged William, Pete Wilson, Jonathan P Wilson, Yuk-Ki Wong, Wanwarang Wongcharoen, Iwona Wozniak, Chau-Chung Wu, Nell Wyatt, Alan Wynne, Hiroshi Yamaguchi, Masahiro Yamasaki, Dilek Yazici, Hung-I Yeh, Yoto Yotov, Qingyang Yuan, Jeffrey Zacher, Olga Zagrebelnaya, Cesar J Zaidman, Alsu Zalevskaya, Stuart Zarich, Maria Chiara Zatelli, Helga Zeller, Elena A Zhdanova, Taiba Zornitzki, Konstantin Zrazhevskiy, Mikhail Zykov, Donna H Ryan, John E Deanfield, Robert F Kushner, Kirstine Brown-Frandsen, Soren Hardt-Lindberg, Christoffer W Tornøe · Lancet (London, England)
2
司美格鲁肽对无糖尿病肥胖患者的心血管结局影响
具有里程碑意义的SELECT试验（纳入17,604名参与者）表明，在超重/肥胖且患有心血管疾病但无糖尿病人群中，司美格鲁肽相比安慰剂可将主要不良心血管事件（心血管死亡、非致死性心肌梗死或非致死性卒中）风险降低20%。
2023 · A Michael Lincoff, Kirstine Brown-Frandsen, Helen M Colhoun, John Deanfield, Scott S Emerson, Sille Esbjerg, Søren Hardt-Lindberg, G Kees Hovingh, Steven E Kahn, Robert F Kushner, Ildiko Lingvay, Tugce K Oral, Marie M Michelsen, Jorge Plutzky, Christoffer W Tornøe, Donna H Ryan · The New England journal of medicine
3
司美格鲁肽与2型糖尿病患者的心血管结局：基于SUSTAIN-6试验按体重减轻分层的亚组分析
对SUSTAIN-6试验的事后分析发现，使用司美格鲁肽后的体重减轻幅度与后续主要不良心血管事件风险之间无关联，提示其心脏保护机制独立于减重作用。
2026 · Angelo Navas, Joshua Noone, Nathan Laney, Sunny Sheth, Xi Tan, Yuanjie Liang, Paloma Munoz, Caroline Swift · Diabetes Therapy
4
司美格鲁肽的心血管获益：一项随机对照试验的系统评价与荟萃分析
一项纳入4项随机对照试验（共27,617名参与者）的荟萃分析发现，司美格鲁肽将主要不良心血管事件风险降低19%，并在心血管死亡和非致命性心脏病发作方面有显著减少，但对非致命性中风或因心力衰竭住院无显著影响。
2025 · Samin Sadraei, Aryan Aarabi, Shahryar Rajai Firouzabadi, Mohammadreza Alinejadfard, Ida Mohammadi, Amir Ghaffari Jolfayi · BMC cardiovascular disorders
5
在心血管事件高风险患者中使用司美格鲁肽相关的不良反应：一项结合荟萃分析与试验序贯分析的系统评价
一项对50项试验（共54,972名参与者）的系统评价发现，高确定性证据表明，司美格鲁肽可使全因死亡率降低15%，心肌梗死风险降低23%，但会增加恶心、呕吐和腹泻的风险。
2025 · C. Sillassen, J. Petersen, P. Faltermeier, Delal Yucel, F. Siddiqui, Rebecca Kjaer Andersen, L. Graever, J. L. Bjerg, C. Kamp, Johannes Grand, Helena Domínguez, A. Frølich, P. Gæde, Christian Gluud, O. Mathiesen, J. Jakobsen · BMC Medicine
6
SELECT试验中，司美格鲁肽对非糖尿病肥胖患者的长期减重效果
SELECT试验的一项预设分析显示，司美格鲁肽可带来持续减重效果（208周时平均减重10.2%），并改善腰围，且在所有BMI类别中严重不良事件均较少。
2024 · Donna H Ryan, Ildiko Lingvay, John Deanfield, Steven E Kahn, Eric Barros, Bartolome Burguera, Helen M Colhoun, Cintia Cercato, Dror Dicker, Deborah B Horn, G Kees Hovingh, Ole Kleist Jeppesen, Alexander Kokkinos, A Michael Lincoff, Sebastian M Meyhöfer, Tugce Kalayci Oral, Jorge Plutzky, André P van Beek, John P H Wilding, Robert F Kushner · Nature medicine
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司美格鲁肽：首个被证实可减少心血管事件发生的抗肥胖药物
对SELECT试验的回顾强调，司美格鲁肽是首个被证实可减少心血管事件的抗肥胖药物，能使主要不良心血管事件（MACE）降低20%，并在血压、血脂和炎症方面带来显著改善。
2024 · Nasser Mikhail, Soma Wali · Annals of Cardiovascular Diseases
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口服司美格鲁肽与高风险2型糖尿病患者的心血管结局
SOUL试验（共9,650名参与者）发现，口服司美格鲁肽可使伴有高心血管风险的2型糖尿病患者的主要不良心血管事件（MACE）降低14%（12.0%对比13.8%），且未增加严重不良事件。
2025 · Darren K. McGuire, N. Marx, S. Mulvagh, J. Deanfield, S. Inzucchi, R. Pop-Busui, J. Mann, S. Emerson, Neil R. Poulter, M. D. Engelmann, M. Ripa, G. Hovingh, K. Brown-Frandsen, Stephen C. Bain, M. Cavender, M. Gislum, J. David, J. Buse · New England Journal of Medicine