Understanding heterogeneity of response to tirzepatide in cardiometabolic multiple long-term conditions
Supervisors:
Dr Ahmad Al‑Mrabeh, Centre for Cardiovascular Science, University of Edinburgh
Prof Roland Stimson, Centre for Cardiovascular Science, University of Edinburgh
Prof Hanieh Yaghootkar, University of Southampton
Dr Katie Marwick, Centre for Clinical Brain Sciences, University of Edinburgh
Summary:
People living with type 2 diabetes commonly experience multiple related long-term conditions, including obesity, cardiovascular disease, chronic kidney disease and fatty liver disease. These cardiometabolic multiple long-term conditions are associated with high treatment burden, poorer health outcomes and widening health inequalities.
Tirzepatide is a new incretin-based therapy that can substantially improve blood glucose, body weight and cardiometabolic risk factors. However, treatment response varies between individuals, and it is unclear why some people benefit more than others, particularly in routine NHS care and among people living with multiple long-term conditions.
This interdisciplinary PhD will investigate how deprivation, multimorbidity burden, treatment burden and underlying metabolic phenotype influence response to tirzepatide. The project will combine a systematic review, analysis of linked NHS healthcare data such as DataLoch, and mechanistic clinical phenotyping.
The student will examine outcomes including treatment adherence and persistence, HbA1c, weight, blood pressure, lipid profile, renal markers, healthcare utilisation, body composition and ectopic fat. The project aims to improve understanding of heterogeneity of treatment response and support more personalised and equitable use of tirzepatide for people living with type 2 diabetes and cardiometabolic multimorbidity. The student will receive interdisciplinary training in epidemiology, health data science, metabolic phenotyping and multimorbidity research.