Nair Rama P, Ren Jun
WPPD Program, University of Florida, Gainesville, FL 32609, USA.
Curr Med Chem. 2009;16(15):1888-97. doi: 10.2174/092986709788186110.
Overweight and obesity, if sustained, are serious medical problems reaching an epidemic proportion. It is estimated that over 55% of the adult population is affected by overweight and obesity. Both overweight and obesity put these individuals at a high risk for the development of insulin resistance, hypertension, dyslipidemia, type 2 diabetes and coronary heart disease. A weight loss of between 5% and 10% of the initial body weight has been shown to greatly reduce these health risks associated with overweight and obesity. Typically, the first-line clinical strategy for weight loss is a combination of supervised diet, exercise and behavior modification. Although life style modification can exert beneficial effects in overweighed and obese individuals, it is difficult to achieve and maintain weight losses solely by life style change. Anti-obesity drugs may be used in obese patients (BMI of 30 or greater), or overweight patients with established comorbidities (BMI > 27), where dietary and lifestyle modifications are unsuccessful in achieving a 10% weight reduction following at least three months of the supervised care. Current anti-obesity drug therapy is geared towards reducing energy/food intake via actions on either gastrointestinal system or the central control of appetite and feeding. A thorough understanding of the molecular pathways involved in weight gain and appetite suppression should help for a better drug design and development. This mini review will focus on the molecular mechanisms and currently available pharmacotherapeutic interventions in overweight and obesity.
超重和肥胖若持续存在，是严重的医学问题，已达到流行程度。据估计，超过55%的成年人口受到超重和肥胖的影响。超重和肥胖都会使这些人患胰岛素抵抗、高血压、血脂异常、2型糖尿病和冠心病的风险大幅增加。已证明，初始体重减轻5%至10%可大大降低与超重和肥胖相关的这些健康风险。通常，减肥的一线临床策略是将监督下的饮食、运动和行为改变相结合。尽管生活方式改变对超重和肥胖个体可能产生有益影响，但仅通过生活方式改变很难实现并维持体重减轻。抗肥胖药物可用于肥胖患者（体重指数为30或更高），或患有已确诊合并症的超重患者（体重指数>27），在经过至少三个月的监督护理后，饮食和生活方式改变未能实现体重减轻10%的情况下使用。当前的抗肥胖药物治疗旨在通过作用于胃肠系统或食欲及进食的中枢控制来减少能量/食物摄入。深入了解体重增加和食欲抑制所涉及的分子途径应有助于更好地进行药物设计和开发。本综述将聚焦于超重和肥胖的分子机制及目前可用的药物治疗干预措施。
