Koutroumanidou Eleni, Pagonopoulou Olga
Clinical and Public Health Nutrition MSc, University College London, London, UK; Department of Physiology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Diabetes Metab Res Rev. 2014 Mar;30(3):165-74. doi: 10.1002/dmrr.2475.
Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease (heart disease and diabetes) and disability. The aim of the study was to perform a systematic review and meta-analysis of published data on the combination of very low energy diets also known as very low calorie diets and pharmacotherapy for its effectiveness in the treatment of obesity. A MEDLINE (Pubmed) search from 1970 to 2009 using multiple combinations of the relevant terms was carried out; the matching articles were also searched for additional references. Meta-analysis tools were used to summarize results. Only randomized controlled trials that compared pharmacotherapy with placebo after a very low energy diet period were selected, and six articles were finally considered to be appropriate for evaluation. The combination of very low energy diet and pharmacotherapy was found to be effective for people with obesity in clinical trials. The net effect of 6.1 kg placebo subtracted weight loss after 1 year represents a clinically meaningful result that is comparable with the effect of drugs given at the start of a weight loss programme. The present meta-analysis contributes to the understanding that combination therapies are expected to achieve greater weight loss than monotherapy; grasping this understanding, researcher has introduced newer anti-obesity pharmacological approaches have embraced combination therapies.
肥胖在全球已达到流行程度，超过10亿成年人超重，其中至少3亿人临床肥胖，肥胖是全球慢性疾病（心脏病和糖尿病）负担及残疾的主要促成因素。本研究的目的是对已发表的关于极低能量饮食（也称为极低热量饮食）与药物疗法联合治疗肥胖有效性的数据进行系统评价和荟萃分析。利用相关术语的多种组合对1970年至2009年的MEDLINE（PubMed）进行了检索；对匹配文章也检索了其他参考文献。使用荟萃分析工具汇总结果。仅选择在极低能量饮食期后将药物疗法与安慰剂进行比较的随机对照试验，最终6篇文章被认为适合评估。在临床试验中，极低能量饮食与药物疗法的联合对肥胖者有效。1年后安慰剂减去的净体重减轻6.1千克代表了具有临床意义的结果，这与减肥计划开始时给予药物的效果相当。目前的荟萃分析有助于理解联合疗法预计比单一疗法能实现更大的体重减轻；基于这种理解，研究人员引入了更新的抗肥胖药理学方法，采用了联合疗法。
