Clinical Fellow in Endocrinology, Division of Endocrinology, Diabetes and Metabolism, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Associate Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Cleve Clin J Med. 2017 Jul;84(7 Suppl 1):S22-S29. doi: 10.3949/ccjm.84.s1.04.
Evidence of a neurophysiologic mechanism that involves hormones from adipocytes, pancreatic islet cells, and the gastrointestinal tract implicated in both obesity and diabetes has led to a search for drugs that not only either target obesity and diabetes or reduce hemoglobin A1c, but also have weight loss as a potential side effect. The authors review medications approved for the treatment of type 2 diabetes mellitus (including pramlintide, also approved for type 1 diabetes) that also have weight loss as a side effect. Drugs discussed include glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, neuroendocrine peptide hormones, alpha-glucosidase inhibitors, and metformin. Where appropriate, the authors comment on the cardiovascular effects of these drugs.
涉及脂肪细胞、胰岛细胞和胃肠道激素的神经生理机制的证据表明，这些激素与肥胖和糖尿病都有关，这促使人们寻找不仅能针对肥胖和糖尿病或降低血红蛋白 A1c 的药物，而且还能将体重减轻作为一种潜在的副作用。作者回顾了批准用于治疗 2 型糖尿病（包括也批准用于 1 型糖尿病的普兰林肽）的药物，这些药物也有体重减轻的副作用。讨论的药物包括胰高血糖素样肽-1（GLP-1）受体激动剂、钠-葡萄糖共转运蛋白-2（SGLT-2）抑制剂、神经内分泌肽激素、α-葡萄糖苷酶抑制剂和二甲双胍。在适当的情况下，作者对这些药物的心血管作用进行了评论。
