二甲双胍：在人类肥胖和减肥中的作用机制。
Metformin: Mechanisms in Human Obesity and Weight Loss.
机构信息
Department of Medicine, Diabetes Unit, Endocrine Division, and Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, CPZN6224, Boston, MA, 02114, USA.
Department of Medicine, Harvard Medical School, Boston, MA, 02114, USA.
出版信息
Curr Obes Rep. 2019 Jun;8(2):156-164. doi: 10.1007/s13679-019-00335-3.
PURPOSE OF REVIEW
Metformin has multiple benefits for health beyond its anti-hyperglycemic properties. The purpose of this manuscript is to review the mechanisms that underlie metformin's effects on obesity.
RECENT FINDINGS
Metformin is a first-line therapy for type 2 diabetes. Large cohort studies have shown weight loss benefits associated with metformin therapy. Metabolic consequences were traditionally thought to underlie this effect, including reduction in hepatic gluconeogenesis and reduction in insulin production. Emerging evidence suggests that metformin-associated weight loss is due to modulation of hypothalamic appetite regulatory centers, alteration in the gut microbiome, and reversal of consequences of aging. Metformin is also being explored in the management of obesity's sequelae such as hepatic steatosis, obstructive sleep apnea, and osteoarthritis. Multiple mechanisms underlie the weight loss-inducing and health-promoting effects of metformin. Further exploration of these pathways may be important in identifying new pharmacologic targets for obesity and other aging-associated metabolic diseases.
目的综述
二甲双胍除了具有降血糖作用外，对健康还有多种益处。本文旨在综述二甲双胍影响肥胖的作用机制。
最近的发现
二甲双胍是 2 型糖尿病的一线治疗药物。大型队列研究表明，二甲双胍治疗可带来体重减轻的益处。传统上认为代谢后果是其发挥作用的基础，包括减少肝糖异生和胰岛素生成。新出现的证据表明，二甲双胍相关的体重减轻是由于调节下丘脑食欲调节中心、改变肠道微生物群和逆转衰老的后果。二甲双胍也正在探索用于治疗肥胖的后遗症，如脂肪肝、阻塞性睡眠呼吸暂停和骨关节炎。多种机制共同导致二甲双胍发挥减轻体重和促进健康的作用。进一步探索这些途径对于确定肥胖和其他与衰老相关的代谢性疾病的新药物靶点可能很重要。
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