Oh Tae Jung
Department of Internal Medicine, Seoul National University College of Medicine, Seoul; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Obes Metab Syndr. 2019 Sep;28(3):158-166. doi: 10.7570/jomes.2019.28.3.158. Epub 2019 Mar 30.
Diabetes is prevalent in obese population, and obesity management is the first step in preventing diabetes. Traditionally, lifestyle modification including reduced-calorie diet, physical activity, and behavior intervention is the core of obesity management. However, pharmacotherapy is frequently required in addition to the lifestyle modification for effective reduction of body weight. There are five classes of anti-obesity medications approved by the U.S. Food and Drug Administration for chronic treatment used in obesity management. As the goal of obesity management is to prevent obesity-related comorbidities, clinical trials were conducted to evaluate the effect of anti-obesity medications on cardiovascular risk factors including hyperglycemia. Orlistat and liraglutide have been tested for their effect on diabetes prevention as a primary outcome. Cardiovascular safety studies were conducted for lorcaserin and liraglutide (as an anti-diabetic medication). In addition, there are many indirect evidences of the role of anti-obesity medications on diabetes prevention and its microvascular and macrovascular complications. This review focused on current evidences of anti-obesity medications related with diabetes, which is a major complication of obesity.
糖尿病在肥胖人群中很常见，而肥胖管理是预防糖尿病的第一步。传统上，包括低热量饮食、体育活动和行为干预在内的生活方式改变是肥胖管理的核心。然而，除了生活方式改变外，通常还需要药物治疗以有效减轻体重。美国食品药品监督管理局批准了五类用于肥胖管理慢性治疗的抗肥胖药物。由于肥胖管理的目标是预防肥胖相关的合并症，因此进行了临床试验以评估抗肥胖药物对包括高血糖在内的心血管危险因素的影响。奥利司他和利拉鲁肽已作为主要结局对其预防糖尿病的效果进行了测试。对氯卡色林和利拉鲁肽（作为一种抗糖尿病药物）进行了心血管安全性研究。此外，有许多间接证据表明抗肥胖药物在预防糖尿病及其微血管和大血管并发症方面的作用。本综述重点关注与糖尿病相关的抗肥胖药物的当前证据，糖尿病是肥胖的主要并发症。
