The Association of Diabetes Investigators, Newport Coast, CA, USA.
Expert Rev Endocrinol Metab. 2023 Jan;18(1):81-94. doi: 10.1080/17446651.2023.2168643. Epub 2023 Jan 29.
Obesity is a key target in the treatment and prevention of diabetes and independently to reduce the burden of cardiovascular disease. We reviewed the options now available and anticipated to deal with obesity.
We considered the epidemiology, genetics, and causation of obesity and the relationship to diabetes, and the dietary, pharmaceutical, and surgical management of the condition. The literature search covered both popular media via Google Search and the academic literature as indexed on PubMed with search terms including obesity, childhood obesity, adipocytes, insulin resistance, mechanisms of satiety, bariatric surgery, GLP-1 receptor agonists, and SGLT2 inhibitors.
Although bariatric surgery has been the primary approach to treating obese individuals, the emergence of agents impacting the brain satiety centers now promises effective, non-invasive treatment of obesity for individuals with and without diabetes. The GLP-1 receptor agonists have assumed the primary role in treating obesity with significant weight loss. Long-term results with semaglutide and tirzepatide are now approaching the success seen with bariatric surgery. Future agents combining the benefits of satiety control and thermogenesis to dissipate caloric excess are under investigation.
肥胖是治疗和预防糖尿病以及独立降低心血管疾病负担的关键目标。我们回顾了现有的和预期的治疗肥胖的方法。
我们考虑了肥胖的流行病学、遗传学和病因，以及肥胖与糖尿病的关系，以及该疾病的饮食、药物和手术管理。文献检索包括通过谷歌搜索的大众媒体和在 PubMed 上索引的学术文献，搜索词包括肥胖、儿童肥胖、脂肪细胞、胰岛素抵抗、饱腹感机制、减肥手术、GLP-1 受体激动剂和 SGLT2 抑制剂。
尽管减肥手术一直是治疗肥胖个体的主要方法，但影响大脑饱腹感中心的药物的出现现在有望为有或没有糖尿病的个体提供有效的非侵入性肥胖治疗。GLP-1 受体激动剂在治疗肥胖症方面发挥了主要作用，显著减轻了体重。现在，司美格鲁肽和替西帕肽的长期结果接近减肥手术的成功。正在研究结合饱腹感控制和产热以消耗多余热量的联合药物。
