Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA.
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Obes Rev. 2023 Jul;24(7):e13568. doi: 10.1111/obr.13568. Epub 2023 Apr 17.
Obesity treatment requires a chronic state of negative energy balance. Obesity medications can help with this, increasing long-term dietary compliance by promoting satiety or reducing hunger. However, efficacy and safety of obesity medications vary for individuals. Early identification of non-responders to obesity medications may limit drug exposure while optimizing benefits for responders. This review summarizes factors that impact weight-loss response to liraglutide. Factors linked to greater weight loss on liraglutide include being female, not having diabetes, having relatively high baseline weight, and losing at least 4% of initial weight after 16 weeks of treatment. Other covariates that may predict treatment response but require further confirmation include central effects, nausea, gastric emptying of solids, and genotype. Baseline body mass index, race, and age seem less relevant for predicting weight-loss response to liraglutide. Lesser known and harder-to-measure factors such as cerebral blood flow, food cue reactivity, gut hormone levels, and dietary adherence possibly impact variability of response to liraglutide. This information should assist healthcare providers with establishing realistic weight-loss probability for individual patients. Future research should improve the ability to identify responders to liraglutide. Importantly, this review may provide a framework to identify responders to other obesity medications.
肥胖症的治疗需要长期处于负能量平衡状态。肥胖症药物可以通过促进饱腹感或减少饥饿感来帮助实现这一点，从而提高长期的饮食依从性。然而，肥胖症药物对个体的疗效和安全性存在差异。早期识别肥胖症药物的无应答者可能会限制药物暴露，同时优化应答者的获益。本综述总结了影响利拉鲁肽减肥效果的因素。与利拉鲁肽减肥效果更好相关的因素包括女性、无糖尿病、基线体重相对较高，以及在治疗 16 周后体重至少减轻初始体重的 4%。其他可能预测治疗反应但需要进一步证实的协变量包括中枢作用、恶心、固体胃排空和基因型。基线体重指数、种族和年龄似乎对预测利拉鲁肽的减肥反应相关性较低。不太为人所知且更难测量的因素，如脑血流、食物线索反应性、肠道激素水平和饮食依从性，可能会影响利拉鲁肽反应的可变性。这些信息应有助于医疗保健提供者为个体患者确定现实的减肥概率。未来的研究应提高识别利拉鲁肽应答者的能力。重要的是，本综述可能为识别其他肥胖症药物的应答者提供了一个框架。
