Imam Ahmad, Alim Hussam, Binhussein Mohammad, Kabli Abdulrahman, Alhasnani Husam, Allehyani Abdullah, Aljohani Ammar, Mohorjy Ahmad, Tawakul Abdullah, Samannodi Mohammed, Taha Wael
Department of Internal Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia.
Department of Internal Medicine, Division of Endocrinology, Wayne State University, Detroit, MI 48201, USA.
J Endocr Soc. 2023 Oct 19;7(12):bvad129. doi: 10.1210/jendso/bvad129. eCollection 2023 Nov 2.
Different treatment modalities are available for obesity management, including lifestyle changes, pharmacotherapy, endoscopic interventions, and surgeries. Limited evidence is available on the weight loss effect of combining glucagon-like peptide 1 receptor agonists (GLP-1 RAs) with endoscopic bariatric therapy (EBT) and bariatric surgeries (BS).
In this systematic review, we compared the weight loss effect and metabolic changes of combining GLP-1 RAs with EBT and BS.
Literature searches were performed in the Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, Embase, PubMed, Google Scholar, and PRISMA databases. Only randomized control trials and retrospective studies were included.
A total of 11 studies was included. Nine studies compared BS with and without liraglutide and 2 compared EBT with and without liraglutide. Adding liraglutide to EBT or BS provided significant weight loss when compared with EBT or BS alone. When changes in weight were compared across the studies, EBT with liraglutide showed a weight loss effect comparable to the net weight loss (ie, nadir weight loss after BS-regained weight) achieved following BS alone.
This review showcases a promising approach for managing obesity that combines GLP-1 RAs with EBT. This approach is expected to achieve shorter hospital stays, fewer side effects, and longer term weight loss benefits than BS alone. However, additional prospective studies with higher quality, more consistent outcome measures for weight loss and metabolic changes are needed to further evaluate the approach.
肥胖管理有多种治疗方式，包括生活方式改变、药物治疗、内镜干预和手术。关于胰高血糖素样肽1受体激动剂（GLP-1 RAs）与内镜减重治疗（EBT）及减重手术（BS）联合使用的减肥效果，现有证据有限。
在本系统评价中，我们比较了GLP-1 RAs与EBT及BS联合使用的减肥效果和代谢变化。
在Cochrane系统评价数据库、Cochrane对照试验中心注册库、Embase、PubMed、谷歌学术和PRISMA数据库中进行文献检索。仅纳入随机对照试验和回顾性研究。
共纳入11项研究。9项研究比较了使用和未使用利拉鲁肽的减重手术，2项研究比较了使用和未使用利拉鲁肽的内镜减重治疗。与单独使用EBT或BS相比，在EBT或BS中添加利拉鲁肽可显著减重。当比较各项研究中的体重变化时，使用利拉鲁肽的EBT显示出的减肥效果与单独进行BS后实现的净体重减轻（即BS后最低点体重减轻 - 恢复的体重）相当。
本综述展示了一种将GLP-1 RAs与EBT相结合的有前景的肥胖管理方法。与单独进行BS相比，这种方法预计可实现更短的住院时间、更少的副作用以及更长期的减肥益处。然而，需要更多高质量的前瞻性研究，采用更一致的减肥和代谢变化结果测量方法，以进一步评估该方法。
