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儿童肥胖症中减肥药物的有效及合理使用:一篇叙述性综述

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review.

作者信息

Chung Yoojin Lindsey

机构信息

Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

出版信息

J Yeungnam Med Sci. 2024 Jul;41(3):158-165. doi: 10.12701/jyms.2024.00353. Epub 2024 Jul 2.

Abstract

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

摘要

在过去几十年中,儿童肥胖症的发病率显著上升,这是一个重大的公共卫生问题。肥胖儿童患2型糖尿病、高血压、血脂异常、多囊卵巢综合征、阻塞性睡眠呼吸暂停和成人肥胖症的风险更高。生活方式改变疗法通常是治疗儿童肥胖症的初始方法。对于仅通过生活方式改变疗法未取得成功的患者,药物治疗是下一个合理的治疗选择。在选择抗肥胖药物(AOM)时,首先必须确定患者的医学背景,包括当前用药情况和肥胖相关的合并症。评估患者的肥胖表型也可能有益。用于儿童肥胖症的AOM包括二甲双胍、奥利司他、胰高血糖素样肽1激动剂、苯丁胺以及苯丁胺/托吡酯组合。在考虑药物治疗之前应给予充分的生活方式改变疗法,并在开始使用AOM后继续进行。为确保健康发育,在抗肥胖治疗期间监测生长和青春期发育至关重要。

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Clinical review: Guide to pharmacological management in pediatric obesity medicine.临床综述:儿童肥胖医学药理学管理指南
Obes Pillars. 2023 Apr 27;6:100066. doi: 10.1016/j.obpill.2023.100066. eCollection 2023 Jun.
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NEJM Evid. 2022 Jun;1(6). doi: 10.1056/evidoa2200014. Epub 2022 Apr 30.
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Once-Weekly Semaglutide in Adolescents with Obesity.每周一次司美格鲁肽治疗肥胖青少年。
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