Pediatric Gastroenterology, Hepatology and Nutrition Division, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.
Curr Opin Pediatr. 2024 Oct 1;36(5):542-546. doi: 10.1097/MOP.0000000000001379. Epub 2024 Jun 13.
Pediatric obesity is a growing epidemic. Lifestyle modifications remain central to obesity treatment, however pharmacologic options have gained traction, particularly glucagon-like peptide-1 receptor agonists (GLP-1RA). This review aims to summarize evidence on the use of GLP-1RAs in the management of pediatric obesity, physiological mechanisms of action of GLP-1RAs and their role in appetite regulation and glucose homeostasis and address the challenges and special considerations surrounding GLP-1RA use.
Recent studies have highlighted the efficacy of GLP-1RAs, such as exenatide, liraglutide, and semaglutide, in promoting weight loss and improving metabolic parameters in children and adolescents. GLP-1RA's efficacy extends beyond glycemic control to include weight loss mechanisms such as delayed gastric emptying (gastroparesis), and appetite suppression. Semaglutide, the newest GLP-1RA, holds potential for substantial weight loss in adolescents and demonstrates a similar safety and efficacy as seen in adults.
GLP-1RAs may offer a promising adjunct therapy for pediatric obesity, particularly in cases where lifestyle interventions alone are insufficient. However, further research is needed to elucidate long-term safety and efficacy outcomes and to address potential disparities in access to care. Overall, this review highlights the relevance and timeliness of incorporating GLP-1RAs into the comprehensive management of pediatric obesity.
儿科肥胖是一种日益严重的流行疾病。生活方式的改变仍然是肥胖治疗的核心,但药物治疗选择也越来越受到关注,特别是胰高血糖素样肽-1 受体激动剂(GLP-1RA)。本文旨在总结 GLP-1RA 在儿科肥胖管理中的应用证据,包括 GLP-1RA 的作用机制、在食欲调节和血糖稳态中的作用,并探讨 GLP-1RA 使用所面临的挑战和特殊考虑因素。
最近的研究强调了 GLP-1RA,如 exenatide、liraglutide 和 semaglutide,在促进儿童和青少年体重减轻和改善代谢参数方面的疗效。GLP-1RA 的疗效不仅限于血糖控制,还包括通过延迟胃排空(胃轻瘫)和抑制食欲来实现体重减轻的机制。作为最新的 GLP-1RA,semaglutide 在青少年中具有显著的减重潜力,并且在安全性和疗效方面与成人相似。
GLP-1RA 可能为儿科肥胖症提供一种有前途的辅助治疗方法,特别是在单独进行生活方式干预不足的情况下。然而,需要进一步研究来阐明长期的安全性和疗效结果,并解决潜在的获得治疗的差异。总的来说,本文强调了将 GLP-1RA 纳入儿科肥胖综合管理的相关性和及时性。