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胰高血糖素样肽 1 受体激动剂在儿童肥胖治疗中的应用。

Use of glucagon-like-peptide 1 receptor agonist in the treatment of childhood obesity.

机构信息

Pediatric Gastroenterology, Hepatology and Nutrition Division, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA.

出版信息

Curr Opin Pediatr. 2024 Oct 1;36(5):542-546. doi: 10.1097/MOP.0000000000001379. Epub 2024 Jun 13.

DOI:10.1097/MOP.0000000000001379
PMID:39254757
Abstract

PURPOSE OF REVIEW

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 FINDINGS

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.

SUMMARY

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.

摘要

目的综述

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。

最新研究进展

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。

总结

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。

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