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抗消费剂:替尔泊肽和司美格鲁肽用于治疗肥胖相关疾病和成瘾,并提高预期寿命。

Anti-consumption agents: Tirzepatide and semaglutide for treating obesity-related diseases and addictions, and improving life expectancy.

作者信息

O'Keefe James H, Franco W Grant, O'Keefe Evan L

机构信息

Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, United States of America.

Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, United States of America.

出版信息

Prog Cardiovasc Dis. 2025 Mar-Apr;89:102-112. doi: 10.1016/j.pcad.2024.12.010. Epub 2024 Dec 30.

Abstract

American culture encourages overconsumption, fueled by ubiquitous availability and pervasive marketing of ultra-processed foods and other addictive substances. This chronic overindulgence has contributed to rising rates of obesity, type 2 diabetes (T2D), substance abuse, mental health disorders and premature mortality. Glucose-like peptide-1 agonists (GLP-1RAs) affect the brain's reward pathway that mediates addiction to foods and various other substances. Evolving data suggest that tirzepatide and semaglutide may be the first effective "anti-consumption" agents with potential applications in reducing food cravings, obesity, alcohol consumption, nicotine addiction, recreational drug use, and even uncontrollable shopping behaviors. Tirzepatide and semaglutide, unlike prior weight-loss drugs, are effective and relatively safe/well-tolerated medications that are associated with reduced risks for myocardial infarction, stroke, cardiovascular death, heart failure, progressive kidney and liver disease, obstructive sleep apnea, debilitating osteoarthritis, polycystic ovarian syndrome, neurodegenerative disease and premature mortality. Observational studies show that GLP-1RAs are associated with spontaneous nonvolitional reductions in use of alcohol, nicotine, and recreational drugs. Because obesity and substance abuse are so prevalent in the United States, GLP-1RA drugs may be uniquely helpful in addressing overconsumption and addiction issues thereby improving overall health and life expectancy.

摘要

美国文化鼓励过度消费,无处不在的超加工食品和其他成瘾性物质供应以及无孔不入的营销手段助长了这种现象。这种长期的过度放纵导致肥胖、2型糖尿病(T2D)、药物滥用、心理健康障碍和过早死亡的发生率不断上升。胰高血糖素样肽-1激动剂(GLP-1RAs)会影响大脑的奖赏通路,该通路介导对食物和各种其他物质的成瘾。越来越多的数据表明,替尔泊肽和司美格鲁肽可能是首批有效的“抗消费”药物,在减少食物渴望、肥胖、酒精消费、尼古丁成瘾、消遣性药物使用甚至无法控制的购物行为方面具有潜在应用价值。与先前的减肥药物不同,替尔泊肽和司美格鲁肽是有效且相对安全/耐受性良好的药物,与降低心肌梗死、中风、心血管死亡、心力衰竭、进行性肾脏和肝脏疾病、阻塞性睡眠呼吸暂停、使人衰弱的骨关节炎、多囊卵巢综合征、神经退行性疾病和过早死亡的风险相关。观察性研究表明,GLP-1RAs与酒精、尼古丁和消遣性药物使用的自发非自愿减少有关。由于肥胖和药物滥用在美国非常普遍,GLP-1RA药物可能在解决过度消费和成瘾问题方面具有独特的帮助,从而改善整体健康状况和预期寿命。

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Tirzepatide for Obesity Treatment and Diabetes Prevention.替尔泊肽用于肥胖治疗和糖尿病预防。
N Engl J Med. 2025 Mar 6;392(10):958-971. doi: 10.1056/NEJMoa2410819. Epub 2024 Nov 13.

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