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胰高血糖素样肽-1(GLP-1)激动剂在饮食失调治疗中的作用:一项系统评价和荟萃分析。

The impact of glucagon-like peptide-1 (GLP-1) agonists in the treatment of eating disorders: a systematic review and meta-analysis.

作者信息

Radkhah Hanieh, Rahimipour Anaraki Shiva, Parhizkar Roudsari Peyvand, Arabzadeh Bahri Razman, Zooravar Diar, Asgarian Sara, Hosseini Dolama Reza, Alirezaei Ali, Khalooeifard Razieh

机构信息

Sina Hospital, Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.

School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Eat Weight Disord. 2025 Feb 1;30(1):10. doi: 10.1007/s40519-025-01720-9.

Abstract

PURPOSE

Glucagon-like peptide-1 (GLP-1) receptor agonists have shown potential in managing eating disorders (EDs). Recent studies highlight their effects on pathophysiological pathways, indicating their therapeutic promise, particularly for binge eating disorder (BED). This systematic review evaluates the therapeutic effects of GLP-1 agonists on BED, focusing on weight management and eating behaviors.

METHODS

A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library, along with manual searches, identified studies assessing GLP-1 agonists in BED patients up to November 8, 2024. Observational studies and clinical trials meeting inclusion criteria were analyzed.

RESULTS

Five studies (182 participants) were included. Patients receiving GLP-1 agonists experienced greater weight loss (- 3.81 kg; 95% CI - 5.14 to - 2.49; p < 0.01, I: 59.88%) compared to controls. GLP-1 agonists significantly reduced BMI (- 1.48 kg/m) and waist circumference (- 3.14 cm). Binge Eating Scale (BES) scores improved significantly (- 8.14 points; 95% CI - 13.13 to - 3.15; p < 0.01), though heterogeneity was noted.

CONCLUSIONS

This review underscores the potential role of GLP-1 agonists in BED management. However, given the limited data, especially concerning EDs other than BED and the long-term effects of these medications, further comprehensive clinical trials are recommended to evaluate the impact of various GLP-1 agonists on different EDs across diverse demographic groups.

LEVEL OF EVIDENCE

Level I, randomized controlled trials.

摘要

目的

胰高血糖素样肽-1(GLP-1)受体激动剂在治疗饮食失调(EDs)方面已显示出潜力。最近的研究突出了它们对病理生理途径的影响,表明其治疗前景,特别是对暴食症(BED)。本系统评价评估GLP-1激动剂对BED的治疗效果,重点关注体重管理和饮食行为。

方法

对PubMed、Scopus、Web of Science和Cochrane图书馆进行系统检索,并进行手工检索,以确定截至2024年11月8日评估BED患者使用GLP-1激动剂的研究。对符合纳入标准的观察性研究和临床试验进行分析。

结果

纳入了五项研究(182名参与者)。与对照组相比,接受GLP-1激动剂治疗的患者体重减轻更多(-3.81 kg;95%置信区间-5.14至-2.49;p<0.01,I:59.88%)。GLP-1激动剂显著降低了体重指数(-1.48 kg/m²)和腰围(-3.14 cm)。暴食量表(BES)评分显著改善(-8.14分;95%置信区间-13.13至-3.15;p<0.01),不过存在异质性。

结论

本评价强调了GLP-1激动剂在BED管理中的潜在作用。然而,鉴于数据有限,特别是关于BED以外的其他饮食失调以及这些药物的长期影响,建议进一步开展全面的临床试验,以评估各种GLP-1激动剂对不同人口群体中不同饮食失调的影响。

证据水平

I级,随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fee5/11787217/dfd91f540bec/40519_2025_1720_Fig1_HTML.jpg

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