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一种关于胰高血糖素样肽-1受体激动剂通过激活单磷酸腺苷激活蛋白激酶(AMPK)发挥即时和多方面作用的假说。

A Hypothesis That Glucagon-like Peptide-1 Receptor Agonists Exert Immediate and Multifaceted Effects by Activating Adenosine Monophosphate-Activate Protein Kinase (AMPK).

作者信息

Schooling C Mary, Yang Guoyi, Soliman Ghada A, Leung Gabriel M

机构信息

School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

School of Public Health and Health Policy, City University of New York, Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY 10027, USA.

出版信息

Life (Basel). 2025 Feb 7;15(2):253. doi: 10.3390/life15020253.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce bodyweight and blood glucose. Extensive evidence from randomized controlled trials has indicated that GLP-1RAs have benefits well beyond weight loss and glucose control, extending from reductions in cardiovascular mortality to reductions in prostate cancer risk. Notably, some benefits of GLP-1RAs for the cardiovascular-kidney-metabolic (CKM) system arise before weight loss occurs for reasons that are not entirely clear but are key to patient care and drug development. Here, we hypothesize that GLP-1RAs act by inducing calorie restriction and by activating adenosine monophosphate-activated protein kinase (AMPK), which not only provides an explanation for the unique effectiveness of GLP-1RAs but also indicates a common mechanism shared by effective CKM therapies, including salicylates, metformin, statins, healthy diet, and physical activity. Whether AMPK activation is obligatory for effective CKM therapies should be considered. As such, we propose a mechanism of action for GLP-1RAs and explain how it provides an overarching framework for identifying means of preventing and treating cardiovascular, kidney, metabolic and related diseases, as well as informing the complementary question as to the components of a healthy lifestyle.

摘要

胰高血糖素样肽-1受体激动剂(GLP-1RAs)可减轻体重并降低血糖。随机对照试验的大量证据表明,GLP-1RAs的益处远不止于体重减轻和血糖控制,从降低心血管死亡率到降低前列腺癌风险均有体现。值得注意的是,GLP-1RAs对心血管-肾脏-代谢(CKM)系统的一些益处早在体重减轻之前就已出现,其原因尚不完全清楚,但这对患者护理和药物研发至关重要。在此,我们假设GLP-1RAs通过诱导热量限制和激活单磷酸腺苷激活蛋白激酶(AMPK)发挥作用,这不仅为GLP-1RAs的独特疗效提供了解释,还表明了包括水杨酸盐、二甲双胍、他汀类药物、健康饮食和体育活动在内的有效CKM疗法所共有的一种机制。应考虑AMPK激活对于有效的CKM疗法是否必不可少。因此,我们提出了GLP-1RAs的作用机制,并解释了它如何为识别预防和治疗心血管、肾脏、代谢及相关疾病的方法提供一个总体框架,同时也为健康生活方式的组成部分这一补充问题提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04aa/11857512/cc5ce78e0d9a/life-15-00253-g001.jpg

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