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肥胖症及其在基层医疗环境中的管理。

Obesity and its management in primary care setting.

作者信息

Ibrahim Mahmoud, Ba-Essa Ebtesam M, Alvarez Jessica A, Baker Jason, Bruni Vincenzo, Cahn Avivit, Ceriello Antonio, Cosentino Francesco, Davies Melanie J, De Domenico Francesco, Eckel Robert H, Friedman Allon N, Goldney Jonathan, Hamtzany Omer, Isaacs Scott, Karadeniz Sehnaz, Leslie Richard David, Lingvay Ildiko, McLaughlin Sue, Mobarak Omar, Del Prato Stefano, Prattichizzo Francesco, Rizzo Manfredi, Rötzer René D, le Roux Carel W, Schnell Oliver, Seferovic Petar M, Somers Virend K, Standl Eberhard, Thomas Abraham, Tuccinardi Dario, Valensi Paul, Umpierrez Guillermo E

机构信息

EDC, Centre for Diabetes Education, Charlotte, NC, USA.

Al-Rawdah General Hospital, Dammam, Saudi Arabia.

出版信息

J Diabetes Complications. 2025 Jul;39(7):109045. doi: 10.1016/j.jdiacomp.2025.109045. Epub 2025 Apr 19.

Abstract

Obesity is a worldwide epidemic affecting adults and children, regardless of their socioeconomic status. Significant progress has been made in understanding the genetic causes contributing to obesity, shedding light on a portion of cases worldwide. In young children with severe obesity however, recessive mutations, i.e., leptin or leptin receptor deficiency should be sought. Much more has been learned about the far-reaching impact of obesity on complications, including cardiovascular disease, liver and kidney dysfunction, diabetes, inflammation, hypertension, sleep, cancer, and the eye. Preventive strategies, particularly in children, are crucial for reducing obesity rates and mitigating its long-term complications. While dietary modifications and lifestyle changes remain the cornerstone of obesity prevention or treatment, recent advancements have introduced highly effective pharmacological options complementing weight-reduction surgery. Newer medications, like incretin-based therapies including glucagon-like peptide-1 agonists (GLP-1RA), have demonstrated remarkable efficacy in promoting weight loss, offering new insights into margining obesity-related conditions. Primary care providers, whether treating adults or children, play a pivotal role in preventing obesity, initiating treatment, and making onward referrals to specialists to assist in managing obesity and obesity-related complications.

摘要

肥胖是一种影响成人和儿童的全球性流行病,无论其社会经济地位如何。在了解导致肥胖的遗传原因方面已经取得了重大进展,为全球一部分肥胖病例提供了线索。然而,对于患有严重肥胖症的幼儿,应寻找隐性突变,即瘦素或瘦素受体缺乏症。人们对肥胖对并发症的深远影响有了更多了解,这些并发症包括心血管疾病、肝肾功能障碍、糖尿病、炎症、高血压、睡眠、癌症和眼部疾病。预防策略,尤其是针对儿童的预防策略,对于降低肥胖率和减轻其长期并发症至关重要。虽然饮食调整和生活方式改变仍然是肥胖预防或治疗的基石,但最近的进展引入了高效的药物选择,作为减重手术的补充。新型药物,如基于肠促胰岛素的疗法,包括胰高血糖素样肽-1激动剂(GLP-1RA),在促进体重减轻方面已显示出显著疗效,为治疗肥胖相关病症提供了新的思路。无论是治疗成人还是儿童,初级保健提供者在预防肥胖、启动治疗以及将患者转诊给专科医生以协助管理肥胖及肥胖相关并发症方面都发挥着关键作用。

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