Alnagar Amr, Sinha Yashashwi, Ahmad Adil N, Ahmed Awais, Noormohamed Mohamed Saleem
University Hospitals of Birmingham, Bordesley Green E, Birmingham, B9 5SS, UK.
Worcestershire Acute Hospitals, Worcester, UK.
Curr Obes Rep. 2025 May 23;14(1):48. doi: 10.1007/s13679-025-00640-0.
This review evaluates the comparative efficacy of bariatric surgery and pharmacological interventions targeting Glucagon-Like Peptide-1 (GLP-1) and Glucose-Dependent Insulinotropic Polypeptide (GIP) receptors. Recent advancements, including the FDA approval of Tirzepatide (Zepbound) for OSA, are critically analysed alongside existing literature, offering insights into physiological mechanisms, long-term outcomes, and patient selection criteria.
OSA is a chronic condition characterized by repetitive upper airway collapse during sleep, resulting in intermittent hypoxia and sleep fragmentation. With obesity being a primary risk factor, weight management has emerged as a key intervention in OSA treatment. Direct comparisons of bariatric surgery and GLP-1/GIP receptor agonists in treating OSA are limited due to a lack of randomised controlled trials. Observational studies suggest that bariatric surgery typically results in faster and more sustained weight loss, leading to better initial OSA improvement. In contrast, pharmacotherapy offers a non-invasive option for patients who cannot undergo surgery. Randomized trials comparing these treatment modalities are essential to refine treatment algorithms and enhance patient care. A multidisciplinary, patient-centered approach is crucial for ensuring long-term success and improving the quality of life for individuals with obesity-related OSA.
本综述评估了减肥手术以及针对胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）受体的药物干预措施的相对疗效。对包括美国食品药品监督管理局（FDA）批准替尔泊肽（Zepbound）用于阻塞性睡眠呼吸暂停（OSA）在内的最新进展与现有文献进行了批判性分析，深入探讨了生理机制、长期结局和患者选择标准。
OSA是一种慢性病，其特征是睡眠期间上呼吸道反复塌陷，导致间歇性缺氧和睡眠片段化。肥胖是主要危险因素，体重管理已成为OSA治疗的关键干预措施。由于缺乏随机对照试验，减肥手术与GLP-1/GIP受体激动剂在治疗OSA方面的直接比较有限。观察性研究表明，减肥手术通常能带来更快、更持久的体重减轻，从而使OSA得到更好的初始改善。相比之下，药物治疗为无法接受手术的患者提供了一种非侵入性选择。比较这些治疗方式的随机试验对于完善治疗方案和提高患者护理水平至关重要。多学科、以患者为中心的方法对于确保长期成功和改善肥胖相关OSA患者的生活质量至关重要。
