Bellavance Danielle, Chua Samantha, Mashimo Hiroshi
Department of Medicine, VA Boston Healthcare System, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Curr Gastroenterol Rep. 2025 Jul 7;27(1):49. doi: 10.1007/s11894-025-00995-3.
This review summarizes the current understanding of the physiologic influence of GLP-1 RAs on gastrointestinal motility, highlights key clinical implications of these effects, and defines areas for future investigation.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have revolutionized the treatment of diabetes and obesity and are increasingly being identified as promising therapies for a wide range of conditions. GLP-1 RAs mimic naturally occurring GLP-1, an enterohormone produced in response to oral intake that regulates glucose metabolism and promotes weight loss. While GLP-1 RAs target a wide range of organ systems, their impacts on gastrointestinal motility are widely regarded as a major mechanism by which they exert their metabolic effects. However, the drugs' alterations in gut motility may account for many of their commonly reported adverse effects including nausea, vomiting, early satiety, dyspepsia, and bowel habit changes. GLP-1 RAs alter gastrointestinal motility at all levels of the GI tract, with delayed gastric emptying being the most well characterized. The effects of GLP-1 RAs on gastrointestinal motility have important clinical implications, including possible increased periprocedural aspiration risk and potential challenges with medication adherence and tolerability.
本综述总结了目前对胰高血糖素样肽-1受体激动剂(GLP-1 RAs)对胃肠动力生理影响的理解,强调了这些作用的关键临床意义,并确定了未来研究的领域。
胰高血糖素样肽-1受体激动剂(GLP-1 RAs)彻底改变了糖尿病和肥胖症的治疗方式,并且越来越多地被认为是治疗多种疾病的有前景的疗法。GLP-1 RAs模拟天然存在的GLP-1,这是一种在口服摄入后产生的肠激素,可调节葡萄糖代谢并促进体重减轻。虽然GLP-1 RAs作用于广泛的器官系统,但其对胃肠动力的影响被广泛认为是它们发挥代谢作用的主要机制。然而,药物引起的肠道动力改变可能是其许多常见不良反应的原因,包括恶心、呕吐、早饱、消化不良和排便习惯改变。GLP-1 RAs在胃肠道的各个层面都会改变胃肠动力,其中胃排空延迟是最有特征性的。GLP-1 RAs对胃肠动力的影响具有重要的临床意义,包括围手术期误吸风险可能增加以及药物依从性和耐受性方面的潜在挑战。