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迷走神经刺激对代谢的影响:一项系统评价与荟萃分析。

Effect of vagus nerve stimulation on metabolism: a systematic review and meta-analysis.

作者信息

Shen Tianxiao, Tang Xinyue, Pan Yixin, He Hua, Hu Kejia

机构信息

Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, Anhui, China.

出版信息

Int J Obes (Lond). 2025 Aug 29. doi: 10.1038/s41366-025-01871-w.

Abstract

BACKGROUND

Vagus Nerve Stimulation (VNS) has long been a standard surgical procedure for patients with treatment-resistant depression or epilepsy. However, several studies have confirmed a side-effect of VNS treatment as weight loss. Animal model studies (e.g., rats, minipigs) and clinical trials have shown promising outcomes regarding weight and appetite, but further statistical analysis is limited.

METHODS

We searched PubMed and several databases for rat model studies, minipig model studies, and human trials between 1966 and March 2024. All reported changes in weight, appetite, and energy expenditure were assessed. Meta-analysis was employed to calculate the overall pooled effects across studies with different durations or measurements.

RESULTS

Of the 529 papers identified, 15 studies were eligible for this meta-analysis, including 12 animal trials and 4 human randomized controlled trials (RCTs). VNS showed a significant effect on reducing weight gain in both animal models (rats 95% CI -0.91 to -0.27, I = 88%, Z = 3.60, P = 0.0003; minipigs 95% CI -209.17 to -36.61, I = 98%, Z = 2.79, P = 0.005) and human trials (95% CI 1.06 to 2.07, I = 98%, Z = 6.11, P < 0.00001). VNS also significantly reduced appetite (95% CI -6.47 to -5.82, I = 95%, Z = 36.91, P < 0.00001) and changed energy expenditure (95% CI -2.83 to -0.81, I = 80%, Z = 3.53, P = 0.0004) in the rat model. The effect on human energy expenditure could not be estimated.

CONCLUSION

VNS has demonstrated notable impacts on reducing weight, suppressing appetite, and enhancing energy expenditure in rat and minipig models, indicating a promising therapeutic application in addressing metabolic disorders. Human trials also showed the effectiveness and safety of VNS on metabolism.

摘要

背景

长期以来,迷走神经刺激术(VNS)一直是治疗难治性抑郁症或癫痫患者的标准外科手术。然而,多项研究证实VNS治疗存在体重减轻的副作用。动物模型研究(如大鼠、小型猪)和临床试验在体重和食欲方面显示出了有前景的结果,但进一步的统计分析有限。

方法

我们在PubMed和其他几个数据库中搜索了1966年至2024年3月期间的大鼠模型研究、小型猪模型研究和人体试验。对所有报告的体重、食欲和能量消耗变化进行了评估。采用荟萃分析来计算不同持续时间或测量方法的研究的总体合并效应。

结果

在识别出的529篇论文中,有15项研究符合该荟萃分析的条件,包括12项动物试验和4项人体随机对照试验(RCT)。VNS在动物模型(大鼠95%可信区间-0.91至-0.27,I=88%,Z=3.60,P=0.0003;小型猪95%可信区间-209.17至-36.61,I=98%,Z=2.79,P=0.005)和人体试验(95%可信区间1.06至2.07,I=98%,Z=6.11,P<0.00001)中均显示出对减轻体重增加有显著效果。VNS在大鼠模型中还显著降低了食欲(95%可信区间-6.47至-5.82,I=95%,Z=36.91,P<0.00001)并改变了能量消耗(95%可信区间-2.83至-0.81,I=80%,Z=3.53,P=0.0004)。对人体能量消耗的影响无法估计。

结论

VNS在大鼠和小型猪模型中已显示出对减轻体重、抑制食欲和增加能量消耗有显著影响,表明在解决代谢紊乱方面有前景的治疗应用。人体试验也显示了VNS对代谢的有效性和安全性。

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