下丘脑性肥胖的药物治疗研究进展  

Advancements in pharmacological treatment of hypothalamic obesity

作　　者：郑怀君 赵宇星 龚凤英 朱惠娟 王林杰 Zheng Huaijun;Zhao Yuxing;Gong Fengying;Zhu Huijuan;Wang Linjie(Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,the Translational Medicine Center of PUMCH,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,协和转化医学中心,北京100730

出　　处：《国际内分泌代谢杂志》2024年第2期119-122,共4页International Journal of Endocrinology and Metabolism

基　　金：国家临床重点专科能力提升项目;中央高水平医院临床科研业务费资助项目(2022-PUMCH-A-064)。

摘　　要：下丘脑性肥胖(hypothalamic obesity, HO)是指下丘脑结构或功能损伤引起的肥胖, 其临床特征包括食欲亢进、能量摄入增加、消耗减少、高胰岛素血症等, 不仅降低了患者的生活质量, 还增加了代谢性疾病的发生风险, 导致患病率和死亡率增加。由于下丘脑影响能量平衡调节的机制复杂, 因此HO仍是临床治疗的难点。目前, 对于HO, 生活方式干预作用有限, 且尚无针对HO的药物, 但一些药物在HO的治疗中显示出一定的疗效, 包括二甲双胍联合二氮嗪、生长抑素、催产素、司美诺肽、胰高血糖素样肽-1受体激动剂(GLP-1RA)及Tesomet等。这些药物为HO的治疗提供了新的策略, 有望缓解症状、改善生活质量。Hypothalamic obesity(HO)is obesity that occurs as a result of structural or functional damage to the hypothalamus.Its clinical features include hyperphagia,elevated energy intake,reduced energy expenditure,hyperinsulinemia,etc.The intricate nature of the systems controlled by the hypothalamus in maintaining energy balance makes HO a persistent therapeutic obstacle.Currently,lifestyle interventions for HO are limited,and there are no specific pharmacological treatments.However,certain drugs have shown efficacy in the treatment of HO,including metformin combined with diazoxide,somatostatin,oxytocin,setmelanotide and glucagon-like peptide-1 receptor agonists(GLP-1RA),and Tesomet etc.These pharmaceutical drugs introduce novel therapeutic approaches for HO,providing the possibility to reduce symptoms and improve overall quality of life.

关 键 词：下丘脑性肥胖 生长抑素 催产素 司美诺肽 胰高血糖素样肽-1受体激动剂 

分 类 号：R589.2[医药卫生—内分泌]