鞍区病变相关下丘脑性肥胖诊疗中国专家共识  

Chinese Experts′Consensus on the Management of Hypothalamic Obesity Secondary to Sellar Lesions

作　　者：中国罕见病联盟下丘脑垂体疾病学组 叶红英 李舍予[3] 朱惠娟[4] 廖志红[5] 余叶蓉[6] 王秀敏[7] 郭清华[8] 钟历勇[9] 吴蔚 苗青 Hypothalamic and Pituitary Disease Group of China Alliance for Rare Diseases;YE Hongying;LI Sheyu;ZHU Huijuan(不详;Department of Endocrinology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Endocrinology and Metabolism,West China Hospital,Sichuan University,China Center for Evidence-based Medicine,MAGIC China Center,Chengdu 610041,China;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]不详 [2]复旦大学附属华山医院内分泌科,上海200040 [3]四川大学华西医院内分泌代谢科中国循证医学中心MAGIC中国中心,成都610041 [4]中国医学科学院北京协和医院内分泌科,北京100730 [5]中山大学附属第一医院内分泌科 [6]四川大学华西医院内分泌科 [7]上海交通大学附属上海儿童医学中心内分泌科 [8]解放军总医院内分泌科 [9]首都医科大学附属北京天坛医院内分泌科

出　　处：《罕见病研究》2024年第4期479-491,共13页Journal of Rare Diseases

摘　　要：肥胖是鞍区疾病及相关治疗的常见并发症,对临床医师综合管理能力要求较高。为提升鞍区病变相关下丘脑性肥胖的诊疗质量,该共识整合了国内外临床研究证据及中国多学科专家的临床诊疗经验,总结了下丘脑性肥胖的临床特征和诊断标准,采用GRADE方法就鞍区病变相关下丘脑性肥胖的识别、筛查、评估、药物治疗、减重手术及预防等关键问题分别进行了推荐。推荐鞍区病变或其治疗累及下丘脑并出现肥胖的患者,以及肥胖伴下丘脑/垂体功能障碍的患者进行体重指数、下丘脑垂体内分泌及非内分泌功能评估,判断是否为下丘脑性肥胖,建议同时评估代谢并发症及原发病。推荐下丘脑性肥胖患者强化生活方式干预,必要时考虑减重药物或代谢手术治疗,同时注意内分泌激素的合理替代治疗。Obesity is a common complication of sellar lesions.The treatment of the disease is a great challenge to the physicians.To promote effective management for hypothalamic obesity secondary to sellar lesions,our team developed this consensus based on the latest research and clinical experiences in China.We summarized the clinical characteristics and diagnostic criteria for hypothalamic obesity.Using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system,we provided practical recommendations for the screening,clinical evaluation,and comprehensive management of hypothalamic obesity secondary to sellar lesions.Specifically,we recommend examining the body mass index and evaluating endocrine and non-endocrine functions of the hypothalamus to screen out the hypothalamic obesity in patients whose sellar lesions and their treatment involving the hypothalamus,and in obese patients who have hypothalamic or pituitary dysfunction.Meanwhile,we recommend evaluating metabolic complications and primary diseases,too.Furthermore,we recommend that lifestyle interventions be strengthened to patients with hypothalamic obesity,coupled with administering weight-losing drugs or bariatric surgery when necessary,and taking appropriate hormonal replacement for hypopituitarism.

关 键 词：鞍区病变 下丘脑性肥胖 垂体功能减退 专家共识 

分 类 号：R58[医药卫生—内分泌]