营养支持,同时胰高血糖素样肽-1为基础的治疗。有必要吗?

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Alvaro M Chavez, Ruben Carrasco Barria, Miguel León-Sanz
{"title":"营养支持,同时胰高血糖素样肽-1为基础的治疗。有必要吗?","authors":"Alvaro M Chavez, Ruben Carrasco Barria, Miguel León-Sanz","doi":"10.1097/MCO.0000000000001130","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim of the review: </strong>Weight loss is a primary goal in the treatment of obesity, but its effect on body composition - particularly fat-free mass (FFM) and skeletal muscle mass (SM) - is of increasing concern. This review examines the effects of antiobesity medications, particularly glucagon-like peptide-1 receptor analogs (GLP-1 RA), on body composition, the risk of sarcopenia, and strategies to preserve muscle mass during pharmacological weight loss.</p><p><strong>Recent findings: </strong>Studies have shown that while GLP-1 RA are effective in reducing fat mass, up to 40% of the total weight loss can come from FFM. However, it is important to distinguish between FFM and SM, as FFM includes nonmuscle components. Resistance training and adequate protein intake can mitigate muscle loss, but the evidence for their efficacy in the context of GLP-1 RA therapy is mixed. If these measures are insufficient to prevent and maintain muscle mass, the use of some nutrients, such as branched chain amino acids, creatine, leucine, omega-3 fatty acids and vitamin D, may be beneficial. Newer pharmacological approaches, such as bimagrumab, a human monoclonal antibody that acts by binding to the activin type II receptor II (ActRII), and other activin or myostatin inhibitors, show promise in preserving muscle mass while promoting fat loss.</p><p><strong>Summary: </strong>GLP-1 RA therapy for obesity should include resistance training, optimal protein intake and, if needed, specific nutrients and possibly pharmacological interventions to preserve muscle mass. Further research is needed to assess the long-term effects of GLP-1 RA on muscle health and to refine strategies to prevent sarcopenia in patients undergoing pharmacological weight loss.</p>","PeriodicalId":10962,"journal":{"name":"Current Opinion in Clinical Nutrition and Metabolic Care","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nutrition support whilst on glucagon-like peptide-1 based therapy. Is it necessary?\",\"authors\":\"Alvaro M Chavez, Ruben Carrasco Barria, Miguel León-Sanz\",\"doi\":\"10.1097/MCO.0000000000001130\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim of the review: </strong>Weight loss is a primary goal in the treatment of obesity, but its effect on body composition - particularly fat-free mass (FFM) and skeletal muscle mass (SM) - is of increasing concern. This review examines the effects of antiobesity medications, particularly glucagon-like peptide-1 receptor analogs (GLP-1 RA), on body composition, the risk of sarcopenia, and strategies to preserve muscle mass during pharmacological weight loss.</p><p><strong>Recent findings: </strong>Studies have shown that while GLP-1 RA are effective in reducing fat mass, up to 40% of the total weight loss can come from FFM. However, it is important to distinguish between FFM and SM, as FFM includes nonmuscle components. Resistance training and adequate protein intake can mitigate muscle loss, but the evidence for their efficacy in the context of GLP-1 RA therapy is mixed. If these measures are insufficient to prevent and maintain muscle mass, the use of some nutrients, such as branched chain amino acids, creatine, leucine, omega-3 fatty acids and vitamin D, may be beneficial. Newer pharmacological approaches, such as bimagrumab, a human monoclonal antibody that acts by binding to the activin type II receptor II (ActRII), and other activin or myostatin inhibitors, show promise in preserving muscle mass while promoting fat loss.</p><p><strong>Summary: </strong>GLP-1 RA therapy for obesity should include resistance training, optimal protein intake and, if needed, specific nutrients and possibly pharmacological interventions to preserve muscle mass. Further research is needed to assess the long-term effects of GLP-1 RA on muscle health and to refine strategies to prevent sarcopenia in patients undergoing pharmacological weight loss.</p>\",\"PeriodicalId\":10962,\"journal\":{\"name\":\"Current Opinion in Clinical Nutrition and Metabolic Care\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Opinion in Clinical Nutrition and Metabolic Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MCO.0000000000001130\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Clinical Nutrition and Metabolic Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCO.0000000000001130","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

摘要

本综述的目的:减肥是肥胖治疗的首要目标,但其对身体成分的影响——尤其是无脂量(FFM)和骨骼肌量(SM)——越来越受到关注。本综述探讨了抗肥胖药物,特别是胰高血糖素样肽-1受体类似物(GLP-1 RA)对身体成分、肌肉减少症的风险以及在药物减肥期间保持肌肉质量的策略的影响。最近的发现:研究表明,虽然GLP-1 RA在减少脂肪量方面是有效的,但高达40%的总体重减轻可以来自FFM。然而,区分FFM和SM是很重要的,因为FFM包括非肌肉成分。阻力训练和充足的蛋白质摄入可以减轻肌肉损失,但其在GLP-1类风湿性关节炎治疗中的疗效证据不一。如果这些措施不足以预防和维持肌肉质量,使用一些营养物质,如支链氨基酸、肌酸、亮氨酸、omega-3脂肪酸和维生素D,可能是有益的。较新的药理学方法,如bimagrumab,一种通过结合激活素II型受体II (ActRII)和其他激活素或肌肉生长抑制素抑制剂起作用的人单克隆抗体,显示出在促进脂肪减少的同时保持肌肉质量的希望。总结:肥胖的GLP-1类风湿性关节炎治疗应包括抗阻训练、最佳蛋白质摄入,如果需要,还应包括特定营养素和可能的药物干预,以保持肌肉质量。需要进一步的研究来评估GLP-1 RA对肌肉健康的长期影响,并完善药物减肥患者预防肌肉减少症的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nutrition support whilst on glucagon-like peptide-1 based therapy. Is it necessary?

Aim of the review: Weight loss is a primary goal in the treatment of obesity, but its effect on body composition - particularly fat-free mass (FFM) and skeletal muscle mass (SM) - is of increasing concern. This review examines the effects of antiobesity medications, particularly glucagon-like peptide-1 receptor analogs (GLP-1 RA), on body composition, the risk of sarcopenia, and strategies to preserve muscle mass during pharmacological weight loss.

Recent findings: Studies have shown that while GLP-1 RA are effective in reducing fat mass, up to 40% of the total weight loss can come from FFM. However, it is important to distinguish between FFM and SM, as FFM includes nonmuscle components. Resistance training and adequate protein intake can mitigate muscle loss, but the evidence for their efficacy in the context of GLP-1 RA therapy is mixed. If these measures are insufficient to prevent and maintain muscle mass, the use of some nutrients, such as branched chain amino acids, creatine, leucine, omega-3 fatty acids and vitamin D, may be beneficial. Newer pharmacological approaches, such as bimagrumab, a human monoclonal antibody that acts by binding to the activin type II receptor II (ActRII), and other activin or myostatin inhibitors, show promise in preserving muscle mass while promoting fat loss.

Summary: GLP-1 RA therapy for obesity should include resistance training, optimal protein intake and, if needed, specific nutrients and possibly pharmacological interventions to preserve muscle mass. Further research is needed to assess the long-term effects of GLP-1 RA on muscle health and to refine strategies to prevent sarcopenia in patients undergoing pharmacological weight loss.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.30
自引率
6.50%
发文量
116
审稿时长
6-12 weeks
期刊介绍: A high impact review journal which boasts an international readership, Current Opinion in Clinical Nutrition and Metabolic Care offers a broad-based perspective on the most recent and exciting developments within the field of clinical nutrition and metabolic care. Published bimonthly, each issue features insightful editorials and high quality invited reviews covering two or three key disciplines which include protein, amino acid metabolism and therapy, lipid metabolism and therapy, nutrition and the intensive care unit and carbohydrates. Each discipline introduces world renowned guest editors to ensure the journal is at the forefront of knowledge development and delivers balanced, expert assessments of advances from the previous year.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信