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}
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.
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.