GLP-1RAs在儿童青少年肥胖的研究进展

Research Progress on GLP-1RAs in the Treatment of Obesity in Children or Adolescents

摘要: 肥胖是一种慢性疾病，常合并糖脂代谢异常，对心血管、呼吸系统等都有很大危害。近年来，儿童青少年肥胖的发病率不断上升，儿童青少年肥胖问题十分严峻。儿童青少年时期肥胖常常持续到成年时期，增加长期疾病负担。因此，越早控制体重，获益越大。生活方式干预是目前肥胖儿童青少年减重的首选方案，但部分患者减重效果欠佳，需药物或手术辅助减重。胰高血糖素样肽-1受体激动剂(glucagon-like peptide-1 receptor agonists, GLP-1RAs)已被证实有显著的减重作用，应用前景广阔。本文系统阐述了儿童青少年肥胖的发病机制，首次整合了GLP-1RAs在该人群中的临床证据及儿科试验设计考量，并从精准医疗、安全性评估、多学科管理与社会效益等维度展望了未来研究方向，以推动该群体药物治疗策略的优化与发展。

Abstract: Obesity is a chronic disease, often accompanied by abnormal glucose and lipid metabolism, posing significant risks to the cardiovascular and respiratory systems. In recent years, the incidence of childhood and adolescent obesity has been rising, making it a very serious problem. Childhood and adolescent obesity often persists into adulthood, increasing the long-term disease burden. Therefore, the earlier the weight is controlled, the greater the benefits will be. Lifestyle intervention is currently the preferred approach for weight loss in obese children and adolescents, but some patients do not achieve satisfactory results and require medication or surgery to assist in weight loss. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been proven to have significant weight-loss effects and show great promise for application. This article systematically elaborates on the pathogenesis of obesity in children and adolescents, and for the first time integrates clinical evidence and pediatric trial design considerations of GLP-1RAs in this population. It also looks forward to future research directions from the perspectives of precision medicine, safety assessment, multidisciplinary team, and social benefits, in order to promote the optimization and development of drug treatment strategies for this group.