胰高血糖素样肽-1受体激动剂对肥胖2型糖尿病患者骨代谢的双向调控作用
Bidirectional Regulation of Glucagon-Like Peptide-1 Receptor Agonist on Bone Metabolism in Obese Patients with Type 2 Diabetes Mellitus
DOI: 10.12677/acm.2026.163787, PDF,   
作者: 王钰琪：济宁医学院临床学院，山东 济宁；李艳英*：济宁医学院附属医院内分泌与遗传代谢科，山东 济宁
关键词: GLP-1受体激动剂；肥胖；2型糖尿病；骨代谢；双向调控；GLP-1 RAs； Obesity； Type 2 Diabetes； Bone Metabolism； Bidirectional Regulation
摘要: 胰高血糖素样肽-1受体激动剂(GLP-1 RAs)通过发挥肠促胰岛素作用，在控制血糖、体重管理、改善心血管结局等方面受到广泛关注。肥胖与2型糖尿病(Type 2 diabetes)均可通过多种作用机制导致骨代谢紊乱，且许多研究发现，当两者共存时，上述负面效应呈协同放大，而目前，关于GLP-1 RAs对骨代谢的作用机制尚不明确，在其发挥降糖、减重作用的同时是否可以增加骨骼获益仍需进一步探讨，因此，本综述系统整合临床证据、动物与细胞研究，探讨GLP-1 RAs在肥胖2型糖尿病背景下对骨密度、骨转换标志物及骨折风险的综合效应，解析其双重调控机制，旨在为糖尿病骨并发症的精准管理和临床合理用药提供循证依据与未来研究方向。
Abstract: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), by exerting their incretin effect, have attracted widespread attention for improving glycaemic control, promoting weight loss and delivering cardiovascular benefits. Both obesity and type 2 diabetes mellitus (T2DM) can disturb bone metabolism through multiple mechanisms, and accumulating evidence indicates that these deleterious effects are synergistically amplified when the two conditions coexist. At present, however, the precise actions of GLP-1 RAs on bone remain unclear; whether these agents can confer additional skeletal advantages while lowering glucose and reducing body weight still needs to be fully elucidated. Therefore, this review systematically integrates clinical, animal and cellular studies to evaluate the overall impact of GLP-1 RAs on bone mineral density, bone-turnover markers and fracture risk in the setting of obese T2DM, and to dissect their dual regulatory mechanisms. Our aim is to provide evidence-based guidance for the precision management of diabetic bone complications and for rational clinical use of these drugs, while also identifying directions for future research.
文章引用：王钰琪, 李艳英. 胰高血糖素样肽-1受体激动剂对肥胖2型糖尿病患者骨代谢的双向调控作用[J]. 临床医学进展, 2026, 16(3): 253-261. https://doi.org/10.12677/acm.2026.163787

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