胰高血糖素样肽1 (GLP-1)在肥胖外科治疗中的作用研究进展

Progress in the Study of the Role of Glucagon-Like Peptide 1 (GLP-1) in the Surgical Treatment of Obesity

摘要: 肥胖，传统上被定义为导致健康受损的身体脂肪过量，在临床实践中通常通过体重指数(身体质量指数)来评估，该指数被表示为以千克为单位的体重除以以平方米为单位的身高(kg/m2)的比率。尽管有大量的研究致力于理解肥胖和能量平衡的生物学，显而易见的是，现有的知识迄今为止对遏制肥胖流行几乎没有帮助，世界上没有一个地方能够幸免于这一现象。在过去半个世纪中，全球范围内肥胖患病率呈上升趋势，并已达到相当高的流行水平。由于大大增加了2型糖尿病、脂肪肝、高血压、心肌梗塞、阻塞性睡眠呼吸暂停等疾病以及一些癌症风险，从而导致生活质量下降，寿命下降，肥胖是一个重大的健康挑战。尤其是肥胖合并T2DM的患者比重在单纯肥胖人群中比例增大，使得肥胖与T2DM成为社会广泛关注的公共卫生问题。肥胖与T2DM密切相关，体重增加是T2DM的独立危险因素，而肥胖特别是中心性肥胖容易造成胰岛素抵抗，促使胰岛β细胞高负荷运转，从而使胰岛功能受损，导致T2DM的发生。肥胖与T2DM之间的关系相当复杂，最近比较热门的研究越来越重视肥胖与T2DM之间的分子、信号通路、免疫以及基因水平。故本文就肥胖及T2DM之间的分子、信号通路以及其近来在肥胖外科治疗中的作用作一简要综述。

Abstract: Obesity, traditionally defined as an excess of body fat leading to impaired health, is commonly as-sessed in clinical practice by the body mass index (BMI), expressed as the ratio of body weight in kilograms divided by height in square meters (kg/m2). Despite the large amount of research dedi-cated to understand the biology of obesity and energy balance, it is clear that the available knowledge has so far done little to curb the obesity epidemic, from which no part of the world is immune. The prevalence of obesity has been on the rise globally over the past half century and has reached considerable epidemic levels. Obesity is a major health challenge due to the greatly in-creased risk of diseases such as type 2 diabetes, fatty liver, hypertension, myocardial infarction, ob-structive sleep apnea, and some cancers, which lead to reduced quality of life and decreased life expectancy. In particular, the proportion of patients with obesity combined with T2DM has in-creased in the population with simple obesity, making obesity and T2DM a public health problem of wide social concern. Obesity and T2DM are closely related, and weight gain is an independent risk factor for T2DM, while obesity, especially central obesity, tends to cause insulin resistance and con-tribute to high islet β-cell load, thus impairing islet function and leading to the development of T2DM. The relationship between obesity and T2DM is quite complex, and recent more popular studies have increasingly focused on the molecular, signaling pathways, immune, and genetic levels between obesity and T2DM. Therefore, this paper provides a brief review of the molecular and sig-naling pathways between obesity and T2DM and their recent role in the surgical treatment of obe-sity.