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减肥手术或用GLP-1受体激活剂治疗后的身体组成变化
Zicheng Wang1, Lei Wang1, Xinmeng Zhang2
1Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|January 9, 2026
概括
腹部外科手术和GLP-1RAs (semaglutide, tirzepatide) 显著减少脂肪质量,并保持无脂肪质量. 这两种治疗方法都能改善身体成分,手术显示脂肪量减少更大,脂肪量保存更好.
科学领域:
- 代谢和腹部手术 代谢和腹部手术
- 药理学和药物发现
- 肥胖医学 肥胖医学
背景情况:
- 在临床环境中,证据将减肥手术和更新的葡萄糖类-1受体激动剂 (GLP-1RAs) 联系起来,如semaglutide和tirzepatide对身体组成的变化是有限的.
- 了解这些干预措施对无脂肪质量 (FFM),脂肪质量 (FM) 和它们的比例的影响,对于管理肥胖和代谢健康至关重要.
研究的目的:
- 在减肥手术或GLP-1RA治疗后24个月内调查FFM,FM和FFM与FM比率的时间变化.
- 为了比较减肥手术与GLP-1RA治疗对身体组成参数的影响.
主要方法:
- 一个回顾性队列研究利用电子健康记录从范德比尔特大学医学中心.
- 包括1257名接受减肥手术的患者和1809名接受了半黄或提泽帕提德治疗的非手术患者.
- 分析了24个月的生物电阻分析数据,控制了人口和临床因素.
主要成果:
- 减肥手术和GLP-1RA治疗都导致显著的脂肪质量减少和中度的无脂肪质量损失.
- 与GLP-1RA相比,腹部外科手术导致脂肪量减少 (49.7%在24个月内) 较大 (24个月后18.0%).
- 手术后的无脂肪质量损失也更大 (24个月后11.7%),而不是GLP-1RAs (24个月后3.3%),但FFM与FM的比率在两组中都有所改善,有利于手术.
结论:
- 腹腔外科手术和GLP-1RA治疗 (塞马格卢提德,蒂尔泽帕提德) 与大量的脂肪损失和中度的无脂肪质量损失有关.
- 这两种干预措施都改善了FFM与FM的比率,表明了身体组成的有利转变.
- 研究结果支持使用这些干预措施来减肥,并为保存无脂肪质量的策略提供了洞察力.
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