肠促胰岛素革命：将基于肠促胰岛素的疗法整合到临床护理中

文献信息

中文摘要

基于肠促胰岛素的疗法已经改变了现代医学实践的格局。在接受这些药物治疗的患者中，包括2型糖尿病、心血管疾病、慢性肾脏病、代谢功能障碍相关脂肪性肝病和阻塞性睡眠呼吸暂停在内的肥胖相关疾病过程得到改善，其中几种药物现在已获得器官特异性监管适应症。在这篇叙述性综述中，我们总结了这些药物的作用机制，按研究设计和终点状态评估了每种适应症的证据，并提出了一个将肠促胰岛素疗法整合到内分泌科以外护理中的实用框架，涵盖根据主要合并症选择药物、与其他疾病修饰疗法的排序、监测、安全性和长期管理，以及在可及性受限情况下的处方。

英文摘要

Incretin-based therapies have changed the landscape of modern medical practice. Obesity-related disease processes including type 2 diabetes mellitus, cardiovascular disease, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, and obstructive sleep apnea improve in patients treated with these medications, and several now carry organ-specific regulatory indications. In this narrative review we summarize the mechanisms through which these medications act, appraise the evidence for each indication by study design and endpoint status, and set out a practical framework for integrating incretin therapy into care outside endocrinology, covering agent selection by dominant comorbidity, sequencing with other disease-modifying therapy, monitoring, safety and long-term management, and prescribing where access is constrained.