王 丽,宋 康

肥胖系代谢异常引发的慢性疾病，特征为体脂过多堆积或分布异常，临床常以体重指数（BMI）≥28 kg/m²作为诊断标准之一。作为与2型糖尿病（type 2 diabetes mellitus，T2DM）发生及进展密切相关的关键可调控危险因素，肥胖发生率的攀升已成为近期T2DM患病率与发病率持续上升的核心驱动因素。大量临床研究结果明确证实，采取适度且长期坚持的减重措施，不仅能够有效改善机体血糖控制水平、减轻胰岛素抵抗状态，还可显著降低对糖尿病治疗药物的依赖需求。除饮食控制、运动干预等基础治疗外，双胍类（Biguanides）、二肽基肽酶-Ⅳ抑制剂（dipeptidyl peptidase-Ⅳinhibitor,DPP-4 inhibitor）、钠－葡萄糖协同转运蛋白2抑制剂（sodium-glucose contransporter 2 inhibitor,SGLT-2 inhibitor）、胰高血糖素样肽-1受体激动剂（glucagon like peptide-1receptor agonist,GLP-1RA）等降血糖药，不仅能有效控制血糖，还对肥胖管理具有显著积极作用。鉴于肥胖与糖尿病均为全球范围内日益流行的慢性疾病，且存在密切的相互作用，进一步探究降血糖药与肥胖的相关性，为合并肥胖的糖尿病患者的临床治疗与预防提供了新的研究视角。本文旨在系统综述降血糖药对肥胖的作用效果及其潜在机制，探讨其临床应用价值及未来研究方向，以期为代谢综合征的个体化治疗提供参考依据。

降血糖药；肥胖；体重

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