- MeSH
- agonisté receptoru pro glukagonu podobný peptid 1 aplikace a dávkování farmakologie terapeutické užití MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- glifloziny aplikace a dávkování farmakologie terapeutické užití MeSH
- hypoglykemika aplikace a dávkování farmakologie terapeutické užití MeSH
- látky proti obezitě aplikace a dávkování farmakologie škodlivé účinky terapeutické užití MeSH
- léčba obezity MeSH
- lidé MeSH
- obezita * farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- diabetes mellitus * MeSH
- lékaři MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population.
Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to provide adequate perfusion to tissues and organs, resulting in typical symptoms such as fatigue, dyspnea, dyspepsia, or swelling due to decreased cardiac output. With its increasing prevalence, heart failure has become one of the leading causes of morbidity and mortality worldwide, imposing a significant burden on the population by reducing long-term life expectancy and raising hospital costs. Indeed, over 20 million people worldwide suffer from heart failure, with a 5-year mortality rate of 60-70%. As heart failure progresses, various structural and metabolic changes occur within the myocardium and organ systems. In the past two decades, therapeutic options for heart failure patients have significantly expanded. In addition to novel pharmacological treatment, advanced surgical methods such as heart transplantation (HTx) and the implantation of durable left ventricular assist devices (LVADs) are available for patients with end-stage heart failure. This review discusses the pathophysiological aspects and metabolic consequences of heart failure and metabolic changes, as well as the benefits and challenges of implanting a left ventricular assist device. Furthermore, future targets for heart failure diagnostics and therapy will be highlighted.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) represents a major clinical complication of obesity. Methods: In this study, we used magnetic resonance (MR) methods to determine the effect of obesity treatment with semaglutide, a GLP-1 receptor agonist, on the liver fat content and selected metabolic variables. We investigated whether treatment would affect the acute response of liver fat to glucose and fructose administration and whether it would affect the fatty acid profile of VLDL-triglycerides. Sixteen obese non-diabetic men underwent a 16-week dietary intervention and 16-week treatment with subcutaneous semaglutide in a crossover design without a washout period. The order of the interventions was randomized. Results: After treatment, body weight of the subjects decreased by 5% and liver fat by a third, whereas dietary intervention had no impact on these parameters. The decrease in liver fat with semaglutide did not correlate with changes in body weight and other measures of adiposity and was unrelated to improved insulin sensitivity. Conclusions: The proportion of palmitic and palmitoleic acids in VLDL-triglycerides decreased after treatment, suggesting that the beneficial effects of semaglutide on liver fat are mediated by the suppression of de novo lipogenesis.
- Publikační typ
- časopisecké články MeSH
x
x
- MeSH
- benzhydrylové sloučeniny * terapeutické užití farmakologie MeSH
- glifloziny * terapeutické užití farmakologie MeSH
- glukosidy * terapeutické užití farmakologie MeSH
- hmotnostní úbytek * účinky léků MeSH
- lidé MeSH
- peptid YY * metabolismus MeSH
- srdeční selhání * farmakoterapie patofyziologie MeSH
- tepový objem * fyziologie účinky léků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Podávání agonistů GLP-1 (giucagon-iike peptide 1) představuje v současné době jeden z nejúčinnějších způsobů léčby obezity, který má kromě snížení hmotnosti také pozitivní vliv na celou řadu kardiovaskulárních rizikových faktorů včetně dyslipidemie, arteriální hypertenze a glykemie. V tomto článku se věnujeme jedinému zástupci agonistů GLP-1, který je aktuálně v České republice dostupný v indikaci léčby nadváhy či obezity - iiragiutidu. Liraglutid je používán bud' jako antidiabetikum v dávkování maximálně 1,8 mg 1x denně, nebo jako antiobezitikum (bez ohledu na přítomnost diabetu) v dávkování maximálně 3,0 mg 1x denně. Jde o účinný lék s velmi dobrým efektem na tělesnou hmotnost a s řadou studií jednoznačně potvrzující jeho komplexní pozitivní metabolické účinky. U diabetiků 2. typu bylo při podávání iiragiutidu v dávkování 1,8 mg 1x denně prokázáno snížení kardiovaskulárních komplikací, celkové a kardiovaskulární mortality a zpomalení progrese diabetického onemocnění ledvin. V tomto článku shrnujeme komplexní účinky iiragiutidu v rámci léčby nadváhy a obezity a věnujeme se praktickým aspektům jeho podávání v klinické praxi.
Administration of agonists GLP-1 (giucagon-iike peptide 1) is currently one of the most effective treatments for obesity, which, in addition to weight reduction, also has a positive effect on a number of cardiovascular risk factors including dysiipidemia, arterial hypertension and giycemia. In this article, we focus on the only GLP-1 agonist currently available in the Czech Republic in the indication of overweight or obesity treatment - iiragiutide. Liragiutide is currently available as an antidiabetic agent at a maximum dosage of 1.8 mg once daily or as an antiobesity agent at a maximum dosage of 3.0 mg once daily. It is an effective drug with a very good effect on body weight and with a number of studies cieariy confirming its complex positive metabolic effects. In type 2 diabetes patients, iiragiutide at a dosage of 1.8 mg once daily has been shown to reduce cardiovascuiar compiications, overaii and cardiovascuiar mortaiity and to siow the progression of diabetic kidney disease. In this articie, we summarize the compiex effects of iiragiutide in the treatment of overweight and obesity and discuss the practicai aspects of its administration in ciinicai practice.
