medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-25-8-12medalphabet-4004Research ArticleСтатьиВопросы контроля веса: перспективы в эстетической медицинеWeight control issues: perspectives in aesthetic medicinehttps://orcid.org/0000-0002-5044-5265КругловаЛ. С.KruglovaL. S.

Круглова Лариса Сергеевна - д.м.н., проф., зав. кафедрой дерматовенерологии и косметологии

Москва

Larisa S. Kruglova - DM Sci (habil.), professor, head of Dept of Dermatovenereology and Cosmetology.

Moscow

kruglovals@mail.ruhttps://orcid.org/0000-0002-4672-697XТамразоваА. В.TamrazovaA. V.

Тамразова Анаит Вардановна - аспирант кафедры дерматовенерологии и косметологии.

Москва

Anait V. Tamrazova - postgraduate student of Dept of Dermatovenereology and Cosmetology.

Moscow

anaittamrazova@gmail.comФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Administrative Department of the President of RussiaRussian Federation202405122024025Дерматология (2)812Copyright © Круглова Л.С., Тамразова А.В., 20242024Круглова Л.С., Тамразова А.В.Kruglova L.S., Tamrazova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4004

За последние 30 лет в мире почти вдвое увеличилось количество людей с ожирением – хроническим заболеванием, сопровождающимся прогрессирующим нарушением обмена веществ и повышенным риском развития таких заболеваний как сахарный диабет, гипертония, ишемическая болезнь сердца и др. Стремительный рост числе взрослых и подростков с излишним весом, тяжесть, а также малая эффективность существующих традиционных способов лечения ожирения, подталкивают к поиску наиболее эффективных и безопасных методов терапии. Семаглутид – это агонист глюканоподобного пептида 1, который продемонстрировал многообещающую эффективность не только в контроли гликемии, но и в снижении веса за счет задержки опорожнения желудка, усилении и продлении чувства сытости, снижении аппетита и потреблении энергии. В статье рассматриваются основные механизма действия семаглутида, а таже представлены данные исследований STEP, посвященных эффективности и безопасности применения семаглутида в дозе 2,4 мг в неделю у пациентов с ожирением или излишним весом без сахарного диабета.

Over the past 30 years, the number of people with obesity has almost doubled in the world – a chronic disease accompanied by progressive metabolic disorders and an increased risk of developing diseases such as diabetes, hypertension, coronary heart disease, etc. The rapidly growing number of overweight adults and adolescents, the severity and low efficiency of existing traditional methods of treating obesity, prompt the search for the most effective and safe methods of therapy. Semaglutide is a glucan-like peptide 1 agonist that has demonstrated promising efficacy not only in glycemic control, but also in weight loss by delaying gastric emptying, enhancing and prolonging the feeling of satiety, reducing appetite and energy consumption. The article discusses the main mechanisms of action of semaglutide, and also presents data from STEP studies on the efficacy and safety of semaglutide at a dose of 2.4 mg per week in patients with obesity or overweight without diabetes mellitus.

семаглутидагонисты рецепторов ГГП-1ожирениеизбыточный весSTEPтерапия ожиренияsemaglutideGLP-1 receptor agonistsobesityoverweightSTEPobesity therapyReferencesДедов И. И., Мельниченко Г. А., Шестакова М. В. и соавт. Национальные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-й пересмотр (лечение морбидного ожирения у взрослых). Ожирение и метаболизм. 2018;15(1):53–70. https://doi.org/10.14341/omet2018153–70Dedov I. I., Melnichenko G. A., Shestakova M. V., et al. National clinical guidelines for the treatment of morbid obesity in adults. 3rd revision (treatment of morbid obesity in adults). Obesity and Metabolism. 2018; 15 (1): 53–70. (In Russ.). https://doi.org/10.14341/omet2018153–70Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9(1). doi: 10.1186/1471-2458-9-88Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9(1). doi: 10.1186/1471-2458-9-88NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027–1050. doi:10.1016/S0140–6736(23)02750-2NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027–1050. doi:10.1016/S0140–6736(23)02750-2Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30(1):67–77.e3. doi:10.1016/j.cmet.2019.05.008Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30(1):67–77.e3. doi:10.1016/j.cmet.2019.05.008Dollman J, Norton K, Norton L. Evidence for secular trends in children’s physical activity behaviour. Br J Sports Med. 2005;39(12):892–897. doi:10.1136/bjsm.2004.016675Dollman J, Norton K, Norton L. Evidence for secular trends in children’s physical activity behaviour. Br J Sports Med. 2005;39(12):892–897. doi:10.1136/bjsm.2004.016675Ryan, DH, and Sarah Ryan Yockey. “Weight Loss and Improvement in Comorbidity: Differences at 5 %, 10 %, 15 %, and Over.” Current obesity reports vol. 6,2 (2017): 187–194. doi:10.1007/s13679–017–0262-yRyan, DH, and Sarah Ryan Yockey. “Weight Loss and Improvement in Comorbidity: Differences at 5 %, 10 %, 15 %, and Over.” Current obesity reports vol. 6,2 (2017): 187–194. doi:10.1007/s13679–017–0262-yWadden TA, Bailey TS, Billings LK, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021;325(14):1403–1413. doi:10.1001/jama.2021.1831Wadden TA, Bailey TS, Billings LK, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial. JAMA. 2021;325(14):1403–1413. doi:10.1001/jama.2021.1831Aggarwal, Rahul et al. “Potential implications of the FDA approval of semaglutide for overweight and obese adults in the United States.” Progress in cardiovascular diseases vol. 68 (2021): 97–98. doi:10.1016/j.pcad.2021.09.007Aggarwal, Rahul et al. “Potential implications of the FDA approval of semaglutide for overweight and obese adults in the United States.” Progress in cardiovascular diseases vol. 68 (2021): 97–98. doi:10.1016/j.pcad.2021.09.007Chao AM, Tronieri JS, Amaro A, Wadden TA. Semaglutide for the treatment of obesity. Trends Cardiovasc Med. 2023;33(3):159–166. doi:10.1016/j.tcm.2021.12.008Chao AM, Tronieri JS, Amaro A, Wadden TA. Semaglutide for the treatment of obesity. Trends Cardiovasc Med. 2023;33(3):159–166. doi:10.1016/j.tcm.2021.12.008Chrysi К., Doupis J. Incretin-based therapy: a powerful and promising weapon in the treatment of type 2 diabetes mellitus. Diabetes therapy: research, treatment and education of diabetes and related disorders vol. 2,2 (2011): 101–21. doi:10.1007/s13300-011-0002-3Chrysi К., Doupis J. Incretin-based therapy: a powerful and promising weapon in the treatment of type 2 diabetes mellitus. Diabetes therapy: research, treatment and education of diabetes and related disorders vol. 2,2 (2011): 101–21. doi:10.1007/s13300-011-0002-3Ard J, Fitch A, Fruh S, Herman L. Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide 1 Receptor Agonists. Adv Ther. 2021;38(6):2821–2839. doi:10.1007/s12325-021-01710-0Ard J, Fitch A, Fruh S, Herman L. Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide 1 Receptor Agonists. Adv Ther. 2021;38(6):2821–2839. doi:10.1007/s12325-021-01710-0Donnelly D. The structure and function of the glucagon-like peptide-1 receptor and its ligands. Br J Pharmacol. 2012;166(1):27–41. doi:10.1111/j.1476–5381.2011.01687.xDonnelly D. The structure and function of the glucagon-like peptide-1 receptor and its ligands. Br J Pharmacol. 2012;166(1):27–41. doi:10.1111/j.1476–5381.2011.01687.xVilsbøll T., et al. “Similar elimination rates of glucagon-like peptide-1 in obese type 2 diabetic patients and healthy subjects.” The Journal of clinical endocrinology and metabolism vol. 88,1 (2003): 220–4. doi:10.1210/jc.2002–021053Vilsbøll T., et al. “Similar elimination rates of glucagon-like peptide-1 in obese type 2 diabetic patients and healthy subjects.” The Journal of clinical endocrinology and metabolism vol. 88,1 (2003): 220–4. doi:10.1210/jc.2002–021053Lau J, Bloch P, Schäffer L, et al. Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1) Analogue Semaglutide. J Med Chem. 2015;58(18):7370–7380. doi:10.1021/acs.jmedchem.5b00726Lau J, Bloch P, Schäffer L, et al. Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1) Analogue Semaglutide. J Med Chem. 2015;58(18):7370–7380. doi:10.1021/acs.jmedchem.5b00726Food and Drug Administration. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 20142021. [Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014.]Food and Drug Administration. FDA Approves New Drug Treatment for Chronic Weight Management, First Since 20142021. [Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014.]Yang XD, Yang YY. Clinical Pharmacokinetics of Semaglutide: A Systematic Review. Drug Des Devel Ther. 2024;18:2555–2570. Published 2024 Jun 25. doi:10.2147/DDDT.S470826Yang XD, Yang YY. Clinical Pharmacokinetics of Semaglutide: A Systematic Review. Drug Des Devel Ther. 2024;18:2555–2570. Published 2024 Jun 25. doi:10.2147/DDDT.S470826Шабутдинова О. Р., Даутов А. Р., Самков А. А. и соавт. Семаглутид – эффективность в снижении веса и побочные эффекты при применении по данным исследований SUSTAIN, PIONEER, STEP. Проблемы Эндокринологии. 2023;69(3):68–82. https://doi.org/10.14341/probl13197Shabutdinova O. R., Dautov A. R., Samkov A. A. et al. Semaglutide: efficacy in weight loss and side effects when used according to the SUSTAIN, PIONEER, STEP studies. Problems of Endocrinology. 2023;69(3):68–82. (In Russ.). https://doi.org/10.14341/probl13197Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553–1564. doi:10.1111/dom.14725Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553–1564. doi:10.1111/dom.14725Khera R, Murad MH, Chandar AK, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis [published correction appears in JAMA. 2016 Sep 6;316(9):995. doi: 10.1001/ jama.2016.11657]. JAMA. 2016;315(22):2424–2434. doi:10.1001/jama.2016.7602Khera R, Murad MH, Chandar AK, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis [published correction appears in JAMA. 2016 Sep 6;316(9):995. doi: 10.1001/ jama.2016.11657]. JAMA. 2016;315(22):2424–2434. doi:10.1001/jama.2016.7602Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083–2091. doi:10.1038/s41591-022-02026-4Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083–2091. doi:10.1038/s41591-022-02026-4Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414–1425. doi:10.1001/jama.2021.3224Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414–1425. doi:10.1001/jama.2021.3224Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023;389:2221–32. DOI: 10.1056/NEJMoa2307563Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023;389:2221–32. DOI: 10.1056/NEJMoa2307563Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021;397(10278):971–984. doi:10.1016/S 0140–6736(21)00213-0Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021;397(10278):971–984. doi:10.1016/S 0140–6736(21)00213-0Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834–1844. doi:10.1056/NEJMoa1607141Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834–1844. doi:10.1056/NEJMoa1607141Ruder K. As Semaglutide’s Popularity Soars, Rare but Serious Adverse Effects Are Emerging. JAMA. 2023;330(22):2140–2142. doi:10.1001/jama.2023.16620Ruder K. As Semaglutide’s Popularity Soars, Rare but Serious Adverse Effects Are Emerging. JAMA. 2023;330(22):2140–2142. doi:10.1001/jama.2023.16620Sun K., Kusminski C. M., Scherer P. E. Adipose tissue remodeling and obesity // J. Clin. Invest. 2011. Vol. 121, N 6. P. 2094–101. DOI: https://doi.org/10.1172/JCI45887 PMID: 21633177; PMCID: PMC 3104761Sun K., Kusminski C. M., Scherer P. E. Adipose tissue remodeling and obesity // J. Clin. Invest. 2011. Vol. 121, N 6. P. 2094–101. DOI: https://doi.org/10.1172/JCI45887 PMID: 21633177; PMCID: PMC 3104761Gkogkolou Р., Böhm М. Advanced glycation endproducts, Dermato-Endocrinology.-2012.– 4:3, 259–270, DOI: 10.4161/derm.22028Gkogkolou Р., Böhm М. Advanced glycation endproducts, Dermato-Endocrinology.-2012.– 4:3, 259–270, DOI: 10.4161/derm.22028Garcia-Hidalgo L., Orozco-Topete R., Gonzalez-Barranco J., Villa A. R., Dalman J. J., Ortiz-Pedroza G. Dermatoses in 156 obese adults // Obes. Res. 1999. Vol. 7, N 3. P. 299–302. DOI: https://doi.org/10.1002/j.1550–8528.1999.tb00410.x PMID: 10348502Garcia-Hidalgo L., Orozco-Topete R., Gonzalez-Barranco J., Villa A. R., Dalman J. J., Ortiz-Pedroza G. Dermatoses in 156 obese adults // Obes. Res. 1999. Vol. 7, N 3. P. 299–302. DOI: https://doi.org/10.1002/j.1550–8528.1999.tb00410.x PMID: 10348502Немчанинова О. Б., Долгих М. Ю. Структура дерматологической патологии у детей и подростков с избыточной массой тела и ожирением // Journal of Siberian Medical Sciences. 2019. № 2. С. 61–70. DOI: https://doi.org/10.31549/2542-1174-2019-2-61-70Nemchaninova O. B., Dolgikh M. Yu. Structure of dermatological pathology in children and adolescents with overweight and obesity // Journal of Siberian Medical Sciences. 2019. No. 2. P. 61–70. (In Russ.). DOI: https://doi.org/10.31549/2542-1174-2019-2-61-70

The authors declare that there are no conflicts of interest present.