References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2024-530

medsovet-8838

Research Article

ЭНДОКРИНОЛОГИЯ

ENDOCRINOLOGY

Потенциал метформина в снижении веса

The potential of metformin in weight loss

https://orcid.org/0000-0003-0069-7744

Григорьева

И. Н.

Grigor’eva

I. N.

Григорьева Ирина Николаевна, д.м.н., профессор, главный научный сотрудник, руководитель группы биохимических исследований в гастроэнтерологии, профессор отдела образования; Scopus Author ID: 7004630757; Researcher ID: JGE-0324-2023.

630089, Новосибирск, ул. Бориса Богаткова, д. 175/1

Irina N. Grigor’eva - Dr. Sci. (Med.), Professor, Chief Scientific Officer, Head of the Group of Biochemical Research in Gastroenterology, Professor of the Department of Education.

175/1, Boris Bogatkov St., Novosibirsk, 630089

grigorieva2024@yandex.ru

Непомнящих

Д. Л.

Nepomnyashchikh

D. L.

Непомнящих Давид Львович - д.м.н., профессор кафедры внутренних болезней.

630091, Новосибирск, Красный проспект, д. 52

David L. Nepomnyashchikh - Dr. Sci. (Med.), Professor of the Department of Internal Medicine.

52, Krasny Ave., Novosibirsk, 630090

dln_nco@mail.ru

Научно-исследовательский институт терапии и профилактической медицины – филиал Федерального исследовательского центра «Институт цитологии и генетики Сибирского отделения Российской академии наук»РоссияResearch Institute of Therapy and Preventive Medicine – branch of the Federal Scientific Center “Institute of Cytology and Genetics of the Siberian Branch of the RAS”Russian Federation

Новосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation

2024

22012025

023130136

2024

Григорьева И.Н., Непомнящих Д.Л.

Grigor’eva I.N., Nepomnyashchikh D.L.

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-sovet.pro/jour/article/view/8838

Метформин как уникальный противодиабетический препарат первой линии также может быть эффективным в терапии ожирения и связанных с ним метаболических дисфункций. В метаанализах и многочисленных РКИ у лиц с ожирением, с и без сахарного диабета 2-го типа (СД2) при приеме метформина отмечено снижение веса и жировой массы (≈ на 3 кг), а также липидов крови и адипонектина. Механизмы действия метформина по снижению веса, зависимые и независимые от AMP-активируемой протеинкиназы (AMPK): усиление митохондриального биогенеза, уменьшение поглощения жирных кислот за счет подавления передачи сигналов трансформирующего фактора роста-β1 (TGF-β1)/Smad3, модулирования кишечной микробиоты и регулирования ряда других сигналов – фруктозы-1,6-бифосфатазы 1 (FBP1), протеинфосфатазы 2 (PP2A), фактора роста фибробластов 21 (FGF21), сиртуина 1 (SIRT1) и мишени рапамицина (mTOR) и др., подавления экспрессии липогенных генов приводят к снижению потребления энергии. Однако существуют противоположные данные о незначительном влиянии метформина на снижение веса, потребление энергии и состав тела – его эффект варьирует в зависимости от пола, возраста, продолжительности лечения, не обязательно сохраняется после прекращения лечения и существенно не влияет на состав тела. Метформин во всем мире и в РФ пока не включен в список препаратов для лечения ожирения. Необходимы комплексные исследования с достаточной мощностью и более длительным сроком лечения для дальнейшей оценки эффективности и безопасности метформина по снижению и контролю увеличения веса.

Metformin, as a unique first-line antidiabetic drug, it may also be effective in the treatment of obesity and related metabolic disorders. In meta-analyses and numerous RCTs in obese persons with and without type 2 diabetes mellitus with metformin, a decrease in weight and fat mass (≈ 3 kg), as well as blood lipids and adiponectin was noted. Mechanisms of metformin action for weight loss, dependent and independent of AMP-activated protein kinase (AMPK): enhancement of mitochondrial biogenesis, reduction of fatty acid uptake, due to suppression of transforming growth factor-β1 (TGF-β1)/Smad3 signaling, modulation of the gut microbiota and regulation of a number of other signals – fructose-1.6-biphosphatase 1 (FBP1), protein phosphatase 2 (PP2A), fibroblast growth factor 21 (FG F21), sirtuin 1 (SIRT1), target of rapamycin (mTOR), etc., reduction of lipogenic gene expression, which leads to decrease in energy intake. However, there is conflicting evidence that metformin has little effect on weight loss, energy intake, and body composition – its effect varies depending on gender, age, duration of treatment, does not necessarily persist after treatment is stopped, does not significantly affect body composition. Metformin worldwide and in the Russian Federation has not yet been included in list of medications for the treatment of obesity. Comprehensive, adequately powered studies with longer treatment durations are needed to further evaluate the efficacy and safety of metformin for weight loss and weight gain control.

метформинснижение весамеханизмы развития ожирениядлительный энергетический дисбаланспрепараты для лечения ожирения

metforminweight lossmechanisms of obesity developmentprolonged energy imbalancemedications for obesity treatment

Работа выполнена в рамках темы государственного задания «Изучение молекулярно-генетических и молекулярно-биологических механизмов развития распространенных терапевтических заболеваний в Сибири для совершенствования подходов к их ранней диагностике и профилактике», 2024–2028 гг. (FWNR-2024-0004)

The work was carried out within the framework of the topic of the state task “Study of molecular genetic and molecular biological mechanisms of the development of common therapeutic diseases in Siberia to improve approaches to their early diagnosis and prevention”, 2024–2028 (FWNR-2024-0004)

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