1. Mechanism of Action
Glucagon-like peptide-1 (GLP-1)hehomona incretinhuna ʻia e nā ʻōpū L-cell i pane i ka ʻai ʻana i ka meaʻai. Hoʻohālike ka GLP-1 receptor agonists (GLP-1 RAs) i ka hopena physiological o kēia hormone ma o nā ala metabolic.
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Hoʻopau i ka ʻai a me ka hoʻokaʻawale ʻana i ka ʻōpū
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Hana i nā kikowaena maona hypothalamic (ʻoi aku ka POMC / CART neurons), e hōʻemi ana i ka pōloli.
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ʻO ka lohi ʻana o ka ʻōpū, hoʻolōʻihi i ka manaʻo o ka piha.
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Hoʻonui ʻia ka huna ʻana o ka insulin a me ka hoʻokuʻu ʻana o ka Glucagon
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Hoʻoulu i nā ʻāpana β-pancreatic e huna i ka insulin ma ke ʻano pili i ka glucose.
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Hoʻopau i ka huna ʻana o ka glucagon, hoʻomaikaʻi i nā pae glucose hoʻokē ʻai a me ka postprandial.
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Hoʻomaikaʻi i ka Metabolism Energy
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Hoʻonui i ka naʻau o ka insulin a hoʻoikaika i ka momona momona.
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Hoʻemi i ka synthesis momona o ka hepatic a hoʻomaikaʻi i ka metabolism lipid.
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2. Kiʻi GLP-1–Ma muli o ke kaumaha kaumaha
| Laau laau | Hōʻike nui | Hooponopono | ʻAwelika Kaumaha |
|---|---|---|---|
| Liraglutide | ʻO ka maʻi diabetes type 2, ka momona | Hoʻokomo i kēlā me kēia lā | 5–8% |
| Semaglutide | ʻO ka maʻi diabetes type 2, ka momona | ʻImi pule / waha | 10–15% |
| Tirzepatide | ʻO ka maʻi diabetes type 2, ka momona | Hoʻokomo i kēlā me kēia pule | 15–22% |
| Retatrutide (i nā hoʻokolohua) | ʻObesity (non-diabetic) | Hoʻokomo i kēlā me kēia pule | A hiki i 24% |
Auana:Ke holomua nei ka hoʻomohala lāʻau mai ka GLP-1 receptor agonists → dual GIP/GLP-1 agonists → triple agonists (GIP/GLP-1/GCGR).
3. Nā ho'āʻo nui a me nā hopena
Semaglutide - Nā ho'āʻo STEP
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KANAWAI 1 (NEJM, 2021)
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Nā mea komo: ʻO nā mākua me ka momona, ʻaʻohe maʻi diabetes
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ʻAi: 2.4 mg i kēlā me kēia pule (subcutaneous)
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Nā hualoaʻa: Mean kino-kaumaha hoemi o14.9%i nā pule he 68 vs. 2.4% me kahi placebo
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~ 33% o nā mea komo i loaʻa i ka ≥20% ka pohō kaumaha.
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KANAWAI 5 (2022)
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Ua hōʻike ʻia ka pohō kaumaha ma mua o 2 mau makahiki a me ka hoʻomaikaʻi ʻana i nā kumu pilikia cardiometabolic.
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Tirzepatide - Nā polokalamu SURMOUNT & SURPASS
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SURMOUNT-1 (NEJM, 2022)
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Nā mea komo: ʻO nā mākua me ka momona, ʻaʻohe maʻi diabetes
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Ka nui: 5 mg, 10 mg, 15 mg i kēlā me kēia pule
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Nā hualoaʻa: Mean paona poho o15–21%ma hope o nā pule he 72 (pili i ka dose)
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Ma kahi kokoke i 40% i loaʻa i ka ≥25% ka hoʻemi kaumaha.
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ʻO nā hoʻāʻo SURPASS (ka heluna kanaka maʻi diabetes)
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Hoemi HbA1c: a hiki i2.2%
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Concurrent awelika poho kaumaha o10–15%.
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4. Nā Pono Ola Ola a me Metabolic
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Hoemi ike koko koko, LDL-cholesterol, atriglycerides
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Hoʻemi ʻiavisceralamomona o ka ʻōpū(hoʻomaikaʻi ma NAFLD)
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Haʻahaʻa pilikia onā hanana cardiovascular(e laʻa, MI, hahau)
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Hoʻopaneʻe ka piʻi ʻana mai ka prediabetes i ka maʻi diabetes type 2
5. Palekana Palekana a me ka noonoo
Nā hopena ʻaoʻao maʻamau (maʻamau maʻamau a haʻahaʻa):
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Nausea, luaʻi, puʻu, paʻa
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Pau ka ʻai
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ʻAʻole ʻoluʻolu o ka ʻōpū o ka ʻōpū
Nā ʻōlelo aʻoaʻo / contraindications:
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ʻO ka mōʻaukala o ka pancreatitis a i ʻole medullary thyroid carcinoma
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Ka hāpai ʻana a me ka hānai ʻana
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Manaʻo ʻia ka titration dose e hoʻomaikaʻi i ka hoʻomanawanui
6. Nā kuhikuhi no ka noiʻi hou aku
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ʻO nā hanauna hou aʻe agonists:
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Triple agonists e huli ana i ka GIP/GLP-1/GCGR (e laʻa,Retatrutide)
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Nā hoʻohua GLP-1 waha:
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Semaglutide waha kiʻekiʻe (a hiki i 50 mg) ma lalo o ka loiloi
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Nā lāʻau lapaʻau hui:
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GLP-1 + insulin a i ʻole SGLT2 inhibitors
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Nā hōʻailona metabolic ākea:
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ʻO ka maʻi momona momona ʻole (NAFLD), ka maʻi polycystic ovary (PCOS), ka hiamoe hiamoe, ka pale ʻana i ka naʻau.
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7. Ka hopena
Hōʻike nā lāʻau lapaʻau GLP-1 i kahi hoʻololi paradigm mai ka mālama maʻi diabetes i ka metabolic a me ka hoʻokele kaumaha.
Me nā ʻelele likeSemaglutideaTirzepatide, ua hiki ke ho'okō 'ia ka pohō kaumaha ma mua o 20%.
Manaʻo ʻia nā agonists multi-receptor e hiki mai ana e hoʻomaikaʻi hou i ka pono, ka lōʻihi, a me nā pono cardiometabolic.
Ka manawa hoʻouna: Oct-11-2025