睾酮替代治疗
尽管只有很少的随机对照研究报道了睾酮替代治疗似乎能够改善代谢综合征和性腺功能减退患者的代谢控制,也能改善向心性肥胖。[55]Corona G, Monami M, Rastrelli G, et al. Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med. 2011;8:272-283.http://www.ncbi.nlm.nih.gov/pubmed/20807333?tool=bestpractice.com[56]Cattabiani C, Basaria S, Ceda GP, et al. Relationship between testosterone deficiency and cardiovascular risk and mortality in adult men. J Endocrinol Invest. 2012;35:104-120.http://www.ncbi.nlm.nih.gov/pubmed/22082684?tool=bestpractice.com
11β-羟化脱氢酶 1 型抑制剂
新出现的来自动物和人类研究显示,11β-羟化脱氢酶 1 型(11-β-HSD1)过表达与肥胖和糖脂代谢紊乱有关。这就导致一种假说,11-β-HSD1 的选择性抑制可以用于治疗代谢综合征和糖尿病。除了自然作物和较旧的药物(如噻唑烷二酮类和贝特类),一些新型化合物(如金刚烷三唑、芳香磺胺噻唑、苯胺基噻唑、BVT2733、INCB-13739、MK-0916 和 MK-0736 等)均在研究中。前期工作发现,他们对糖脂代谢、减重和脂联素水平均有益处。[127]Feig PU, Shah S, Hermanowski-Vosatka A, et al. Effects of an 11-beta-hydroxysteroid dehydrogenase type 1 inhibitor, MK-0916, in patients with type 2 diabetes mellitus and metabolic syndrome. Diabetes Obes Metab. 2011;13:498-504.http://www.ncbi.nlm.nih.gov/pubmed/21272190?tool=bestpractice.com[128]Anagnostis P, Katsiki N, Adamidou F, et al. 11beta-Hydroxysteroid dehydrogenase type 1 inhibitors: novel agents for the treatment of metabolic syndrome and obesity-related disorders? Metabolism. 2013;62:21-33.http://www.ncbi.nlm.nih.gov/pubmed/22652056?tool=bestpractice.com
胰高血糖素样肽-1 (Glucagon-like peptide-1, GLP-1) 类似物
GLP-1 类似物 (如利拉鲁肽) 也许在将来可作为减重的一种选择。研究发现GLP-1 类似物比奥利司他获益更多。[129]Astrup A, Carraro R, Finer N, et al; NN8022-1807 Investigators. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond). 2012;36:843-854. [Errata in Int J Obes (Lond). 2012;36:890 and Int J Obes (Lond). 2013;37:322.]http://www.nature.com/ijo/journal/v36/n6/full/ijo2011158a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/21844879?tool=bestpractice.com
过氧化物酶体增殖物激活受体 δ (PPAR- δ) 激动剂
PPAR-δ 激动剂 (例如 GW501516)诱导脂肪酸氧化在骨骼肌的上调,并对 HDL-C、LDL-C、apoA1 和 apoB 产生有益的改变(致动脉粥样硬化趋势更小)。[130]Olson EJ, Pearce GL, Jones NP, et al. Lipid effects of peroxisome proliferator-activated receptor-delta agonist GW501516 in subjects with low high-density lipoprotein cholesterol: characteristics of metabolic syndrome. Arterioscler Thromb Vasc Biol. 2012;32:2289-2294.http://atvb.ahajournals.org/content/32/9/2289.fullhttp://www.ncbi.nlm.nih.gov/pubmed/22814748?tool=bestpractice.com