鞍区病变相关下丘脑性肥胖诊疗中国专家共识
Chinese Experts'Consensus on the Management of Hypothalamic Obesity Secondary to Sellar Lesions
中国罕见病联盟下丘脑垂体疾病学组 叶红英 1李舍予 2朱惠娟3
作者信息
- 1. 复旦大学附属华山医院内分泌科,上海 200040
- 2. 四川大学华西医院内分泌代谢科中国循证医学中心MAGIC中国中心,成都 610041
- 3. 中国医学科学院北京协和医院内分泌科,北京 100730
- 折叠
摘要
肥胖是鞍区疾病及相关治疗的常见并发症,对临床医师综合管理能力要求较高.为提升鞍区病变相关下丘脑性肥胖的诊疗质量,该共识整合了国内外临床研究证据及中国多学科专家的临床诊疗经验,总结了下丘脑性肥胖的临床特征和诊断标准,采用GRADE方法就鞍区病变相关下丘脑性肥胖的识别、筛查、评估、药物治疗、减重手术及预防等关键问题分别进行了推荐.推荐鞍区病变或其治疗累及下丘脑并出现肥胖的患者,以及肥胖伴下丘脑/垂体功能障碍的患者进行体重指数、下丘脑垂体内分泌及非内分泌功能评估,判断是否为下丘脑性肥胖,建议同时评估代谢并发症及原发病.推荐下丘脑性肥胖患者强化生活方式干预,必要时考虑减重药物或代谢手术治疗,同时注意内分泌激素的合理替代治疗.
Abstract
Obesity is a common complication of sellar lesions.The treatment of the disease is a great chal-lenge to the physicians.To promote effective management for hypothalamic obesity secondary to sellar lesions,our team developed this consensus based on the latest research and clinical experiences in China.We summarized the clinical characteristics and diagnostic criteria for hypothalamic obesity.Using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system,we provided practical recommendations for the screening,clinical evaluation,and comprehensive management of hypothalamic obesity secondary to sellar le-sions.Specifically,we recommend examining the body mass index and evaluating endocrine and non-endocrine functions of the hypothalamus to screen out the hypothalamic obesity in patients whose sellar lesions and their treatment involving the hypothalamus,and in obese patients who have hypothalamic or pituitary dysfunction.Meanwhile,we recommend evaluating metabolic complications and primary diseases,too.Furthermore,we rec-ommend that lifestyle interventions be strengthened to patients with hypothalamic obesity,coupled with adminis-tering weight-losing drugs or bariatric surgery when necessary,and taking appropriate hormonal replacement for hypopituitarism.
关键词
鞍区病变/下丘脑性肥胖/垂体功能减退/专家共识Key words
lesions in the sellar region/hypothalamic obesity/hypopituitarism/expert consensus引用本文复制引用
出版年
2024
NETL
NSTL
万方数据