Vnitřní lékařství 2/2026

PŘEHLEDOVÉ ČLÁNKY Antiobezitika nové generace a jejich vliv na kostní zdraví postmenopauzálních žen 112 | VNITŘNÍ LÉKAŘSTVÍ / Vnitř Lék. 2026;72(2):104-112 / www.casopisvnitrnilekarstvi.cz Na druhou stranu některé klinické studie naznačují, že vliv GLP-1RA a dalších antidiabetik na riziko zlomenin může být heterogenní a závislý na konkrétní molekule i metabolickém kontextu pacienta. Zdá se však, že farmakologická intervence pomocí GLP-1RA představuje z hlediska muskuloskeletálního systému bezpečnější alternativu k radikálním chirurgickým přístupům, které jsou spojeny s vyšším rizikem fraktur (2). K objasnění jejich přímých účinků na kostní tkáň a jejich dopadu u rizikových skupin, zejména žen po menopauze, je proto zapotřebí dalších prospektivních a cílených studií. PROHLÁŠENÍ AUTORŮ: Prohlášení o původnosti: Publikace byla zpracována s využitím uvedené literatury a nebyla publikována ani zaslána k recenznímu řízení do jiného média. Střet zájmů: Žádný. Financování: Ne. Poděkování: N/A. Registrace v databázích: N/A. Projednání etickou komisí: N/A. LITERATURA 1. Lingvay I, Cohen RV, Roux CWL, et al. Obesity in adults. Lancet. 2024 Sep 7;404(10456):972987. doi: 10.1016/S0140-6736(24)01210-8. Epub 2024 Aug 16. PMID: 39159652. 2. Kim MJ, Kim S, Jung HN, et al. Effects of Anti-Obesity Strategies on Bone Mineral Density: A Comprehensive Meta-Analysis of Randomized Controlled Trials. J Obes Metab Syndr. 2025 Jan 30;34(1):41-53. doi: 10.7570/jomes24009. Epub 2025 Jan 13. PMID: 39800333; PMCID: PMC11799600. 3. Paccou J, Compston JE. Bone health in adults with obesity before and after interventions to promote weight loss. Lancet Diabetes Endocrinol. 2024 Oct;12(10):748-760. doi: 10.1016/S2213-8587(24)00163-3. Epub 2024 Jul 22. Erratum in: Lancet Diabetes Endocrinol. 2024 Sep;12(9):e18. doi: 10.1016/S2213-8587(24)00235-3. PMID: 39053479. 4. Yosibash Z, Trabelsi N, Buchnik I, et al. Hip fracture risk assessment in elderly and diabetic patients: combining autonomous finite element analysis and machine learning. J Bone mineral research: Off J Am Soc Bone Mineral Res. (2023) 38:876–86. doi: 10.1002/jbmr.4805 5. Martiniakova M, Biro R, Penzes N, et al. Links among obesity, type 2 diabetes mellitus, and osteoporosis: bone as a target. Int J Mol Sci. (2024) 25(9):4827. doi: 10.3390/ijms25094827 6. Graaf CD, Donnelly D, Wootten D, et al. Glucagon-Like Peptide-1 and Its Class B G Protein-Coupled Receptors: A Long March to Therapeutic Successes. Pharmacol Rev. 2016 Oct;68(4):954-1013. doi: 10.1124/pr.115.011395. PMID: 27630114; PMCID: PMC5050443 7. Drucker DJ. Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1. Cell Metab. 2018 Apr 3;27(4):740-756. doi: 10.1016/j.cmet.2018. 03. 001. PMID: 29617641. 8. Wang JY, Wang QW, Yang XY, et al. GLP-1 receptor agonists for the treatment of obesity: Role as a promising approach. Front Endocrinol (Lausanne). 2023 Feb 1;14:1085799. doi: 10.3389/fendo.2023.1085799. PMID: 36843578; PMCID: PMC9945324. 9. Mariam Z, Niazi SK. Glucagon-like peptide agonists: A prospective review. Endocrinol Diabetes Metab. 2024 Jan;7(1):e462. doi: 10.1002/edm2.462. Epub 2023 Dec 14. PMID: 38093651; PMCID: PMC10782143. 10. Viljoen A, Bain SC. Glucagon-Like Peptide 1 Therapy: From Discovery to Type 2 Diabetes and Beyond. Endocrinol Metab (Seoul). 2023 Feb;38(1):25-33. doi: 10.3803/EnM.2022.1642. Epub 2023 Feb 6. PMID: 36740965; PMCID: PMC10008669. 11. Blackman A, Foster GD, Zammit G, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024;391(7):607-620. doi:10.1056/NEJMoa2404859 12. Bettge K, Kahle M, Abd El Aziz MS, et al. Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: A systematic analysis of published clinical studies. Diabetes Obes Metab. 2017;19(3):336-347. doi:10.1111/dom.12824 13. Smits MM, Van Raalte DH. Safety of GLP-1 Receptor Agonists: Adverse Effects and Characteristics. Front Endocrinol (Lausanne). 2021;12:651095. doi:10.3389/fendo.2021.651095 14. Nauck MA, Quast DR, Wefers J, et al. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metab. 2021;46:101102. doi:10.1016/j.molmet.2020.101102 15. Hammad BF, Zafar N, Ullah M, et al. Exploring the multifaceted roles of GLP-1 receptor agonists; a comprehensive review. Front Clin Diabetes Healthc. 2025 Jul 10;6:1590530. doi: 10.3389/fcdhc.2025.1590530. PMID: 40708853; PMCID: PMC12286811. 16. Bilgin E, Venerito V, Bogdanos DP. Glucagon-Like Peptide-1 (GLP-1) receptor agonists in rheumatology: A review of current evidence and future directions. Autoimmun Rev. 2025 Aug 29;24(9):103864. doi: 10.1016/j.autrev.2025.103864. Epub 2025 Jul 3. PMID: 40617296. 17. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375(4):311-322. doi:10.1056/NEJMoa1603827 18. Davies MJ, Aroda VR, Collins BS, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786 19. Moiz A, Filion KB, Tsoukas MA, et al. Mechanisms of GLP-1 Receptor Agonist-Induced Weight Loss: A Review of Central and Peripheral Pathways in Appetite and Energy Regulation. Am J Med. 2025 Jun;138(6):934-940. doi: 10.1016/j.amjmed.2025. 01. 021. Epub 2025 Jan 31. PMID: 39892489. 20. Svačina S. Agonisté GLP-1 propojují léčbu obezity, diabetu i psoriázy. Medical Tribune. 2025, roč. 21, č. 19, s. 4-5. ISSN 1214-8725. 21. Wang L, Volkow ND, Kaelber DC, et al. Semaglutide or Tirzepatide and Optic Nerve and Visual Pathway Disorders in Type 2 Diabetes. JAMA Netw Open. 2025;8(8):e2526327. doi:10.1001/jamanetworkopen.2025.26327 22. Hathaway JT, Shah MP, Hathaway DB, et al. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmol. 2024 Aug 1;142(8):732-739. doi: 10.1001/jamaophthalmol.2024.2296. PMID: 38958939; PMCID: PMC11223051. 23. Cai TT, Li HQ, Jiang LL, et al. Effects of GLP-1 receptor agonists on bone mineral density in patients with type 2 diabetes mellitus: a 52-week clinical study. Biomed Res Int. 2021;2021:3361309. doi: 10.1155/2021/3361309. 24. Akyay OZ, Canturk Z, Selek A, et al. The effects of exenatide and insulin glargine treatments on bone turnover markers and bone mineral density in postmenopausal patients with type 2 diabetes mellitus. Medicine (Baltimore). 2023 Sep 29;102(39):e35394. doi: 10.1097/MD.0000000000035394. PMID: 37773814; PMCID: PMC10545322. 25. Pereira M, Jeyabalan J, Jørgensen CS, et al. Chronic administration of Glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice. Bone. (2015) 81:459–67. doi: 10.1016/j.bone.2015. 08. 006 26. Chen M, Lyu Y, Zhao J, et al. Use of GLP-1 receptor agonist and risk of osteoporosis among patients with type 2 diabetes: a real-world study. Front Endocrinol (Lausanne). 2025 May 21;16:1586589. doi: 10.3389/fendo.2025.1586589. PMID: 40469447; PMCID: PMC12133453. 27. Drucker DJ. The GLP-1 journey: from discovery science to therapeutic impact. J Clin Invest. 2024 Jan 16;134(2):e175634. doi: 10.1172/JCI175634. PMID: 38226625; PMCID: PMC10786682. 28. Kim JA, Yoo HJ. Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning. Diabetes Metab J. 2025 Jul;49(4):525-541. doi: 10.4093/dmj.2025.0242. Epub 2025 Jul 1. PMID: 40631457; PMCID: PMC12270588. 29. Witham MD, Granic A, Pearson E, et al. Repurposing Drugs for Diabetes Mellitus as Potential Pharmacological Treatments for Sarcopenia - A Narrative Review. Drugs Aging. 2023 Aug;40(8):703-719. doi: 10.1007/s40266-023-01042-4. Epub 2023 Jul 24. PMID: 37486575; PMCID: PMC10371965. 30. Neeland IJ, Linge J, Birkenfeld AL. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes Obes Metab. 2024 Sep;26 Suppl 4:16-27. doi: 10.1111/dom.15728. Epub 2024 Jun 27. PMID: 38937282. 31. Gatto A, Liu K, Milan N, et al. The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care. Curr Rev Musculoskelet Med. 2025 Oct;18(10):469-480. doi: 10.1007/ s12178-025-09978-3. Epub 2025 May 15. PMID: 40372699; PMCID: PMC12325148.

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