DANA G. SMITH2026年6月30日 Fortunate JoaquinTwo of the hottest trends in health — longevity medicine and weight loss drugs — are colliding.健康领域两大炙手可热的趋势——长寿医学与减肥药物——正在发生交汇碰撞。A theory that GLP-1 medications like Ozempic or Zepbound might help people live longer has been bandied about by biohackers and aging researchers for several years. Online pharmacies already market compounded versions of the drugs to purportedly extend health span. But so far, academic research into the hypothesis has been scant.关于诺和泰(Ozempic)或Zepbound等GLP-1类药物可能有助于延长寿命的理论在生物黑客和抗衰老研究者圈子里已探讨多年。一些网络药房已开始以延年益寿为噱头，推销这类药物的复合制剂版本。然而，目前关于这一假设的学术研究仍然非常有限。One of the first studies putting the idea to the test was published last month. It showed that, among people with H.I.V. and lipohypertrophy (fatty deposits that develop under the skin), taking semaglutide (the drug in Ozempic) for eight months seemed to slow participants’ biological aging, according to blood tests that measure age-related biomarkers. People with H.I.V. experience accelerated aging because of the infection, so they are a good population in which to conduct age-related research, said Michael Corley, an associate professor of medicine at the University of California, San Diego’s Stein Institute for Research on Aging, who led the study.上月发表的其中一项研究首次验证了这一想法。该研究显示，在感染HIV并患有脂肪增生症（皮下脂肪沉积）的人群中，使用司美格鲁肽（诺和泰的有效成分）八个月后，根据检测衰老相关生物标志物的血液检测，受试者的生物年龄衰老速度似乎有所减缓。研究负责人、加州大学圣地亚哥分校施泰因衰老研究所医学副教授迈克尔·科利表示，HIV感染者因感染病毒而经历加速衰老，因此是开展衰老相关研究的理想群体。The trial was preliminary, but it “provided us an opportunity to say, hey, is there any signal here that warrants all the hype?” Dr. Corley said.这项试验仍属于初步研究，但科利博士说，它“给了我们一个机会，去验证一下这些追捧到底有没有依据”。That hype stems from several lines of evidence. First, there is ample research demonstrating that GLP-1s improve people’s metabolic health by helping to regulate insulin and blood sugar levels and causing weight loss. Several studies show that they also benefit cardiovascular, liver and kidney health.相关热潮源于多方面的证据。首先，大量研究表明，GLP-1药物通过调节胰岛素和血糖水平、促进体重下降来改善人体的代谢健康。多项研究还显示，它们对心血管、肝脏和肾脏健康也有益。Because the drugs offer protection for conditions like diabetes and cardiovascular disease, which are both among the leading causes of death, it could already be reasonable to call GLP-1s longevity drugs.由于这些药物能够预防糖尿病和心血管疾病等病，而这些疾病又都是主要的死亡原因，因此，把GLP-1类药物称为“长寿药”似乎已经有一定道理。“GLP-1 agonists decrease the incidence of diseases that are related to aging and are associated with decreasing life span,” said Dr. Nicolas Musi, the director of the Diabetes and Aging Center at Cedars-Sinai in Los Angeles. “One would assume that they’re also potentially going to increase life span and be beneficial for longevity,” he added.洛杉矶西达赛奈医学中心糖尿病与衰老中心主任尼古拉斯·穆西博士表示：“GLP-1受体激动剂能够降低与衰老相关、且会缩短寿命的疾病发生率。”他还说，“人们自然会认为，它们也有可能延长寿命，有利于长寿。”Another reason experts think these drugs might increase longevity is because of how they affect cellular health. Metabolic health and aging are intricately linked, so drugs that alter the mechanisms involved in metabolism may also affect how the body ages.专家认为这类药物可能延长寿命的另一个原因在于它们对细胞健康的影响。代谢健康与衰老密切相关，因此改变代谢机制的药物也可能影响身体的衰老过程。“Many of these pathways that are modulated by diabetes drugs are also central pathways that control aging and longevity,” Dr. Musi said. (Other drugs that treat diabetes, like metformin and a category known as SGLT2 inhibitors, are similarly being studied for longevity, though the evidence so far has been mixed.)“许多受糖尿病药物调节的通路也是控制衰老和长寿的核心通路，”穆西博士说。（其他治疗糖尿病的药物，如二甲双胍和SGLT2抑制剂类药物，也正在被研究用于长寿，但迄今证据不一。）GLP-1s appear to influence other fundamental cellular changes that occur with aging, most notably inflammation. “We know they have a significant anti-inflammatory effect, and we know inflammation is one of the things that accelerates aging,” said Dr. Thomas Blackwell, a professor of general internal medicine at the University of Texas Medical Branch in Galveston.GLP-1药物似乎还影响随衰老发生的其他基本细胞变化，尤其是炎症。“我们知道它们具有显著的抗炎作用，而我们知道炎症是加速衰老的因素之一，”得克萨斯大学医学分部加尔维斯顿校区普通内科学教授托马斯·布莱克韦尔博士说。All of this sounds promising, but researchers say there’s a huge caveat: Currently little to no data exists on whether the drugs will benefit people who are metabolically healthy.这一切听起来都很有希望，但研究人员表示，其中存在一个巨大的限制条件：目前几乎没有任何数据表明这些药物是否会让代谢健康的人从中受益。There is not even data available about whether the medications extend life span in healthy rodents. Dr. Richard Miller, a professor of pathology at the University of Michigan, who runs a large program there testing potential anti-aging drugs in mice, said that’s mainly because of logistics. The currently available GLP-1s either don’t work in mice the same way they do in humans, or they can only be delivered via injection, and years of weekly injections in mice aren’t practical.甚至连这类药物能否延长健康啮齿动物寿命的数据目前都付之阙如。密歇根大学病理学教授理查德·米勒博士主持着一项大型的小鼠抗衰老药物测试项目，他表示，这种空白主要是操作层面的困难所致：现有GLP-1类药物或者在小鼠体内的作用机制与人类不同，或者只能通过注射给药，而对小鼠进行数年的每周注射并不现实。There are also concerns that GLP-1s negatively affect health in ways that are especially relevant for aging. Most notably, the drugs can cause some muscle loss, a major issue for older adults that is associated with an increased risk of frailty. Rapid weight loss can also lead to a decline in bone density and an increased risk of osteoporosis.此外，也有观点担忧GLP-1类药物在若干与衰老高度相关的方面存在负面影响。最值得关注的是，这类药物可能导致一定程度的肌肉流失——这对老年人而言是一大隐患，因为肌肉减少与虚弱风险的上升密切相关。快速减重还可能引发骨密度下降，增加骨质疏松的风险。A few clinical trials that are testing GLP-1s on several biomarkers of aging, like inflammation levels and biological age clocks, as well as on functional abilities like strength and walking speed, are finally getting underway. At least one of the studies still will not be conducted on healthy older adults, though, since the participants need to meet the criteria for receiving a prescription for the weight loss medications, said Dr. Blackwell, who is leading the trial. But he added that those criteria — for example, a body mass index of 27 or greater and a related health condition, like hypertension — reflect “a whole lot of Americans.”目前，已有数项临床试验陆续启动，将GLP-1类药物对炎症水平、生物年龄时钟等多项衰老生物标志物，以及肌肉力量、步行速度等功能性指标的影响纳入研究范畴。不过，至少有一项研究无法在健康的老年人中展开，主持试验的布莱克韦尔博士表示，因为受试者必须满足此类减肥药的临床处方标准。但他又补充道，这些条件——例如体重指数(BMI)达到27或以上，并伴有一种相关疾病（如高血压）——实际上涵盖了“相当大一部分美国人”。For now, experts generally don’t recommend taking the medications off label for longevity. “In patients that are otherwise healthy, at this point, I think it’s premature, because there are no data justifying it from preclinical or clinical studies,” Dr. Musi said.目前，专家普遍不建议为了延寿而超说明书使用这些药物。穆西博士表示：“对于其他方面都很健康的人来说，我认为现在这么做还为时过早，因为无论是临床前研究还是临床研究，都没有数据为此提供依据。”In Dr. Blackwell’s case, the message seemed to be, do as I say, not as I do. He has been taking tirzepatide (the drug in Zepbound) for the past year with the goal of slowing aging.至于布莱克韦尔博士，他的态度似乎是“听我讲就好，不要看我怎么做”。为了延缓衰老，他已经服用替西帕肽（即Zepbound中的活性成分）一年有余。“Do I know that that’s the right thing? I do not,” he said. “Do I recommend that for patients? I do not.”“我是否知道这么做是对的？我不知道，”他说。“我是否会向患者推荐这么做？不会。”“This is my own personal decision,” he added.他补充道：“这是我个人的决定。”Dana G. Smith是《纽约时报》记者，报道个人健康，特别是衰老和大脑健康问题。翻译：杜然点击查看本文英文版。