双语新闻：肥胖人群目前不需要被纳入药物研究
More than 40 percent of American adults are considered obese, or medically overweight. But the medications many of these individuals take are rarely tested in bigger bodies.
超过40%的美国成年人被认为肥胖，或者医学上超重。但这些人服用的药物很少在更大的身体上进行测试。
Obese people are currently not required to be included in drug studies. Often, they are purposefully left out.
肥胖人群目前不需要被纳入药物研究。通常，他们是被故意忽略的。
This is a problem because the amount of drugs an obese person should take to be safe is unknown, says Christina Chow. She is a researcher who has sought to bring attention to the need to include obese people in drug development and testing. "There's no real emphasis for them to be studied at all," Chow told The Associated Press.
克里斯蒂娜·周说，这是一个问题，因为肥胖者应该服用多少药物才能保证安全，这是未知的。她是一名研究人员，她试图引起人们对将肥胖人群纳入药物开发和测试的必要性的关注。“根本没有真正强调要对它们进行研究，”周告诉美联社。
Medications can work differently in people who are obese, but exactly how and at what amount is not clear. Research suggests this includes antibiotics and antifungal drugs, medications used to treat serious infections. It even includes ibuprofen, a commonly used painkiller that can be bought without a doctor's orders.
药物对肥胖者的作用可能不同，但确切的作用方式和剂量尚不清楚。研究表明，这包括抗生素和抗真菌药物，用于治疗严重感染的药物。它甚至包括布洛芬，一种不用医生处方就能买到的常用止痛药。
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) are the agencies that control and provide money for drug testing. At a gathering last year, FDA Commissioner Dr. Robert Califf noted a "deficit of evidence" about how medicines act in patients who are obese. The NIH now asks researchers to think about the results of not including obese people in their studies, an agency spokesperson said.
美国食品和药物管理局(FDA)和美国国立卫生研究院(NIH)是控制药物测试并为其提供资金的机构。在去年的一次会议上，FDA局长罗伯特·卡利夫博士指出，关于药物对肥胖患者的作用“缺乏证据”。美国国立卫生研究院的一位发言人说，该机构现在要求研究人员考虑不把肥胖人群纳入研究的结果。
At a recent medical conference, Chow presented a review of more than 200 studies for new drugs in the U.S. last year. Nearly two-thirds of the studies failed to include weight or body mass index, a numerical value noting if a person is obese.
在最近的一次医学会议上，Chow介绍了去年美国200多项新药研究的综述。近三分之二的研究没有包括体重或身体质量指数，这是一个衡量一个人是否肥胖的数值。
Historically, some populations have not been included in drug testing to avoid harm, including pregnant women and children. In the past, women, racial and ethnic minorities and aged people have also not been included.
从历史上看，一些人群没有被纳入药物检测以避免伤害，包括孕妇和儿童。在过去，妇女、少数民族和老年人也没有被包括在内。
Dr. Caroline Apovian is a researcher at Brigham and Women's Hospital in Boston. She is the co-author of Chow's study. Apovian told the AP there are many reasons people who are obese are not included in drug tests.
卡罗琳·阿波维安博士是波士顿布里格姆妇女医院的一名研究员。她是周研究的合著者。Apovian告诉美联社，有很多原因导致肥胖的人没有被纳入药物测试。
She noted that people who volunteer for trials are often thin and healthy and this does not effectively represent the general population. Obese individuals can have many health difficulties, and researchers often worry this will affect results of their work.
她指出，自愿参加试验的人往往又瘦又健康，这并不能有效地代表一般人群。肥胖的人可能有许多健康问题，研究人员经常担心这会影响他们的工作结果。
"Sometimes patients with obesity have many more comorbidities than others. They'll have more diabetes, more heart disease, more strokes," Apovian said.
“有时肥胖患者比其他人有更多的合并症。他们会有更多的糖尿病、心脏病和中风。”
But if drugs are not studied in a condition that affects 42 percent of the U.S. population, the real-world effects can be dire, experts say.
但专家表示，如果药物没有在影响42%美国人口的情况下进行研究，那么现实世界的影响可能是可怕的。
Some drugs remain in the body longer in obese people. That could result in harmful drug interactions if another medication is added too soon. There can also be less medication in the blood, leading to undertreatment, Apovian said.
有些药物在肥胖者体内停留的时间更长。如果过早添加另一种药物，可能会导致有害的药物相互作用。Apovian说，血液中的药物也可能较少，导致治疗不足。
Rexulti is a drug often used to treat people with schizophrenia or depression, Chow noted. Research has shown that in obese patients it may take much longer to reach the amount of Rexulti needed to be effective. As a result, many patients and their doctors may stop treatment too early or believe the drug does not work.
Chow指出，Rexulti是一种经常用于治疗精神分裂症或抑郁症的药物。研究表明，肥胖患者可能需要更长的时间才能达到Rexulti的有效剂量。因此，许多患者和他们的医生可能过早停止治疗，或者认为药物不起作用。
"Not treating or undertreating schizophrenia may be dangerous to themselves and the people around them," Chow said.
“不治疗或治疗不足可能对他们自己和周围的人都是危险的，”周说。
Even a drug as common as ibuprofen may not reduce pain in people at higher weights when taken as directed, research shows.
研究表明，即使是像布洛芬这样常见的药物，如果按照指导服用，也可能无法减轻体重较高的人的疼痛。
But without testing and clear directions, doctors won't know the amount of medicine needed for obese people, said Dr. Colleen Tenan. She is a board member of the Association of Clinical Research Professionals. Tenan said it is very hard to be a doctor and direct patients to take amounts of medication that have not been tested.
但Colleen Tenan博士说，如果没有测试和明确的指导，医生就不知道肥胖患者需要多少药物。她是临床研究专业人员协会的董事会成员。Tenan说，作为一名医生，指导病人服用大量未经测试的药物是非常困难的。
Change is coming, but progress is slow, said Dr. Alison Edelman. She is an obstetrician and researcher at Oregon Health & Science University. She told the AP that in 2019, the FDA suggested that researchers permit obese women in studies on birth control. Even though the suggestions are not required, they have already changed how she and other researchers structure their studies.
艾莉森·埃德尔曼博士说，变化正在到来，但进展缓慢。她是俄勒冈健康与科学大学的产科医生和研究员。她告诉美联社，2019年，FDA建议研究人员允许肥胖女性参与节育研究。尽管这些建议不是必需的，但它们已经改变了她和其他研究人员构建研究的方式。
"Because unless we see representation in our study population, we don't end up with treatments that work well for individuals," Edelman said.
埃德尔曼说:“因为除非我们在研究人群中看到代表性，否则我们最终无法找到对个人有效的治疗方法。”
Apovian, from Brigham and Women's Hospital, said patients can ask their doctors about whether the usual amount of a medication is acceptable for their weight. Even if the doctors do not know, the question could start an important discussion about the most effective treatments.
布里格姆妇女医院的阿波维安说，病人可以向他们的医生询问他们的体重是否可以接受通常的药物剂量。即使医生不知道，这个问题也可能引发一场关于最有效治疗方法的重要讨论。
"This is a big issue," Apovian said. "It can be important for patients to speak up."
“这是一个大问题，”Apovian说。“病人说出来可能很重要。”
超过40%的美国成年人被认为肥胖，或者医学上超重。但这些人服用的药物很少在更大的身体上进行测试。
Obese people are currently not required to be included in drug studies. Often, they are purposefully left out.
肥胖人群目前不需要被纳入药物研究。通常，他们是被故意忽略的。
This is a problem because the amount of drugs an obese person should take to be safe is unknown, says Christina Chow. She is a researcher who has sought to bring attention to the need to include obese people in drug development and testing. "There's no real emphasis for them to be studied at all," Chow told The Associated Press.
克里斯蒂娜·周说，这是一个问题，因为肥胖者应该服用多少药物才能保证安全，这是未知的。她是一名研究人员，她试图引起人们对将肥胖人群纳入药物开发和测试的必要性的关注。“根本没有真正强调要对它们进行研究，”周告诉美联社。
Medications can work differently in people who are obese, but exactly how and at what amount is not clear. Research suggests this includes antibiotics and antifungal drugs, medications used to treat serious infections. It even includes ibuprofen, a commonly used painkiller that can be bought without a doctor's orders.
药物对肥胖者的作用可能不同，但确切的作用方式和剂量尚不清楚。研究表明，这包括抗生素和抗真菌药物，用于治疗严重感染的药物。它甚至包括布洛芬，一种不用医生处方就能买到的常用止痛药。
The U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) are the agencies that control and provide money for drug testing. At a gathering last year, FDA Commissioner Dr. Robert Califf noted a "deficit of evidence" about how medicines act in patients who are obese. The NIH now asks researchers to think about the results of not including obese people in their studies, an agency spokesperson said.
美国食品和药物管理局(FDA)和美国国立卫生研究院(NIH)是控制药物测试并为其提供资金的机构。在去年的一次会议上，FDA局长罗伯特·卡利夫博士指出，关于药物对肥胖患者的作用“缺乏证据”。美国国立卫生研究院的一位发言人说，该机构现在要求研究人员考虑不把肥胖人群纳入研究的结果。
At a recent medical conference, Chow presented a review of more than 200 studies for new drugs in the U.S. last year. Nearly two-thirds of the studies failed to include weight or body mass index, a numerical value noting if a person is obese.
在最近的一次医学会议上，Chow介绍了去年美国200多项新药研究的综述。近三分之二的研究没有包括体重或身体质量指数，这是一个衡量一个人是否肥胖的数值。
Historically, some populations have not been included in drug testing to avoid harm, including pregnant women and children. In the past, women, racial and ethnic minorities and aged people have also not been included.
从历史上看，一些人群没有被纳入药物检测以避免伤害，包括孕妇和儿童。在过去，妇女、少数民族和老年人也没有被包括在内。
Dr. Caroline Apovian is a researcher at Brigham and Women's Hospital in Boston. She is the co-author of Chow's study. Apovian told the AP there are many reasons people who are obese are not included in drug tests.
卡罗琳·阿波维安博士是波士顿布里格姆妇女医院的一名研究员。她是周研究的合著者。Apovian告诉美联社，有很多原因导致肥胖的人没有被纳入药物测试。
She noted that people who volunteer for trials are often thin and healthy and this does not effectively represent the general population. Obese individuals can have many health difficulties, and researchers often worry this will affect results of their work.
她指出，自愿参加试验的人往往又瘦又健康，这并不能有效地代表一般人群。肥胖的人可能有许多健康问题，研究人员经常担心这会影响他们的工作结果。
"Sometimes patients with obesity have many more comorbidities than others. They'll have more diabetes, more heart disease, more strokes," Apovian said.
“有时肥胖患者比其他人有更多的合并症。他们会有更多的糖尿病、心脏病和中风。”
But if drugs are not studied in a condition that affects 42 percent of the U.S. population, the real-world effects can be dire, experts say.
但专家表示，如果药物没有在影响42%美国人口的情况下进行研究，那么现实世界的影响可能是可怕的。
Some drugs remain in the body longer in obese people. That could result in harmful drug interactions if another medication is added too soon. There can also be less medication in the blood, leading to undertreatment, Apovian said.
有些药物在肥胖者体内停留的时间更长。如果过早添加另一种药物，可能会导致有害的药物相互作用。Apovian说，血液中的药物也可能较少，导致治疗不足。
Rexulti is a drug often used to treat people with schizophrenia or depression, Chow noted. Research has shown that in obese patients it may take much longer to reach the amount of Rexulti needed to be effective. As a result, many patients and their doctors may stop treatment too early or believe the drug does not work.
Chow指出，Rexulti是一种经常用于治疗精神分裂症或抑郁症的药物。研究表明，肥胖患者可能需要更长的时间才能达到Rexulti的有效剂量。因此，许多患者和他们的医生可能过早停止治疗，或者认为药物不起作用。
"Not treating or undertreating schizophrenia may be dangerous to themselves and the people around them," Chow said.
“不治疗或治疗不足可能对他们自己和周围的人都是危险的，”周说。
Even a drug as common as ibuprofen may not reduce pain in people at higher weights when taken as directed, research shows.
研究表明，即使是像布洛芬这样常见的药物，如果按照指导服用，也可能无法减轻体重较高的人的疼痛。
But without testing and clear directions, doctors won't know the amount of medicine needed for obese people, said Dr. Colleen Tenan. She is a board member of the Association of Clinical Research Professionals. Tenan said it is very hard to be a doctor and direct patients to take amounts of medication that have not been tested.
但Colleen Tenan博士说，如果没有测试和明确的指导，医生就不知道肥胖患者需要多少药物。她是临床研究专业人员协会的董事会成员。Tenan说，作为一名医生，指导病人服用大量未经测试的药物是非常困难的。
Change is coming, but progress is slow, said Dr. Alison Edelman. She is an obstetrician and researcher at Oregon Health & Science University. She told the AP that in 2019, the FDA suggested that researchers permit obese women in studies on birth control. Even though the suggestions are not required, they have already changed how she and other researchers structure their studies.
艾莉森·埃德尔曼博士说，变化正在到来，但进展缓慢。她是俄勒冈健康与科学大学的产科医生和研究员。她告诉美联社，2019年，FDA建议研究人员允许肥胖女性参与节育研究。尽管这些建议不是必需的，但它们已经改变了她和其他研究人员构建研究的方式。
"Because unless we see representation in our study population, we don't end up with treatments that work well for individuals," Edelman said.
埃德尔曼说:“因为除非我们在研究人群中看到代表性，否则我们最终无法找到对个人有效的治疗方法。”
Apovian, from Brigham and Women's Hospital, said patients can ask their doctors about whether the usual amount of a medication is acceptable for their weight. Even if the doctors do not know, the question could start an important discussion about the most effective treatments.
布里格姆妇女医院的阿波维安说，病人可以向他们的医生询问他们的体重是否可以接受通常的药物剂量。即使医生不知道，这个问题也可能引发一场关于最有效治疗方法的重要讨论。
"This is a big issue," Apovian said. "It can be important for patients to speak up."
“这是一个大问题，”Apovian说。“病人说出来可能很重要。”
