The obesity pandemic:: Where have we been and where are we going?

被引:178
作者
Roth, J
Qiang, XL
Marbán, SL
Redelt, H
Lowell, BC
机构
[1] N Shore Long Isl Jewish Hlth Syst, Off Geriatrician Chief, Manhasset, NY 11040 USA
[2] N Shore Long Isl Jewish Hlth Syst, Med Res Inst, Manhasset, NY 11040 USA
[3] Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA
[4] Johns Hopkins Univ, Sch Med, Dept Pediat Neonatol, Baltimore, MD 21218 USA
来源
OBESITY RESEARCH | 2004年 / 12卷
关键词
pandemic; adiposity;
D O I
10.1038/oby.2004.273
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Obesity, a new pandemic, is associated with an increased risk of death, morbidity, and accelerated aging. The multiple therapeutic modalities used to promote weight loss are outlined with caution, especially for patients who are very young or old. Except for very rare single gene defects, the inheritance of obesity is complex and still poorly understood, despite active investigations. Recent advances that have shed light on the pathophysiology of obesity are the recognition that 1) excess fat is deposited in liver, muscle,, and pancreatic islets; 2) fat tissue secretes a large number of active signaling molecules including leptin, adiponectin, and resistin, as well as free fatty acids; and 3) activated macrophages colonize the adipose tissue. Other candidates for key roles in the causes and consequences of, obesity include 1) metabolic programming, where food acts as a developmental regulator;. 2) the constellation of defects known as the "metabolic syndrome;" 3) cortisol overproduction in the adipose tissue; and especially, 4) insulin resistance. The possible etiologies of insulin resistance include cytokine excess, elevated free fatty acids, and hyper-insulinemia itself, as with transgenic overproduction of insulin in mice.
引用
收藏
页码:88S / 101S
页数:14
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