Wolthers T, Lechuga A, Grøfte T, Nørrelund H, Møller N, Christiansen J S, Jørgensen J O
Medical Department of M (Endocrinology and Diabetes), Aarhus University Hospital, Nørrebrogade, Denmark.
Horm Metab Res. 1999 Jan;31(1):37-40. doi: 10.1055/s-2007-978694.
The regulation of adipose tissue mass and energy expenditure is currently subject to intensive research, which primarily relates to the discovery of leptin. Leptin is a peptide, which is the product of the obese (ob) gene expressed in adipose tissue of several species icluding humans. Leptin is supposed to serve both as an index of fat mass and as a sensor of energy balance. Administration of recombinant murine leptin in ob/ob-mice, which do not produce leptin, decreases food intake and increases thermogenesis both of which result in a reduction in body weight and adipose tissue mass. The calorigenic effect of leptin presumably acts through an increase in sympathetic outflow which in turn activates the beta3 adrenergic receptor in brown adipose tissue. The regulation and action of endogenous leptin in humans are less well understood, and clinical grade recombinant human leptin is so far not available. Serum leptin correlates logarithmically with total body fat in both normal weight and obese subjects, which suggest insensitivity to leptin in obese patients. Furthermore, more rapid excursions in serum leptin have been reported following short-term changes in caloric intake and administration of insulin. Growth hormone (GH) exerts pronounced effects on lipid metabolism and resting energy expenditure. The lipolytic actions of GH appear to involve both increased sensitivity to the beta-adrenergic pathway, and a suppression of adipose tissue lipoprotein lipase activity. The calorigenic effects of GH have been shown not only to be secondary to changes in lean body mass. Growth hormone administration furthermore increases the peripheral conversion of thyroxine to triiodothyronine, which may contribute to the overall actions of GH on fuel and energy metabolism. So far, little is known about the effects of GH and iodothyronines on serum leptin levels in humans. We therefore measured serum leptin levels and energy expenditure before and after the administration of GH and triiodothyronine, alone and in combinaion, in a randomized double-blind placebo-controlled study in healthy young male adults. The dose of triiodothyronine was selected to obtain serum levels comparable to those seen after GH administration.
目前,脂肪组织量和能量消耗的调节是深入研究的课题,这主要与瘦素的发现有关。瘦素是一种肽,是肥胖(ob)基因的产物,在包括人类在内的多个物种的脂肪组织中表达。瘦素被认为既是脂肪量的指标,也是能量平衡的传感器。给不产生瘦素的ob/ob小鼠注射重组鼠瘦素,可减少食物摄入量并增加产热,这两者都会导致体重和脂肪组织量的减少。瘦素的产热作用可能是通过增加交感神经输出,进而激活棕色脂肪组织中的β3肾上腺素能受体来实现的。内源性瘦素在人类中的调节和作用尚不太清楚,而且目前还没有临床级别的重组人瘦素。在正常体重和肥胖受试者中,血清瘦素与全身脂肪呈对数相关,这表明肥胖患者对瘦素不敏感。此外,有报道称,热量摄入短期变化和注射胰岛素后,血清瘦素会出现更快速的波动。生长激素(GH)对脂质代谢和静息能量消耗有显著影响。GH的脂解作用似乎既涉及对β-肾上腺素能途径敏感性的增加,也涉及对脂肪组织脂蛋白脂肪酶活性的抑制。GH的产热作用不仅已被证明是瘦体重变化的继发结果。此外,注射生长激素还会增加甲状腺素向三碘甲状腺原氨酸的外周转化,这可能有助于GH对燃料和能量代谢的总体作用。到目前为止,关于GH和碘甲状腺原氨酸对人类血清瘦素水平的影响知之甚少。因此,在一项针对健康年轻男性成年人的随机双盲安慰剂对照研究中,我们测量了单独或联合注射GH和三碘甲状腺原氨酸前后的血清瘦素水平和能量消耗。三碘甲状腺原氨酸的剂量选择是为了使其血清水平与注射GH后观察到的水平相当。