Roemmich James N., Rogol Alan D.
University of Virginia Health Sciences Center, Department of Pediatrics, Charlottesville, Virginia 22908.
Am J Hum Biol. 1999;11(2):209-224. doi: 10.1002/(SICI)1520-6300(1999)11:2<209::AID-AJHB9>3.0.CO;2-G.
In adults, abdominal visceral adiposity is related to an increased risk of cardiovascular diseases, Type 2 diabetes mellitus, and stroke. The antecedents of these conditions likely begin with the alterations in body fat distribution during childhood and adolescence. The sexually dimorphic alterations in fat distribution are influenced by sex differences in hormone concentrations, anatomical differences in the number and density of specific hormone receptors, capillary blood flow, and the activity of enzymes promoting lipid synthesis or degradation. Hormones influencing the amount and regional distribution of adipose tissue during puberty include cortisol, insulin, growth hormone, and the sex steroids. Cortisol and insulin promote fat deposition while the sex steroids and GH stimulate lipolysis. An overly sensitive hypothalamic-pituitary-adrenal axis may exist in obesity and disrupt the balance between the lipogenic effects of cortisol and insulin and the lipolytic effects of sex steroids and growth hormone. Leptin is released from the adipocytes and may act as a metabolic signal to the hypothalamic areas controlling satiety, energy expenditure, and the regulation of cortisol, insulin, sex steroid and growth hormone release. The complex issues of the hormonal control of alterations in body fat distribution during puberty are developed and a working model is proposed. Am. J. Hum. Biol. 11:209-224, 1999. Copyright 1999 Wiley-Liss, Inc.
在成年人中，腹部内脏脂肪过多与心血管疾病、2型糖尿病和中风风险增加有关。这些疾病的起因可能始于儿童期和青春期身体脂肪分布的改变。脂肪分布的性别差异受激素浓度的性别差异、特定激素受体数量和密度的解剖学差异、毛细血管血流量以及促进脂质合成或降解的酶的活性影响。在青春期影响脂肪组织数量和区域分布的激素包括皮质醇、胰岛素、生长激素和性类固醇。皮质醇和胰岛素促进脂肪沉积，而性类固醇和生长激素刺激脂肪分解。肥胖症患者可能存在过度敏感的下丘脑 - 垂体 - 肾上腺轴，从而破坏皮质醇和胰岛素的脂肪生成作用与性类固醇和生长激素的脂肪分解作用之间的平衡。瘦素由脂肪细胞释放，可能作为一种代谢信号作用于控制饱腹感、能量消耗以及皮质醇、胰岛素、性类固醇和生长激素释放调节的下丘脑区域。本文阐述了青春期身体脂肪分布改变的激素控制这一复杂问题，并提出了一个工作模型。《美国人类生物学杂志》11:209 - 224，1999年。版权所有1999年威利 - 利斯公司。
