Pasquali R, Vicennati V, Gambineri A
Endocrinology Unit, Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Endocrinol Invest. 2002 Nov;25(10):893-8. doi: 10.1007/BF03344053.
Obesity is associated with multiple alterations of the endocrine systems, including abnormal circulating blood hormone concentrations, due to changes in their pattern of secretion and/or metabolism, altered hormone transport, and/or action at the level of target tissues. There is evidence that alterations of endocrine systems regulating sex hormones and corticosteroids may play a crucial role in the development of obesity, particularly the abdominal phenotype. Obese women are characterized by a condition of sc"functional hyperandrogenism", whereas in males, obesity is associated with reduced T levels and decreased LH secretory pattern from the pituitary. In addition, in both sexes a dysregulation of the hypothalamic-pituitary-adrenal axis has been reported, including both neuroendocrine and peripheral alterations, finally leading to inappropriately higher than normal exposure to F of peripheral tissues, particularly the visceral adipose tissue. By these mechanisms, it can be hypothesized that both visceral fat enlargement and alterations of insulin action and associated metabolic disturbances may develop, therefore predisposing abdominally obese individuals to Type 2 diabetes and cardiovascular disease.
肥胖与内分泌系统的多种改变相关，包括循环血液中激素浓度异常，这是由于激素分泌和/或代谢模式的变化、激素转运改变和/或在靶组织水平上的作用改变所致。有证据表明，调节性激素和皮质类固醇的内分泌系统改变可能在肥胖尤其是腹型肥胖的发生发展中起关键作用。肥胖女性的特征是“功能性高雄激素血症”，而在男性中，肥胖与睾酮水平降低和垂体促黄体生成素分泌模式改变有关。此外，据报道，男女两性下丘脑-垂体-肾上腺轴均存在失调，包括神经内分泌和外周改变，最终导致外周组织，尤其是内脏脂肪组织暴露于皮质醇的水平高于正常且不合适。通过这些机制，可以推测内脏脂肪增大以及胰岛素作用改变和相关代谢紊乱可能会出现，从而使腹型肥胖个体易患2型糖尿病和心血管疾病。
