Coniglio Raul I, Dahinten Ernesto, Boeri Monica, Lebrun Fernanda, Monsalve Ana M
Laboratorio de Lípidos y Lipoproteínas, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires.
Medicina (B Aires). 2004;64(2):155-62.
Recent population studies in Southern Argentina have found a sharp rise in prevalence of overweight and obesity in both sexes and specially after fifty years of age. Hence, the obesity in itself was found associated with the presence of metabolic syndrome (MS) and coronary heart disease, which have been demonstrated by angiography studies. The regulation of energy homeostasis is controlled by interactions between the central nervous system (neurotransmitters and neuropeptides) and the peripheric system (hormones) through very complex mechanisms. Genetics or acquired alterations in these regulation systems can be the origin of obesity and specially of central obesity. The visceral adipose tissue can be considered a secretor organ and its mass increment could generate insulin-resistance (IR) state, which directly or indirectly, could develop into endothelial dysfunction and coronary atherosclerosis. Although some studies estimate that 40% of IR are of genetic origin, a high proportion of these are acquired by inadequate habits in life style (specially excess of food intake and low physical activity). Finally, a better knowledge of the central and peripheric regulations in alimentation habits and energetic balance could help to develop treatments to decrease the incidence of these metabolic alterations and, consequently the morbidity and mortality due to coronary atherosclerosis.
最近在阿根廷南部开展的人口研究发现，男性和女性的超重及肥胖患病率急剧上升，尤其是在50岁之后。因此，肥胖本身被发现与代谢综合征（MS）和冠心病有关，血管造影研究已证实了这一点。能量稳态的调节是通过非常复杂的机制，由中枢神经系统（神经递质和神经肽）和外周系统（激素）之间的相互作用来控制的。这些调节系统中的遗传或后天改变可能是肥胖尤其是中心性肥胖的根源。内脏脂肪组织可被视为一个分泌器官，其质量增加可能会产生胰岛素抵抗（IR）状态，这可能直接或间接发展为内皮功能障碍和冠状动脉粥样硬化。尽管一些研究估计40%的IR源于遗传，但其中很大一部分是由于生活方式习惯不当（特别是食物摄入过量和体力活动不足）所致。最后，更好地了解饮食和能量平衡的中枢及外周调节机制，可能有助于开发治疗方法，以降低这些代谢改变的发生率，从而降低因冠状动脉粥样硬化导致的发病率和死亡率。
