Douglas Alison J, Johnstone Louise E, Leng Gareth
Centre for Integrative Physiology, University of Edinburgh, Edinburgh, UK.
Physiol Behav. 2007 Jul 24;91(4):352-65. doi: 10.1016/j.physbeh.2007.04.012. Epub 2007 Apr 14.
During pregnancy body weight, and particularly adiposity, increase, due to hyperphagia rather than decreased energy metabolism. These physiological adaptations provide the growing fetus(es) with nutrition and prepare the mother for the metabolically-demanding lactation period following birth. Mechanisms underlying the hyperphagia are still poorly understood. Although the peripheral signals that drive appetite and satiety centers of the brain are increased in pregnancy, the brain may become insensitive to their effects. For example, leptin secretion increases but hypothalamic resistance to leptin actions develops. However, several adaptations in hypothalamic neuroendocrine systems may converge to increase ingestive behavior. Oxytocin is one of the anorectic hypothalamic neuropeptides. Oxytocin neurons, both centrally-projecting parvocellular oxytocin neurons and central dendritic release of oxytocin from magnocellular neurons, may play a key role in regulating energy intake. During feeding in non-pregnant rats, magnocellular oxytocin neurons, especially those in the supraoptic nucleus, become strongly activated indicating their imminent role in meal termination. However, in mid-pregnancy the excitability of these neurons is reduced, central dendritic oxytocin release is inhibited and patterns of oxytocin receptor binding in the brain alter. Our recent data suggest that lack of central oxytocin action may partly contribute to maternal hyperphagia. However, although opioid inhibition is a major factor in oxytocin neuron restraint during pregnancy and opioids enhance food intake, an increase in opioid orexigenic actions were not observed. While changes in several central input pathways to oxytocin neurons are likely to be involved, the high level of progesterone secretion during pregnancy is probably the ultimate trigger for the adaptations.
在怀孕期间,体重尤其是肥胖会增加,这是由于摄食过多而非能量代谢降低所致。这些生理适应性变化为发育中的胎儿提供营养,并使母亲为产后代谢需求高的哺乳期做好准备。导致摄食过多的机制仍知之甚少。尽管在怀孕期间驱动大脑食欲和饱腹感中枢的外周信号会增加,但大脑可能会对其作用变得不敏感。例如,瘦素分泌增加,但下丘脑对瘦素作用产生抵抗。然而,下丘脑神经内分泌系统的几种适应性变化可能共同作用以增加摄食行为。催产素是下丘脑的一种厌食神经肽。催产素神经元,包括中央投射的小细胞催产素神经元以及大细胞神经元中央树突释放的催产素,可能在调节能量摄入中起关键作用。在非妊娠大鼠进食期间,大细胞催产素神经元,尤其是视上核中的那些神经元,会被强烈激活,表明它们在进食终止中即将发挥作用。然而,在妊娠中期,这些神经元的兴奋性降低,中央树突催产素释放受到抑制,大脑中催产素受体结合模式发生改变。我们最近的数据表明,缺乏中央催产素作用可能部分导致母体摄食过多。然而,尽管阿片类物质抑制是怀孕期间催产素神经元受抑制的主要因素,且阿片类物质会增加食物摄入量,但并未观察到阿片类物质促食欲作用的增加。虽然可能涉及到几种通向催产素神经元的中央输入途径的变化,但怀孕期间高水平的孕酮分泌可能是这些适应性变化的最终触发因素。