Lee Paul, Campbell Lesley V
Department of Endocrinology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia.
Curr Pharm Des. 2009;15(23):2751-8. doi: 10.2174/138161209788923895.
The aetiology of obesity is multi-factorial. Recent research has identified a novel association between endotoxaemia (circulating lipopolysaccharide in the systemic circulation) and low-grade inflammation in the adipose organ, which may contribute to obesity. The mechanisms for the low-grade elevation of circulating lipopolysaccharide in obesity are poorly understood. Vitamin D has been increasingly recognised for its pleiotropic actions beyond maintenance of musculoskeletal health. The parathyroid-vitamin D axis is altered in obesity. Circulating vitamin D levels are lower in obese individuals. The regulatory role of vitamin D in the immune system and colonic mucosa may explain the under-appreciated contribution of vitamin D deficiency in the obese to the pathogenesis of endotoxaemia and adipose inflammation. We propose a hypothetical model linking metabolic endotoxaemia with vitamin D deficiency in obesity. A therapeutic approach involving the use of probiotics and vitamin D metabolites in the obese is described.
肥胖的病因是多因素的。最近的研究发现内毒素血症（全身循环中循环的脂多糖）与脂肪器官中的低度炎症之间存在一种新的关联，这可能导致肥胖。肥胖中循环脂多糖低度升高的机制尚不清楚。维生素D因其在维持肌肉骨骼健康之外的多效性作用而越来越受到认可。肥胖时甲状旁腺 - 维生素D轴会发生改变。肥胖个体的循环维生素D水平较低。维生素D在免疫系统和结肠黏膜中的调节作用可能解释了肥胖者维生素D缺乏对内毒素血症和脂肪炎症发病机制的未被充分认识的贡献。我们提出了一个将代谢性内毒素血症与肥胖中的维生素D缺乏联系起来的假设模型。描述了一种涉及在肥胖者中使用益生菌和维生素D代谢物的治疗方法。
