Roth Christian L, Reinehr Thomas
Division of Endocrinology, Seattle Children's Hospital Research Institute, 1900 Ninth Ave, Seattle, WA 98101, USA.
Arch Pediatr Adolesc Med. 2010 Feb;164(2):131-8. doi: 10.1001/archpediatrics.2009.265.
Childhood obesity is a global epidemic and associated with an increased risk of hypertension, diabetes mellitus, and coronary heart disease, in addition to psychological disorders. Interventions such as bariatric surgery are highly invasive and lifestyle modifications are often unsuccessful because of disturbed perceptions of satiety. New signaling peptides discovered in recent years that are produced in peripheral tissues such as the gut, adipose tissue, and pancreas communicate with brain centers of energy homeostasis, such as the hypothalamus and hindbrain. This review discusses the major known gut- and adipose tissue-derived hormones involved in the regulation of food intake and energy homeostasis and their serum levels in childhood obesity before and after weight loss as well as their relationship to consequences of obesity. Since most of the changes of gastrointestinal hormones and adipokines normalize in weight loss, pharmacological interventions based on these hormones will likely not solve the obesity epidemic in childhood. However, a better understanding of the pathways of body weight- and food intake-regulating gut- and adipose tissue-derived hormones will help to find new strategies to treat obesity and its consequences.
儿童肥胖是一种全球性流行病，除心理障碍外，还与高血压、糖尿病和冠心病风险增加相关。诸如减肥手术等干预措施具有高度侵入性，而生活方式的改变往往因饱腹感感知紊乱而不成功。近年来在肠道、脂肪组织和胰腺等外周组织中发现的新信号肽与能量平衡的脑中枢（如下丘脑和后脑）进行交流。本综述讨论了参与食物摄入调节和能量平衡的主要已知肠道和脂肪组织衍生激素，以及它们在儿童肥胖减肥前后的血清水平，以及它们与肥胖后果的关系。由于大多数胃肠激素和脂肪因子的变化在体重减轻时会恢复正常，基于这些激素的药物干预可能无法解决儿童肥胖问题。然而，更好地了解调节体重和食物摄入的肠道和脂肪组织衍生激素的途径将有助于找到治疗肥胖及其后果的新策略。
