Leoni M C, Pizzo D, Marchi A
Clinica Pediatrica, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italia.
Minerva Pediatr. 2010 Apr;62(2):171-8.
Adipose tissue is now considered an important endocrine organ that secretes a large number of physiologically active peptides affecting metabolic homeostasis of human body: they are collectively referred to as adipocytokines. Leptin is a key hormone in the regulation of food intake, energy expenditure, neuroendocrine and immune function. Leptin is related with obesity and its metabolic disorders; starvation-induced depletion of fat stores is accompanied by alterations of circulating adipocytokines that may have potential repercussions in the pathophysiology of anorexia nervosa. Adiponectin enhances insulin sensitivity, controls body weight, prevents atherosclerosis and negatively regulates immune functions. Plasma adiponectin relates inversely to adiposity and reflects the sequelae of accumulation of excess adiposity. Resistin is a protein hormone produced both by adipocytes and immunocompetent cells that affect fuel homeostasis and insulin action. Plasma resistin levels are decreased in anorectic patients, while plasma adiponectin levels are increased. Plasma ghrelin levels present opposite changes in obesity and anorexia nervosa, suggesting that ghrelin is a good marker of nutritional status. Visfatin shows to correlate with visceral fat mass in patients with obesity. Its possible role in patients with anorexia nervosa is unknown. In conclusion, obesity is defined as a state of low-grade inflammation, which is associated with increased leptin, resistin and ghrelin levels and decreased adiponectin levels; anorexia nervosa is characterized by opposite changes. Finally, plasma adipocytokines levels can represent a sensitive parameter of nutritional status that reflects changes in the level of body fat in children and adolescents with obesity and anorexia nervosa.
脂肪组织现在被认为是一个重要的内分泌器官，它分泌大量影响人体代谢稳态的生理活性肽：它们被统称为脂肪细胞因子。瘦素是调节食物摄入、能量消耗、神经内分泌和免疫功能的关键激素。瘦素与肥胖及其代谢紊乱有关；饥饿导致的脂肪储备消耗伴随着循环脂肪细胞因子的改变，这可能对神经性厌食症的病理生理学产生潜在影响。脂联素可增强胰岛素敏感性、控制体重、预防动脉粥样硬化并对免疫功能起负调节作用。血浆脂联素与肥胖呈负相关，反映了肥胖过度积累的后果。抵抗素是一种由脂肪细胞和免疫活性细胞产生的蛋白质激素，影响能量稳态和胰岛素作用。厌食症患者的血浆抵抗素水平降低，而血浆脂联素水平升高。肥胖症和神经性厌食症患者的血浆胃饥饿素水平呈现相反的变化，这表明胃饥饿素是营养状况的良好指标。内脂素在肥胖患者中显示与内脏脂肪量相关。其在神经性厌食症患者中的可能作用尚不清楚。总之，肥胖被定义为一种低度炎症状态，与瘦素、抵抗素和胃饥饿素水平升高以及脂联素水平降低有关；神经性厌食症的特征则是相反的变化。最后，血浆脂肪细胞因子水平可以代表营养状况的一个敏感参数，反映肥胖和神经性厌食症儿童及青少年体内脂肪水平的变化。
