Division of Endocrinology, Department of Clinical Medicine, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
Ann N Y Acad Sci. 2012 Aug;1264(1):20-35. doi: 10.1111/j.1749-6632.2012.06569.x. Epub 2012 May 21.
Obesity, particularly the abdominal phenotype, has been ascribed to an individual maladaptation to chronic environmental stress exposure mediated by a dysregulation of related neuroendocrine axes. Alterations in the control and action of the hypothalamic-pituitary-adrenal axis play a major role in this context, with the participation of the sympathetic nervous system. The ability to adapt to chronic stress may differ according to sex, with specific pathophysiological events leading to the development of stress-related chronic diseases. This seems to be influenced by the regulatory effects of sex hormones, particularly androgens. Stress may also disrupt the control of feeding, with some differences according to sex. Finally, the amount of experimental data in both animals and humans may help to shed more light on specific phenotypes of obesity, strictly related to the chronic exposure to stress. This challenge may potentially imply a different pathophysiological perspective and, possibly, a specific treatment.
肥胖症，特别是腹部表型，被归因于个体对慢性环境应激暴露的适应不良，这种适应不良是由相关神经内分泌轴的失调介导的。在这种情况下，下丘脑-垂体-肾上腺轴的控制和作用的改变起着主要作用，交感神经系统也参与其中。适应慢性应激的能力可能因性别而异，特定的病理生理事件导致与应激相关的慢性疾病的发展。这似乎受到性激素，特别是雄激素的调节作用的影响。应激也可能破坏摄食的控制，其性别间存在一些差异。最后，动物和人类的实验数据量可能有助于更深入地了解与慢性应激密切相关的肥胖特定表型。这一挑战可能潜在地暗示了一种不同的病理生理学观点，并且可能需要特定的治疗方法。
