Neurobiology of Nutrition Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
Trends Endocrinol Metab. 2013 Feb;24(2):101-8. doi: 10.1016/j.tem.2012.11.009. Epub 2013 Jan 11.
The superior efficacy of bariatric surgery compared with intensive medical treatment in reversing metabolic disease is now well accepted, but the critical mechanisms remain unknown. Unlike dieting, which triggers strong counter-regulatory responses such as hunger and craving, some obesity surgeries appear to permanently reset the level of defended body weight. Understanding the molecular mechanisms behind successful surgery would thus go a long way in developing future 'knifeless' treatment options. Major candidates include changes in gut-brain signaling by hormones, bile acids, and other still unidentified factors. By re-sensitizing homeostatic regulatory circuits in the hypothalamus and hedonic-motivational processing in corticolimbic systems to internal signals, bariatric surgery could thus lead to a state of being content with less.
与强化药物治疗相比，减重手术在逆转代谢性疾病方面的卓越疗效已被广泛接受，但关键机制仍不清楚。与节食不同，节食会引发强烈的代偿性反应，如饥饿和渴望，而某些肥胖手术似乎可以永久性地重置身体的防御体重水平。因此，了解成功手术背后的分子机制将极大地促进未来无刀治疗方法的发展。主要候选因素包括激素、胆汁酸和其他尚未确定的因素通过肠道-大脑信号传递的变化。通过使下丘脑的内稳态调节回路和边缘系统的愉悦动机处理重新对内部信号敏感，减重手术可能会导致一种满足于更少的状态。
