Kornhuber H H, Kornhuber J, Wanner W, Kornhuber A, Kaiserauer C H
Department of Neurology, Ulm University, FRG.
Clin Physiol Biochem. 1989;7(3-4):203-16.
Previous work showed that obesity in the average human male is not due to increased caloric intake. To test the hypothesis that 'social' ethanol consumption causes obesity by a hepatotoxic mechanism, the relationships between alcohol intake, cigarette smoking, serum gamma-glutamyl transpeptidase (GGT) and body build were investigated in 816 adult patients, 491 males and 325 females. A large part of the Broca index variance could be explained by hepatic damage as reflected by the GGT level. The higher the GGT, the more overweight were the subjects. Hyperinsulinemia may be the pathogenetic link; insulin is the strongest known blocker of lipolysis. Almost the total variation of obesity with GGT, however, occurred in the range of GGT up to 25 U/l, which is usually, but nevertheless erroneously, considered to be the normal range. This effect was independent of sex and age. Normal GGT is below 10 U/l, which is found on average in females aged less than 20 years. Females tolerate less alcohol than males. Although GGT is as high in females as in males around age 30, males drink about three times as much ethanol. For the same GGT the Broca index is significantly higher in females than in males. GGT generally increases with age; maximum GGT is reached in females in the age group 21-40 years (due to the change in drinking habits around 1968), declining thereafter; in males at age 50. Obesity per se is not correlated with a high GGT. In the females there are hormonal factors influencing obesity. Although in the females GGT decreases on average after age 40, obesity increases (due to the decrease in estrogens). After age 50 ethanol tolerance in males decreases: they reduce their alcohol consumption, and yet the GGT remains high. -Cigarette smoking is a factor which independently influences obesity. Although people who smoke tend also to drink more alcohol, smokers are significantly leaner than nonsmokers. On average males smoke about twice as heavily as females; this contributes to the fact that on average males are leaner than females despite their higher alcohol consumption. Due to lower consumption the influence of ethanol and smoking on body build is smaller in females than in males.
先前的研究表明，一般成年男性肥胖并非热量摄入增加所致。为了验证“社交性”饮酒通过肝毒性机制导致肥胖这一假说，对816名成年患者（491名男性和325名女性）的酒精摄入量、吸烟情况、血清γ-谷氨酰转肽酶（GGT）与体型之间的关系进行了调查。GGT水平所反映的肝损伤能够解释很大一部分布罗卡指数的差异。GGT越高，受试者超重越明显。高胰岛素血症可能是致病环节；胰岛素是已知最强的脂肪分解阻滞剂。然而，肥胖与GGT的几乎所有变化都发生在GGT高达25 U/l的范围内, 而这一范围通常（但错误地）被认为是正常范围。这种影响与性别和年龄无关。正常GGT低于10 U/l，平均见于20岁以下女性。女性比男性更不耐受酒精。尽管30岁左右女性的GGT与男性一样高，但男性饮用的乙醇量约为女性的三倍。对于相同的GGT，女性的布罗卡指数显著高于男性。GGT通常随年龄增长而升高；女性在21 - 40岁年龄组达到GGT最大值（由于1968年左右饮酒习惯的改变），此后下降；男性在50岁时达到最大值。肥胖本身与高GGT无关。女性存在影响肥胖的激素因素。尽管女性40岁以后GGT平均下降，但肥胖却增加了（由于雌激素减少）。50岁以后男性对乙醇的耐受性下降：他们减少饮酒量，但GGT仍然很高。吸烟是独立影响肥胖的一个因素。尽管吸烟者往往饮酒更多，但吸烟者明显比不吸烟者瘦。平均而言，男性吸烟量约为女性的两倍；这导致尽管男性饮酒量较高，但平均而言仍比女性瘦。由于饮酒量较低，乙醇和吸烟对女性体型的影响小于男性。
