Department of Preventative Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Obes Rev. 2017 Feb;18(2):129-139. doi: 10.1111/obr.12481. Epub 2016 Dec 2.
Although low doses of persistent organic pollutants (POPs), strong lipophilic chemicals with long half-lives, have been linked to various endocrine, immune, nervous and reproductive system diseases, few obesity studies have considered adipose tissue as an important POPs exposure source. Because the toxicodynamics of POPs relate directly to the dynamics of adiposity, POPs might explain puzzling findings in obesity research. In two people exposed to the same amounts of environmental POPs, the one having more adipose tissue may be advantaged because POPs storage in adipose tissue can reduce burden on other critical organs. Therefore, adipose tissue can play a protective role against the POPs effects. However, two situations increase the POPs release from adipose tissue into the circulation, thereby increasing the risk that they will reach critical organs: (i) weight loss and (ii) insulin resistance. In contrast, weight gain reduces this possibility. Therefore, avoiding harmful health effects of POPs may mostly contradict conventional judgments about obesity and weight change. These contradictory situations can explain the obesity paradox, the adverse effects of intensive intentional weight loss and the protective effects of obesity against dementia. Future studies should consider that adipose tissue is widely contaminated with POPs in modern society.
尽管低剂量的持久性有机污染物(POPs)——具有长半衰期的强亲脂性化学物质——与各种内分泌、免疫、神经和生殖系统疾病有关,但很少有肥胖研究将脂肪组织视为重要的 POPs 暴露源。由于 POPs 的毒代动力学与肥胖的动态直接相关,因此 POPs 可能可以解释肥胖研究中的一些令人费解的发现。在两个接触相同环境 POPs 剂量的人中,脂肪组织较多的人可能会处于优势地位,因为 POPs 在脂肪组织中的储存可以减少对其他关键器官的负担。因此,脂肪组织可以对 POPs 的影响起到保护作用。然而,有两种情况会增加脂肪组织向循环系统释放 POPs,从而增加它们到达关键器官的风险:(i)体重减轻和(ii)胰岛素抵抗。相比之下,体重增加会降低这种可能性。因此,避免 POPs 的有害健康影响可能与关于肥胖和体重变化的传统判断大多相悖。这些矛盾的情况可以解释肥胖悖论、强化有意减重的不良影响以及肥胖对痴呆的保护作用。未来的研究应该考虑到在现代社会中,脂肪组织广泛受到 POPs 的污染。