Poddar M, Chetty Y, Chetty V T
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
University of Queensland, Brisbane, QLD, Australia.
Clin Obes. 2017 Jun;7(3):136-144. doi: 10.1111/cob.12184. Epub 2017 Mar 15.
Obesity is a chronic, relapsing medical condition that results from an imbalance of energy expenditure and consumption. It is a leading cause of preventable illness, disability and premature death. The causes of obesity are multifactorial and include behavioural, socioeconomic, genetic, environmental and psychosocial factors. Rarely are endocrine diseases, e.g., hypothyroidism or Cushing's syndrome, the cause of obesity. What is less understood is how obesity affects the endocrine system. In this review, we will discuss the impact of obesity on multiple endocrine systems, including the hypothalamic-pituitary axis, changes in vitamin D homeostasis, gender steroids and thyroid hormones. We will also examine the renin angiotensin aldosterone system and insulin pathophysiology associated with obesity. We will provide a general overview of the biochemical changes that can be seen in patients with obesity, review possible aetiologies of these changes and briefly consider current guidelines on their management. This review will not discuss endocrine causes of obesity.
肥胖是一种慢性复发性疾病，由能量消耗与摄入失衡所致。它是可预防疾病、残疾和过早死亡的主要原因。肥胖的成因是多方面的，包括行为、社会经济、遗传、环境和心理社会因素。内分泌疾病，如甲状腺功能减退或库欣综合征，很少是肥胖的原因。人们对肥胖如何影响内分泌系统了解较少。在本综述中，我们将讨论肥胖对多个内分泌系统的影响，包括下丘脑 - 垂体轴、维生素D稳态变化、性腺类固醇和甲状腺激素。我们还将研究与肥胖相关的肾素 - 血管紧张素 - 醛固酮系统和胰岛素病理生理学。我们将概述肥胖患者可见的生化变化，回顾这些变化可能的病因，并简要考虑当前关于其管理的指南。本综述不会讨论肥胖的内分泌原因。
