O'Brien Phillipe D, Hinder Lucy M, Callaghan Brian C, Feldman Eva L
Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Lancet Neurol. 2017 Jun;16(6):465-477. doi: 10.1016/S1474-4422(17)30084-4.
The high prevalence of obesity is associated with an enormous medical, social, and economic burden. The metabolic dysfunction, dyslipidaemia, and inflammation caused by obesity contribute to the development of a wide variety of disorders and effects on the nervous system. In the CNS, mild cognitive impairment can be attributed to obesity-induced alterations in hippocampal structure and function in some patients. Likewise, compromised hypothalamic function and subsequent defects in maintaining whole-body energy balance might be early events that contribute to weight gain and obesity development. In the peripheral nervous system, obesity-driven alterations in the autonomic nervous system prompt imbalances in sympathetic-parasympathetic activity, while alterations in the sensory-somatic nervous system underlie peripheral polyneuropathy, a common complication of diabetes. Pharmacotherapy and bariatric surgery are promising interventions for people with obesity that can improve neurological function. However, lifestyle interventions via dietary changes and exercise are the preferred approach to combat obesity and reduce its associated health risks.
肥胖的高流行率与巨大的医学、社会和经济负担相关。肥胖引起的代谢功能障碍、血脂异常和炎症会导致多种疾病的发生，并对神经系统产生影响。在中枢神经系统中，一些患者的轻度认知障碍可归因于肥胖引起的海马结构和功能改变。同样，下丘脑功能受损以及随后在维持全身能量平衡方面的缺陷可能是导致体重增加和肥胖发展的早期事件。在周围神经系统中，肥胖驱动的自主神经系统改变会促使交感 - 副交感神经活动失衡，而感觉 - 躯体神经系统的改变是糖尿病常见并发症周围神经病变的基础。药物治疗和减肥手术对于肥胖患者来说是有前景的干预措施，可以改善神经功能。然而，通过饮食改变和运动进行生活方式干预是对抗肥胖并降低其相关健康风险的首选方法。
