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肥胖

Obesity.

机构信息

Department of Nutrition, Food Science and Physiology/Centre for Nutrition Research, University of Navarra, Edificio de Investigación, calle de Irunlarrea 1, Pamplona 31008, Navarra, Spain.

IDISNA Navarra's Health Research Institute, Pamplona, Spain.

出版信息

Nat Rev Dis Primers. 2017 Jun 15;3:17034. doi: 10.1038/nrdp.2017.34.

Abstract

Excessive fat deposition in obesity has a multifactorial aetiology, but is widely considered the result of disequilibrium between energy intake and expenditure. Despite specific public health policies and individual treatment efforts to combat the obesity epidemic, >2 billion people worldwide are overweight or obese. The central nervous system circuitry, fuel turnover and metabolism as well as adipose tissue homeostasis are important to comprehend excessive weight gain and associated comorbidities. Obesity has a profound impact on quality of life, even in seemingly healthy individuals. Diet, physical activity or exercise and lifestyle changes are the cornerstones of obesity treatment, but medical treatment and bariatric surgery are becoming important. Family history, food environment, cultural preferences, adverse reactions to food, perinatal nutrition, previous or current diseases and physical activity patterns are relevant aspects for the health care professional to consider when treating the individual with obesity. Clinicians and other health care professionals are often ill-equipped to address the important environmental and socioeconomic drivers of the current obesity epidemic. Finally, understanding the epigenetic and genetic factors as well as metabolic pathways that take advantage of 'omics' technologies could play a very relevant part in combating obesity within a precision approach.

摘要

肥胖症中过多的脂肪沉积有多种病因,但通常被认为是能量摄入与消耗失衡的结果。尽管有专门的公共卫生政策和个人治疗措施来对抗肥胖症流行,但全世界仍有超过 20 亿人超重或肥胖。中枢神经系统回路、燃料周转率和代谢以及脂肪组织的动态平衡对于理解体重过度增加和相关合并症很重要。肥胖症对生活质量有深远的影响,即使是在看似健康的个体中也是如此。饮食、身体活动或运动以及生活方式的改变是肥胖症治疗的基石,但药物治疗和减重手术也变得越来越重要。家族史、食物环境、文化偏好、对食物的不良反应、围产期营养、既往或当前疾病以及身体活动模式,都是医疗保健专业人员在治疗肥胖症患者时需要考虑的相关方面。临床医生和其他医疗保健专业人员在解决当前肥胖症流行的重要环境和社会经济驱动因素方面往往力不从心。最后,利用“组学”技术理解表观遗传和遗传因素以及代谢途径,可能在精准医学方法中对抗肥胖症方面发挥非常重要的作用。

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