Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 4212 North 16th Street, Phoenix, AZ, 85016, USA.
Endocrinology Unit, Obesity Research Center, University Hospital of Pisa, Pisa, Italy.
J Endocrinol Invest. 2018 Jan;41(1):83-89. doi: 10.1007/s40618-017-0732-9. Epub 2017 Jul 24.
The pathogenesis of human obesity is the result of dysregulation of the reciprocal relationship between food intake and energy expenditure (EE), which influences daily energy balance and ultimately leads to weight gain. According to principles of energy homeostasis, a relatively lower EE in a setting of energy balance may lead to weight gain; however, results from different study groups are contradictory and indicate a complex interaction between EE and food intake which may differentially influence weight change in humans. Recently, studies evaluating the adaptive response of one component to perturbations of the other component of energy balance have revealed both the existence of differing metabolic phenotypes ("spendthrift" and "thrifty") resulting from overeating or underfeeding, as well as energy-sensing mechanisms linking EE to food intake, which might explain the propensity of an individual to weight gain. The purpose of this review is to debate the role that human EE plays on body weight regulation and to discuss the physiologic mechanisms linking EE and food intake. An increased understanding of the complex interplay between human metabolism and food consumption may provide insight into pathophysiologic mechanisms underlying weight gain, which may eventually lead to prevention and better treatment of human obesity.
人体肥胖的发病机制是食物摄入和能量消耗（EE）之间的相互关系失调的结果，这种关系会影响日常能量平衡，最终导致体重增加。根据能量平衡的原则，在能量平衡的情况下相对较低的 EE 可能导致体重增加；然而，来自不同研究组的结果相互矛盾，并表明 EE 和食物摄入之间存在复杂的相互作用，这可能会对人体的体重变化产生不同的影响。最近，评估能量平衡的一个组成部分对另一个组成部分的适应性反应的研究揭示了由于过量进食或进食不足而导致的不同代谢表型（“挥霍型”和“节俭型”）的存在，以及将 EE 与食物摄入联系起来的能量感应机制，这可能解释了个体体重增加的倾向。本综述的目的是讨论人类 EE 在体重调节中的作用，并讨论将 EE 和食物摄入联系起来的生理机制。增加对人类代谢和食物消耗之间复杂相互作用的理解可能会深入了解体重增加的病理生理机制，这最终可能会导致人类肥胖的预防和更好的治疗。
