Zdrojewicz Zygmunt, Popowicz Ewa, Szyca Marta, Michalik Tomasz, Śmieszniak Bartłomiej
Department and Clinic of Endocrinology, Diabetology and Isotope Therapy, Wroclaw Medical University.
Medical Faculty University of Wroclaw.
Pediatr Endocrinol Diabetes Metab. 2017;23(2):96-100. doi: 10.18544/PEDM-23.02.0079.
Recent studies have reported a significant increase in the incidence of type 2 diabetes in the past 30 years. They also predict that this trend will continue. This is related to a change in lifestyle, which results in a parallel increase in the incidence of overweight and obesity. However, symptoms of the metabolic syndrome, so far closely related to abdominal obesity, are relatively common among people with normal body mass index (BMI) and waist circumference. The aim of the study is to present the TOFI phenotype (thin outside, fat inside) as an important factor in pathogenesis of type 2 diabetes. In the 1980s, the first study of the MONW (metabolic obese normal weight), a phenotype that is characterized by metabolic diseases in people with normal body weight. Since then, no uniform criteria have been established for MONW deployment, which has created difficulties in identifying affected individuals. Recent work has appeared describing the TOFI phenotype, which seems to lead to the appearance of MONW. People affected by this problem, in spite of undersized fatty tissue, have an increased amount of adipose tissue surrounding the internal organs, which increases the risk of insulin resistance and type 2 diabetes. In the diagnostics of the TOFI phenotype, magnetic resonance imaging is of paramount importance. Previous studies did not provide clear answers about the pathogenesis of TOFI nor which factors stimulate its development. Prophylaxis and treatment of the syndrome include increased physical activity, the promotion of correct eating habits, and a use of metformin.
最近的研究报告称，在过去30年里2型糖尿病的发病率显著上升。他们还预测这一趋势将持续下去。这与生活方式的改变有关，生活方式的改变导致超重和肥胖的发病率同时上升。然而，代谢综合征的症状，迄今为止与腹部肥胖密切相关，在体重指数（BMI）和腰围正常的人群中相对常见。本研究的目的是提出“外瘦内胖”（TOFI）表型作为2型糖尿病发病机制中的一个重要因素。在20世纪80年代，首次对“代谢性肥胖正常体重”（MONW）进行研究，该表型的特征是体重正常的人患有代谢疾病。从那时起，尚未建立统一的MONW诊断标准，这给识别受影响个体带来了困难。最近有研究描述了TOFI表型，它似乎导致了MONW的出现。受此问题影响的人，尽管脂肪组织量不足，但内脏周围的脂肪组织量增加，这增加了胰岛素抵抗和2型糖尿病的风险。在TOFI表型的诊断中，磁共振成像至关重要。先前的研究没有就TOFI的发病机制以及哪些因素刺激其发展给出明确答案。该综合征的预防和治疗包括增加体育活动、推广正确的饮食习惯以及使用二甲双胍。
