Department of Metabolic Neurology (CH, SPM, HB, AJS), Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Birmingham Neuro-Ophthalmology Unit (SPM, AJS), Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Centre for Endocrinology, Diabetes and Metabolism (HB, MWOR, AJS), Birmingham Health Partners, United Kingdom; and Department of Neurology (AJS), University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
J Neuroophthalmol. 2018 Dec;38(4):522-530. doi: 10.1097/WNO.0000000000000684.
Traditional risk factors associated with idiopathic intracranial hypertension (IIH) include obesity, weight gain, and female sex. The incidence of IIH is increasing and yet the underlying trigger and the fueling pathological mechanisms are still poorly understood.
Review of ophthalmology, neurology, general surgery, obesity, endocrinology, nutrition, and neurosurgery literature was made.
The facts that implicate sex and obesity in IIH and headache are examined. The role of fat distribution in IIH is questioned, and the concept of adipose tissue functioning as an endocrine organ driving IIH is discussed. The impact of androgen metabolism in IIH is reviewed as is the emerging role of glucagon-like-peptide-1 analogues in modulating intracranial pressure. This introduces the concept of developing targeted disease-modifying therapeutic strategies for IIH.
This review will discuss the possible role of the adipose/gut/brain metabolism axis in IIH and speculate how this may impact the pathogenesis of IIH and therapeutic opportunities.
与特发性颅内高压（IIH）相关的传统危险因素包括肥胖、体重增加和女性。IIH 的发病率正在增加，但潜在的触发因素和促进病理机制仍知之甚少。
对眼科、神经科、普通外科、肥胖、内分泌学、营养学和神经外科文献进行了回顾。
检查了性别和肥胖与 IIH 和头痛的关系。质疑了脂肪分布在 IIH 中的作用，并讨论了脂肪组织作为驱动 IIH 的内分泌器官的概念。审查了雄激素代谢在 IIH 中的作用，以及胰高血糖素样肽-1 类似物在调节颅内压方面的新作用。这引入了为 IIH 开发靶向疾病修正治疗策略的概念。
本综述将讨论脂肪/肠道/大脑代谢轴在 IIH 中的可能作用，并推测这可能如何影响 IIH 的发病机制和治疗机会。
