Miller Gary D
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina.
Am J Lifestyle Med. 2017 Jun 23;13(6):586-601. doi: 10.1177/1559827617716376. eCollection 2019 Nov-Dec.
Understanding body weight regulation will aid in the development of new strategies to combat obesity. This review examines energy homeostasis and food intake behaviors, specifically with regards to hormones, peptides, and neurotransmitters in the periphery and central nervous system, and their potential role in obesity. Dysfunction in feeding signals by the brain is a factor in obesity. The hypothalamic (arcuate nucleus) and brainstem (nucleus tractus solitaris) areas integrate behavioral, endocrine, and autonomic responses via afferent and efferent pathways from and to the brainstem and peripheral organs. Neurons present in the arcuate nucleus express pro-opiomelanocortin, Neuropeptide Y, and Agouti Related Peptide, with the former involved in lowering food intake, and the latter two acutely increasing feeding behaviors. Action of peripheral hormones from the gut, pancreas, adipose, and liver are also involved in energy homeostasis. Vagal afferent neurons are also important in regulating energy homeostasis. Peripheral signals respond to the level of stored and currently available fuel. By studying their actions, new agents maybe developed that disable orexigenic responses and enhance anorexigenic signals. Although there are relatively few medications currently available for obesity treatment, a number of agents are in development that work through these pathways.
了解体重调节将有助于开发对抗肥胖的新策略。本综述探讨能量稳态和食物摄入行为，特别是关于外周和中枢神经系统中的激素、肽和神经递质，以及它们在肥胖中的潜在作用。大脑中进食信号的功能障碍是肥胖的一个因素。下丘脑（弓状核）和脑干（孤束核）区域通过来自脑干和外周器官的传入和传出通路整合行为、内分泌和自主反应。弓状核中的神经元表达促黑素细胞皮质激素原、神经肽Y和刺鼠相关肽，前者参与降低食物摄入量，后两者则会急剧增加进食行为。来自肠道、胰腺、脂肪和肝脏的外周激素的作用也参与能量稳态。迷走神经传入神经元在调节能量稳态中也很重要。外周信号对储存的和当前可用的燃料水平做出反应。通过研究它们的作用，可能会开发出能够抑制促食欲反应并增强抑食欲信号的新药物。尽管目前可用于肥胖治疗的药物相对较少，但有许多药物正在通过这些途径进行研发。
