Fried S K, Kral J G
Department of Surgery, College of Physicians and Surgeons of Columbia University, St. Luke's-Roosevelt Hospital Center, New York, New York.
Gastroenterol Clin North Am. 1987 Jun;16(2):207-13.
As a consequence of their increased total adipose tissue mass, morbidly obese patients have many more fat cells than individuals of normal weight and the cells are enlarged compared to normal. Contrary to earlier beliefs, fat cell numbers can increase throughout adult life. Once formed, fat cells do not undergo involution. Thus, it seems that an individual who has reached the morbidly obese state maintains an increased amount of body fat that limits his/her ability to achieve and maintain commonly accepted levels of "ideal" body weight. Recently the distribution of adipose tissue has been shown to be an important predictor of obesity-associated morbidity and mortality in large population studies. A "male" or central distribution of fat is a significant risk factor for the development of diabetes, hyperlipidemia, hypertension, and coronary heart disease. Sex- and site-specific variations in the distribution of adipose tissue cell size and metabolic activity have been demonstrated that may be of etiologic importance for the development of serious comorbid conditions in obesity.
由于病态肥胖患者的总脂肪组织量增加，他们的脂肪细胞比正常体重的个体多得多，而且与正常细胞相比，这些细胞体积增大。与早期观点相反，脂肪细胞数量在成年期也会增加。一旦形成，脂肪细胞不会退化。因此，似乎达到病态肥胖状态的个体维持着增加的体脂量，这限制了他/她达到并维持普遍认可的“理想”体重水平的能力。最近，在大规模人群研究中，脂肪组织的分布已被证明是肥胖相关发病率和死亡率的重要预测指标。脂肪呈“男性型”或中心性分布是糖尿病、高脂血症、高血压和冠心病发生的重要危险因素。脂肪组织细胞大小和代谢活性的分布存在性别和部位特异性差异，这可能对肥胖患者严重合并症的发生具有病因学意义。
