Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Adv Nutr. 2021 Oct 1;12(5):2023-2034. doi: 10.1093/advances/nmab040.
Obesity is routinely considered as a single disease state, which drives a "one-size-fits-all" approach to treatment. We recently convened the first annual University of North Carolina Interdisciplinary Nutrition Sciences Symposium to discuss the heterogeneity of obesity and the need for translational science to advance understanding of this heterogeneity. The symposium aimed to advance scientific rigor in translational studies from animal to human models with the goal of identifying underlying mechanisms and treatments. In this review, we discuss fundamental gaps in knowledge of the heterogeneity of obesity ranging from cellular to population perspectives. We also advocate approaches to overcoming limitations in the field. Examples include the use of contemporary mouse genetic reference population models such as the Collaborative Cross and Diversity Outbred mice that effectively model human genetic diversity and the use of translational models that integrate -omics and computational approaches from pre-clinical to clinical models of obesity. Finally, we suggest best scientific practices to ensure strong rigor that will allow investigators to delineate the sources of heterogeneity in the population with obesity. Collectively, we propose that it is critical to think of obesity as a heterogeneous disease with complex mechanisms and etiologies, requiring unique prevention and treatment strategies tailored to the individual.
肥胖通常被视为一种单一的疾病状态,这导致了一种“一刀切”的治疗方法。我们最近召开了第一届北卡罗来纳大学跨学科营养科学研讨会,讨论肥胖的异质性以及推进对这种异质性的理解需要转化科学。该研讨会旨在提高从动物模型到人类模型的转化研究的科学严谨性,目标是确定潜在的机制和治疗方法。在这篇综述中,我们从细胞到人群的角度讨论了肥胖异质性的基本知识差距。我们还提倡克服该领域局限性的方法。例如,使用当代的小鼠遗传参考群体模型(如合作交叉和多样性杂交小鼠),这些模型可以有效地模拟人类遗传多样性,以及使用整合了从肥胖的临床前模型到临床模型的组学和计算方法的转化模型。最后,我们提出了确保严谨性的最佳科学实践,以便研究人员能够描绘出肥胖人群中异质性的来源。总的来说,我们认为肥胖是一种具有复杂机制和病因的异质性疾病,需要针对个体制定独特的预防和治疗策略。