Department of Pharmacology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Center for Advanced Research and Development in Experimental Medicine (CEMEX), "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Medicina (Kaunas). 2023 Jun 9;59(6):1119. doi: 10.3390/medicina59061119.
Alarming statistics show that the number of people affected by excessive weight has surpassed 2 billion, representing approximately 30% of the world's population. The aim of this review is to provide a comprehensive overview of one of the most serious public health problems, considering that obesity requires an integrative approach that takes into account its complex etiology, including genetic, environmental, and lifestyle factors. Only an understanding of the connections between the many contributors to obesity and the synergy between treatment interventions can ensure satisfactory outcomes in reducing obesity. Mechanisms such as oxidative stress, chronic inflammation, and dysbiosis play a crucial role in the pathogenesis of obesity and its associated complications. Compounding factors such as the deleterious effects of stress, the novel challenge posed by the obesogenic digital (food) environment, and the stigma associated with obesity should not be overlooked. Preclinical research in animal models has been instrumental in elucidating these mechanisms, and translation into clinical practice has provided promising therapeutic options, including epigenetic approaches, pharmacotherapy, and bariatric surgery. However, more studies are necessary to discover new compounds that target key metabolic pathways, innovative ways to deliver the drugs, the optimal combinations of lifestyle interventions with allopathic treatments, and, last but not least, emerging biological markers for effective monitoring. With each passing day, the obesity crisis tightens its grip, threatening not only individual lives but also burdening healthcare systems and societies at large. It is high time we took action as we confront the urgent imperative to address this escalating global health challenge head-on.
令人震惊的统计数据表明,超重人口已超过 20 亿,约占世界人口的 30%。本综述旨在全面探讨这一严重的公共卫生问题之一,因为肥胖需要一种综合方法,考虑到其复杂的病因,包括遗传、环境和生活方式因素。只有了解肥胖的许多促成因素之间的联系以及治疗干预措施之间的协同作用,才能确保在减少肥胖方面取得令人满意的结果。氧化应激、慢性炎症和菌群失调等机制在肥胖症的发病机制及其相关并发症中起着至关重要的作用。应注意一些复合因素,如压力的有害影响、肥胖相关数字(食品)环境带来的新挑战以及肥胖带来的耻辱感。动物模型中的临床前研究对于阐明这些机制非常重要,并且已经将其转化为临床实践,提供了有前途的治疗选择,包括表观遗传方法、药物治疗和减肥手术。然而,还需要更多的研究来发现针对关键代谢途径的新化合物、创新的药物输送方法、生活方式干预与传统治疗的最佳组合,以及最后但同样重要的是,有效的监测新兴生物标志物。随着时间的推移,肥胖危机越来越严重,不仅威胁到个人的生命,还加重了医疗保健系统和整个社会的负担。我们现在应该采取行动,直面这一日益严重的全球健康挑战。