Bray G A
Int J Obes. 1978;2(2):99-112.
The definition and risks of obesity have been reviewed and a nomogram provided for reference. Organization of information about the syndromes of obesity has been approached from several points of view. An anatomic classification has been developed, in which generalized and localized forms of fat accumulation can be separated. Hypercellularity of the adipose tissue in the childhood-onset forms of obesity is usually, but not always, present. Etiologic mechanisms are also useful in classifying obesity. This nosologic approach has been derived largely from experimental studies but has contributed significantly to understanding of pathogenetic mechanisms in man. Hypothalamic obesity is now thought to result from augmented secretion of insulin. The recessively inherited forms of obesity, on the other hand, appear to result from loss of a thermogenic system involving the ouabain-suppressible thyroid-induced (Na+ + K+) -ATPase which, in turn, accounts for the myriad of defects in these animals. Techniques of cybernetic engineering provide a third approach to classification of the syndromes of obesity. The control of body fat was analyzed as an analogy to the control of temperature in a building. These various approaches, and the new insights which they have provided for understanding the syndromes of obesity, promise to provide new pathways for pharmacologic intervention in the treatment of this problem.
肥胖的定义和风险已被综述，并提供了一个列线图以供参考。肥胖综合征信息的组织已从多个角度进行探讨。已制定了一种解剖学分类方法，可将脂肪堆积的全身性和局部性形式区分开来。儿童期起病型肥胖中脂肪组织的细胞增多通常存在，但并非总是如此。病因机制在肥胖分类中也很有用。这种疾病分类方法很大程度上源自实验研究，但对理解人类发病机制有显著贡献。现在认为下丘脑性肥胖是由胰岛素分泌增加所致。另一方面，隐性遗传型肥胖似乎是由于涉及哇巴因可抑制的甲状腺诱导的（钠 + 钾）-ATP酶的产热系统丧失所致，这反过来又解释了这些动物中众多的缺陷。控制论工程技术为肥胖综合征的分类提供了第三种方法。将身体脂肪的控制作为与建筑物温度控制的类比进行了分析。这些不同的方法以及它们为理解肥胖综合征提供的新见解，有望为治疗这一问题的药物干预提供新途径。
