Kumar A, Mittal S, Buckshee K, Farooq A
Department of Physiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Prog Food Nutr Sci. 1993 Apr-Jun;17(2):89-98.
The prevalence of obesity is increasing in the developed as well as underdeveloped countries. Obesity in women is associated with reproductive disorders. The levels of estrone and androgens are higher in obese women along with a reduction in the levels of sex hormone binding globulin ( SHBG ). The pituitary secretion of hormones is altered either due to a deficient peripheral feedback regulation or a concomitant central defect in the obese. Luteinizing hormone ( LH ) level may increase in some of the obese subjects. The secretion of LH in response to luteinizing hormone releasing hormone ( LHRH or GnRH ), clonidine and naloxone may be altered in obese women. The levels of circulating prolactin may fall along with a delay in the nocturnal surge of the hormone. The secretion of prolactin in response to thyrotropin releasing hormone ( TRH ), insulin-induced hypoglycemia, arginine and chlorpromazine is altered. Similarly growth hormone secretion in response to growth hormone releasing hormone ( GHRH ), clonidine, naloxone and arginine is also altered in obesity. The literature suggests an alteration in the autonomic nervous system activity and the metabolism of carbohydrates and fats in the obese. Steroid hormones could affect the distribution of fat in the various regions of the body, and the distribution of body fat is linked with the severity of hyperandrogenism and metabolic disorders in obese subjects. However, it is heartening to note that many of the endocrinological and reproductive disorders are reversible with weight reduction in the obese subjects.
肥胖症在发达国家和不发达国家的患病率都在上升。女性肥胖与生殖紊乱有关。肥胖女性体内雌酮和雄激素水平较高，同时性激素结合球蛋白（SHBG）水平降低。肥胖者垂体激素分泌的改变，要么是由于外周反馈调节不足，要么是由于同时存在的中枢缺陷。在一些肥胖受试者中，促黄体生成素（LH）水平可能会升高。肥胖女性对促黄体生成素释放激素（LHRH或GnRH）、可乐定和纳洛酮的反应中，LH的分泌可能会发生改变。循环催乳素水平可能会下降，同时该激素的夜间高峰出现延迟。催乳素对促甲状腺激素释放激素（TRH）、胰岛素诱导的低血糖、精氨酸和氯丙嗪的反应分泌也会改变。同样，肥胖时生长激素对生长激素释放激素（GHRH）、可乐定、纳洛酮和精氨酸的反应分泌也会改变。文献表明肥胖者自主神经系统活动以及碳水化合物和脂肪代谢存在改变。类固醇激素可能会影响身体各部位脂肪的分布，而身体脂肪的分布与肥胖受试者高雄激素血症和代谢紊乱的严重程度有关。然而，值得欣慰的是，许多内分泌和生殖紊乱在肥胖受试者体重减轻后是可逆的。
