PDF(Pubmed)
Abstract：
Obesity remains a common metabolic disorder and a threat to health as it is associated with numerous complications. Lifestyle modifications and caloric restriction can achieve limited weight loss. Bariatric surgery is an effective way of achieving substantial weight loss as well as glycemic control secondary to weight-related type 2 diabetes mellitus. It has been suggested that an anorexigenic gut hormone response following bariatric surgery contributes to weight loss. Understanding the changes in gut hormones and their contribution to weight loss physiology can lead to new therapeutic treatments for weight loss. Two distinct types of neurons in the arcuate hypothalamic nuclei control food intake: proopiomelanocortin neurons activated by the anorexigenic (satiety) hormones and neurons activated by the orexigenic peptides that release neuropeptide Y and agouti-related peptide (hunger centre). The arcuate nucleus of the hypothalamus integrates hormonal inputs from the gut and adipose tissue (the anorexigenic hormones cholecystokinin, polypeptide YY, glucagon-like peptide-1, oxyntomodulin, leptin, and others) and orexigeneic peptides (ghrelin). Replicating the endocrine response to bariatric surgery through pharmacological mimicry holds promise for medical treatment. Obesity has genetic and environmental factors. New advances in genetic testing have identified both monogenic and polygenic obesity-related genes. Understanding the function of genes contributing to obesity will increase insights into the biology of obesity. This review includes the physiology of appetite control, the influence of genetics on obesity, and the changes that occur following bariatric surgery. This has the potential to lead to the development of more subtle, individualised, treatments for obesity.
摘要：
肥胖仍然是一种常见的代谢紊乱和对健康的威胁，因为它与许多并发症有关。生活方式的改变和热量限制可以实现有限的体重减轻。减重手术是实现体重相关的2型糖尿病继发的实质性体重减轻以及血糖控制的有效方法。有人提出，减肥手术后的厌食性肠激素反应有助于体重减轻。了解肠道激素的变化及其对减肥生理的贡献可以为减肥带来新的治疗方法。弓状下丘脑核中的两种不同类型的神经元控制食物的摄入：由厌食（饱腹感）激素激活的前黑皮素神经元和由释放神经肽Y和与刺鼠相关的肽（饥饿中心）的食欲肽激活的神经元。下丘脑的弓状核整合了来自肠道和脂肪组织的激素输入（厌食激素胆囊收缩素，多肽YY,胰高血糖素样肽-1，胃泌酸调节素，瘦素,和其他）和食欲肽（ghrelin）。通过药理学模仿复制对减肥手术的内分泌反应为医学治疗带来了希望。肥胖有遗传和环境因素。基因检测的新进展已经确定了单基因和多基因肥胖相关基因。了解导致肥胖的基因的功能将增加对肥胖生物学的认识。这篇综述包括食欲控制的生理学，遗传学对肥胖的影响，以及减肥手术后发生的变化。这有可能导致更微妙的发展，个性化,治疗肥胖。
