益生菌，益生元对肥胖的治疗及其机制的研究进展

肥胖是继心脑血管疾病和癌症之后威胁全人类健康第三大疾病,全球有40%的成年人面临肥胖和超重困扰。中国肥胖人数成人已达到世界第二,儿童达到了世界第一,并且儿童期肥胖极大可能发展为成年期肥胖。研究表明肠道微生物可能是众多导致代谢紊乱的因素之一,这些紊乱会导致肥胖、β细胞功能紊乱、代谢内毒素血症、全身炎症和氧化应激。近年来,应用微生态制剂（益生菌和益生元）治疗肥胖已成为研究热点,本文主要围绕肥胖人群肠道菌群特点以及益生菌、益生元对肥胖的干预作用进行综述,以期为以后相关研究提供参考。     

基于成纤维细胞生长因子1的药物治疗肥胖相关并发症

目前,超重和肥胖的发生率已在全球范围内达到流行病的程度,这对慢性代谢性疾病预防和控制造成了巨大挑战。肥胖是包括2型糖尿病、非酒精性脂肪性肝病、心血管病、神经退行性疾病、睡眠呼吸暂停和某些类型的癌症等在内的一系列代谢疾病的主要危险因素。然而,治疗肥胖及其相关并发症的药物选择仍然有限,大多数抗肥胖药物因严重不良反应而退出市场,迫切需要开发有效的长期治疗方法来应对肥胖相关并发症。成纤维细胞生长因子1（fibroblast growth factor 1,FGF1）是全身能量稳态、糖脂代谢和胰岛素敏感性的重要调节因子。FGF1对于肥胖及2型糖尿病、非酒精性脂肪性肝病、癌症、心脏病等肥胖相关并发症具有一定的治疗益处,但长期使用导致的肿瘤发生风险增加限制了其应用。本综述总结了基于FGF1治疗肥胖相关并发症的生物药物开发的最新进展,强调了临床实施中的主要挑战,并讨论了克服这些障碍的可能策略。     

肥胖孕妇肠道菌群与子代肥胖的相关性

妊娠期肥胖发生率在世界范围内呈上升趋势,成为影响人类健康的公共卫生问题。肥胖母亲肠道菌群失调导致婴儿早期定植菌群异常,而婴儿早期菌群定植情况与其日后生长发育密切相关,容易导致成年后出现肥胖、胰岛素抵抗、代谢综合征等疾病。因此针对肥胖孕妇肠道菌群分析,以及婴儿肠道菌群及生长发育的分析,对于孕妇孕期管理、健康宣教提高国民整体身体素质具有重要意义。     

脂肪组织中巨噬细胞在肥胖过程中的作用及其调控机制

肥胖是一个全球性的健康问题，世界上三分之一的成年人口出现超重或肥胖现象，儿童肥胖的比例也在逐年上升。超重或肥胖会增加患严重慢性疾病的风险，例如II型糖尿病、高血压、心血管疾病和哮喘等。越来越多的证据表明，慢性炎症是肥胖的一个重要特征，持续性炎症可以导致肥胖和肥胖相关的代谢疾病。因此，肥胖现在被认为是一种与代谢紊乱相关的低度慢性炎症疾病。了解脂肪组织中免疫细胞与脂肪沉积的关系可能对开发肥胖及相关代谢疾病的治疗策略具有重要意义。巨噬细胞是脂肪组织中含量最多的免疫细胞，在炎症的诱导和消退方面发挥重要作用。本文概述了脂肪组织中巨噬细胞在肥胖过程中的响应，及巨噬细胞对脂肪细胞的调控机制进而影响肥胖的发生发展。在此基础上，总结出巨噬细胞参与肥胖调控的4条主要途径：(1)巨噬细胞通过分泌外泌体进入邻近脂肪细胞内，通过干扰PPARg或Nadk的表达，引起脂肪沉积的降低或增加；(2)巨噬细胞通过M1型和M2型之间的极化，引起脂肪沉积的变化；(3)巨噬细胞通过分泌调控因子引起脂肪组织中交感神经纤维变化，进而调控脂质沉积；(4)巨噬细胞通过捕获外源线粒体，来调控脂质沉积。巨噬细胞变化作为肥胖过程中关键事件，...     

肥胖诱发胰岛素抵抗的炎性机制

肥胖可诱发一系列慢性代谢性疾病,如2型糖尿病、血脂障碍、高血压和非酒精性脂肪肝等.这些疾病构成了当今世界人类健康的极大威胁.胰岛素抵抗是这些疾病的共有特征.胰岛素抵抗的发生与慢性低度系统炎性密切相关,涉及多条炎性信号通路的激活和胰岛素信号转导的缺陷.本文综述了肥胖、炎性与胰岛素抵抗之间的本质联系,以及肥胖诱发胰岛素抵抗的炎性机制,以期为肥胖相关疾病的防治提供重要参考.     

ROS在脂肪分化中的作用研究新进展

由于肥胖及肥胖相关疾病在全球范围内的广泛流行,明确脂肪组织如何生长非常重要。脂肪组织主要由脂肪细胞分化、脂肪细胞肥大以及脂解作用共同调节。脂肪细胞分化是由多能干细胞或前脂肪细胞分化形成脂肪细胞的一个复杂而又程序化的过程。脂肪细胞的分化过程被分为四个阶段,生长抑制阶段,克隆扩增阶段,早期分化阶段和分化为成熟脂肪细胞表型的终末阶段。来自国内外多个研究的大量数据表明,活性氧(Reactive oxygen species, ROS)可以显著调节脂肪分化的过程进而影响肥胖及相关疾病的发生发展。作为一类重要的高活性分子,ROS在细胞内具有多种来源,主要包括线粒体、NADPH氧化酶、黄嘌呤氧化还原酶、黄嘌呤氧化酶、一氧化氮合酶等。本文回顾近年来的一些文献,对ROS及其生成系统在脂肪细胞分化中的作用进行综述,以期从氧化还原调节的角度明确脂肪细胞分化以及肥胖形成的机制,为肥胖及相关疾病的治疗提供新思路。     

肥胖发病机制及其治疗靶点

人体摄入的食物提供的能量用来维持各种生理和体力活动的正常进行.在生理状态下,能量代谢保持动态平衡,即摄入能量=消耗能量+贮存能量.当由于某种原因打破这一平衡使能量的摄入大于消耗时,机体储能的主要器官--脂肪组织内脂肪(主要为甘油三酯)堆积,体重超过标准体重20％以上者,称为肥胖.随着社会经济的发展和人民生活水平的提高,全球范围内超重/肥胖率急剧增加.肥胖与高甘油三酯血症、高血压、糖尿病在发病机理上密切相关,这些慢性疾病相互影响并常在同一个体聚集存在,肥胖引起的这种交互紊乱更是诱发和加重心脑血管疾病的重要危险因素.因此,研究和分析与肥胖相关的因素及相互关系,有助于肥胖的预防和治疗.     

嗜粘蛋白阿克曼菌在糖尿病和肥胖中的作用

肠道微生物在平衡健康与疾病的过程中起着重要作用。嗜粘蛋白阿克曼菌(Akkermansia muciniphila)是肠道微生物中的一种,其在降解肠道粘蛋白方面的特性使其成为肠腔与宿主细胞黏膜界面的关键生物。嗜粘蛋白阿克曼菌与肥胖、糖尿病、心血管代谢疾病和低度炎症呈负相关。口服嗜粘蛋白阿克曼菌可改善小鼠代谢疾病的相关症状,嗜粘蛋白阿克曼菌有望成为治疗2型糖尿病和肥胖的候选药物。本综述通过总结现有关于嗜粘蛋白阿克曼菌在糖尿病和肥胖症中发挥作用的研究,指出嗜粘蛋白阿克曼菌调节宿主和肠道微生物群之间相互作用可能存在的机制,为嗜粘蛋白阿克曼菌的进一步研究和糖尿病的新药研发提供思路。     

科学营养与运动健身对超重与肥胖的干预

国内外有关肥胖症的相关研究大多都停留在对肥胖症状(单纯性肥胖)产生机制以及肥胖运动治疗的影响因素等研究上。本文综述超重与肥胖的营养干预及运动治疗研究进展,旨在为大众提供一个科学的、合理的、可供参考的、可操作性的营养膳食搭配以及运动减肥负荷量的参考处方。     

特定人群超重及肥胖与相关疾病患病分析

目的:分析特定人群超重患病率,以及超重与高血压、糖尿病、血脂异常、脂肪肝等相关疾病的关系,为及早预防慢性非传染性疾病奠定基础。方法:对平房地区采取长效避孕措施的603名户籍农村已婚育龄妇女进行健康体检,按体重指数(BMI)分为正常组、超重组和肥胖组,比较各组间高血压、高血糖、高血脂、脂肪肝等相关疾病检出率的差异。结果:特定人群超重发病率及超重相关疾病检出率的差异均具有统计学意义(P<0.01)。结论:平房地区特定人群超重及肥胖发病率未明显高于国内平均水平及全市水平。但超重及肥胖与高血压、糖尿病、血脂异常、脂肪肝等疾病存在较大相关关系,为了进一步降低心脑血管高危因素和死亡率,需采取早期、有效的措施控制超重和肥胖倾向。     

Impact of weight loss predictors in severe-morbid obesity patients in the Saudi population

Universally, obesity has been affected more than 650 million and converts as global health problem. Obesity is equally affecting starting from children to elder population. Obese subjects are converting into severe obese and then into morbid obesity. Body mass index is proning from 30 to 50 kg/m² in the adult population. Obesity is connected with the future complications of hypertension, type 2 diabetes mellitus, cardiovascular, stroke, osteoarthritis, obstructive sleep apnea and liver diseases. Loosing of body fat is the only option to avoid obesity and this could be achieved with routine physical activity and diet modifications. Obesity subjects may fail to achieve the daily routine activities or insufficient activity may be involved and finally fail to lose the body fat after the medical course. Then these severe or morbidity obese can be lose with the existing surgery. Currently, Bariatric Surgery (BS) has become the active treatment for long-term weight loss. Various types (Roux-en-Y gastric bypass, sleeve gastrectomy and duodenal switch and the jejunoileal bypass) of BS are performed on the gastrointestinal tract. Throughout the world population, BS has found to be safe in losing the weight and avoiding the future and long-term complications. The prevalence of overweight and obesity in Saudi Arabia is an issue in terms of incidence and health consequences. Maximum obesity studies involved in Saudi Arabia has proven to be develop the long-term complications in the future involving from child to morbid obesity. Limited bariatric studies carried out in the Saudi subjects confirmed as effective tool in lowering the body fat and avoiding the life-threatened complications of human diseases. So, this review recommends BS as effective and safe surgical treatment to lose body fat in the Saudi population. However, post-operative monitoring is mandatory to follow-up.     

Dealing With Obesity as a Chronic Disease

There are major efforts underway to educate the primary care physician about the health risks of obesity. Obesity is a chronic disease that requires chronic management. We must establish models that allow primary care physicians to participate in the chronic management of obesity, while recognizing that the interest and ability of primary care physicians to participate in obesity management will vary. Three general models of obesity management are proposed for the primary care physician, ranging from minimal evaluation to complete evaluation and treatment. In order for the models to be implemented, we must consider establishing a category of obesity specialists who can develop comprehensive treatment programs to which patients with obesity can be referred, and who can provide leadership and guidance for primary care physicians who are involved in obesity management. The North American Association for the Study of Obesity (NAASO) could help establish obesity specialists and provide a structure to allow them to provide leadership for obesity treatment.     

A Temperature Hypothesis of Hypothalamus-Driven Obesity

Obesity is a metabolic state in which excess fat is accumulated in peripheral tissues, including the white adipose tissue, muscle, and liver. Sustained obesity has profound consequences on one’s life, which can span from superficial psychological symptoms to serious co-morbidities that may dramatically diminish both the quality and length of life. Obesity and related metabolic disorders account for the largest financial burden on the health care system. Together, these issues make it imperative that obesity be cured or prevented. Despite the increasing wealth of knowledge on the etiology of obesity (see below), there is no successful medical strategy that is available for the vast majority of patients. We suggest that brain temperature control may be a crucial component in obesity development and that shortcutting the brain metabolic centers by hypothalamic temperature alterations in a non-invasive remote manner will provide a revolutionary approach to the treatment of obesity.     

Obesity in Europe

Obesity, defined as a body mass index > 30 kg/m² is relatively common in Europe, particularly among women, and especially in Southern and Eastern European countries. Among men the distribution of body mass index values is surprisingly similar in most countries of Europe. Educational level is strongly inversely associated with the prevalence of obesity. Although differences in body mass index cannot entirely explain the large variation in risk factors and mortality from coronary heart disease, it can be shown that within populations an increased body mass index is associated with less favorable risk patterns. More research is needed to elucidate the reasons for the large variation in the prevalence of obesity among European women and to the health risks associated with obesity in different European countries.     

Molecular basis of obesity: current status and future prospects

Obesity is a global health problem that is gradually affecting each continent of the world. Obesity is a heterogeneous disorder, and the biological causes of obesity are complex. The rapid increase in obesity prevalence during the past few decades is due to major societal changes (sedentary lifestyle, over-nutrition) but who becomes obese at the individual level is determined to a great extent by genetic susceptibility. In this review, we evidence that obesity is a strongly heritable disorder, and provide an update on the molecular basis of obesity. To date, nine loci have been involved in Mendelian forms of obesity and 58 loci contribute to polygenic obesity, and rare and common structural variants have been reliably associated with obesity. Most of the obesity genes remain to be discovered, but promising technologies, methodologies and the use of "deep phenotyping" lead to optimism to chip away at the 'missing heritability' of obesity in the near future. In the longer term, the genetic dissection of obesity will help to characterize disease mechanisms, provide new targets for drug design, and lead to an early diagnosis, treatment, and prevention of obesity.     

Obesity in Older Adults: Technical Review and Position Statement of the American Society for Nutrition and NAASO,The Obesity Society

Obesity causes serious medical complications and impairs quality of life. Moreover, in older persons, obesity can exacerbate the age‐related decline in physical function and lead to frailty. However, appropriate treatment for obesity in older persons is controversial because of the reduction in relative health risks associated with increasing body mass index and the concern that weight loss could have potential harmful effects in the older population. This joint position statement from the American Society for Nutrition and NAASO, The Obesity Society reviews the clinical issues related to obesity in older persons and provides health professionals with appropriate weight‐management guidelines for obese older patients. The current data show that weight‐loss therapy improves physical function, quality of life, and the medical complications associated with obesity in older persons. Therefore, weight‐loss therapy that minimizes muscle and bone losses is recommended for older persons who are obese and who have functional impairments or medical complications that can benefit from weight loss.     

The Case for Medical Management of Obesity: A Call for Increased Physician Involvement

The United States is in the midst of an escalating epidemic of obesity. Over one-third of the adult population in the United States is currently obese and the prevalence of obesity is growing rapidly. By any criteria, obesity represents a chronic disease which is associated with a wide range of comorbidities, including coronary heart disease (CHD), Type 2 diabetes, hypertension and dyslipidemias. The comorbidities of obesity are common, occurring in over 70% of individuals with a BMI of ≥ 27. In addition to obesity itself, excessive accumulation of visceral abdominal fat and significant adult weight gain also represent health risks. Physicians have an important role to play in the treatment of obesity. Unfortunately, the medical community has not been involved actively enough to help stem the major epidemic of obesity occurring in the United States. This article puts forth a proposed model for the treatment of obesity in clinical practice, including obtaining the “vital signs” of obesity, recommending lifestyle measures, and instituting pharmacologic therapy when appropriate. By utilizing a chronic disease treatment model, physicians can join other health care professionals to effectively treat the chronic disease of obesity. Relatively modest weight loss, on the order of 510% of initial body weight can result in significant health improvements for many patients and represent an achievable goal for most obese patients.     

来源于中药和功能性食品的脂肪酸合酶抑制剂（英文）

肥胖症及其相关疾病已成为迫切需要解决的公共卫生问题。脂肪酸合酶（fatty acid synthase,FAS）是一种多功能复合酶,对长链脂肪酸的生物合成发挥至关重要的作用,是治疗肥胖、2型糖尿病、癌症、炎症和心血管疾病等的潜在靶点。在过去的30年里,FAS抑制剂的研究受到越来越多的关注。在中国,传统中药和功能性食品广泛被应用于慢性疾病的预防和治疗,其中有多种天然产物对FAS的活性表现出很强的抑制作用。本文综述了来源于中药和功能性食品中的FAS抑制剂结构和活性特点,为天然来源的FAS抑制剂治疗肥胖症和相关疾病提供了依据。     

Prevalencia de obesidad y riesgo cardiovascular asociado en la población general de un área de salud de Extremadura. Estudio Hermex

Introduction and objectivesTo estimate the prevalence of obesity and its associated cardiovascular risk in the general population of a health area in Extremadura.Materials and methodsA cross-sectional study on a random population sample aged 25-79 years from the Don Benito-Villanueva (Badajoz) health area. Risk factors and cardiovascular disease were examined. Anthropometric and blood pressure measurements were collected, and a blood sample was taken. Obese subjects were categorized into different risk levels as proposed by the Spanish Society for the Study of Obesity, and the influence of obesity on estimation of the risk of ischemic heart disease was studied using the Framingham function, as adapted for Spain.ResultsA total of 2833 of the 3521 subjects screened (80.5%) participated in the study. Mean age was 51.2 years (SD 14.7), and 46.5% were males. Male subjects had a greater prevalence of overweight and obesity (46.2% and 37.7% respectively) as compared to females (37.7% and 32.6%) (p<0.005 and p<0.05 respectively). Only 10% of obese subjects had no increased cardiovascular risk. Obesity was associated to an 8-fold increase in the presence of a high risk for ischemic heart disease in females (p<0.001), as compared to a 1.4-fold increase in males (p=0.095).ConclusionsObesity is highly prevalent and affects, together with overweight, 74.1% of the population in an Extremadura health area. A vast majority of obese subjects have an increased cardiovascular risk, which is very marked for ischemic heart disease in females.     

线粒体质量控制与米色脂肪之间的关系

近年来,肥胖患病率不断上升,肥胖已成为全球性公共卫生问题.肥胖能够增加高血压、冠心病等心血管疾病的发病风险,防治肥胖已经成为亟待解决的社会问题.米色脂肪是一种产热型脂肪细胞,可在受到寒冷、药物、运动等外界刺激下由白色脂肪细胞转化而来,但其形态和功能却与白色脂肪细胞不同,而与棕色脂肪细胞类似,即米色脂肪同样含有丰富的线粒...