701
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Zafra MA, Molina F, Puerto A. Chemical afferent vagal axotomy blocks re-intake after partial withdrawal of gastric food contents. Nutr Neurosci 2016; 20:587-597. [DOI: 10.1080/1028415x.2016.1208970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- María A. Zafra
- Department of Psychobiology, University of Granada, Campus de Cartuja, Granada 18071, Spain
| | - Filomena Molina
- Department of Psychobiology, University of Granada, Campus de Cartuja, Granada 18071, Spain
| | - Amadeo Puerto
- Department of Psychobiology, University of Granada, Campus de Cartuja, Granada 18071, Spain
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702
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Abstract
As the most significant cause of death worldwide, obesity has become one of the world's most important public health problems, but approved anti-obesity drugs are extremely limited. This article summarizes the feeding control circuits and regulators involved in obesity development, highlight the hypothalamus, melanocortin system and brain-gut peptide actions in this process, and the five US FDA approved anti-obesity medications in long term use, namely phentermine/topiramate, lorcaserin, naltrexone/bupropion, liraglutide and orlistat.
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Affiliation(s)
- Yue Chen
- Pharmacy Department, PLA General Hospital
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703
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Abstract
Zusammenfassung
Adipositas und Typ 2 Diabetes werden heute gerne unter dem Namen „Diabesity“ zusammengefasst. Das trägt dem Umstand Rechnung, dass die Adipositas dem Diabetes häufig vorangeht und wohl der wichtigste Faktor in der Zunahme des Typ 2 Diabetes mellitus ist. Der Body-Mass-Index (BMI) ist nur ein sehr grobes Maß der Körperverfettung. Sogar Normalgewichtige können bei Muskelmangel zu viel Körperfett aufweisen (Sarkopenie), weswegen Messungen des Bauchumfanges und des Körperfettes empfohlen werden (z. B. BIA). Lebensstilmanagement mit Ernährung und Bewegung ist eine der wichtigsten Maßnahmen in der Diabetesprävention. In der Therapie des Typ 2 Diabetes hat das Gewicht als sekundärer Zielparameter zunehmend Bedeutung erlangt. Auch die Wahl der antidiabetischen Therapie, aber auch der Begleittherapien, nimmt immer mehr darauf Rücksicht. Welchen Stellenwert Antiadiposita selbst in der antidiabetischen Therapie erlangen werden, wird durch zukünftige Studien zu klären sein. Die bariatrische Chirurgie ist derzeit bei einem Typ 2 Diabetes mit BMI > 35 kg/m2 indiziert und kann zumindest teilweise zur Diabetes-Remission beitragen, sie muss aber in ein entsprechendes lebenslanges Betreuungskonzept eingebunden sein.
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704
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de Simone G, Mancusi C, Izzo R, Losi MA, Aldo Ferrara L. Obesity and hypertensive heart disease: focus on body composition and sex differences. Diabetol Metab Syndr 2016; 8:79. [PMID: 27956942 PMCID: PMC5129668 DOI: 10.1186/s13098-016-0193-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/22/2016] [Indexed: 12/15/2022] Open
Abstract
There is evidence that hypertension is frequently associated with overweight/obesity even in kids and adolescents. Either conditions influence development of left ventricular (LV) hypertrophy (LVH), through different biological and hemodynamic mechanisms: obesity is conventionally thought to elicit a coherent growth of LV chamber dimensions and myocardial wall thickness (eccentric LV geometry), whereas a more accentuated increase in wall-thickness (concentric LV geometry) is attributed to hypertension. While during youth these differences are visible, proportion of LV concentric geometry, the most harmful LV geometric pattern, sharply raises in obese individuals during middle age, and becomes the most frequent geometric patterns among obese-hypertensive individuals. Two conditions with elevated hemodynamic impact, severe obstructive sleep apnea and masked hypertension contribute to the development of such a geometric pattern, but non-hemodynamic factors, and specifically body composition, also influence prevalence of concentric LV geometry. Contrasting a general belief, it has been observed that adipose mass strongly influences LV mass, particularly in women, especially when fat-free mass is relatively deficient. Thus, though blood pressure control is mandatory for prevention and reduction of LVH in obese hypertensive patients, without reduction of visceral adiposity regression of LVH is difficult. Future researches should be addressed on (1) assessing whether LVH resulting from alteration of body composition carries the same prognosis as pressure overload LVH; (2) defining tissue characterization of the hypertrophic heart in obese-hypertensive patients; (3) evaluating whether assessment of hemodynamic loading conditions and biological markers can help defining management of the association of obesity with hypertension.
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Affiliation(s)
- Giovanni de Simone
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Costantino Mancusi
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Maria Angela Losi
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
- Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - L. Aldo Ferrara
- Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, Building 1, 80131 Naples, Italy
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705
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Lizcano F, Vargas D. Biology of Beige Adipocyte and Possible Therapy for Type 2 Diabetes and Obesity. Int J Endocrinol 2016; 2016:9542061. [PMID: 27528872 PMCID: PMC4977401 DOI: 10.1155/2016/9542061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/12/2016] [Accepted: 06/26/2016] [Indexed: 12/13/2022] Open
Abstract
All mammals own two main forms of fat. The classical white adipose tissue builds up energy in the form of triglycerides and is useful for preventing fatigue during periods of low caloric intake and the brown adipose tissue instead of inducing fat accumulation can produce energy as heat. Since adult humans possess significant amounts of active brown fat depots and their mass inversely correlates with adiposity, brown fat might play an important role in human obesity and energy homeostasis. New evidence suggests two types of thermogenic adipocytes with distinct developmental and anatomical features: classical brown adipocytes and beige adipocytes. Beige adipocyte has recently attracted special interest because of its ability to dissipate energy and the possible ability to differentiate itself from white adipocytes. Importantly, adult human brown adipocyte appears to be mainly composed of beige-like adipocytes, making this cell type an attractive therapeutic target for obesity and obesity-related diseases. Because many epigenetic changes can affect beige adipocyte differentiation, the knowledge of the circumstances that affect the development of beige adipocyte cells may be important for therapeutic strategies. In this review we discuss some recent observations arising from the great physiological capacity of these cells and their possible role as ways to treat obesity and diabetes mellitus type 2.
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Affiliation(s)
- Fernando Lizcano
- Center of Biomedical Research (CIBUS), Universidad de La Sabana, Chia, Colombia
- Fundacion Cardioinfantil IC, Bogota, Colombia
- *Fernando Lizcano:
| | - Diana Vargas
- Center of Biomedical Research (CIBUS), Universidad de La Sabana, Chia, Colombia
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706
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Bala C, Craciun AE, Hancu N. UPDATING THE CONCEPT OF METABOLICALLY HEALTHY OBESITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2016; 12:197-205. [PMID: 31149087 DOI: 10.4183/aeb.2016.197] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Obesity is a well-recognized risk factor for type 2 diabetes, cardiovascular disease, and several types of cancer. However, a proportion of the obese individuals display a significantly lower risk for metabolic complications than expected for their degree of body mass index, and this subtype of obesity was described as "metabolically healthy obesity" (MHO). No universally accepted criteria for the diagnosis of MHO exists and the prevalence of this subtype of obesity varies largely according to criteria used. Broadly, MHO is characterized by a lower amount of visceral fat, a more favorable inflammatory profile, and less insulin resistance as compared to the metabolically unhealthy obesity. Currently, controversies exist regarding the risk of cardiovascular events and all-cause mortality associated with MHO as compared to metabolically-healthy non-obese individuals. Further research is needed in order to identify the MHO phenotype and if MHO is truly healthy for a long period of time or if it is a transient state from normal metabolic/normal weight to abnormal metabolic/obese state. This review will discuss the MHO definition criteria; the differences between MHO and metabolically unhealthy obesity; the possible underlying mechanisms and clinical implications of MHO.
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Affiliation(s)
- C Bala
- "Iuliu Haţieganu" University of Medicine and Pharmacy, Dept. of Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania
| | - A-E Craciun
- "Iuliu Haţieganu" University of Medicine and Pharmacy, Dept. of Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania
| | - N Hancu
- "Iuliu Haţieganu" University of Medicine and Pharmacy, Dept. of Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania
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