肥胖发生机理假说与肥胖治疗现状.docVIP

肥胖发生机理假说与肥胖治疗现状 方忠宏（复旦大学金山医院 上海 200540） 50%以上的成人属于肥胖或超重，而且肥胖在世界范围内的发病率在不断增加。迄今为止，还没有以肥胖发病率或死亡率作为基本目标的系统性研究，对已有研究的分析表明，特意减肥者(IWL)的死亡率并未下降；药物的治疗作用有限，有些药物有严重的副作用，近期不可能有减肥特效药。 leptin的减肥研究已受到世人的非常关注。虽然leptin的研究进一步揭示了肥胖及其相关疾病的发生机制，但总结有关leptin的研究，并不能支持leptin成为减肥的特效药。 ”，破坏了能量平衡机制，改变了能量摄入规律，使人体代谢机能失调，不应是简单的能量摄入大于支出。 worsening feedforward）引起肥胖。“不良营养状态”与人类目前的食物源的微量营养素缺乏有密切关系，高产及快速育肥技术使动物能量摄入大于消耗的作用可通过食物链作用于人体，这就是说能量平衡机制的破坏早已在人类的食物链上存在了，人体肥胖实际上是食物链上肥胖效应的积累，肥胖者体内的抗Leptin及较高的血浓度给出这样的提示。 【关键词】肥胖; 治疗; leptin; 假说 Hypothesis of Obesity Mechanism and Status of Obesity Treatments Fang Zhonghong (Jinshan Hospital, Fudan UniversityShanghai 200540) Abstract: Obesity has become serious health issue globally, which is closely related to many modern diseases. In the US, more than half American adults are overweight or obese, and morbidity of obesity is increasing over the world. Up-to-date, the effects of obesity treatments are limited. No studies of obesity treatments using the primary outcomes of morbidity or mortality can be found. The analyzing of the existing studies indicates that intentional weight loss (IWL) do not decrease mortality rate. Some drugs for obesity have serious side-effects, and there will be no potential drugs within the near future in obesity therapy. The research of leptin on obesity is paid great attention, by which the mechanism of obesity and of related diseases are disclosed further. However leptin has not been proved to be a potential drug on obesity therapy. The mechanism of obesity is generally regarded as more energy intake than energy expenditure, the so-called over-nutrition. Actually the maintaining of the energy balance is complicated, which is influenced by many factors. Obesity is the confusion of human metabolism. The close relationship between obesity and many kinds of modern diseases suggests this. The destruction of energy-balance mechanism is due to many modern life factors that cause ‘unwell nutrient condition’ and change the prin