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Birth weight and childhood obesity: a 12-country study. 出生体重与儿童肥胖:12 个国家的研究。
Pub Date : 2015-12-01 Epub Date: 2015-12-08 DOI: 10.1038/ijosup.2015.23
Y Qiao, J Ma, Y Wang, W Li, P T Katzmarzyk, J-P Chaput, M Fogelholm, W D Johnson, R Kuriyan, A Kurpad, E V Lambert, C Maher, J Maia, V Matsudo, T Olds, V Onywera, O L Sarmiento, M Standage, M S Tremblay, C Tudor-Locke, T S Church, P Zhao, G Hu

Objectives: Few studies have investigated the association between the full range of birth weight and the risk of childhood obesity in high-, middle- and low-income countries. The aim of the present study is to assess the association between different levels of birth weight and the risk of obesity among children aged 9-11 years in 12 countries.

Methods: A multinational, cross-sectional study of 5141 children aged 9-11 years was conducted in 12 countries. Height and weight were obtained using standardized methods. Time spent in moderate-to-vigorous physical activity (MVPA), sedentary and sleeping were objectively measured using 24-h, waist-worn accelerometer (Actigraph GT3X+) monitored for 7 days. Birth weight and other factors (regions, parental education, maternal history of gestational diabetes, children age, gender, breast feeding, gestational age, unhealthy diet scores and healthy diet scores) were collected by parental and children's questionnaires. Multilevel modeling was used to account for the nested nature of the data.

Results: The overall prevalence of obesity (BMI z-score>+2 s.d.) was 15.4% for boys and 10.0% for girls. There was a positive association between birth weight and BMI z-scores. The multivariable-adjusted odds ratios (ORs) of childhood obesity were significantly higher among children whose birth weights were 3500-3999 g (OR 1.45; 95% confidence interval (CI): 1.10-1.92), and >4000 g (OR 2.08; 95% CI: 1.47-2.93), compared with the reference group (2500-2999 g). The positive association between birth weight and the odds of childhood obesity was seen in girls, whereas a U-shaped association appeared in boys.

Conclusions: High levels of birth weight, defined as birth weight ⩾3500 g, were associated with increased odds of obesity among 9-11-year-old children in 12 countries. However, sex differences in the association between birth weight and the risk of obesity need to be considered when planning interventions to reduce childhood obesity.

目的:很少有研究调查过高、中、低收入国家的所有出生体重与儿童肥胖风险之间的关系。本研究旨在评估 12 个国家 9-11 岁儿童不同出生体重水平与肥胖风险之间的关系:方法:在 12 个国家对 5141 名 9-11 岁儿童进行了跨国横断面研究。身高和体重采用标准化方法测量。使用监测 7 天的 24 小时腰部佩戴式加速度计(Actigraph GT3X+)客观测量了中等强度体力活动(MVPA)、久坐和睡眠时间。出生体重和其他因素(地区、父母教育程度、母亲妊娠糖尿病史、儿童年龄、性别、母乳喂养、胎龄、不健康饮食评分和健康饮食评分)通过父母和儿童的问卷调查收集。为了考虑数据的嵌套性,我们使用了多层次模型:结果:肥胖症(体重指数 z 值>+2 s.d.)的总体发病率为:男孩 15.4%,女孩 10.0%。出生体重与体重指数 z 值呈正相关。与参照组(2500-2999 克)相比,出生体重为 3500-3999 克(OR 1.45;95% 置信区间(CI):1.10-1.92)和大于 4000 克(OR 2.08;95% 置信区间(CI):1.47-2.93)的儿童患儿童肥胖症的多变量调整后的几率比(ORs)明显更高。出生体重与儿童肥胖几率之间的正相关在女孩中出现,而在男孩中呈 U 型关系:结论:在 12 个国家的 9-11 岁儿童中,出生体重高(定义为出生体重⩾3500 克)与肥胖几率增加有关。然而,在规划减少儿童肥胖的干预措施时,需要考虑出生体重与肥胖风险之间的性别差异。
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引用次数: 0
Are participant characteristics from ISCOLE study sites comparable to the rest of their country? 来自ISCOLE研究地点的参与者特征与他们国家的其他地区是否具有可比性?
Pub Date : 2015-12-01 Epub Date: 2015-12-08 DOI: 10.1038/ijosup.2015.13
A G LeBlanc, P T Katzmarzyk, T V Barreira, S T Broyles, J-P Chaput, T S Church, M Fogelholm, D M Harrington, G Hu, R Kuriyan, A Kurpad, E V Lambert, C Maher, J Maia, V Matsudo, T Olds, V Onywera, O L Sarmiento, M Standage, C Tudor-Locke, P Zhao, M S Tremblay

Objectives: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) provides robust, multi-national information on physical activity, diet and weight status in 9-11-year-old children around the world. The purpose of this analysis was to examine the similarities and differences between participant characteristics from ISCOLE sites and data from nationally representative surveys from ISCOLE countries (Australia, Brazil, Canada, China, Colombia, Finland, Kenya, India, Portugal, South Africa, the United Kingdom and the United States).

Methods: Distributions of characteristics were assessed within each ISCOLE country-level database, and compared with published data from national or regional surveys, where available. Variables of comparison were identified a priori and included body mass index (BMI), physical activity (accelerometer-determined steps per day) and screen time (child-report).

Results: Of 12 countries, data on weight status (BMI) were available in 8 countries, data on measured physical activity (steps per day) were available in 5 countries and data on self-reported screen time were available in 9 countries. The five ISCOLE countries that were part of the Health Behaviour in School-aged Children Survey (that is, Canada, Finland, Portugal, the United Kingdom (England) and the United States) also provided comparable data on self-reported physical activity. Available country-specific data often used different measurement tools or cut-points, making direct comparisons difficult. Where possible, ISCOLE data were re-analyzed to match country-level data, but this step limited between-country comparisons.

Conclusions: From the analyses performed, the ISCOLE data do not seem to be systematically biased; however, owing to limitations in data availability, data from ISCOLE should be used with appropriate caution when planning country-level population health interventions. This work highlights the need for harmonized measurement tools around the world while accounting for culturally specific characteristics, and the need for collaboration across study centers and research groups.

目的:国际儿童肥胖、生活方式和环境研究(ISCOLE)为世界各地9-11岁儿童的身体活动、饮食和体重状况提供了强有力的多国信息。本分析的目的是检查ISCOLE站点的参与者特征与来自ISCOLE国家(澳大利亚、巴西、加拿大、中国、哥伦比亚、芬兰、肯尼亚、印度、葡萄牙、南非、英国和美国)的全国代表性调查数据之间的异同。方法:在每个ISCOLE国家级数据库中评估特征分布,并与国家或区域调查公布的数据(如有)进行比较。比较变量是先验确定的,包括身体质量指数(BMI)、身体活动(每天由加速度计确定的步数)和屏幕时间(儿童报告)。结果:在12个国家中,8个国家有体重状况(BMI)数据,5个国家有测量身体活动(每天步数)数据,9个国家有自我报告的屏幕时间数据。参加学龄儿童健康行为调查的五个《儿童健康行为调查》国家(即加拿大、芬兰、葡萄牙、联合王国(英格兰)和美国)也提供了关于自我报告的身体活动的可比数据。现有的具体国家数据通常使用不同的测量工具或临界值,因此难以进行直接比较。在可能的情况下,重新分析ISCOLE数据以匹配国家层面的数据,但这一步骤限制了国家之间的比较。结论:从所进行的分析来看,ISCOLE的数据似乎没有系统偏差;然而,由于数据的可得性有限,在规划国家一级的人口健康干预措施时,应适当谨慎地使用ISCOLE的数据。这项工作强调了在考虑文化特定特征的同时,需要在世界范围内统一测量工具,以及需要在研究中心和研究小组之间进行合作。
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引用次数: 15
Paracrine, endocrine and neurocrine controls of the adipocyte color phenotype: view from the chair. 旁分泌、内分泌和神经分泌对脂肪细胞颜色表型的控制:从椅子上看。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.2
F Picard

After a long drought caused by misjudged irrelevance to human biology, the research field of brown adipose tissue has seen a period of resurgence since 2009 when discoveries of brown fat in adults were reported. However, the molecular and physiological regulators of the different types of adipose tissues-white, beige or brown-are still far from being fully determined. Speakers of the morning session of the 16th Annual Symposium of the Université Laval's Chair in Obesity, a series interestingly launched in 1998 precisely on the topic of uncoupling proteins, presented past and recent findings on non-adrenergic signaling pathways-both upstream and downstream-regulating the metabolic and thermogenic activities of adipose tissue. They went on to show that these pathways are altered in the contexts of obesity and aging, the latter being a very important factor involved in the decline of non-shivering thermogenesis. Whereas opinions diverged on readily applicable solutions for development of candidate therapeutics, the panelists agreed that the new factors involved in the control of the adipose thermogenic program hold great promise for innovation. This will likely depend on how this novel knowledge is integrated into the complex regulation of thermogenesis, which will be achieved through better-defined experimental protocols, both in humans and non-human models.

由于与人类生物学的不相关性被错误地判断,棕色脂肪组织的研究领域在经历了长时间的干旱之后,自2009年发现成人棕色脂肪的报道以来,棕色脂肪组织的研究领域出现了一段复苏时期。然而,不同类型脂肪组织(白色、米色或棕色)的分子和生理调节因子仍远未完全确定。第16届拉瓦尔大学肥胖讲座(1998年推出的一系列有趣的关于解偶联蛋白的专题)的上午会议上,演讲者介绍了过去和最近关于调节脂肪组织代谢和产热活动的上游和下游非肾上腺素能信号通路的发现。他们继续表明,这些途径在肥胖和衰老的情况下会发生改变,后者是导致非寒颤产热下降的一个非常重要的因素。尽管对于候选疗法开发的可行解决方案存在分歧,但小组成员一致认为,涉及脂肪产热程序控制的新因素具有很大的创新前景。这可能取决于如何将这些新知识整合到复杂的产热调节中,这将通过在人类和非人类模型中更好地定义实验方案来实现。
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引用次数: 1
Of mice and men: novel insights regarding constitutive and recruitable brown adipocytes. 小鼠和人类:关于构成性和可再生棕色脂肪细胞的新见解。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.5
K L Townsend, Y-H Tseng

Recently, there has been great attention given to the possibility of combating obesity by targeting brown fat activity or increasing differentiation of brown adipocytes in white fat depots through a process termed 'browning'. Sympathetic innervation of brown and white adipose tissues provides adrenergic input that drives thermogenesis and regulates fatty acid metabolism, as well as stimulating adipogenesis of recruitable brown adipocyte tissue (rBAT, also known as beige or brite) in white fat. Other factors acting in an endocrine or autocrine/paracrine manner in adipose tissue may also stimulate browning. There have been significant recent advances in understanding the mechanisms of increasing adipose tissue energy expenditure, as well as how brown adipocytes appear in white fat depots, including via de novo adipogenesis from tissue precursor cells. In this article, we integrate this new knowledge with a historical perspective on the discovery of 'browning'. We also provide an overview of constitutive BAT vs rBAT in mouse and human.

最近,人们非常关注通过一种称为“褐变”的过程来靶向棕色脂肪活性或增加白色脂肪库中棕色脂肪细胞的分化来对抗肥胖的可能性。棕色和白色脂肪组织的交感神经支配提供肾上腺素能输入,驱动产热和调节脂肪酸代谢,以及刺激白色脂肪中可再生棕色脂肪细胞组织(rBAT,也称为beige或brite)的脂肪生成。在脂肪组织中以内分泌或自分泌/旁分泌方式起作用的其他因素也可能刺激褐变。最近在了解增加脂肪组织能量消耗的机制以及棕色脂肪细胞如何在白色脂肪库中出现,包括通过组织前体细胞重新形成脂肪方面取得了重大进展。在这篇文章中,我们将这一新知识与发现“褐变”的历史观点结合起来。我们还概述了小鼠和人的组成型BAT与rBAT。
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引用次数: 19
Thermogenic potential and physiological relevance of human epicardial adipose tissue. 人心外膜脂肪组织的生热潜能和生理相关性。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.8
K Chechi, D Richard

Epicardial adipose tissue is a unique fat depot around the heart that shares a close anatomic proximity and vascular supply with the myocardium and coronary arteries. Its accumulation around the heart, measured using various imaging modalities, has been associated with the onset and progression of coronary artery disease in humans. Epicardial adipose tissue is also the only fat depot around the heart that is known to express uncoupling protein 1 at both mRNA and protein levels in the detectable range. Recent advances have further indicated that human epicardial fat exhibits beige fat-like features. Here we provide an overview of the physiological and pathophysiological relevance of human epicardial fat, and further discuss whether its thermogenic properties can serve as a target for the therapeutic management of coronary heart disease in humans.

心外膜脂肪组织是心脏周围独特的脂肪库,与心肌和冠状动脉有密切的解剖距离和血管供应。利用各种成像方式测量其在心脏周围的积聚与人类冠状动脉疾病的发生和进展有关。心外膜脂肪组织也是心脏周围唯一已知在可检测范围内以mRNA和蛋白水平表达解偶联蛋白1的脂肪库。最近的进展进一步表明,人类心外膜脂肪表现出米色脂肪样特征。在这里,我们概述了人类心外膜脂肪的生理和病理生理相关性,并进一步讨论其产热特性是否可以作为人类冠心病治疗管理的靶点。
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引用次数: 22
Neural control of white, beige and brown adipocytes. 白色、米色和棕色脂肪细胞的神经控制。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.9
T J Bartness, V Ryu

Reports of brown-like adipocytes in traditionally white adipose tissue (WAT) depots occurred ~30 years ago, but interest in white adipocyte 'browning' only has gained attention more recently. We integrate some of what is known about the sympathetic nervous system (SNS) innervation of WAT and brown adipose tissue (BAT) with the few studies focusing on the sympathetic innervation of the so-called 'brite' or 'beige' adipocytes that appear when WAT sympathetic drive increases (for example, cold exposure and food deprivation). Only one brain site, the dorsomedial hypothalamic nucleus (DMH), selectively browns some (inguinal WAT (IWAT) and dorsomedial subcutaneous WAT), but not all WAT depots and only when DMH neuropeptide Y gene expression is knocked down, a browning effect is mediated by WAT SNS innervation. Other studies show that WAT sympathetic fiber density is correlated with the number of brown-like adipocytes (multilocular lipid droplets, uncoupling protein-1 immunoreactivity) at both warm and cold ambient temperatures. WAT and BAT have sensory innervation, the latter important for acute BAT cold-induced temperature increases, therefore suggesting the possible importance of sensory neural feedback from brite/beige cells for heat production. Only one report shows browned WAT capable of producing heat in vivo. Collectively, increases in WAT sympathetic drive and the phenotype of these stimulated adipocytes seems critical for the production of new and/or transdifferentiation of white to brite/beige adipocytes. Selective harnessing of WAT SNS drive to produce browning or selective browning independent of the SNS to counter increases in adiposity by increasing expenditure appears to be extremely challenging.

在传统的白色脂肪组织(WAT)储存库中发现棕色样脂肪细胞的报道大约发生在30年前,但对白色脂肪细胞“褐变”的兴趣直到最近才得到关注。我们将WAT和棕色脂肪组织(BAT)的交感神经系统(SNS)神经支配的一些已知知识与少数研究集中在所谓的“白色”或“米色”脂肪细胞的交感神经支配上,这些细胞在WAT交感神经驱动增加时出现(例如,寒冷暴露和食物匮乏)。只有一个大脑部位,即下丘脑背内侧核(DMH)选择性地使某些部位(腹股沟WAT (IWAT)和背内侧皮下WAT)褐化,但并非所有的WAT储藏库,而且只有当DMH神经肽Y基因表达下调时,WAT SNS神经支配才会介导褐化作用。其他研究表明,在温暖和寒冷的环境温度下,WAT交感神经纤维密度与棕色样脂肪细胞(多室脂滴,解偶联蛋白-1免疫反应性)的数量相关。WAT和BAT有感觉神经支配,后者对于急性BAT冷致温度升高很重要,因此表明来自白色/米色细胞的感觉神经反馈对产热可能很重要。只有一份报告显示褐色的WAT能够在体内产生热量。总的来说,WAT交感驱动的增加和这些受刺激的脂肪细胞的表型似乎对产生新的和/或白色脂肪细胞向浅白色/米色脂肪细胞的转分化至关重要。选择性利用WAT SNS驱动产生褐变或独立于SNS的选择性褐变来通过增加支出来对抗肥胖的增加似乎极具挑战性。
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引用次数: 64
Physiological determinants and impacts of the adipocyte phenotype. 脂肪细胞表型的生理决定因素和影响。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.6
A Tchernof, D Richard

The properties of adipose tissues accumulating in various compartments and ectopic sites around the body represent critical determinants of the relationship between obesity and metabolic disease. The increasingly recognized plasticity of the adipose cell phenotype led to many articles on the cellular characteristics and origins on brown, white and also of 'beige' or 'brite' adipocytes in recent years. This overview is a summary of manuscripts that were prepared by speakers at the 16th International Symposium of the Laval University Research Chair in Obesity. The data reviewed herein suggest that brown adipose tissue-inducing therapies may also modulate skeletal status through their effects on bone morphology and structure. Moreover, recently identified beige-like properties of epicardial fat in humans could eventually be considered for the management of coronary heart disease in humans. The regulation of brown adipose tissue activation through sympathetic nervous system innervation or non-sympathetic activators is also a complex phenomenon that needs further investigation. Scientific work aimed at better understanding the characteristics and regulation of metabolic homeostasis in each adipose compartment is an important aspect of our progression toward preventive or even curative approaches for obesity.

脂肪组织在体内不同部位和异位部位积聚的特性是肥胖和代谢性疾病之间关系的关键决定因素。近年来,人们越来越认识到脂肪细胞表型的可塑性,导致了许多关于棕色、白色以及“米色”或“白色”脂肪细胞的细胞特征和起源的文章。本综述是在拉瓦尔大学肥胖研究主席第16届国际研讨会上演讲者准备的手稿摘要。本文回顾的数据表明,棕色脂肪组织诱导疗法也可以通过其对骨骼形态和结构的影响来调节骨骼状态。此外,最近发现的人类心外膜脂肪的米色样特性可能最终被认为可用于人类冠心病的治疗。通过交感神经系统支配或非交感神经激活剂调节棕色脂肪组织的激活也是一个复杂的现象,需要进一步研究。科学工作旨在更好地了解每个脂肪室代谢稳态的特征和调节,这是我们在预防甚至治疗肥胖方面取得进展的重要方面。
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引用次数: 2
Brown adipose tissue and bone. 褐色脂肪组织和骨骼。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.7
M E Lidell, S Enerbäck

Brown adipose tissue (BAT) is capable of transforming chemically stored energy, in the form of triglycerides, into heat. Recent studies have shown that metabolically active BAT is present in a large proportion of adult humans, where its activity correlates with a favorable metabolic status. Hence, the tissue is now regarded as an interesting target for therapies against obesity and associated diseases such as type 2 diabetes, the hypothesis being that an induction of BAT would be beneficial for these disease states. Apart from the association between BAT activity and a healthier metabolic status, later studies have also shown a positive correlation between BAT volume and both bone cross-sectional area and bone mineral density, suggesting that BAT might stimulate bone anabolism. The aim of this review is to give the reader a brief overview of the BAT research field and to summarize and discuss recent findings regarding BAT being a potential player in bone metabolism.

棕色脂肪组织(BAT)能够以甘油三酯的形式将化学储存的能量转化为热量。最近的研究表明,代谢活性BAT存在于很大比例的成年人中,其活性与良好的代谢状态相关。因此,该组织现在被认为是治疗肥胖和相关疾病(如2型糖尿病)的一个有趣的靶点,假设是BAT的诱导将有益于这些疾病状态。除了BAT活性与更健康的代谢状态相关外,后来的研究还表明BAT体积与骨横截面积和骨矿物质密度呈正相关,表明BAT可能刺激骨合成代谢。这篇综述的目的是让读者对BAT的研究领域有一个简要的概述,并总结和讨论关于BAT在骨代谢中的潜在作用的最新发现。
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引用次数: 23
Promoting brown and beige adipocyte biogenesis through the PRDM16 pathway. 通过PRDM16途径促进棕色和米色脂肪细胞的生物发生。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.4
S Kajimura

Obesity develops from a chronic energy imbalance in which energy intake exceeds energy expenditure. As brown adipose tissue (BAT) dissipates energy and produces heat, increasing energy expenditure via BAT thermogenesis may constitute a novel therapeutic intervention for the treatment of obesity and obesity-related diseases. Studies over the past few years have identified key regulatory molecules of brown and beige adipocyte biogenesis, including a dominant transcriptional co-regulator PRDM16 (PR domain containing 16) and its co-factors, which allows for engineering functional BAT by genetic approaches. A next step toward the goal of promoting BAT thermogenesis by pharmacological approaches necessitates a better understanding of the enzymatic components and signaling pathways for brown and beige adipocyte development. This review covers recent advances regarding this topic, with a special emphasis on the PRDM16 transcriptional pathway.

肥胖源于能量摄入超过能量消耗的慢性能量失衡。由于棕色脂肪组织(BAT)耗散能量并产生热量,通过BAT产热增加能量消耗可能成为治疗肥胖和肥胖相关疾病的一种新的治疗干预手段。过去几年的研究已经确定了棕色和米色脂肪细胞生物发生的关键调控分子,包括显性转录共调控因子PRDM16 (PR结构域包含16)及其辅助因子,这使得通过遗传方法工程功能BAT成为可能。通过药理学方法促进BAT产热的下一步需要更好地了解棕色和米色脂肪细胞发育的酶成分和信号通路。本文综述了关于这一主题的最新进展,特别强调了PRDM16的转录途径。
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引用次数: 33
Renaissance of brown adipose tissue research: integrating the old and new. 棕色脂肪组织研究的复兴:新旧结合。
Pub Date : 2015-08-01 Epub Date: 2015-08-04 DOI: 10.1038/ijosup.2015.3
J G Granneman

The recent demonstration of active brown adipose tissue (BAT) in adult humans, along with the discovery of vast cellular and metabolic plasticity of adipocyte phenotypes, has given new hope of targeting adipose tissue for therapeutic benefit. Application of principles learned from the first wave of obesity-related BAT research, conducted 30 years earlier, suggests that the activity and/or mass of brown fat will need to be greatly expanded for it to significantly contribute to total energy expenditure. Although the thermogenic capacity of human brown fat is very modest, its presence often correlates with improved metabolic status, suggesting possible beneficial endocrine functions. Recent advances in our understanding of the nature of progenitors and the transcriptional programs that guide phenotypic diversity have demonstrated the possibility of expanding the population of brown adipocytes in rodent models. Expanded populations of brown and beige adipocytes will require tight control of their metabolic activity, which might be achieved by selective neural activation, tissue-selective signaling or direct activation of lipolysis, which supplies the central fuel of thermogenesis.

最近在成人中发现的活性棕色脂肪组织(BAT),以及脂肪细胞表型巨大的细胞和代谢可塑性的发现,给靶向脂肪组织的治疗带来了新的希望。从30年前进行的第一波与肥胖相关的BAT研究中吸取的原则的应用表明,棕色脂肪的活动和/或质量需要大大增加,才能显著促进总能量消耗。尽管人类棕色脂肪的产热能力非常有限,但它的存在往往与代谢状态的改善有关,这表明它可能具有有益的内分泌功能。最近我们对祖细胞的本质和引导表型多样性的转录程序的理解取得了进展,证明了在啮齿动物模型中扩大棕色脂肪细胞群体的可能性。棕色和米色脂肪细胞群体的扩大将需要严格控制其代谢活动,这可能通过选择性神经激活,组织选择性信号传导或直接激活脂肪分解来实现,脂肪分解提供了产热的主要燃料。
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引用次数: 10
期刊
International journal of obesity supplements
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