Upoznaj svog neprijatelja: priroda i biohemija gojaznosti
Sažetak
Gojaznost predstavlja ozbiljno zdravstveno stanje i danas je dostigla razmere pandemije. Komorbiditeti povezani sa gojaznošću su teški i utiču na skoro sve sisteme organa. Masno tkivo ima nekoliko važnih zadataka: da obezbedi skladištenje energije, da održava telesnu temperaturu kroz proces termogeneze i da održava ravnotežu u različitim metaboličkim reakcijama. Masno tkivo je endokrini organ sa brojnim biohemijskim ulogama i kod gojaznih osoba ono postaje ili hipertrofično ili hiperplastično, kada dolazi do oštećenja funkcije samog tkiva. Aktivnost imunog sistema i metabolička regulacija u masnom tkivu su izuzetno povezani procesi. Gubitak ravnoteže ove ose izaziva brojne poremećaje povezane sa gojaznošću, a u osnovi ovih poremećaja je insulinska rezistencija, koja je obeležje gojaznosti. Hormoni koji se skoro isključivo proizvode u adipocitima i proučavaju u različitim biohemijskim procesima su leptin, adiponektin i rezistin. Uspešno lečenje gojaznosti se danas postiže modifikacijom načina života i ishrane, farmakoterapijom, uglavnom glukagonu sličnom peptid-1 agonistima, kao i barijatrijskom hirurgijom, koja ostaje najefikasnija metoda lečenja selektivne populacije teško gojaznih osoba. Pozitivni efekti barijatrijske hirurgije ogledaju se ne samo u ograničenju unosa hrane, već u hormonskim promenama, posebno u hormonima intestinalnog porekla odgovornim za regulaciju gladi i energetski metabolizam.
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