MEDIX, God. 15 Br. 80/81  •  Pregledni članak  •  Endokrinologija HR ENG

Pretilost i šećerna bolestObesity and diabetes mellitus

Željka Crnčević Orlić

Pretilost i šećerna bolest rastuće su epidemije svih slojeva društva i svih kontinenata. Na poligenetsku podlogu pretilosti i šećerne bolesti tipa 2 uvelike utječe i način života današnjeg čovjeka. Neurocentralna regulacija metabolizma energije i glukoze zbiva se preklapajućim djelovanjem inzulina i leptina na POMC i NPY/AgRP neurone u nucleusu arcuatusu hipotalamusa. Višak masnog tkiva, osobito visceralnog, svojim endokrinim, parakrinim i autokrinim lučenjem i uz pomoć adipokina, citokina i enzima na razne načine stvara inzulinsku rezistenciju i ostale komponente kardiovaskularnog rizika. Promjenom načina života, farmakoterapijom, intragastričnim balonom ili kirurškom metodom nije važno samo smršaviti, već održati postignuti cilj. Bilo kojom danas preporučljivom metodom smanjenja masnog tkiva uvelike se smanjuje i pojavnost šećerne bolesti tipa 2 a time i ukupni mortalitet

Ključne riječi:
adipokini; inzulin; leptin; pretilost; šećerna bolest tip 2

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Obesity and type 2 diabetes mellitus are increasing epidemics on all continents and in all societies. Polygenetic heredity of both disorders is strongly associated with modern urban lifestyle. Neurocentral regulation of energy and glucose consumption is mediated by the overlapping leptin and insulin activity on the neurons in the hypothalamic nucleus arcuatus, which contain neuropeptide Y and proopiomelanocortin. Excess fat tissue, specially the visceral fat, leads to insuline resistance and development of cardiovascular risk factors through its endocrine, paracrine and autocrine activity, which is additionally enhanced by the action of adipokines, cytokines and enzimes. It is important not only to lose weight by changing one’s lifestyle, using pharmacotherapy, or undergoing intragastric ballon or bariatric surgery, but also to maintain the reduced weight. Reduction in fat tissue reduces the occurrence of diabetes mellitus type 2 and overall mortality.

Key words:
adipokines; diabetes mellitus, type 2; insulin; leptin; obesity