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1.
Gene ; 757: 144949, 2020 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-32679290

RESUMO

Melanocortin-2 receptor accessory protein (MRAP) has an unusual dual topology and influences the expression, localisation, signalling and internalisation of the melanocortin receptor 2 (MC2); the adrenocorticotropic hormone (ACTH) receptor. Mutations in MRAP are associated with familial glucocorticoid deficiency type-2 and evidence is emerging of the importance of MRAP in adrenal development and ACTH signalling. Human MRAP has two functional splice variants: MRAP-α and MRAP-ß, unlike MRAP-ß, MRAP-α has little expression in brain but is highly expressed in ovary. MRAP2, identified through whole human genome sequence analysis, has approximately 40% sequence homology to MRAP. MRAP2 facilitates MC2 localisation to the cell surface but not ACTH signalling. MRAP and MRAP2 have been found to regulate the surface expression and signalling of all melanocortin receptors (MC1-5). Additionally, MRAP2 moderates the signalling of the G-protein coupled receptors (GCPRs): orexin, prokineticin and GHSR1a; the ghrelin receptor. Whilst MRAP appears to be mainly involved in glucocorticoid synthesis, an important role is emerging for MRAP2 in regulating appetite and energy homeostasis. Transgenic models indicate the importance of MRAP in adrenal gland formation. Like MC3R and MC4R knockout mice, MRAP2 knockout mice have an obese phenotype. In vitro studies indicate that MRAP2 enhances the MC3 and MC4 response to the agonist αMSH, which, like ACTH, is produced through precursor polypeptide proopiomelanocortin (POMC) cleavage. Analysis of cohorts of individuals with obesity have revealed several MRAP2 genetic variants with loss of function mutations which are causative of monogenic hyperphagic obesity with hyperglycaemia and hypertension. MRAP2 may also be associated with female infertility. This review summarises current knowledge of MRAP and MRAP2, their influence on GPCR signalling, and focusses on pathophysiology, particularly familial glucocorticoid deficiency type-2 and obesity.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Insuficiência Adrenal/genética , Proteínas de Membrana/metabolismo , Erros Inatos do Metabolismo de Esteroides/genética , Proteínas Adaptadoras de Transdução de Sinal/química , Proteínas Adaptadoras de Transdução de Sinal/genética , Insuficiência Adrenal/metabolismo , Animais , Regulação do Apetite , Humanos , Insulina/metabolismo , Melanocortinas/metabolismo , Proteínas de Membrana/química , Proteínas de Membrana/genética , Erros Inatos do Metabolismo de Esteroides/metabolismo
2.
ACS Chem Neurosci ; 11(11): 1520-1522, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: covidwho-324525

RESUMO

Accumulating data have now shown strong evidence that COVID-19 infection leads to the occurrence of neurological signs with different injury severity. Anosmia and agueusia are now well documented and included in the criteria list for diagnosis, and specialists have stressed that doctors screen COVID-19 patients for these two signs. The eventual brainstem dysregulation, due to the invasion of SARS CoV-2, as a cause of respiratory problems linked to COVID-19, has also been extensively discussed. All these findings lead to an implication of the central nervous system in the pathophysiology of COVID-19. Here we provide additional elements that could explain other described signs like appetite loss, vomiting, and nausea. For this, we investigated the role of brainstem structures located in the medulla oblongata involved in food intake and vomiting control. We also discussed the possible pathways the virus uses to reach the brainstem, i.e., neurotropic and hematogenous (with its two variants) routes.


Assuntos
Anorexia/fisiopatologia , Regulação do Apetite/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Ingestão de Alimentos/fisiologia , Náusea/fisiopatologia , Pneumonia Viral/fisiopatologia , Núcleo Solitário/fisiopatologia , Vômito/fisiopatologia , Ageusia/etiologia , Anorexia/etiologia , Área Postrema/fisiopatologia , Barreira Hematoencefálica , Infecções por Coronavirus/complicações , Humanos , Hipotálamo/fisiopatologia , Bulbo/fisiopatologia , Náusea/etiologia , Vias Neurais/fisiopatologia , Transtornos do Olfato/etiologia , Nervo Olfatório , Pandemias , Pneumonia Viral/complicações , Nervo Vago , Vômito/etiologia
3.
ACS Chem Neurosci ; 11(11): 1520-1522, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32427468

RESUMO

Accumulating data have now shown strong evidence that COVID-19 infection leads to the occurrence of neurological signs with different injury severity. Anosmia and agueusia are now well documented and included in the criteria list for diagnosis, and specialists have stressed that doctors screen COVID-19 patients for these two signs. The eventual brainstem dysregulation, due to the invasion of SARS CoV-2, as a cause of respiratory problems linked to COVID-19, has also been extensively discussed. All these findings lead to an implication of the central nervous system in the pathophysiology of COVID-19. Here we provide additional elements that could explain other described signs like appetite loss, vomiting, and nausea. For this, we investigated the role of brainstem structures located in the medulla oblongata involved in food intake and vomiting control. We also discussed the possible pathways the virus uses to reach the brainstem, i.e., neurotropic and hematogenous (with its two variants) routes.


Assuntos
Anorexia/fisiopatologia , Regulação do Apetite/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Ingestão de Alimentos/fisiologia , Náusea/fisiopatologia , Pneumonia Viral/fisiopatologia , Núcleo Solitário/fisiopatologia , Vômito/fisiopatologia , Ageusia/etiologia , Anorexia/etiologia , Área Postrema/fisiopatologia , Barreira Hematoencefálica , Infecções por Coronavirus/complicações , Humanos , Hipotálamo/fisiopatologia , Bulbo/fisiopatologia , Náusea/etiologia , Vias Neurais/fisiopatologia , Transtornos do Olfato/etiologia , Nervo Olfatório , Pandemias , Pneumonia Viral/complicações , Nervo Vago , Vômito/etiologia
4.
J Dairy Sci ; 103(5): 4765-4776, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32229118

RESUMO

Dairy cows consume inadequate amounts of feed in early lactation and during conditions and diseases such as excessive fatness, heat stress, and infectious diseases. Affected cows often experience increases in plasma concentrations of acute phase proteins consistent with the negative effect of inflammation on appetite. The acute phase protein orosomucoid 1 (ORM1), also known as alpha-1-acid glycoprotein, was recently reported to reduce appetite in the mouse through its ability to bind the full-length leptin receptor (Ob-Rb) and activate appetite-suppressing signal transducer and activator of transcription 3 (STAT3) signaling. These observations raise the possibility that ORM1 exerts appetite-suppressing effects in dairy cattle during periods of increased inflammatory tone. The applicability of this model was assessed in 2 ways. First, we asked whether ORM1 is regulated during periods of inadequate appetite such as the transition from late pregnancy to early lactation and periods of increased inflammatory tone. Plasma ORM1 was invariant in late pregnancy but increased 2.5-fold between parturition and d 7 of lactation. Gene expression studies showed that liver was the major source of this elevation with little contribution by adipose tissue or mammary gland. Additional studies showed that plasma ORM1 was not increased further by excessive fatness or by reproductive dysfunction in early lactation and was completely unresponsive to inflammatory stimuli such as heat stress or intravascular administration of the endotoxin lipopolysaccharide during established lactation. Second, we tested the ability of ORM1 to trigger STAT3 signaling through Ob-Rb using Chinese hamster ovary K1 (CHO-K1) cells transfected with a STAT3 expression plasmid. In this configuration, CHO-K1 cells did not express Ob-Rb and were incapable of leptin-induced STAT3 phosphorylation. Leptin responsiveness was conferred by co-transfecting with bovine Ob-Rb, with leptin causing increases of 5.7-fold in STAT3 phosphorylation and 2.1-fold in the expression of the STAT3-dependent gene, SOCS3. In contrast, neither bovine or human ORM1 triggered STAT3 phosphorylation irrespective of dose and period of incubation tested. In summary, bovine ORM1 is not increased during periods of increased inflammatory tone except in early lactation and is incapable of Ob-Rb-dependent STAT3 signaling. Overall, these data are inconsistent with ORM1 mediating the appetite-suppressing effects of inflammation in cattle through Ob-Rb.


Assuntos
Regulação do Apetite/fisiologia , Bovinos/metabolismo , Lactação/fisiologia , Orosomucoide/metabolismo , Receptores para Leptina/metabolismo , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais , Proteínas da Fase Aguda/metabolismo , Tecido Adiposo/metabolismo , Animais , Células CHO , Cricetinae , Cricetulus , Feminino , Leptina/metabolismo , Gravidez , Regulação para Cima
5.
Am J Physiol Regul Integr Comp Physiol ; 318(5): R1014-R1023, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32292065

RESUMO

In rats, overnight fasting reduces the ability of systemic cholecystokinin-8 (CCK) to suppress food intake and to activate cFos in the caudal nucleus of the solitary tract (cNTS), specifically within glucagon-like peptide-1 (GLP-1) and noradrenergic (NA) neurons of the A2 cell group. Systemic CCK increases vagal sensory signaling to the cNTS, an effect that is amplified by leptin and reduced by ghrelin. Since fasting reduces plasma leptin and increases plasma ghrelin levels, we hypothesized that peripheral leptin administration and/or antagonism of ghrelin receptors in fasted rats would rescue the ability of CCK to activate GLP-1 neurons and a caudal subset of A2 neurons that coexpress prolactin-releasing peptide (PrRP). To test this, cFos expression was examined in ad libitum-fed and overnight food-deprived (DEP) rats after intraperitoneal CCK, after coadministration of leptin and CCK, or after intraperitoneal injection of a ghrelin receptor antagonist (GRA) before CCK. In fed rats, CCK activated cFos in ~60% of GLP-1 and PrRP neurons. Few or no GLP-1 or PrRP neurons expressed cFos in DEP rats treated with CCK alone, CCK combined with leptin, or GRA alone. However, GRA pretreatment increased the ability of CCK to activate GLP-1 and PrRP neurons and also enhanced the hypophagic effect of CCK in DEP rats. Considered together, these new findings suggest that reduced behavioral sensitivity to CCK in fasted rats is at least partially due to ghrelin-mediated suppression of hindbrain GLP-1 and PrRP neural responsiveness to CCK.


Assuntos
Regulação do Apetite/efeitos dos fármacos , Colecistocinina/administração & dosagem , Ingestão de Alimentos/efeitos dos fármacos , Jejum/metabolismo , Comportamento Alimentar/efeitos dos fármacos , Grelina/sangue , Neurônios/efeitos dos fármacos , Rombencéfalo/efeitos dos fármacos , Animais , Peptídeo 1 Semelhante ao Glucagon/metabolismo , Leptina/sangue , Masculino , Neurônios/metabolismo , Hormônio Liberador de Prolactina/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos Sprague-Dawley , Receptores de Grelina/metabolismo , Rombencéfalo/metabolismo , Transdução de Sinais
6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(3): 179-185, mar. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188146

RESUMO

Introducción: Los pacientes con obesidad, con frecuencia, tienen dificultad para adherirse a una dieta baja en calorías durante largos períodos de tiempo. Una de las causas del fracaso dietético es la sensación continua de hambre. La grelina es un péptido orexígeno, secretado por células enterocromafines del fundus gástrico. El objetivo de este estudio fue analizar las variaciones de los valores plasmáticos de grelina tras PENS del dermatoma T6 asociado a dieta hipocalórica, así como la modificación del apetito y la pérdida de peso, comparándolo con un grupo control en el que solo se pautó una dieta hipocalórica. Material y métodos: Realizamos un estudio prospectivo no aleatorizado, incluyendo 20 pacientes sometidos a PENS del dermatoma T6, asociado a dieta hipocalórica, como tratamiento previo a ser sometidos a una técnica de cirugía bariátrica y con el fin de reducir peso (grupo 1), y 20 pacientes a los que se les pautó exclusivamente dieta hipocalórica previa a la intervención quirúrgica (grupo 2). En el grupo 1 se analizaron los niveles de grelina plasmática en 5 momentos diferentes del procedimiento: antes de realizar la primera sesión de PENS (muestra 1a), al finalizar la primera sesión de PENS (muestra 1b), antes de realizar la última sesión de PENS (muestra 2a), al finalizar la última sesión de PENS (muestra 2b) y un mes después de haber finalizado el tratamiento (muestra 3). En el grupo 2 se obtuvieron solo 2 muestras, antes de comenzar la dieta (muestra 1) y tras 12 semanas de dieta (muestra 2). Resultados: Tras 12 semanas de tratamiento se observó una pérdida de IMC del 8,42 ± 2,6% en el grupo 1 y del 1,32 ± 0,98% en el grupo 2 (p = 0,007). En el grupo 1 se apreció un descenso significativo de los valores de grelina entre las muestras 1a y 2a, y entre las muestras 1a y 3. En el grupo 2 se observó un aumento no significativo de los niveles de grelina entre las muestras 1 y 2. Conclusión: El PENS del dermatoma T6 se asoció con una disminución en los valores de grelina plasmática. Esta terapia, asociada a una dieta hipocalórica, consigue una pérdida de IMC superior al 8% en 12 semanas de tratamiento


Introduction: Obese patients often find it difficult to adhere to long-term low-calorie diets. One of the reasons for dietary failure is the permanent feeling of hunger. Ghrelin is an orexigenic hormone, secreted by enterochromaffin cells in the gastric fundus. The aim of this study was to analyze changes in plasma ghrelin levels after PENS of dermatome T6 associated to a low-calorie diet, as well as changes in appetite and weight loss, as compared to a control group on a low-calorie alone. Material and methods: A prospective, non-randomized study was conducted including 20 patients who underwent PENS of dermatome T6 associated to a low-calorie diet before undergoing bariatric surgery to lose weight (Group 1), and 20 patients who were only prescribed a low-calorie diet before surgery (Group 2). In Group 1, plasma ghrelin levels were measured at 5 timepoints: before the first PENS session (Sample 1a); after the first PENS session (Sample 1b); before the last PENS session (Sample 2a); after the last PENS session (Sample 2b); and one month after treatment completion (Sample 3). In Group 2, only two samples were collected: before the start of the diet (Sample 1) and after 12 weeks of diet (Sample 2). Results: After 12 weeks of treatment, BMI decreases of 8.42% ± 2.6% and 1.32% ± 0.98% were seen in Group 1 and Group 2 respectively (p = 0.007). A significant decrease was seen in ghrelin levels between samples 1a and 2a, and between samples 1a and 3. In Group 2, a non-significant increase was seen in ghrelin levels. Conclusion: PENS of dermatome T6 was associated to decreased plasma ghrelin levels. This therapy, associated to a low-calorie diet, achieves a BMI reduction greater than 8% after 12 weeks of treatment


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Grelina/uso terapêutico , Estimulação Elétrica Nervosa Transcutânea/métodos , Obesidade/terapia , Regulação do Apetite , Dieta Redutora , Grelina/metabolismo , Perda de Peso , Estudos Prospectivos , Índice de Massa Corporal , Dieta Mediterrânea , Grelina/sangue , Análise de Variância , Antropometria/métodos
7.
Nutr Metab Cardiovasc Dis ; 30(5): 810-821, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32143895

RESUMO

BACKGROUND AND AIMS: Atherosclerosis begins early in life, thus optimal cardiovascular health needs to be promoted early. We investigated whether appetitive behaviors among 7 year olds are associated with their cardiometabolic health years later. METHODS AND RESULTS: A sample of 2951 children from a Portuguese birth cohort was analyzed. The Children's Eating Behavior Questionnaire assessed eating behaviors, and a measure of cardiometabolic risk (higher risk group: those in the upper quartile of triglycerides, homeostatic model assessment-insulin resistance, waist circumference and systolic blood pressure and in the lower quartile of high-density lipoprotein cholesterol z-scores) was created. Linear and logistic regressions were run. Children with more food avoidant behaviors had lower cardiometabolic risk (Satiety Responsiveness - boys: OR = 0.39, 95% CI 0.16; 0.93, girls: OR=0.37, 95% CI 0.17; 0.82 and Slowness in eating - boys: OR = 0.49, 95% CI 0.25; 0.95, girls: OR = 0.49, 95% CI 0.27; 0.91). Food approach behaviors (Food responsiveness (CEBQ-FR), Enjoyment of food (CEBQ-EF) and Emotional overeating (CEBQ-EOE)) increased cardiometabolic risks (e.g. CEBQ-FR: boys: OR = 2.50, 95% CI 1.45; 4.32, girls: OR = 2.33, 95% CI 1.46; 3.71). CEBQ-EF had stronger effects in boys, while CEBQ-EOE was positively associated with cardiometabolic risk among girls. When adjusting for BMIz at 7y, associations did not remain significant. Appetitive behaviors were also associated with isolated cardiometabolic parameters; the strongest association being with waist circumference. CONCLUSIONS: Appetitive behaviors at 7-years are associated with cardiometabolic risk at age 10. While 'food avoidant' behaviors protect against cardiometabolic risk and 'food approach' behaviors increase cardiometabolic risk, these associations are largely dependent of child's adiposity.


Assuntos
Regulação do Apetite , Doenças Cardiovasculares/epidemiologia , Comportamento Infantil , Comportamento Alimentar , Doenças Metabólicas/epidemiologia , Obesidade Pediátrica/epidemiologia , Fatores Etários , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/prevenção & controle , Criança , Emoções , Feminino , Seletividade Alimentar , Preferências Alimentares , Humanos , Masculino , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/prevenção & controle , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/prevenção & controle , Portugal/epidemiologia , Estudos Prospectivos , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Fatores Sexuais
8.
Am J Physiol Regul Integr Comp Physiol ; 318(5): R886-R893, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32189509

RESUMO

This minireview focuses on the interpretative value of ingestive microstructure by summarizing observations from both rodent and human studies. Preliminary data on the therapeutic manipulation of distinct microstructural components of eating are also outlined. In rodents, the interpretative framework of ingestive microstructure mainly concentrates on deprivation state, palatability, satiation, and the role of learning from previous experiences. In humans, however, the control of eating is further influenced by genetic, psychosocial, cultural, and environmental factors, which add complexity and challenges to the interpretation of the microstructure of meal intake. Nevertheless, the presented findings stress the importance of microstructural analyses of ingestion, as a method to investigate specific behavioral variables that underlie the regulation of appetite control.


Assuntos
Regulação do Apetite , Dieta , Ingestão de Alimentos , Comportamento Alimentar , Animais , Ingestão de Energia , Humanos , Estilo de Vida , Refeições , Valor Nutritivo , Tamanho da Porção , Fatores de Tempo
9.
Am J Physiol Regul Integr Comp Physiol ; 318(5): R917-R928, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32208925

RESUMO

Phoenixin is a 20-amino acid peptide (PNX-20) cleaved from the small integral membrane protein 20 (SMIM20), with multiple biological roles in mammals. However, its role in nonmammalian vertebrates is poorly understood. This research aimed to determine whether PNX-20 influences feeding and metabolism in zebrafish. The mRNAs encoding SMIM20 and its putative receptor, super conserved receptor expressed in brain 3 (SREB3), are present in both central and peripheral tissues of zebrafish. Immunohistochemical analysis confirmed the presence of PNX-like immunoreactivity in the gut and in zebrafish liver (ZFL) cell line. We also found that short-term fasting (7 days) significantly decreased smim20 mRNA expression in the brain, gut, liver, gonads, and muscle, which suggests a role for PNX-20 in food intake regulation. Indeed, single intraperitoneal injection of 1,000 ng/g body wt PNX-20 reduced feeding in both male and female zebrafish, likely in part by enhancing hypothalamic cart and reducing hypothalamic/gut preproghrelin mRNAs. Furthermore, the present results demonstrated that PNX-20 modulates the expression of genes involved in glucose transport and metabolism in ZFL cells. In general terms, such PNX-induced modulation of gene expression was characterized by the upregulation of glycolytic genes and the downregulation of gluconeogenic genes. A kinetic study of the ATP production rate from both glycolytic and mitochondrial pathways demonstrated that PNX-20-treated ZFL cells exhibited significantly higher ATP production rate associated with glycolysis than control cells. This confirms a positive role for PNX-20 on glycolysis. Together, these results indicate that PNX-20 is an anorexigen with important metabolic roles in zebrafish.


Assuntos
Depressores do Apetite/farmacologia , Ingestão de Alimentos/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Glucose/metabolismo , Glicólise/efeitos dos fármacos , Proteínas de Homeodomínio/farmacologia , Fragmentos de Peptídeos/farmacologia , Proteínas de Peixe-Zebra/farmacologia , Peixe-Zebra/metabolismo , Animais , Regulação do Apetite/efeitos dos fármacos , Linhagem Celular , Feminino , Regulação da Expressão Gênica , Glicólise/genética , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Masculino , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/metabolismo , Transdução de Sinais , Peixe-Zebra/genética , Proteínas de Peixe-Zebra/genética , Proteínas de Peixe-Zebra/metabolismo
10.
Tech Vasc Interv Radiol ; 23(1): 100653, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192633

RESUMO

Obesity is a public health epidemic in the United States, with implications for patients across many organ systems. Despite improvements in understanding the pathophysiology and increasing number of therapies for obesity, its prevalence continues to rise. The purpose of this review is to provide the interventional radiologist with an understanding of (1) the epidemiology of obesity; (2) the impact of obesity on patients and the healthcare system; (3) the causes of obesity; (4) conservative management of obesity; and (5) pharmacologic management of obesity.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Estilo de Vida Saudável , Obesidade/terapia , Comportamento de Redução do Risco , Fármacos Antiobesidade/efeitos adversos , Regulação do Apetite/efeitos dos fármacos , Dieta Saudável , Exercício Físico , Comportamento Alimentar , Humanos , Obesidade/epidemiologia , Obesidade/fisiopatologia , Obesidade/psicologia , Fatores de Risco , Resultado do Tratamento , Perda de Peso
11.
Tech Vasc Interv Radiol ; 23(1): 100654, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192634

RESUMO

Bariatric surgery comprises a group of operative procedures designed to improve weight-related medical conditions. In the United States, these include vertical sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, and the duodenal switch procedure. Bariatric surgery is the only durable and effective way for most humans to lose a significant amount of weight, and see improvement in obesity-related comorbidities. It can improve quality of life, prevent a number of cancers, and decrease overall mortality. Bariatric procedures work through several avenues, including restriction of food intake, malabsorption of food calories, an increase in metabolic rate, decreased hunger, increased satiety, and a variety of other hormonal mechanisms. Several other surgical, endoscopic, and non-permanent approaches to weight loss will also be covered in this section.


Assuntos
Cirurgia Bariátrica , Obesidade/cirurgia , Regulação do Apetite , Cirurgia Bariátrica/efeitos adversos , Comportamento Alimentar , Humanos , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/psicologia , Qualidade de Vida , Resultado do Tratamento , Perda de Peso
12.
Tech Vasc Interv Radiol ; 23(1): 100655, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192635

RESUMO

Obesity poses a significant health care concern in the United States, with 39.8% of adults being classified as obese. Several different methods have been introduced to combat obesity, from medical therapy to surgical options. Bariatric surgery has been demonstrated to be superior to medical therapy alone for weight loss in obese patients. Despite this information, only about 1% of eligible patients undergo bariatric surgery per year. The reason for this treatment gap is multifactorial, but patient apprehension to undergo surgery is a major driving force. Many patients perceive bariatric surgery as dangerous, and believe that living with their current weight is safer than undergoing surgery. To combat this treatment gap, endoscopic therapies have been developed to reach more patients in a less invasive way. This article will review endoscopic treatment options currently available and approved by the Food and Drug Administration, as well as other treatment modalities that are currently in development.


Assuntos
Cirurgia Bariátrica , Endoscopia Gastrointestinal , Obesidade/cirurgia , Perda de Peso , Regulação do Apetite , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/instrumentação , Endoscopia Gastrointestinal/efeitos adversos , Endoscopia Gastrointestinal/instrumentação , Desenho de Equipamento , Comportamento Alimentar , Humanos , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Segurança do Paciente , Medição de Risco , Fatores de Risco , Resultado do Tratamento
14.
Tech Vasc Interv Radiol ; 23(1): 100657, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192637

RESUMO

Obesity is a well-known major public health concern associated with significant morbidity and mortality. Bariatric arterial embolization (BAE) is a minimally invasive, image-guided therapy that targets hormones linked to obesity by defunctionalizing specific portions of the stomach with the delivery of embolics. The goal of BAE is to induce weight loss through a reduction of appetite-mediating hormones with transarterial embolization of the gastric fundus. This article will review the anatomical and technical considerations for successful BAE.


Assuntos
Embolização Terapêutica , Artéria Gástrica , Fundo Gástrico/irrigação sanguínea , Obesidade/terapia , Regulação do Apetite , Embolização Terapêutica/efeitos adversos , Comportamento Alimentar , Fundo Gástrico/metabolismo , Grelina/metabolismo , Humanos , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/psicologia , Transdução de Sinais , Resultado do Tratamento , Perda de Peso
15.
Tech Vasc Interv Radiol ; 23(1): 100658, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192638

RESUMO

Bariatric arterial embolization (BAE) is a novel technique that is investigated as an alternative, often supplementary, method for weight management. BAE reduces blood perfusion to the gastric fundus, and thus, reduces the production of appetite-inducing hormones. No randomized controlled trial has evaluated the efficacy of BAE to date. Available evidence from published studies include retrospective evaluations of patients undergoing left gastric artery embolization for gastrointestinal bleeding, and early prospective, single-arm clinical trials. Review of clinical data from human trials suggest an average weight loss of about 8-9 kg (ranging 7.6-22.0 kg), corresponding to 8-9% (ranging 4.8-17.2%) of the patients' baseline weight. Common complications include superficial gastric ulcers. Though uncommon, gastric perforation and splenic infarct are important major complication that may arise after left gastric artery embolization. Overall, BAE is an effective, relatively safe procedure that may be associated with clinically significant weight loss in patients with obesity.


Assuntos
Embolização Terapêutica , Artéria Gástrica , Fundo Gástrico/irrigação sanguínea , Obesidade/terapia , Regulação do Apetite , Ensaios Clínicos como Assunto , Embolização Terapêutica/efeitos adversos , Medicina Baseada em Evidências , Comportamento Alimentar , Fundo Gástrico/metabolismo , Grelina/metabolismo , Humanos , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/psicologia , Transdução de Sinais , Resultado do Tratamento , Perda de Peso
16.
Tech Vasc Interv Radiol ; 23(1): 100660, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192640

RESUMO

There are a number of pathologic conditions in the human body that may be modified by the interruption of neural signaling, both related to pain and otherwise. Many of these treatments currently involve implantable neuromodulation or frank surgical neural ligation, representing opportunities for the implementation of percutaneous device-mediated cryoneurolysis in interventional radiology. Computed tomography-guided cryovagotomy for the management of mild to moderate obesity represents one such opportunity currently under investigation. This procedure is designed to attenuate hunger signals by targeting the posterior vagal trunk using computed tomography for cryoablation with a needle, based on historical surgical and electrical vagotomy experience. Future investigations of this technique and others will expand and iterate the concept of percutaneous, image-guided cryoneurolysis as potential management for a wide variety of clinical challenges.


Assuntos
Criocirurgia , Obesidade/cirurgia , Radiografia Intervencionista , Estômago/inervação , Tomografia Computadorizada por Raios X , Vagotomia Troncular , Regulação do Apetite , Criocirurgia/efeitos adversos , Comportamento Alimentar , Humanos , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/psicologia , Seleção de Pacientes , Radiografia Intervencionista/efeitos adversos , Medição de Risco , Fatores de Risco , Resultado do Tratamento , Vagotomia Troncular/efeitos adversos , Perda de Peso
17.
Tech Vasc Interv Radiol ; 23(1): 100656, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32192641

RESUMO

The prevalence of obesity is increasing globally, leading to significantly increased morbidity, mortality, and health care costs. However, there is a lack of effective treatment options that can treat patients with obesity less invasively than with bariatric surgery. Bariatric arterial embolization (BAE) is an image-guided, minimally invasive, percutaneous procedure that is currently being investigated in preclinical animal models and early clinical trials. If successful, BAE may represent a viable interventional approach for obesity treatment. The purpose of this article is to introduce the physiological and anatomical rationale for BAE, review techniques involved in performing BAE for weight modulation, and provide up-to-date preclinical evidence that supports the translation of BAE into patients.


Assuntos
Embolização Terapêutica , Artéria Gástrica , Fundo Gástrico/irrigação sanguínea , Obesidade/terapia , Animais , Regulação do Apetite , Embolização Terapêutica/efeitos adversos , Comportamento Alimentar , Grelina/metabolismo , Humanos , Obesidade/metabolismo , Obesidade/fisiopatologia , Obesidade/psicologia , Transdução de Sinais , Pesquisa Médica Translacional , Resultado do Tratamento , Perda de Peso
18.
Nutr. hosp ; 37(1): 123-128, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-187582

RESUMO

Introducción: es conocido que la dieta juega un papel clave en la composición corporal y afecta al balance energético; sin embargo, la información es limitada acerca de la influencia de alimentos y nutrientes específicos como es el caso de los productos lácteos, un grupo básico de alimentos y una importante fuente de nutrientes en la dieta. Objetivos: evaluar la influencia del consumo de leche fermentada de cabra o vaca sobre la composición corporal y la regulación del apetito en animales adultos. Material y métodos: se han utilizado 20 ratas Wistar macho adultas, alimentadas durante 30 días con dietas basadas en leche fermentada de vaca o de cabra. Se analizaron la evolución de la composición corporal y las concentraciones plasmáticas de adipoquinas (leptina y adiponectina), hormonas reguladoras del metabolismo intermediario (grelina, insulina, hormona estimulante de la glándula tiroides, triyodotironina y tiroxina) y ácidos grasos no esterificados (AGNE). Resultados: el peso y el porcentaje de grasa corporal fueron menores (p < 0,001) y la masa magra fue mayor (p < 0,01) en los animales alimentados con la dieta basada en leche fermentada de cabra. No se registraron diferencias entre dietas para las concentraciones plasmáticas de hormonas tiroideas y de insulina. Las concentraciones plasmáticas de grelina y adiponectina disminuyeron (p < 0,001), y las de leptina y AGNE aumentaron (p < 0,001) con la dieta basada en leche fermentada de cabra. Conclusión: el consumo habitual de leche fermentada de cabra disminuye la adiposidad y el peso corporal en las ratas adultas al incrementar el gasto energético, la lipólisis y la sensación de saciedad


Introduction and objective: it is known that diet plays a key role in body composition and affects energy balance. However, scarce information is available in the scientific literature about the influence of food and specific nutrients such us dairy products, a basic food group and an important source of nutrients in the diet. The objective of this work was to evaluate the influence of fermented dairy products (goat or cow milk) on body composition and appetite regulation in adult animals. Material and methods: twenty adult male Wistar albino rats were fed fermented goat or cow milk-based diets for 30 days. The evolution of body composition and plasma concentrations of adipokines (leptine and adiponectine), intermediary metabolism regulating hormones (ghrelin, insulin, thyroid stimulating hormone, triyodotironine, thyroxine), and non-esterified fatty acid (NEFA) were analyzed. Results: body weight and body fat percentage were lower (p < 0.001) in rats fed fermented goat milk versus those fed fermented cow milk, whereas lean mass percentage was higher (p < 0.01). Plasma thyroid hormone and insulin concentrations did not show significant differences between diets. The fermented goat milk-based diet decreased ghrelin and adiponectin levels (p < 0.001), and increased leptine and NEFA concentrations (p < 0.001). Conclusion: fermented goat milk consumption decreases adiposity and body weight in adult rats by increasing energy expenditure, lipolysis, and satiety sensation


Assuntos
Animais , Ratos , Composição Corporal , Metabolismo Basal , Produtos Fermentados do Leite , Substitutos do Leite Humano , Regulação do Apetite , Ingestão de Alimentos , Adipocinas/metabolismo , Tecido Adiposo
19.
PLoS One ; 15(1): e0228039, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31968008

RESUMO

Stress is prevalent in modern society and can affect human health through its effects on appetite. Therefore, in the present study, we aimed to clarify the neural mechanisms by which acute stress affects appetite in healthy, non-obese males during fasting. In total, 22 volunteers participated in two experiments (stress and control conditions) on different days. The participants performed a stress-inducing speech-and-mental-arithmetic task under both conditions, and then viewed images of food, during which, their neural activity was recorded using magnetoencephalography (MEG). In the stress condition, the participants were told to perform the speech-and-mental-arithmetic task again subsequently to viewing the food images; however, another speech-and-mental-arithmetic task was not performed actually. Subjective levels of stress and appetite were then assessed using a visual analog scale. Electrocardiography was performed to assess the index of heart rate variability reflecting sympathetic nerve activity. The findings showed that subjective levels of stress and sympathetic nerve activity were increased in the MEG session in the stress condition, whereas appetite gradually increased in the MEG session only in the control condition. The decrease in alpha band power in the frontal pole caused by viewing the food images was greater in the stress condition than in the control condition. These findings suggest that acute stress can suppress the increase of appetite, and this suppression is associated with the frontal pole. The results of the present study may provide valuable clues to gain a further understanding of the neural mechanisms by which acute stress affects appetite. However, since the stress examined in the present study was related to the expectation of forthcoming stressful event, our present findings may not be generalized to the stress unrelated to the expectation of forthcoming stressful event.


Assuntos
Regulação do Apetite/fisiologia , Encéfalo/fisiologia , Fadiga Mental/psicologia , Estresse Psicológico , Adulto , Jejum/psicologia , Voluntários Saudáveis , Frequência Cardíaca/fisiologia , Humanos , Magnetoencefalografia/métodos , Masculino , Adulto Jovem
20.
PLoS One ; 15(1): e0227154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31910243

RESUMO

Mesenteric fat is a visceral fat depot that increases with cattle maturity and can be influenced by diet. There may be a relationship between the accumulation of mesenteric fat and feed efficiency in beef cattle. The purpose of this study was to identify genes that may be differentially expressed in steers with high and low BW gain and feed intake. RNA-Seq was used to evaluate the transcript abundance of genes in the mesenteric fat from a total of 78 steers collected over 5 different cohorts. A meta-analysis was used to identify genes involved with gain, feed intake or the interaction of both phenotypes. The interaction analysis identified 11 genes as differentially expressed. For the main effect of gain, a total of 87 differentially expressed genes (DEG) were identified (PADJ<0.05), and 24 were identified in the analysis for feed intake. Genes identified for gain were involved in functions and pathways including lipid metabolism, stress response/protein folding, cell proliferation/growth, axon guidance and inflammation. The genes for feed intake did not cluster into pathways, but some of the DEG for intake had functions related to inflammation, immunity, and/or signal transduction (JCHAIN, RIPK1, LY86, SPP1, LYZ, CD5, CD53, SRPX, and NF2). At PADJ<0.1, only 4 genes (OLFML3, LOC100300716, MRPL15, and PUS10) were identified as differentially expressed in two or more cohorts, highlighting the importance of evaluating the transcriptome of more than one group of animals and incorporating a meta-analysis. This meta-analysis has produced many mesenteric fat DEG that may be contributing to gain and feed intake in cattle.


Assuntos
Fenômenos Fisiológicos da Nutrição Animal/genética , Regulação do Apetite/genética , Regulação da Expressão Gênica/fisiologia , Gordura Intra-Abdominal/metabolismo , Ganho de Peso/genética , Criação de Animais Domésticos , Animais , Bovinos , Masculino , RNA-Seq , Transcriptoma
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