Obesidade: regulação hormonal
DOI:
https://doi.org/10.25758/set.1421Palavras-chave:
Obesidade, Hormonas, Tecido adiposo, Trato gastrointestinal, Abordagem terapêuticaResumo
A obesidade é considerada um problema de saúde pública pela OMS, existindo mundialmente cerca de 1,9 mil milhões de pessoas com excesso de peso e, destas, 600 milhões são obesas. Esta patologia representa um risco elevado para doenças cardiovasculares, diabetes, hipertensão e cancro. Na sua génese está um desequilíbrio entre a energia ingerida e a energia despendida. Este desequilíbrio pode resultar de fatores psicológicos, ambientais, genéticos e metabólicos, indutores de perturbações do comportamento alimentar, como o aumento de ingestão alimentar ou de um estilo de vida sedentário. A regulação do balanço energético resulta de uma variedade de estímulos aferentes que são processados no sistema nervoso central e respostas eferentes, reguladoras do apetite e saciedade. Os sinais aferentes podem ser transmitidos ao cérebro através do nervo vago ou pela via sistémica e envolver hormonas libertadas pelo tecido adiposo (leptina, adiponectina, resistina e visfatina) e pelo trato gastrointestinal (ghrelina, PYY, PP, GPL-1 e CCK). A resposta aos estímulos provoca ativação ou inibição de neurónios orexígenos (NPY, AgRP) e/ou anorexígenos (POMC, CART) localizados no hipotálamo. Enquanto a ativação dos neurónios que expressam NPY e AgRP aumenta o apetite, a ativação dos neurónios que expressam POMC ou CART origina saciedade. Muitos são os estudos que procuraram compreender os mecanismos do balanço energético. Contudo, os resultados são ainda, em alguns casos, pouco esclarecedores ou mesmo contraditórios. Pretende-se, com este artigo, fazer uma revisão sobre os mecanismos de regulação hormonal envolvidos na patogénese da obesidade, dando especial relevo às hormonas produzidas no tecido adiposo, estômago e intestino. Considerada uma epidemia do século XXI pela sua elevada prevalência e complicações associadas, tornam-se cruciais mais estudos nesta área a fim de encontrar novas abordagens terapêuticas.
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