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The Interaction of Obesity and Ghrelin/Leptin

Year 2018, Volume: 9 Issue: 35, 136 - 151, 31.12.2018
https://doi.org/10.17944/mkutfd.328412

Abstract

The incidence of obesity, the most important health problem in the developing world, has increased dramatically both adults and children in recent years. Obesity usually occurs with limited actions and unbalanced received/spent energy. Obesity is the basis for the formation of many metabolic diseases and a component of metabolic syndrome accompanied by hypertension, insulin resistance, high triglyceride and low HDL concentrations. The hypothalamus is the brain region in which hunger and satiety are managed by signals of the peripheral polypeptite hormones the release from peripheral organs. In mammals, the peripheral peptite identified as oreksigen and an appetite enhancer is the ghrelin hormone. Ghrelin is produced by the fundus region cells and released in the circulation. It binds to growth hormone stimulating receptors and induces food intake through the arcuate nucleus neuropeptite Y (NPY) and arguate-associated peptite (AgRP) in the hypothalamus. Leptin, which is antagonist to ghrelin and expressed by adipose tissue, inhibits AgRP and NPY activity while activating pro-opiomelanocortin (POMC) and cocaine and amphetamine-regulated transcript (CART) in the hypothalamus and suppressing appetite. The quality of the food and the mutations in receptors or genes of these hormones are significantly caused for the pathogenesis of obesity.

The aim of this review, in the light of current studies, is to focus on the obesity and relationship between ghrelin and leptin hormones stimulating of hunger / satiety signals in the hypothalamus and provide an approach to the use of agonists or antagonists of these hormones as a treatment option.

References

  • Hiraga M, Ono F, Omura N, Sato M, Yamamura A. A case of gastric necrosis and perforation due to overeating-induced gastric 202 North Clin Istanbul – NCI dilatation: A case report. J Jpn Surg Assoc 2012;73:1933–37.
  • Todd SR, Marshall GT, Tyroch AH. Acute gastric dilatation revisited. Am Surg 2000;66:709–10.
  • Lim JE, Duke GL, Eachempati SR. Superior mesenteric artery syndrome presenting with acute massive gastric dilatation, gastric wall pneumatosis, and portal venous gas. Surgery 2003;134:840–3.
  • Kaneda T, Miyazawa H, Kobayashi T, Shimizu N, Katayama M, Sato T. A case of acute gastric dilatation occurring after bulimia while on a diet. J Tokyo Med Univ 1996;54:66–8.
  • Celikkaya ME, Atıcı A, El Ç A significant danger to children: Foreign body ingestion. Annals of Medical Research 2018;25(2):211-3
  • Usuda M, Koizumi M, Kouda H, Nakahara C, Ueki H, Shibazaki S. Gastric necrosis caused by acute gastric dilatation after an episode of bulimia- A case report. Jpn J Gastroenterol Surg1998;31:2346–9.
  • Dincel O, Goksu M Acute gastric dilatation due to binge eating may be fatal North Clin Istanbul 2017;4(2):199–202.
  • Luncă S, Rikkers A, Stănescu A. Acute massive gastric dilatation: severe ischemia and gastric necrosis without perforation. Rom J Gastroenterol 2005; 14: 279-283.
  • Todd SR, Marshall GT, Tyroch AH. Acute gastric dilatation revisited. Am Surg 2000; 66: 709-710.
  • Turan M, Sen M, Canbay E, Karadayi K, Yildiz E. Gastric necrosis and perforation caused by acute gastric dilatation: report of a case. Surg Today 2003; 33: 302-304.
  • Holtkamp K, Mogharrebi R, Hanisch C, Schumpelick V, Herpertz-Dahlmann B. Gastric dilatation in a girl with former obesity and atypical anorexia nervosa. Int J Eat Disord 2002;32:372– 6

Obezite ve Ghrelin/Leptin İlişkisi

Year 2018, Volume: 9 Issue: 35, 136 - 151, 31.12.2018
https://doi.org/10.17944/mkutfd.328412

Abstract

Gelişen dünyanın en önemli sağlık sorunlarından olan obezitenin insidansı son yıllarda hem yetişkinlerde hem de çocuklarda dramatik şekilde artış göstermektedir. Obezite genellikle kısıtlı hareket etme ve alınan/harcanan enerji arasındaki dengesizlik sonucunda meydana gelmekte ve pek çok metabolik hastalığın oluşumuna zemin hazırlamaktadır. Hipertansiyon, insülin rezistansı, yüksek trigliserid ve düşük HDL konsantrasyonları ile birlikte obezite metabolik sendromun bir parçasıdır. 

Hipotalamus, periferal organlardaki polipeptit hormonlar tarafından alınan sinyaller ile açlık ve tokluğun yönetildiği beyin bölgesidir. Memelilerde oreksijen yani iştah artırıcı olarak tanımlanan periferal peptit ghrelin hormonudur. Ghrelin midenin fundus bölgesinden üretilerek dolaşıma salınır. Büyüme hormonunu stimüle eden reseptörlere bağlanır ve hipotalamusta arkuat nükleustaki nöropeptit Y (NPY) ve aguti ilişkili peptit (AgRP) ifadelerini artırarak gıda alımını uyarır. Ghrelin’le antagonist etki gösteren ve adipoz dokudan ifade edilen leptin ise AgRP ve NPY etkisini inhibe ederken, hipotalamusta bulunan pro-opiomelanokortin (POMC), kokain ve amfetamin ile düzenlenen transkriptinin (CART) aktive edilmesi yoluyla iştahı baskılar. Obezitenin patogenezinde yer alan bu hormonların reseptör ya da genlerinde meydana gelen mutasyonlar ve alınan gıdanın niteliği obezitenin önemli nedenlerindendir.

Yapılan bu derlemenin amacı, güncel çalışmalar ışığında obezite ve hipotalamusta açlık/tokluk sinyallerini uyaran ghrelin ve leptin hormonlarının ilişkisi üzerinde durmak ve bu hormonların agonist ya da antagonistlerinin kullanımının bir tedavi seçeneği olup olmayacağına da bir yaklaşım sunmaktadır.

References

  • Hiraga M, Ono F, Omura N, Sato M, Yamamura A. A case of gastric necrosis and perforation due to overeating-induced gastric 202 North Clin Istanbul – NCI dilatation: A case report. J Jpn Surg Assoc 2012;73:1933–37.
  • Todd SR, Marshall GT, Tyroch AH. Acute gastric dilatation revisited. Am Surg 2000;66:709–10.
  • Lim JE, Duke GL, Eachempati SR. Superior mesenteric artery syndrome presenting with acute massive gastric dilatation, gastric wall pneumatosis, and portal venous gas. Surgery 2003;134:840–3.
  • Kaneda T, Miyazawa H, Kobayashi T, Shimizu N, Katayama M, Sato T. A case of acute gastric dilatation occurring after bulimia while on a diet. J Tokyo Med Univ 1996;54:66–8.
  • Celikkaya ME, Atıcı A, El Ç A significant danger to children: Foreign body ingestion. Annals of Medical Research 2018;25(2):211-3
  • Usuda M, Koizumi M, Kouda H, Nakahara C, Ueki H, Shibazaki S. Gastric necrosis caused by acute gastric dilatation after an episode of bulimia- A case report. Jpn J Gastroenterol Surg1998;31:2346–9.
  • Dincel O, Goksu M Acute gastric dilatation due to binge eating may be fatal North Clin Istanbul 2017;4(2):199–202.
  • Luncă S, Rikkers A, Stănescu A. Acute massive gastric dilatation: severe ischemia and gastric necrosis without perforation. Rom J Gastroenterol 2005; 14: 279-283.
  • Todd SR, Marshall GT, Tyroch AH. Acute gastric dilatation revisited. Am Surg 2000; 66: 709-710.
  • Turan M, Sen M, Canbay E, Karadayi K, Yildiz E. Gastric necrosis and perforation caused by acute gastric dilatation: report of a case. Surg Today 2003; 33: 302-304.
  • Holtkamp K, Mogharrebi R, Hanisch C, Schumpelick V, Herpertz-Dahlmann B. Gastric dilatation in a girl with former obesity and atypical anorexia nervosa. Int J Eat Disord 2002;32:372– 6
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Aliye Sağkan Öztürk

Abdullah Arpacı

Publication Date December 31, 2018
Submission Date July 14, 2017
Acceptance Date December 17, 2018
Published in Issue Year 2018 Volume: 9 Issue: 35

Cite

Vancouver Sağkan Öztürk A, Arpacı A. Obezite ve Ghrelin/Leptin İlişkisi. mkutfd. 2018;9(35):136-51.