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Obesidad: epidemia del nuevo milenio
Obesity: epidemy of new millennium
Palabras clave:
obesidad, diabetes mellitus, tejido adiposo, metabolismo basal, termodinámica, hiperfagia, salud pública, leptina, apetito, saciedad (es)obesity, diabetes mellitus, adipose tissue, basal metabolism, thermodynamics, hyperphagia, public health, appetite, satiation (en)
La obesidad es una de las enfermedades más antiguas del mundo, sin embargo hasta hace relativamente poco se ha reconocido como tal, debido a su gran incidencia en la salud pública por sus características epidémicas y por las funestas asociaciones que la acompañan.
Aún cuando es sus comienzos esta acumulación de energía permitió la supervivencia en épocas de hambruna, la evolución hormonal que implica este fenómeno la ha convertido en una afección epidémica, propiciada por el sedentarismo y la sobre alimentación. El sueño de nuestros ancestros de comida disponible con menor esfuerzo ha llegado a ser una pesadilla. Un gran número de factores hormonales producidos en diversos tejidos por más de 450 genes se encargan de mantener una homeostasis energética cuya alteración puede promover la obesidad; a su vez los adipocitos hipertróficos producen adipocinas que alteran el metabolismo de la glucosa, predisponiendo a diabetes mellitus y a la lesión del endotelio vascular generando enfermedad cardiovascular. La obesidad se constituye así en un estado proinflamatorio crónico de bajo grado.
Las diferentes estrategias de tratamiento de esta enfermedad multifactorial implican una disminución en el aporte y un aumento del gasto energéticos. El tratamiento definitivo a muy largo plazo posiblemente resulte del desarrollo de la biología molecular, sin embargo en el momento actual ese horizonte está tan lejano que el conocimiento de las graves complicaciones de la obesidad, los esfuerzos educativos, los cambios en el medio ambiente y en el estilo de vida son críticos para enfrentar el desafío.
Obesity is one of the oldest diseases in the world.
Nevertheless, the importance of this true epidemic and its unfortunate pathological associations have been called into attention since relatively a short time ago. Even if energy storage in early times allowed survival of mankind during starvation times, the hormonal machinery responsible for this has turned against us in modern days, due to industrialization, sedentarism and overfeeding that characterises industrialized societies.
Therefore, the dream of our ancestors, food easily available with less physical work, has turned into a nightmare. More than 450 genes work together to produce a great number of hormonal factors that regulate energyhomeostasis, and their variation is the cornerstone of obesity. Hypertrophied and dysfunctional adipocytes produce adipokines that alter glucose metabolism, predispose to the diabetes mellitus type 2 and can also damage vascular endothelium, making obesity a chronic low grade proinflammatory state.
Development of different strategies for treatment of this multifactorial disease necessarily implies a reduction in energy storage, and an increase in its expenditure. In the long term, definitive treatment of obesity might result from advances related to molecular biology development. Nonetheless, that horizon is very distant at the present time, and knowledge of the serious complications of obesity, educational efforts, and changes in our environment and lifestyle are critical to face the challenge of obesity.
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Derechos de autor 2005 Revista de la Facultad de Medicina
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
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