Overweight, defined as body-mass index (BMI) greater than 25, and obesity, defined as BMI greater than 30, are characterized by excessive fat accumulation which poses adverse risks to health. Worldwide, there are more than one billion overweight and 300 million obese adults. Obesity is a major risk factor for diabetes, cardiovascular disease, sleep apnea, non-alcoholic fatty liver disease, arthritis, cancer and other diseases, and has been associated with enormous health costs, premature death, reduction in the quality of life and disability. The increasing global incidence of child obesity is also a major concern. The obesity epidemic is not just a problem for industrialized societies. Indeed, obesity rates have risen three times or more over the past two decades in some developing countries. Although the growing obesity epidemic undoubtedly reflects profound changes in diet and lifestyle over recent decades, genetic factors are important in determining a person’s susceptibility to weight gain and adverse health consequences of obesity.
The goal of this book is to highlight the pathophysiolgy of obesity and associated diseases. While a completely comprehensive discussion of the metabolic basis of obesity is beyond the scope of this book, it presents in-depth reviews of a wide range of topics, including energy homeostasis and intermediary metabolism, adipocyte biology, central neuronal pathways, adipokines, cytokines, classical hormones, abnormal glucose and lipid metabolism, and dysregulation of major organs, with an emphasis on human obesity. These topics will be interesting and provide critical information on the metabolic basis of obesity to researchers, clinicians, students, and the public at large.
Contents
1 Principles of Human Energy Metabolism
- Energy Expenditure
- Measurement of Energy Expenditure
- Energy Balance and Implications for Obesity
- Metabolic Risk Factors for Weight Gain
2 Intermediary Metabolism of Carbohydrate, Protein, and Fat
- Carbohydrate and Energy Metabolism
- Triglyceride and Fatty Acid Metabolism
- Protein and Amino Acid Metabolism
- AMP-Activated Protein Kinase: An Integrated Modulator of Cellular Metabolism
- Transgenic Models: Some Answers and More Questions
3 Adipose Tissue Development, Structure and Function
- Multiple Functions of Adipose Tissue
- Biochemical Properties of Adipocytes
- Adipose Tissue is Connected to Other Physiological Systems
- Anatomical Distribution and Structure of Adipose Tissue
- In Vivo Regulation of WAT Expansion
- Regulation of White Adipocyte Differentiation
- Identification of White Adipocyte Progenitors
- Brown Adipose Tissue (BAT)
- In Vivo Regulation of BAT
- Recent Advances in Human Adult BAT
4 Adipokines in Health and Disease
- Leptin
- Adiponectin
- Resistin
- Other Adipokines Related to Obesity: Proinflammatory Cytokines, Retinol Binding Protein-4
5 Neural Control of Feeding and Energy Homeostasis
- Hypothalamic Regulation of Feeding and Energy Homeostasis
- Brainstem Regulation of Feeding and Energy Homeostasis
- Short-Term Regulation of Energy Homeostasis by Nutrients and Gut Hormones
- Long-Term Regulation of Energy Stores by Adiposity Hormones
- Role of Biogenic Amines in Feeding Regulation and Energy Homeostasis
6 Gastrointestinal Hormones and Obesity
- Hormones Secreted by the Upper Gastrointestinal Tract: Ghrelin, Cholecystokinin (CCK), Incretins and Enteroinsular Axis
- Hormones Secreted by the Distal Gut: Oxyntomodulin (OXM), Peptide YY (PYY)
- Pancreatic Hormones: Pancreatic Polypeptide (PP), Amylin (Islet Amyloid Polypeptide)
- Other Gut Hormones
- Bombesin-Related Peptides
- Hormonal Interactions
7 Genes and Human Obesity
- Heritability
- Gene–Environment Interaction
- Candidate Genes
- Common Obesity and Rare Gene Variation
- Linkage Studies
- Whole-Genome Association Studies
- Disparate Approaches Appear to Converge
- Unanticipated Genes
- Epigenetic Modification
- Applications: Prevention and Therapy
8 Classical Hormones Linked to Obesity
- Insulin and Obesity
- Glucocorticoids
- Thyroid Hormone
- Growth Hormone
9 Inflammation and Adipose Dysfunction
- Systemic Activation of Inflammatory Pathways
- Adipose-Specific Activation of Immune Pathways
- Adipose Leukocyte Infiltration
- Adipose Inflammation Attenuates Insulin Signaling
- Endotoxemia and Adipose TLR Signaling
- The Adipose Inflammatory Secretome
- Role of Intracellular Kinases
- Suppressor of Cytokine Signaling Proteins
- Modulation of Transcription Factors
- Gene Expression Profiling and Proteomics
- Therapeutic Implications
- Modulation of Systemic inflammation
- Modulation of Leukocyte Infiltration in Adipose
10 Insulin Resistance in the Metabolic Syndrome
- Clinical Versus molecular definitions of insulin resistance
- Insulin Signaling Pathway
- Metabolic Effects of Insulin Resistance: Lessons from Knockout Mice
- Molecular Mechanisms of Insulin Resistance
- Insulin Resistance in Humans
11 Pancreatic Islet b-Cell Failure in Obesity
- Neuropeptides Regulating the Islet–Hypothalamic Axis
- Gut Peptides Regulating the Islet–Hypothalamic Axis
- Adipokines and Cytokines Regulating the Islet–Hypothalamic Axis
- Potential Therapeutic Approaches to Pancreatic b-Cell Failure in Obesity
12 Non-Alcoholic Fatty Liver Disease and the Metabolic Syndrome
- NAFLD and the Metabolic Syndrome
- The Intertwined Paths of Insulin and Lipid Metabolism in the Pathogenesis of Hepatic Steatosis
- Pathogenesis of NASH
13 Sleep, Circadian Rhythms and Metabolism
- Molecular Relationships Between Metabolism and Circadian Rhythms
- From Circadian Disruption to Cardiometabolic Diseases
- Neurophysiological Structures: Interconnection Between Circadian, Sleep and Energy Centers
- From Metabolism to Circadian Cycles
14 Obesity and Cardiac Dysfunction
- Epidemiology and Pathophysiology of Cardiac Dysfunction in Human Obesity
- Comorbidities that Contribute to Cardiac Dysfunction in Obesity
- Mechanistic Insights Gained from Studies in Animal Models of Obesity
- Postulated Mechanisms for Cardiac Dysfunction in Obesity
- Clinical Considerations
15 Atherogenic Lipid Metabolism in Obesity
- VLDL Overproduction
- Reduced Hepatic Sensitivity to Insulin Leading to Increased Hepatic Lipogenesis, VLDL-Apolipoprotein-B Assembly and Secretion
- Impaired Catabolism of Atherogenic Lipoprotein Remnants
- Hypercatabolism of HDL
16 Gut Microbes, Immunity, and Metabolism
- Gut Microecology
- Current Technology and Characterization of the Gut Microbiota / Microbiome
- Metagonomics and Metabolomics
- The Gut Microbiota and Obesity
- Gut Microbiota and Diet
- Connecting the Gut Microbiome, Innate Immunity and Obesity
- Gut Microbiota and Type 1 diabetes
- Gut Microbiota and Nitrogen Balance
17 Impact of Obesity on Female Reproductive Health
- Energy Homeostasis and Reproduction
- Pathogenesis of Polycystic Ovary Syndrome
18 Lessons from HIV Lipodystrophy and Drug-Induced Metabolic Dysfunction
- Metabolic and Anthropometric Changes Among HIV-Infected Patients
- Effects of Specific Antiretroviral Medications on Body Composition and Metabolic Changes
- Genetic Predictors of Metabolic Risk in Acquired HIV Lipodystrophy Syndrome
- Cardiovascular Risk Among HIV-Infected Patients and Potential Mechanisms
- Novel Pharmacological Strategies to Improve Metabolic Abnormalities and Fat Redistribution Among HIV-Infected Patients
19 Principles of Obesity Therapy
- Clinical Evaluation of Obesity
- Treatment of Obesity
- Exercise
- Pharmacotherapy
- Surgical Treatment of Obesity
Index
About the Editor
- Rexford S. Ahima, Division of Endocrinology, Diabetes and Metabolism, and the Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania, School of Medicine, 415 Curie Boulevard, 712A Clinical Research Building, Philadelphia, PA 19104, USA. Email: ahima@mail.med.upenn.edu
Product Details
- Hardcover: 405 pages
- Publisher: Springer; 1st edition (2011)
- Language: English
- ISBN-10: 1441916067
- ISBN-13: 978-1441916068
- Product Dimensions: 9.2 x 6.1 x 1.1 inches
List Price: $219.00