KFO 218: Hormonal Regulation of Body Weight Maintenance

肥胖是最普遍的疾病之一，它对肥胖者的发病率、死亡率和生活质量产生了巨大的影响，对世界各地的卫生保健系统构成了挑战。各种策略，包括生活方式，也包括药物方法，已经被证明在短期内支持或诱导减肥。然而，这些策略通常无法在新的设定点建立持续的能量平衡，也不能长期稳定体重。相比之下，许多人恢复体重的速度相对较快，通常干预后的体重甚至比基线(体重循环)有所增加，这一现象可能与并发症方面的结果比肥胖本身更糟糕有关。肥胖者的体重减轻与减少能量消耗的矛盾的反调节有关。最近的研究表明，荷尔蒙机制对这一现象有重要影响。这种协调的荷尔蒙反应有利于体重恢复，因此，对长期保持体重非常重要。改变体重恢复的内分泌成分的机会意味着治疗干预，以提高体重维持的成功率。需要对减肥过程中的这些逆调节内分泌反应进行更详细和个性化的研究，以将这些发现转化为基于激素的减肥维持临床治疗试验。进一步的内分泌反应，如性激素、糖皮质激素和IGF1，到目前为止还没有在这个减肥-恢复范例中进行研究。此外，通过改变生活方式，如体力活动或营养来改变这些系统还没有得到调查。因此，这个临床研究单位的战略目标是确定和描述荷尔蒙机制，以平衡在前一段时间能量负平衡后的体重维持。临床研究股的结构利用了柏林/波茨坦地区内分泌学和能量动态平衡方面的临床和基础研究方面的专业知识，并促进将实验结果转化为治疗方法，从而改善体重维持和代谢健康。

Obesity is one of the most prevalent disorders that challenge the health care systems worldwide due to the enormous implications for morbidity, mortality and quality of life of obese individuals. Various strategies, including lifestyle but also pharmacological approaches, have been shown to support or induce weight loss on the short run. However, those strategies usually fail to establish a sustained energy balance at a novel setpoint and do not stabilise body weight on the long-term. In contrast, many individuals regain weight relatively fast and often the post-intervention body weight even increases compared to baseline (weight cycling), a phenomenon, which may be associated with a worse outcome in terms of complications than adiposity itself. Loss of body weight in obese individuals is associated with a paradox counterregulation that reduces energy expenditure. Recent studies demonstrated that hormonal mechanisms contribute significantly to this phenomenon. This coordinated hormonal response favours weight regain and is, therefore, of major importance for the long-term maintenance of body weight. The opportunity to modify endocrine components of weight regain implies therapeutic interventions to improve the success of body weight maintenance. A more detailed and individualised investigation of these counter-regulatory endocrine responses under weight loss are required to translate these findings into hormone-based clinical treatment trials for weight loss maintenance. Further endocrine responses like sex steroids, glucocorticoids and IGF1 have not been studied within this weight-loss-regain paradigm so far. In addition, the modification of those systems by lifestyle modifications such as physical activity or nutrition has not yet been investigated. Therefore, the strategic objective of this Clinical Research Unit is to identify and characterise hormonal mechanisms counterbalancing weight maintenance after a previous period of negative energy balance. The structure of the Clinical Research Unit takes advantage of the expertise in clinical and basic research within the topics of endocrinology and energy homeostasis in the region of Berlin/Potsdam and facilitates the translation of experimental findings to therapeutic approaches resulting in improved weight maintenance and metabolic health.