代谢减重手术调控促食/厌食神经因子及信号通路的研究进展

Advances in the regulation of orexigenic/anorexigenic neuropeptides and signaling pathways by metabolic bariatric surgery

摘要:

代谢减重手术作为肥胖及相关代谢疾病的有效干预手段，除显著降低体质量外，还可通过调节促食与厌食神经因子及其信号通路，改善能量代谢与代谢稳态。本文综述了不同类型代谢减重手术（如Roux-en-Y胃旁路术和胃袖状切除术）对促食和厌食神经因子表达及功能的影响，阐述其在哺乳动物雷帕霉素靶蛋白与腺苷酸活化蛋白激酶等关键信号通路中的作用机制，并探讨其在体质量控制、胰岛素敏感性及代谢疾病改善中的临床意义。研究表明，代谢减重手术通过中枢与外周多靶点调节能量平衡，为个体化肥胖治疗提供了新的生物学依据。未来应聚焦手术反应的个体差异及神经-代谢网络的长期重塑机制，以期优化治疗策略并提升患者预后。

Abstract:

Metabolic bariatric surgery is an effective intervention for obesity and related metabolic disorders. Beyond substantial weight reduction, it modulates orexigenic and anorexigenic neuropeptides and their signaling pathways to improve energy homeostasis and metabolic function. This review summarizes the regulatory effects of various bariatric procedures (such as Roux-en-Y gastric bypass and sleeve gastrectomy) on orexigenic neuropeptides and anorexigenic factors, highlighting the involvement of key signaling pathways including mTOR and AMPK. These mechanisms contribute to weight control, enhanced insulin sensitivity, and remission of metabolic diseases. By integrating central and peripheral regulatory processes, metabolic surgery provides new biological insights into individualized obesity management. Future research should focus on interindividual variability and long-term neuro-metabolic adaptations to optimize surgical outcomes and improve metabolic health.