O CONTROLE DO APETITE, A SACIEDADE E A INGESTÃO DE ALIMENTOS.
É um exemplo de uma paciente na qual o apetite/alimentação "set-point" foi perturbada por danos neurológicos ao seu hipotálamo; que irá introduzir o controle neural e endócrino da ingestão de alimentos. Aparelhos de ressonância nuclear magnética de apresentação da secção sagital mostra a grande massa do hipotálamo (setas superiores) em conjunto com uma menor massa do tronco cerebral (setas inferiores). A primeira seção coronal mostra a extensão do envolvimento do hipotálamo.
A regulação da ingestão alimentar e saciedade é um processo complexo que envolve a coordenação de estímulos sensoriais, hormônios circulantes (p. ex., cortisol, insulina, hormônios intestinais e leptina secretada pelos adipócitos) e aferentes vagais do intestino retransmitida via os Núcleo do Trato Solitarius (NTS ). O hipotálamo coordena esta informação através de uma rede complexa de peptídeos orexígenos e anorexígenos - a regulação hipotalâmica da saciedade e do apetite. a leptina - é segregada por adipócitos e é transportado através da barreira hemato-encefálica. O jejum ou perda de gordura corporal diminui as concentrações séricas de leptina e CSF (leptin cerebrospinal fluid). o núcleo arqueado (ARC) é rico em leptina.
WIDESPREAD INFLUENCE ON CHILD GROWTH, YOUTH AND TEENAGE: BEYOND PITUITARY, GH, AND SLEEP, THE AUTONOMIC HYPOTHALAMUS FUNCTIONS.
HOW TO GROW HEALTHY: THE HYPOTHALAMUS IS IMPORTANT IN REGULATION OF PITUITARY FUNCTION, BUT ALSO HAS A NUMBER OF OTHER FEATURES COMMONLY AWARDED FOR ADJUSTMENT AUTONOMIC. THESE INCLUDE THE CORPORAL TEMPERATURE CONTROL, FOOD INTAKE, EMOTION AND MEMORY. PHYSIOLOGY-ENDOCRINOLOGY-NEUROENDOCRINOLOGY-GENETICS-ENDOCRINE-PEDIATRICS (SUBDIVISION OF ENDOCRINOLOGY): DR. JOÃO SANTOS CAIO JR. ET DRA. HENRIQUETA VERLANGIERI CAIO.
The hypothalamic arcuate nucleus-pituitary axis, adding the third ventricle is responsible for a remarkable set of functions implies that virtually every metabolic commands and autonomic functions in human. An important aspect of the hypothalamus autonomic control with respect to the endocrine system is the control of food intake. The effects of obesity on endocrine function can be generalized and endocrine abnormalities can cause obesity.
A number of hormones play a central role in the control of food intake. There is good experimental evidence that these 2 types of adipose tissue metabolically behave differently. The gynecoid distribution leads to low rates of circumference, waist hip, while the android distribution leads to a high rate of abdominal circumference. The android obesity is associated particularly with insulin resistance and increased cardiovascular morbidity and mortality (e.g., risk of heart attacks). It is the etiological association with other diseases that obesity becomes important, reducing life expectancy and reducing its quality.
THE APPETITE CONTROL, SATIETY AND FOOD INTAKE.
It is an example of a patient in whom the appetite/feeding "set-point" were disturbed by neurological damage to their hypothalamus; it will introduce the neural and endocrine control of food intake. MRI machines on presentation of the sagittal section shows the great mass of the hypothalamus (upper arrows) together with a smaller mass of the brainstem (arrows) below. The first section displays the coronal extent of involvement of the hypothalamus. The regulation of food intake and satiety is a complex process that involves the coordination of sensory stimuli, circulating hormones (e.g., cortisol, insulin, leptin and gut hormones secreted by adipocytes) and vagal Afferent Bowel Solitarius relayed via the nucleus of the tract (NTS).
The hypothalamus coordinates this information across a complex network of orexogenic and anorexigenic peptides - hypothalamic regulation of appetite and satiety. The Leptin is secreted by adipocytes transported across the blood-brain barrier. Fasting or losing body fat decreases serum concentrations of leptin and CSF (leptin cerebrospinal fluid). Arcuate Nucleus (ARC) is rich in leptin.
Dr. João Santos Caio Jr.
Endocrinologia – Neuroendocrinologista
CRM 20611
Dra. Henriqueta V. Caio
Endocrinologista – Medicina Interna
CRM 28930
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AUTORIZADO O USO DOS DIREITOS AUTORAIS COM CITAÇÃO
DOS AUTORES PROSPECTIVOS ET REFERÊNCIA BIBLIOGRÁFICA.
Referências Bibliográficas:
Caio Jr, João Santos, Dr.; Endocrinologista, Neuroendocrinologista, Caio,H. V., Dra. Endocrinologista, Medicina Interna – Van Der Häägen Brazil, São Paulo, Brasil; Graaff, Kent M.Van De, Anatomia Humana, 6°ed.,1942; Machado, Neuroanatomia Funcional, 2ª edição, 2004; Afifi, Functional Neuroanatomy - Text and Atlas, 2ª edição, 2005; Berne RM, Levy MN, Koeppew BM, Stanton BA. The hypothalamus and pituitary gland. Physiology. Fifth edition, 8/9.859. Mosby 2004; Farhy LS & Veldhuir (2003) Joint pituitary – hypothalamic and intrhypothalamic auto feedback construct of pulsatile growth hormone secretion. Am J Physiol. Integr Comp Physiol. 285: R1240-R1249; Dasgupta P (2004) Somatostatin analogues: multiple roles in cellular proliferation, neoplasisa and angiogenesis. Pharmacol & Therapeutics. 102: 61-85; Herbison AE (1988) Multimodal influence of estrogen upon gonadotrophin – releasing hormone neurons. Endocrine Rev. 19: 302-330; Ooi GT, Tawadros N, Escalona RM (2004) Pituitary cell lines and their endocrine applications. M;ol Cell Endocrinol. 228: 1-21; Forsyth IA & Wallis M (2002) Growth hormone and prolactin – Molecular and functional evolution. J Mammaru Gland Biol & neoplasic. 7: 291-312; Laron Z (2001) Insulin-like growth factor 1(IGF-1): a growth hormone. J Clin Pathol Mol Pathol. 54: 311-316; Woolfle J, Chia DJ, Massart Schlesinger MB, et al (2004) Molecular physiology pathology and regulation of the growth hormone insulin-like growth factos1 system. Pediatric Nephrol. 4: 1-18; Shefield–Moore & Urban R (2004) An overview of the endocrinology of skeletal muscle. Trends in Endocrinol and Metab. 15: 110-115; Zofková I (2003) Pathophysiological and clinical importance of insulin-like growth factor1 with respect to bone metabolism. Physiol Res. 52: 657-679; Olney RC (2003) Regulation of bone mass by growth hormone. Med Pediet Oncol. 41: 228-234; VanDam PS & Aleman A (2004) Insulin-like growth factor1, cognition and brain aging. Europ J Pharmacol. 490: 87-95; Daltani M & Preece M (2004) Growth hormone deficiency and related disorders: insights into causation, diagnosis and treatment. Lancet. 363: 1977-1987; Freeman ME, Kanyicska B, Larent A & Nagy G (2000) Prolactin: structure, function and regulation of secretion. Physiol Rev. 80: 1523-1631.
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