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The Gut and Energy Balance: Visceral Allies in the Obesity Wars
Michael K. Badman and
Jeffrey S. Flier*
In addition to digesting and assimilating nutrients, the intestineand associated visceral organs play a key sensing and signalingrole in the physiology of energy homeostasis. The gut, the pancreaticislets of Langerhans, elements in the portal vasculature, andeven visceral adipose tissue communicate with the controllersof energy balance in the brain by means of neural and endocrinepathways. Signals reflecting energy stores, recent nutritionalstate, and other parameters are integrated in the central nervoussystem, particularly in the hypothalamus, to coordinate energyintake and expenditure. Our understanding of regulatory neuralcircuits and the signaling molecules that influence them hasprogressed rapidly, particularly after the discovery of theadipocyte hormone leptin. These discoveries have led to explorationof novel routes for obesity control, some of which involve gut-derivedpathways.
Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Finard 202, 330 Brookline Avenue, Boston, MA 02215, USA.
* To whom correspondence should be addressed. E-mail: JFlier{at}bidmc.harvard.edu
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