title: [Role of the brain in the regulation of metabolism and energy expenditure: the central role of insulin, and insulin resistance of the brain].
abstract: Regulatory role of the brain in energy expenditure, appetite, glucose metabolism, and central effects of insulin has been prominently studied. Certain neurons in the hypothalamus increase or decrease appetite via orexigenes and anorexigenes, regulating energy balance and food intake. Hypothalamus is the site of afferent and efferent stimuli between special nuclei and beta- and alpha cells, and it regulates induction/inhibition of glucose output from the liver. Incretines, produced in intestine and in certain brain cells (brain-gut hormones), link to special receptors in the hypothalamus. Central role of insulin has been proved both in animals and in humans. Insulin gets across the blood-brain barrier, links to special hypothalamic receptors, regulating peripheral glucose metabolism. Central glucose sensing, via "glucose-excited" and "glucose-inhibited" cells have outstanding role. Former are active in hyperglycaemia, latter in hypoglycaemia, via influencing beta- and alpha cells, independently of traditional metabolic pathways. Evidence of brain insulin resistance needs centrally acting drugs, paradigm changes in therapy and prevention of metabolic syndrome, diabetes, cardiovascular and oncological diseases.
authors.affiliation: MAZSIHISZ Szeretet Kórház Metabolikus Ambulancia Budapest Amerikai út 53-55. 1145. fishwash@t-online.hu
authors.forename: Tamás
authors.initials: T
authors.lastname: Halmos
authors.forename: Ilona
authors.initials: I
authors.lastname: Suba
mesh_terms: D000818:Animals; D001067:Appetite Depressants / Q000378:metabolism; D001069:Appetite Regulation / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D002518:Ceramides / Q000378:metabolism; D003071:Cognition; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D004734:Energy Metabolism; D005234:Fatty Liver / Q000378:metabolism; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D007031:Hypothalamus / Q000378:metabolism; D054795:Incretins / Q000378:metabolism; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D047908:Intracellular Signaling Peptides and Proteins / Q000378:metabolism; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000523:psychology; D009479:Neuropeptides / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease; D009842:Oligopeptides / Q000378:metabolism; D000068797:Orexins; D011761:Pyrrolidonecarboxylic Acid / Q000031:analogs & derivatives / Q000378:metabolism
chemical_list: D001067:Appetite Depressants; D001786:Blood Glucose; D002518:Ceramides; D054795:Incretins; D007328:Insulin; D047908:Intracellular Signaling Peptides and Proteins; D009479:Neuropeptides; D009842:Oligopeptides; D000068797:Orexins; C023866:pyroglutamyl-histidyl-glycine; D052216:Glucagon-Like Peptide 1; D011761:Pyrrolidonecarboxylic Acid