Research Article| Volume 44, SUPPLEMENT 2, 38-41, February 1995

Download started.


Neuroendocrine abnormalities in human obesity

  • Per Björntorp
    Address reprint requests to Per Björntorp, MD, PhD, Department of Heart and Lung Diseases, University of Göteborg, Sahlgren's Hospital, 413 45 Göteborg, Sweden.
    Department of Heart and Lung Diseases, University of Göteborg, Göteborg, Sweden
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Recent research has indicated that visceral obesity is associated with multiple endocrine disturbances. Insulin resistance, as well as visceral fat accumulation, may be consequences of these abnormalities. The complex endocrine aberrations are probably of central origin, and suggest a neuroendocrine background with a “hypothalamic arousal” syndrome. Such a syndrome has been found after excess alcohol intake, tobacco smoking, and certain types of stress reactions. Subjects with visceral obesity might be characterized by a high prevalence of such factors, although only indirect evidence is available for the stress component, maybe caused by a poor socioeconomic and psychosocial situation. In primate experiments, a submissive stress reaction is followed by a syndrome essentially identical to that seen in humans with visceral obesity, including visceral fat accumulation. These observations strongly support a similar chain of events in humans. Recent studies have indicated several abnormalities in cerebrospinal fluid (CSF) concentrations of catecholamines and neuropeptides. In particular, serotonin metabolites and corticotropin-releasing factor (CRF) concentrations are apparently lower than normal. In women with visceral obesity, these low concentrations are associated with food choices that indicate a preference for carbohydrates. This finding emphasizes the importance of serotonin agonists in the treatment of human obesity. It seems possible that such drugs may have effects on metabolic and other symptoms particularly prevalent in abdominal obesity, and that these effects might be independent of the decrease in energy intake. It would seem highly desirable to explore these possibilities further. Such observations may also provide a link between the abnormalities of low serotonin and CRF concentrations in the central nervous system on one hand and peripheral metabolic and other abnormalities on the other.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Metabolism - Clinical and Experimental
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Björntorp P
        Visceral obesity: A “Civilization syndrome”.
        Obes Res. 1993; 1: 206-222
        • Reaven GH
        Role of insulin resistance in human disease.
        Diabetes. 1988; 37: 1595-1607
        • Kissebah AH
        • Peiris AN
        Biology of regional body fat distribution.
        in: Relationship to non—insulin-dependent diabetes mellitus. Diabetes Metab Rev. 5. 1989: 83-109
        • Björntorp P
        Metabolic implications of body fat distribution.
        Diabetes Care. 1991; 14: 1132-1143
        • Björntorp P
        “Portal” adipose tissue as a generator of risk factors for cardiovascular disease and diabetes.
        Arteriosclerosis. 1990; 10: 493-496
        • Marin P
        • Darin N
        • Amemiya T
        • et al.
        Cortisol secretion in relation to body fat distribution in obese premenopausal women.
        Metabolism. 1992; 41: 882-886
        • Jern S
        • Bergbrant A
        • Björntorp P
        • et al.
        Relation of central hemodynamics to obesity and body fat distribution.
        Hypertension. 1992; 19: 520-527
        • Henry JP
        • Stephens PM
        Stress, Health, and the Social Environment.
        in: A Sociobiological Approach to Medicine. 1977 (Springfield, NY)
        • Gossain VV
        • Sherma NK
        • Srivastava L
        • et al.
        Hormonal effects of smoking. II. Effects on plasma, cortisol, growth hormone, and prolactin.
        Am J Med Sci. 1986; 291: 325-327
        • Cicero TJ
        Sex differences in the effects of alcohol and other psychoactive drugs on endocrine function.
        in: Israel Y Kalant O Kalant H Research Advances in Alcohol and Drug Problems. Plenum, New York, NY1980: 544-593
        • Larsson B
        • Seidell JC
        • Svärdsudd K
        • et al.
        Obesity, adipose tissue distribution and health in men.
        in: The study of men born in 1913. Appetite. 13. 1989: 37-44
        • Lapidus L
        • Bengtsson C
        • Hällström T
        • et al.
        Obesity, adipose tissue distribution and health in women.
        in: Results from a population study in Gothenburg, Sweden. Appetite. 12. 1989: 25-35
        • Karasek RA
        • Russel RS
        • Theorell T
        Physiology of stress and regeneration in job-related cardiovascular illness.
        J Hum Stress. 1982; 3: 29-42
        • Björntorp P
        Visceral fat accumulation: The missing link between psycho-social factors and cardiovascular disease.
        J Int Med. 1991; 230: 195-201
        • Wing RR
        • Matthews KA
        • Kuller LH
        • et al.
        Waist to hip ratio in middle-aged women.
        in: Associations with behavioural and psycho-social factors and with changes in cardiovascular risk factors. Arterioscler Thromb. 11. 1991: 1250-1257
        • Leonetti DL
        • Bergstrom RW
        • Shuman WP
        • et al.
        Urinary catecholamines, plasma insulin and environmental factors in relation to body fat distribution.
        Int J Obes. 1991; 15: 345-357
        • Hamm Jr, TE
        • Kaplan JR
        • Clarkson TB
        • et al.
        Effects of general and social behaviour on the development of coronary artery atherosclerosis in cynomolgus macaques.
        Atherosclerosis. 1983; 48: 221-223
        • Folkow B
        Stress, hypothalamic function and neuroendocrine consequences.
        Acta Med Scand. 1988; 4 ([Suppl]): 61-69
        • Shively C
        • Clarkson TB
        • Miller CL
        • et al.
        Body fat as a risk factor for coronary artery atherosclerosis in female cynomolgus monkeys.
        Arteriosclerosis. 1987; 7: 226-231
        • Jayo J
        • Shively C
        • Kaplan J
        • et al.
        Effects of exercise and stress on body fat distribution in male cynomolgus monkeys.
        Int J Obes. 1993; 17: 597-604
        • Andersson B
        • Zimmermann ME
        • Hedner T
        • et al.
        Haemodynamic, metabolic and endocrine effects of short-term dexfenfluramine treatment in young, obese women.
        Eur J Clin Pharmacol. 1991; 40: 249-254
        • Scheen AY
        • Paolisso G
        • Salvatore T
        • et al.
        Improvement of insulin induced glucose disposal in obese patients with NIDDM after a 1 week treatment with dexfenfluramine.
        Diabetes Care. 1991; 14: 325-332