The relationship between adrenal cortex function and obesity and the widespread effects of obesity on the endocrine system

40. What is the relationship between adrenal cortex function and obesity?

The three zones of the adrenal cortex each have different secretory functions.

These are mineralocorticoids, glucocorticoids, and sex corticosteroids.

Hormones secreted by zona glomerulosa cells are mainly involved in salt (sodium) metabolism in the body, hence they are called mineralocorticoids.

The cells of the zona fasciculata secrete the largest amount of hormones, which have a wide range of effects and participate in the three major metabolic processes in the body, mainly glucose metabolism, hence they are called glucocorticoids.

Hormones secreted by the reticular cells have similar structure and function to those secreted by the human gonads (testes in men and ovaries in women), hence they are called sex cortical hormones.

Glucocorticoids play an important role in regulating the metabolism of proteins, fats, and carbohydrates.

Under normal physiological conditions, appropriate amounts of glucocorticoids promote a balance in the metabolism of the three major nutrients.

If, for some reason, there is an excessive secretion of glucocorticoids (medically known as "Coliquitosis"), it will lead to increased protein catabolism, muscle atrophy, reduced bone matrix, redistribution of body fat, reduction of peripheral adipose tissue, and increased fat in the face, neck, shoulder blades, abdomen, and buttocks, resulting in a body type with a fat trunk and thin limbs, which is called central obesity.

Because of the abundance of subcutaneous fat on the face, the dilation of capillaries, and the thinning of the skin, the face becomes red and round, like a newborn baby just one month old. In addition, the subcutaneous fat pads on the neck and back are formed, hence the names "moon face" and "buffalo hump".

This physical sign has characteristic differences from the physical signs of general obesity.

Although these patients are obese, they are relatively light in weight because of reduced muscle and bone mass and a high proportion of fat. Therefore, their actual weight gain is not significant and is often within the normal weight range. Clinically, this should be distinguished from obesity.

Due to the sodium-storing and potassium-excreting effects of excessive glucocorticoids, patients often experience hypertension and hypokalemia. Careful examination helps to establish a diagnosis.

Long-term or high-dose use of glucocorticoids for other diseases can promote exogenous hypercortisolism and also present with the same clinical signs. The patient can return to the original body type after stopping the medication.

41. What are the effects of obesity on the endocrine system?

Obese patients are often referred to endocrinologists for diagnosis and treatment.

In reality, symptomatic obesity caused by endocrine disorders is very rare, while endocrine disorders caused by obesity are common.

As mentioned earlier, obesity causes excessive insulin secretion, leading to abnormal sex hormone secretion and resulting in corresponding functional and metabolic disorders.

In addition, obese patients show a reduced secretory response of pituitary growth hormone and prolactin to physiological stimuli (hypoglycemia); enhanced conversion of adrenocortical hormones; elevated parathyroid hormone levels; increased levels of some gastrointestinal hormones (endorphins, enteropressin, neurotensin, vasodilator intestinal peptide), while others (gastrin, motilin) ​​remain normal; a slower response of hypothalamic antidiuretic hormone to water load; and higher responses of aldosterone and renin to furosemide stimulation than normal individuals, etc.

These changes usually improve on their own after weight loss.

Clinical manifestations of obesity

42. What are the warning signs before you start gaining weight?

Many diseases cause abnormal reactions in the body before they develop.

Obesity is no exception; a person may experience certain symptoms even before they "gain weight".

Aside from medical conditions, if you experience the following symptoms, it indicates that you are likely to become obese soon.

(1) Fatigue: I feel easily fatigued recently. I sweat easily when I move around. If I exert myself, I will be drenched in sweat and out of breath.

But after a short rest, you can recover your strength.

(2) Fear of movement: People who originally liked cultural and sports activities or were always diligent became increasingly lazy and unwilling to move.

I can no longer muster the energy for activities I used to enjoy, such as dancing, playing ball, or boxing.

(3) Excessive sleepiness: There is no lack of sleep, and even quite enough sleep, but still want to sleep, feel heavy, and often feel sleepy.

(4) Loves to eat: Has a great appetite for all kinds of food, especially sweets and meats, especially at night.

After dinner, while watching TV and resting, I would eat peanuts, chocolate, and pastries, and then crave a late-night snack in the middle of the night.

Otherwise, you'll feel like your stomach and intestines are empty, and you won't be able to sleep soundly.