Ukucingwa kweNdalo malunga nokunyanyisa (2014)

. Juni 2014; 87 (2): 99-112.

Ipapashwe kwi-intanethi ye-2014 Jun 6.

PMCID: PMC4031802

Ukugxila: Ukutyeba ngokugqithiseleyo

Abstract

Ukutyeba ngokugqithiseleyo, isifo seswekile, kunye nesifo semetabolism ziyakhula iinkxalabo zempilo kwihlabathi liphela, ukanti oonobangela bazo abaqondwa ngokupheleleyo. Uphando kwi-etiology yobhubhani wokutyeba kakhulu luphenjelelwa kakhulu kukuqonda kwethu iingcambu zendaleko zolawulo lwe-metabolic. Kangangesiqingatha senkulungwane, i-hypothesis yemfuza eyongamileyo, ethi ukutyeba kukuziqhelanisa nokuziqhelanisa nokusinda ngamaxesha endlala, kuye kwalawula ukucinga ngalo mba. Abaphandi bokutyeba ngokugqithisileyo bahlala bengazi ukuba kukho, enyanisweni, ubungqina obulinganiselweyo bokuxhasa ingqikelelo yemfuza egciniweyo kunye nokuba ezinye iingqikelelo ziye zacetyiswa. Olu phononongo lubonisa ubungqina kunye noluchasene ne-hypothesis yemfuza eyongayo kwaye yazisa abafundi kwiingqikelelo ezongezelelweyo ngemvelaphi yokuzivelela kobhubhani wokutyeba. Ngenxa yokuba ezi ngqikelelo zitshintshayo zithetha izicwangciso ezahlukeneyo zophando kunye nolawulo lwezonyango lokutyeba, ukuqwalaselwa kwabo kubalulekile ekuthinteleni ukusasazeka kwesi sifo.

Internet: uphononongo, ukutyeba, isifo seswekile, isifo semetabolism, indaleko, ihypothesis yemfuza eyongayo

intshayelelo

Izehlo zokutyeba emhlabeni jikelele zinyuke ngokumangalisayo kwinkulungwane edlulileyo, ngokwaneleyo ukuba kubhengezwe ngokusesikweni ubhubhani wehlabathi nguMbutho wezeMpilo weHlabathi ngo-1997 []. Ukutyeba ngokugqithiseleyo (okuchazwa ngumlinganiselo wobunzima bomzimba obudlula i-30 kg / m), kunye nokumelana ne-insulin, i-dyslipidemia, kunye neemeko ezinxulumene nazo, ichaza "i-metabolic syndrome," ebeka phambili kakhulu i-2 isifo seswekile, isifo senhliziyo, kunye nokufa kwangaphambili.]. I-Metabolic syndrome ichaphazela ama-34 ekhulwini abantu baseMerika, i-53 ekhulwini kubo batyebe kakhulu.]. Ukutyeba kukuxhalaba okukhulayo kumazwe asakhasayo [,] kwaye ngoku ngomnye woonobangela abaphambili bokufa okunokuthintelwa kwihlabathi jikelele [].

Ngokusengqiqweni, ukwanda okukhawulezayo kuyo nayiphi na imeko yezonyango kufuneka kubangelwe kutshintsho lwendalo, kodwa ukutyeba kuye kwaboniswa kwizifundo ezininzi ukuba necandelo eliqinileyo lemfuza [,], ebonisa intsebenziswano enokubakho yemfuza-esingqongileyo []. Okumangalisayo kukuba, abantu abathile babonakala besengozini yokutyeba kakhulu kunye nesifo se-metabolic syndrome [,], ngelixa ezinye zibonakala zixhathisa [,]. Ukuxhaphaka okuphezulu kwale meko ibonakala iyingozi, kudityaniswa nokungalingani kwayo phakathi kwabantu kunye nabemi, kukhokelele kuqikelelo malunga nemvelaphi enokubakho yokutyeba kakhulu kunye nesifo se-metabolic syndrome [-].

Apha ndiza kuphonononga iingqikelelo ezininzi (zombini ezikhuphisanayo nezixhasayo) ngemvelaphi yendaleko yobhubhani wokutyeba kwaye ndixoxe ngeziphumo zazo. Ndixoxa ukuba ukuqonda ngcono amandla endaleko eye yabumba ulawulo lwemetabolism yomntu ibalulekile ekulweni ubhubhane wanamhlanje wokutyeba. Ukuqonda imvelaphi yendalo yokutyeba kunokukhokelela kwiindlela ezintsha zophando kwi-pathophysiology yokutyeba kakhulu kunye nolawulo lwayo lwezonyango.

Kutheni Ulawula Ubunzima Bomzimba?

Ukuqonda i-pathophysiology yale mihla yokutyeba, kuluncedo ukujonga indawo edlalwa ngumgaqo wobunzima bomzimba kwimpilo yezilwanyana. Yiyiphi imikhosi eqhuba i-organism ukugcina ubuncinci okanye ubuninzi bomlinganiselo wobunzima? Kubalulekile ukuqaphela kuqala ukuba "ukulawulwa kobunzima bomzimba" yinkqubo entsonkothileyo kakhulu ebandakanya okungaphezulu kokusebenza ngokulula kwemetabolism. Ibandakanya zombini i-peripheral kunye ne-central satiety / imiqondiso yendlala [,] kunye nolawulo lokuqonda [], zonke ziphenjelelwa yimiba yemfuza neyendalo.

Maninzi amandla asebenzayo ukulawula ubunzima bomzimba kunye nokutyeba kwezilwanyana ezanyisayo. Isisongelo sendlala siqhuba imfuneko yokugcina umda ophantsi kumafutha omzimba. Iivenkile zamandla ziyafuneka ukunqanda ukulamba de ufe nakuphi na ukuphazamiseka okungephi ekufikeleleni kokutya. Ukuchuma kwakhona kuchatshazelwa kakhulu ngamafutha omzimba []. Imijikelo ye-ovarian inovakalelo kakhulu kwimiqondiso yokulinganisa amandla [], kwaye ipesenti ethile yamafutha omzimba iyafuneka ukuze izilwanyana ezincancisayo zikwazi ukugcina ukuzala nokuzala ngempumelelo inzala []. Ukongeza, amanqatha omzimba anceda ukugcina ubushushu be-homeostasis. Izicubu ze-adipose ezimhlophe zisebenza njenge-insulator [], ngelixa i-adipose emdaka inegalelo ngokusebenzayo kwi-thermogenesis [].

Amandla amaninzi agcina umda ophezulu wamafutha omzimba kwizilwanyana. Ixesha elifunekayo lokunikela ekutyeni lilinye. Ukugcina i-adiposity ephezulu kubiza ngamandla kwaye kufuna igalelo elikhulu lekhalori []. Kuninzi lwezilwanyana zasendle, kuya kufuneka ixesha elininzi kakhulu lichithwe ekutyeni kuchithwa ezinye izinto ezibalulekileyo njengokukhwelana, ukulala, okanye ukuphepha amarhamncwa []. Izilwanyana ezizixhoba kufuneka zihlale zibhityile ngokwaneleyo ukuze ziphephe ukuhlaselwa. Isilwanyana esityebileyo asikwazi ukuhamba ngokukhawuleza okanye ukuzifihla njengesilwanyana esibhityileyo []. Kubonisiwe kwizifundo zaselabhoratri ukuba izilwanyana ezincinci ezizixhoba ziyaxhathisa ukutyeba okubangelwa kukutya, nokuba nokufikelela okungenamkhawulo ekutyeni okunekhalori ephezulu []. Ukongeza, ezinye izilwanyana ezizixhoba ziye zaboniswa ngokulinga ukunciphisa ubunzima bomzimba xa amarhamncwa ekhona kwindawo yazo [,], ukuphepha ukuhlaselwa.

Abantu banamhlanje bakhuselwe kakhulu kwezi zinto. Uqoqosho lwehlabathi lukhusela amazwe aphuhlileyo endlaleni kwaye luvumela ukufikelela lula ekutyeni okunekhalori ephezulu. Ikhusi nempahla zisikhusela kwingqele. Asifane sinyanzelwe ukuba sizingele amaxhoba, kwaye asikhathazeki nokuba sibe ngamaxhoba []. Nangona abantu banamhlanje besenokungasakwazi ukuthobela la mandla, basabalulekile kwimpilo yethu. Ukuqonda ukuba la mandla abe negalelo njani ekuziphendukeleni kwemvelo komntu kusinika ukuqonda malunga nendlela ubunzima bomzimba womntu obulawulwa ngayo kwaye loluphi utshintsho ekufuneka lwenziwe kuluntu lwethu kunye nezicwangciso zokhathalelo lwempilo ukukhusela ngcono kwisifo se-metabolic.

Ukuziqhelanisa noBugcisa

I-Thrifty Gene Hypothesis

Ngo-1962, isazi ngemfuza uJames Neel wazisa ingcaciso yokuqala engundoqo esekwe kwindaleko malunga nobhubhani wanamhlanje wokutyeba.]. Ingqikelelo yakhe yantlandlolo igxile ekuchazeni ukuxhaphaka okuphezulu ngokungaqhelekanga kwesifo seswekile kubantu abathile, kodwa iye yahlaziywa ukuba ibandakanye ukutyeba kakhulu kunye namanye amacandelo e-metabolic syndrome [].

UNeel wathi utyekelo lokuba nesifo seswekile (okanye utyebe ngokugqithiseleyo) luphawu oluguquguqukayo oluye lwangahambelani nendlela yokuphila yanamhlanje. I-“thrifty gene hypothesis (TGH)” yakhe isekelwe kwintelekelelo yokuba ngexesha lokuzivelela komntu, abantu babesoloko bephantsi kwamaxesha ezidlo nendlala. Ngexesha lendlala, abantu ababeneendawo zogcino-mandla ezininzi babenokuphila kwaye bavelise inzala eninzi. Ngoko ke, indaleko yakhetha ukukhetha imizila yemfuza eyenza abo babenazo babe nobuchule bokugcina amafutha ngamaxesha obuninzi. Kuluntu lwale mihla oluphuhlileyo apho izidlo zixhaphakile kwaye indlala inqabile, oku kuziqhelanisa nokuziphendukela kwemvelo kuba yi-maladaptive. Ngoko ke, kukho ukungangqinelani phakathi kwemekobume abantu abahlala kuyo kunye nemekobume esiye savela kuyo. Imizila yemfuza eyongayo isebenza ngokugcina amandla ngokufanelekileyo ukulungiselela indlala engayi kufika [].

I-TGH ibonelela ngengcaciso elula necacileyo yobhubhani wokutyeba kakhulu kwaye yamkelwa ngokukhawuleza zizazinzulu kwaye yalala abantu ngokufanayo. Obunye ubungqina buxhasa le ngcamango. Intsingiselo ebalulekileyo ye-TGH kukuba i-polymorphisms yemfuza ebonakalayo enika "i-thrifty" phenotype kufuneka ibe khona. Zombini ukutyeba nesifo seswekile ziyaziwa ukuba zinecandelo elomeleleyo lemfuza [,,,], kunye neepolymorphisms ezininzi zofuzo ziye zafunyanwa ezenza abantu batyebe kakhulu [,], icebisa iinxalenye ezinokubakho ze "thrifty genotype." Uninzi lwee-nucleotide polymorphisms (SNPs) ezinxulumene nomngcipheko okhulayo wokutyeba ngoku zichongiwe ngezifundo ze-genome-wide association (GWA), nangona nganye inempembelelo encinci [].

Esinye isigxeko esiphambili kwi-hypothesis yemfuza eyongayo kukuba ayikwazi ukuchaza ukungafani kwesifo seswekile kunye nokutyeba phakathi nangaphakathi kwabantu []. Ukuba umjikelo wesidlo kunye nendlala yayiyeyona nto ibalulekileyo yokuqhubela phambili kuyo yonke indaleko yabantu, kutheni abantu bengatyebanga bonke? Uluntu lubonisa umahluko omkhulu ekuthandeni kwabo ukutyeba nesifo seswekile [,]. Ngaphaya koko, naphakathi kwabantu abahlala kwindawo enye kukho abantu abaninzi ababonakala bexhathisa ukutyeba []. Ukulungisa le ntsilelo, kamva u-Andrew Prentice wacebisa ukuba kunokuba indlala ibe luxinzelelo “oluhlala lukhona” kulo lonke ixesha lokuzivelela kwabantu, kutsha nje, kwiminyaka emalunga ne-10,000 ukususela ekufikeni kwezolimo, ukuba indlala iye yaba yeyona nto ikhethekileyo. uxinzelelo, kwaye ngenxa yoko kunokwenzeka ukuba akukhange kubekho xesha laneleyo lemfuza eyongayo ukufikelela ekulungisweni []. Uluntu lwabazingeli, eyona ndlela yokuphila yabantu bakudala, abasoloko behlelwa yindlala ngenxa yokuba ukuhamba kwabo kunye nokuguquguquka kwabo kubavumela ukuba bahambe okanye basebenzise enye imithombo yokutya xa behlangabezana nobunzima bokusingqongileyo []. Ngokwahlukileyo koko, abalimi basebenzisa izityalo ezimbalwa ezizezona zibalulekileyo yaye abakwazi ukumelana nembalela nezinye iintlekele. Ke, umjikelo womthendeleko / wendlala unokuba ukhethe kwiimfuza ezinobutyebi kuphela kuluntu lwezolimo []. Oku kunokucacisa ukuba kutheni ingengabo bonke abantu abatyebe kakhulu kwaye kutheni kukho umahluko phakathi kwabantu. Abanye abantu basenokuba baye bafumana indlala eyongezelelekileyo okanye amaxesha okunqongophala kokutya kwimbali yabo kwaye ngenxa yoko babenoxinzelelo olukhulu lokuphuhlisa i-genotype eyongayo.

I-TGH ibonelela ngeengqikelelo ezininzi ezinokuvavanywa. Olunye uqikelelo olunjalo, ukuba imodeli ye-post-agricultural icingelwa, kukuba i-loci yofuzo ehambelana nokutyeba kunye nesifo sikashukela kufuneka ibonise iimpawu zokhetho oluchanekileyo lwamva nje. Nangona kunjalo, uphando olwenziwe nguSoutham et al. (2007) ukuvavanya ukutyeba kwe-13- kunye ne-17 yohlobo lwe-2 yeswekile-enxulumene nokwahluka kofuzo (okubandakanya uluhlu olubanzi lweyona nto iqiniweyo yokutyeba- kunye ne-diabetes-enxulumene ne-loci ngexesha lokupapashwa) ifumene ubungqina obuncinane bokukhetha okulungileyo kutshanje []. Olu phononongo lufumene i-loci enye kuphela yomngcipheko, ukuguqulwa kofuzo olunxulumene nokutyeba kweFTO, ebonisa ubungqina bokhetho olulungileyo lwamva nje. Oku kuya kubonakala ubukhulu becala bubungqina obuchasene ne-TGH; nangona kunjalo, ixhomekeke kwidatha ye-SNP, kwaye ke ezi loci zinokuba zidibaniselwano kunokuba zisebenze. Ukucocwa kofuzo lokutyeba kakhulu kunye nomngcipheko wesifo seswekile kufuneka kubangele iimvavanyo ezinolwazi oluthe chatha ekukhethweni.

Olunye uqikelelo lwe-TGH yasemva kwezolimo kukuba abantu abaye bahlangabezana nendlala eninzi kunye nokunqongophala kokutya kufuneka batyekele ngakumbi ekutyebeni nesifo seswekile xa sele bevezwe kwindawo ene-obesogenic. Ukuza kuthi ga ngoku, kukho ubungqina obuxubeneyo bolu qikelelo. Abanye abantu abazingeli-abaqokeleli, indlala ibingaqhelekanga ngokwembali, babonakala bebonisa ukuxhathisa ukutyeba okubangelwa kukutya [] xa kuthelekiswa nabemi abanembali yezolimo, engqinelanayo noqikelelo lwe-TGH. Nangona kunjalo, le modeli ikwaxela kwangaphambili ukuba uluntu lwezolimo, ngakumbi olo lusuka kwiindawo ezibandayo, luya kuba namava oxinzelelo olunamandla olukhetha ukonga ngokwemfuza kwaye ke lunotyekelo lokutyeba kakhulu kunye nohlobo lwesi-2 seswekile. IYurophu ingumzekelo obalaseleyo wolu hlobo lokusingqongileyo: abantu bayo kudala besenza ezolimo, kwaye ingxelo yembali yemfazwe nendlala kulo mmandla ide kwaye ibanzi []. Nangona kunjalo abantu baseYurophu banezinga elisezantsi lokutyeba kunabantu abaninzi kwaye babonakala benganyangeki ngokuyinxenye kuhlobo lwesi-2 seswekile [,]. Abemi beSiqithi sePasifiki, ngokuchaseneyo, banawona mazinga aphezulu okutyeba kunye nohlobo lwesi-2 seswekile kwihlabathi [], phezu kwako nje ukuhlala kwindawo etshisayo enembali encinane yendlala [,].

Abanye abaphandi bachaza ezi ntlukwano ngokujonga i-TGH, besithi endaweni yokhetho lwamva nje lwemfuza eyongayo, eneneni lufuzo olunika ukuxhathisa ukutyeba kunye nezinye iziphazamiso zemetabolism ezilulungelelwaniso lwangoku. Le TGH elungisiweyo ibeka ukuba ulungelelwaniso lobutyebi yinto yakudala, kodwa abantu abatshintshele kwimithombo yokutya etyebileyo ukusukela ekufikeni kwezolimo baye bafumana uhlengahlengiso oluthile lokuthintela ukuphazamiseka kwemetabolism. Ukutya okungaziwayo kwemfuzo kaRiccardo Baschetti ithi abantu baseYurophu baye baqhelana nenxalenye yokutya kwe-diabetogenic.]. Ukwaziswa kwendlela yokutya yaseYurophu kubantu abangayiqhelanga, njengabemi bomthonyama baseMelika kunye nabemi beSiqithi sePasifiki, kudala ukungafani phakathi kokutya kwabo kwale mihla kunye nokutya abathe bavela ngako, okukhokelela kukungasebenzi kakuhle kwe-metabolic. Oku kunokuchaza ukwanda okumangalisayo kwesifo seswekile kunye nokutyeba kakhulu kwaba bantu. Abanye bacebisa ukuba ukulahleka kobutyebi luhlengahlengiso lwamva nje, olubangela umahluko kubukho besifo semetabolism phakathi kwabantu []. Endaweni yokukhangela imfuza esemngciphekweni wesifo enikezela ukuchaphazeleka kwisifo semetabolism, endaweni yoko kufuneka sigxile kwiinzame zokufumana ukwahluka kwemfuzo enika ukuxhathisa kwezi ngxaki []. Uphononongo olwenziwe nguSoutham et al. Ufumene ubungqina bokhetho lwamva nje olulungileyo kwi-allele enye ekhusela isifo seswekile []. Uphononongo olukhulu olukhangela iimpawu zokhetho lwamva nje olulungileyo kwisifo seswekile kunye ne-alleles yokumelana nokutyeba kunokuba neziqhamo ukuvavanya ezi ngcamango.

Ngokuphathelele kulawulo lwezonyango lokutyeba ngokugqithiseleyo kunye nezinye iziphazamiso zemetabolism, i-TGH ithetha ukuba ukubuyela kwindlela yokuphila yemveli yoluntu kuya kuba luncedo ekunyangeni isifo semetabolism. Ukuba ukutyeba kakhulu kubangelwa kukungahambelani phakathi kofuzo kunye nendawo esihlala kuyo ngoku, ukutshintsha imeko-bume ukuze ihambelane nendlela iigenomes zethu eziziqhelanise ngayo kufanele kubuyise umva ubhubhani wokutyeba. Ngokucacileyo, ukubuyela kwiindlela zokuphila zookhokho bethu abazingeli abazingeli akwenzeki. Nangona kunjalo, kuyenzeka ukunciphisa iikhalori kunye nokwandisa umthambo ukuze ulingise ngokusondeleyo iindlela ezahlukeneyo zokuphila zesiNtu []. Izikhokelo zonyango zangoku zokulawula ukutyeba kunye nesifo sikashukela zisekelwe kwesi sicwangciso [,]. Nangona esi sicwangciso sibonakala sisebenza kwezinye izigulana, kukho ukuguquguquka okukhulu ekusebenzeni kwayo, ngakumbi ekulawuleni ukutyeba kunye nesifo seswekile ixesha elide [,].

I-Thrifty Phenotype Hypothesis

Ayingabo bonke abaphandi abaqinisekileyo ukuba i-TGH yachaza ngokwanelisayo i-etiology yokutyeba kakhulu kunye nesifo se-metabolic syndrome. Ngo-1992, uCharles Hales kunye noDavid Barker bacebisa "i-hypothesis ye-hypothesis" yakhe (ekwabizwa ngokuba yi-Barker Hypothesis), ngokuyinxenye ukulungisa ukusilela kwe-gene-based osity hypotheses efana ne-TGH kunye nokucacisa into eyenzekayo: ukuba iintsana eziphantsi. Ubunzima bokuzalwa bubonakala buthanda kakhulu isifo seswekile, ukutyeba, isifo sentliziyo, kunye nezinye iingxaki zemetabolism kamva ebomini [].

Ingqikelelo kaBarker igxile kwingqikelelo “yokonga,” kodwa ngendlela eyahluke kakhulu kunengcamango kaNeel. Kwi-hypothesis ka-Barker, lusana olusakhulayo olumele lube nobutyebi. Imveku engekazalwa engondlekanga kufuneka yabe ubuncwane ngononophelo ukuba iza kuphila de ibelwe naxa ibe mdala. U-Barker uxoxa ukuba umntwana osakhulayo ongekazalwa, xa ejongene nokunqongophala kwamandla, uya kwabela amandla kude ne-pancreas ngokuthanda ezinye izihlunu ezifana nengqondo. Olu lurhwebo olufanelekileyo, kuba ukuba indawo yesondlo efanayo apho umntwana ongekazalwa eqhubeka ekhula ebuntwaneni nasebudaleni bakhe, kuya kubakho imfuneko encinci yeenkqubo zokuphendula i-glucose ephuhliswe kakuhle. Nangona kunjalo, ukuba isondlo siphucula kamva ebomini, umntu owakhe wafumana umntwana okhulelweyo uya kuba ne-pancreas engakwaziyo ukujongana namandla e-glucose ngoku ekwaziyo ukufikelela kuyo kwaye uya kuba nesifo seswekile kunye nezinye izifo ze-metabolic. Oku kunokucacisa ukuba kutheni iintsana ezinobunzima obuphantsi zibonakala ngathi zisengozini yokuphazamiseka kwemetabolism yabantu abadala [].

Ingqikelelo yantlandlolo kaBarker ayithethi ngokuthe ngqo kwimbali yendaleko, kodwa ineempembelelo zendaleko. Kolu qikelelo, lufuzo oluvumela ukugqityezelwa kophuhliso lwaphambi kokubeleka kunye nokuphila komntwana ongekazalwa ezikhethelwe yona, endaweni yokukwazi ukuziqhelanisa nobomi babantu abadala. Kuphela kungenxa yokuba kwixesha elidlulileyo isondlo saphambi kokubeleka sasingqamana nesondlo sabantu abadala eyathi le nkqubo yayiziqhelanisa neemeko. Ngoku oku kungenzeki njalo, olu lwabiwo lwezibonelelo kude ne-pancreas luba lubi.

Ukusukela kwisiphakamiso sayo, i-hypothesis eyongayo iye yaphefumlela umsebenzi owongezelelekileyo odibanisa ingqikelelo kwithiyori yendaleko. U-Jonathan Wells uphonononge iimodeli ezininzi ezikhuphisanayo okanye ezongezelelweyo zokusetyenziswa kwendaleko kweengqikelelo zephenotype ngo-2007 []. Ezi modeli ngokubanzi ziwela kwiindidi ezimbini: imodeli yoqikelelo lwemozulu kunye neemodeli zokuqina komama.

Iimodeli zoqikelelo lwemozulu ziphikisa ukuba umntwana ongekazalwa usebenzisa imiqondiso evela kwi utero okusingqongileyo ― ngakumbi imiqondiso yesondlo — “ukuqikelela” ukuba loluphi uhlobo lwemo engqongileyo ekunokwenzeka ukuba udibane nayo ngexesha lobuntwana kunye/okanye ubomi babantu abadala. Kunokuxoxiwa ukuba kuluncedo ngokuvela kwemvelo kwiinkqubo “eziphambili” zemetabolism yokonga ukuba isondlo esilambathayo sibonwa kwangethuba ebomini, ukuze ujongane ngcono nobomi bokutya okunesondlo. Ukuphazamiseka kweMetabolic emva koko kwenzeka ukuba indawo yabantu abadala okanye yobuntwana kunye nemeko yosana olungekazalwa ayihambelani. Umntu onomntwana osingqongileyo "uqikelele" ubomi bendlala uya kuba nesifo seswekile kunye nokutyeba xa efumana ukutya okunekhalori ephezulu [,,]. Nangona le ntsapho yeemodeli inokuchaza ukuqala ngokukhawuleza kwesifo sokutyeba kwiinkcubeko ngokukhawuleza zaziswa kwizidlo zaseNtshona, ayichazi ngokwaneleyo ukuba kutheni ukukhuluphala kunye nesifo sikashukela kuqhubeka emva kwezizukulwana ezilandelayo.

Iimodeli zokomelela komama zixoxa ukuba imiqondiso efunyanwa lusana olungekazalwa malunga nesondlo esisesibelekweni luyivumela ukuba ilungelelanise iimfuno zayo zamandla kunye nokukwazi kukanina ukubonelela ngexesha lobuntwana. Abantu banexesha elide ngokungaqhelekanga lokukhula kobuntwana, ngelo xesha abantwana baphantse baxhomekeke ngokupheleleyo kumama wabo ukuze bafumane ubuncwane, kwanangaphaya kokulunyulwa. Ngoko ke iyaziqhelanisa nonina nomntwana ukuba imfuno yemetabolism yomntwana idityaniswa nephenotype kamama, ukuze umntwana angafuni okungaphezulu (okanye ngaphantsi) kunoko anokubonelela. Ukulungelelanisa inkqubo yemetabolism yomntwana kunye nomama kunciphisa ingxabano yabazali nabantwana kwaye kubalulekile ekukhuliseni umntwana ngempumelelo [,], kwaye ke oku kuziqhelanisa kwandisa ukomelela okuqukayo. Le modeli yokongayo ye-phenotype inokuchaza ukuba kutheni ukutyeba kakhulu kunokwenzeka naxa usana olungekazalwa lungondlekanga.

Iimpembelelo ze-hyfty phenotype hypotheses kulawulo lweklinikhi ye-metabolic syndrome zicacile: Isondlo esifanelekileyo sikamama kunye nokukhulelwa kubaluleke kakhulu kunokungenelela kubomi babantu abadala. Ukuba i-hyfty phenotype hypothesis ichanekile, ukujolisa kwimithombo yothintelo yezempilo yoluntu kowasetyhini okhulelweyo kuya kwenza okuninzi ukulwa ubhubhane wokutyeba kunokujolisa ekunyangeni izifo kubantu abadala okanye nasebantwaneni.

I-Thrifty Epigenome Hypothesis

Esinye sezigxeko eziphambili ze-TGH kukuba ukuba indlala ibingamandla okuqhuba ngamandla kulo lonke ixesha lokuzivelela kwabantu, kutheni le nto bonke abantu bengatyeba? Njengoko kukhankanyiwe ngaphambili, abaxhasi be-TGH bahlala bexoxa ukuba mhlawumbi indlala yaba luxinzelelo oluqinileyo olukhethiweyo ukususela ekunyukeni kwezolimo kwaye, ngoko ke, ngabantu abathile kuphela abaye baphantsi kolu hlobo loxinzelelo olukhethiweyo []. Ingcamango kaRichard Stöger ethi “thrifty epigenome” ithatha imbono eyahlukileyo kwaye ithi bonke abantu banegenome eyongayo. Ngapha koko, uthi ukunqongophala kokutya kusenokwenzeka ukuba yenye yezona zinto ziphambili kwimbali yobomi, kwaye ukonyuka kwe-metabolic luphawu lwazo zonke izinto eziphilayo. Ingqikelelo kaStöger imisela ukulungelelanisa eminye yemingxuma kwingqikelelo eyongayo ye-genotype ngelixa eyidibanisa nengqikelelo eyongayo yephenotype [].

Ingqikelelo kaStöger ixhomekeke kwingqikelelo yokwenziwa komjelo wemfuza. I-Genetic canalization yinkqubo apho i-polygenic phenotype iba "i-buffered" ngokuchasene ne-polymorphism yemfuza kunye nokwahluka kokusingqongileyo. Le nkqubo iyaguquguquka kuba uxinzelelo oluguquguqukayo lokusingqongileyo lunokushiya izizukulwana ezilandelayo zingayilungelanga indawo yazo entsha. Ke, imbali yexesha elide yendalo yendalo ikhetha inkqubo ye-multigenetic apho utshintsho oluncinci lwenze umahluko omncinci kwimbonakalo yephenotypic []. Enye yeendlela ezinokuthi iintlobo zezilwanyana zikwazi ukugcina olu hlobo lwe-phenotypic robustness ngolawulo lwe-epigenetic [].

UStöger uxoxa ukuba i-metabolic thrift ixhomekeke kwi-canalization yemfuza kwaye yimpawu ye-phenotypic ekwazi ukulungelelanisa kwiingcinezelo ezahlukeneyo zokusingqongileyo ngokuguqulwa kwe-epigenetic. Bonke abantu bane-genome eyongayo, kodwa intetho ye-phenotypic inokwahluka ngokusekwe kwigalelo lokusingqongileyo ngenxa yohlengahlengiso lwe-epigenetic oluzuzwe njengelifa kwizizukulwana ngezizukulwana. Ngaloo ndlela, isizukulwana esizalwa ngexesha lendlala sinokuba neenguqu ze-epigenetic genome ezivumela ukugcinwa kwamandla afanelekileyo, kwaye ezi zilungiso zinokugqithiswa kumgca wentsholongwane. Ubungqina obuvela kuphononongo “lwe-Dutch Hunger Winter” luyakuxhasa oku. Olu phononongo lulandelele impilo yeqela lamadoda azalwe ngaphambi, emva, nangexesha lendlala enzima eyenzeka eNetherlands ngeMfazwe Yehlabathi II []. Uphononongo lwafumanisa ukuba amadoda anoomama abafumene indlala ngexesha leenyanga ezimbini zokuqala zokukhulelwa babenezinga eliphezulu lokutyeba kunye nesifo seswekile kunamadoda azalwe ngaphambi okanye emva kwendlala.]. Okubalulekileyo, ezininzi iimpawu zendlala yaseDatshi ziye zadlula kwizizukulwana ezilandelayo, ezikhokelela kwingcamango yokuba le ngqungquthela yayixhomekeke kuhlobo oluthile lokuguqulwa kwe-epigenetic echaphazela ubunzima bomzimba kwaye ngoko kunokuthiwa "i-epigenotype enqabileyo" []. Ukuvavanya le ngcamango, uTobi et al. (2009) uvavanye iipateni ze-methylation kubantu abakhawulwe ngexesha okanye kungekudala ngaphambi kwendlala ye-1944 kwaye bathelekisa kunye nabantakwabo abangachazwanga besini esifanayo []. Bafumene utshintsho kwipatheni ye-DNA methylation yokukhula okuliqela kunye ne-metabolism-ehambelana ne-loci kubantu abavezwe yindlala, ukubonelela ngenkxaso kwi-hypothesis yokuba. utero okusingqongileyo okunesondlo kunokubangela ukuguqulwa kwe-epigenetic [].

Ngokunjalo, isizukulwana esizelwe ngexesha lokutya okugqithisileyo kufuneka sicwangciselwe le meko yendalo esingqongileyo kwaye ngaloo ndlela singabinotyekelo lokutyeba. UStöger uthi le yeyona nto kanye iqalisa ukwenzeka phakathi kwabantu baseNauru abakuMzantsi Pasifiki. Kukholelwa ukuba aba bantu baye bahlangabezana nokunqongophala kokutya kwimbali yonke kwaye ngoku banelona nani liphezulu lokutyeba kunye nezinga leswekile kwihlabathi, elibonisa ukuba "bane-genotype." Nangona kunjalo, kwiminyaka yakutshanje, lo mkhwa uye waqala ukuguquka, kunye nesantya sohlobo lwe-2 yeswekile ehlayo, nangona utshintsho oluncinci kwindlela yokutya okanye indlela yokuphila. UStöger uthi amaNauru aqalisa ukutshintshela kwi “feast epigenotype” [].

Intsingiselo ebalulekileyo yolu qikelelo kukuba i-polymorphisms yemfuza inokuba nefuthe elincinci kakhulu kwi-pathophysiology yokutyeba. Oku kunokuba yingcaciso yokuba kutheni, ngaphandle kwamashumi eminyaka yophando kunye nezifundo ze-GWA ezingenakubalwa ze-polymorphism yemfuza, kufunyenwe iindidi ezimbalwa zofuzo ezinxulumene nophuhliso lokutyeba kakhulu okanye uhlobo lwe-2 yeswekile. Endaweni yoko, i-hypothesis ye-epigenome eyongayo ithetha ukuba izifundo ze-GWA zeempawu ze-epigenetic zokutyeba kakhulu ziya kuba neziqhamo ngakumbi.

Ukongezelela, okucacileyo kule ngcamango yingcamango yokuba ubhubhani wokutyeba ekugqibeleni uya kuzisombulula ngokwawo, ukuba ukutya kwaseNtshona kuhlala kunjalo. Abemi ngoku abanengxaki yokutyeba ngokugqithisileyo baya kuthi ekugqibeleni batshintshe ukusuka kwi-epigenome eyongayo ukuya kwi-epigenome yomthendeleko. Ubungqina bamva nje bubonisa ukuba olu tshintsho sele luqalisile. Izinga lokutyeba e-US libonakala lihlile kwiminyaka yakutshanje [], kunye nedatha yehlabathi ibonisa ukuba izinga lokutyeba kwabantwana liye lenyuka [].

Ukuziqhelanisa nokuziphatha

Ngelixa ukutyeba kakhulu kunye ne-metabolic syndrome zihlala zijongwa kuphela ngokwemigaqo yenkqubo yomzimba kunye neendlela ezisisiseko zokusinda, abanye abaninzi baye baqulunqa ezi ngxaki kwimeko yentlalo ngakumbi. UMankar (2008) ubonise ukuba abantu banxulumanisa amanqanaba ahlukeneyo okutyeba kunye nesimo sentlalo []. Abanye bathi ngexesha lembali yoluntu, ukutyeba kuye kwaba luphawu lobutyebi okanye ukuchuma, nto leyo evumela abo batyeba ngokulula ukuba batsale amaqabane amaninzi kwaye bavelise ngempumelelo kwaye bakhulise inzala eninzi []. Ewe, eminye yeyona mizekelo midala yobugcisa babantu ― Paleolithic Venus figurines - ibonisa abafazi abanemizimba etyebileyo kwaye kucingelwa ukuba zizisimboli zokuzala []. Abantu baluhlobo lwentlalo ephezulu, kwaye ke, unxibelelwano lwentlalo ludlale indima enkulu ekubumbeni indaleko yomntu.

UWatve noYajnik's (2007) "i-hypothesis yokutshintsha kokuziphatha" idibanisa iindlela zentlalo kunye nezomzimba zibe yithiyori emanyeneyo yemvelaphi yendaleko yokumelana ne-insulin kunye nokutyeba. Ibonisa ukuba izifo ze-metabolic zivela kwi-socio-ecological adaptation evumela abantu ukuba batshintshe phakathi kweendlela zokuzala kunye nentlalo yokuziphatha. Amacebo abatshintsha phakathi kwawo kukuvelisa kwakhona okukhethiweyo kwe-r- kunye ne-K kunye neendlela zokuphila "zomelele kwaye zihlakaniphile" (ezichaza njengenguqu "yejoni ukuya kwidiplomat". Ithiyori yokhetho ye-r/K ijongene nengqikelelo yotyalo-mali lwabazali kwinzala kunye norhwebo phakathi komgangatho kunye nobungakanani. Izinto eziziqhelanisa nokukhetha “r” zityala amandla amaninzi ekuveliseni inzala eninzi, notyalo-mali oluncinane kukhathalelo ngalunye []. Kukhethwa xa uhlobo oluthile lungaphantsi kakhulu kumthamo wokuthwala wendalo yawo []. Izinto eziphilayo ezisebenzisa ukhetho lwe-K zityala ixesha elininzi kunye namandla kwinzala yazo, kodwa zivelisa ezimbalwa []. Ithandwa kwiintlobo ezikufutshane nomthamo wokuthwala indawo yazo []. Ababhali bathetha ukuba iimeko zokusingqongileyo kunye nezentlalo ezithanda isicwangciso sokuzala "esikhethwe ngu-K" (njengokuxinana kwabantu abaninzi) ziyafana nezo zikhetha isicwangciso sokuziphatha "sodiplomat" (njengobuninzi bokutya kunye noxinzelelo lwentlalontle), kwaye i-insulin iye yaguquka yaba lutshintsho oluqhelekileyo kuzo zombini ezi nguqulelo.

Kule ngqikelelo, izinto ezikhuthazayo zokusingqongileyo ezinje ngobuninzi bokutya, ukuxinana kwabemi, uxinzelelo lwentlalo, kunye nezinye zisebenza njengenye kumzimba ukuguqula ukusetyenziswa kwe-insulin. I-hypothesis yabo ixhomekeke kwingcamango yokuba izihlunu ezahlukeneyo zinamanqanaba ahlukeneyo okuxhomekeka kwi-insulin ekufumaneni i-glucose, kunye nezicubu zomzimba zamathambo ziphakathi kwezona zixhomekeke kwi-insulin kunye nengqondo kunye nezicubu ze-placental ziphakathi kwezona zizimeleyo ze-insulin.]. Ngokunciphisa ukusetyenziswa kwe-insulin ngezihlunu kunye nezinye izicubu ezixhomekeke kwi-insulin, ukuxhathisa kwe-insulin kukhulula amandla okusetyenziswa kwengqondo kunye / okanye i-placenta, iququzelele utshintsho kwiindlela zombini zokuziphatha kunye nokuzala. I-glucose eyongezelelekileyo ijikelwe kwi-placenta inokubangela ubunzima obukhulu bokuzala kunye nokulamla ukutshintshela kwiqhinga lokuzala elikhethwe ngu-K. Ukongezelela, ukuxhathisa kwe-insulin kunciphisa i-ovulation, ngaloo ndlela kubangele inzala encinci kwaye ivumele utyalo-mali olukhulu kuyo nganye. Ukuphambukisa iswekile kwizicubu zemisipha ukuya ebuchotsheni kunokulamla utshintsho ukusuka “kwijoni” ukuya kubomi “bonozakuzaku”. Xa ukutya kunqongophele, amandla ajikelwa kwisihlunu samathambo ukuze kuphuculwe amandla okutya, ngoko ke uvakalelo lwe-insulin buya kwandiswa. Xa ukutya kuninzi, ingqondo ibaluleke ngakumbi kunezihlunu kwimpilo yesilwanyana sentlalontle, ngoko ke uvakalelo lwe-insulin buya kuncipha ukuze kwabelwe izixhobo ezininzi kuphuhliso lobuchopho. Ukubonakaliswa kwe-insulin kwingqondo kubandakanyeka kwiinkqubo ezininzi zokuqonda. Ababhali bacebisa ukuba xa umsebenzi onzima wengqondo ufuneka, amanqanaba eplasma e-insulin ayanda, okuvumela ukuba kubonakaliswe ngakumbi i-insulin kwingqondo. Ngenxa yokuba amanqanaba aphezulu e-insulin kwiplasma anokukhokelela kwi-hypoglycemia, umzimba uphuhlisa ukuxhathisa kwe-insulin ye-peripheral ukubuyisela [].

I-hypothesis icebisa inkcazo yonxulumano phakathi kokumelana ne-insulin kunye nokugula. Ababhali baqaphela ukuba i-testosterone ephakamileyo yonyusa ubundlongondlongo bendoda kwaye inxulunyaniswa nendlela yokuphila “yamajoni”, ukusasaza kwakhona amajoni omzimba ukugxininisa izicubu ezingaphantsi kwesikhumba ngokulindela ukwanda kwesidingo sokuphiliswa kwesilonda []. Bacinga ukuba ukutyeba kwesisu okunxulunyaniswa notshintsho olusuka kwijoni ukuya kwindlela yokuphila yonozakuzaku kwenza okwahlukileyo: Isasaza kwakhona umsebenzi wokuzikhusela kude nomda kwaye igxile kwizicubu ezisembindini. Kwiindlela zokuphila "zobuchwephesha" ezibaxiweyo zempucuko yanamhlanje, olu lwabiwo luba yi-pathological, ekhokelela ekupholiseni okucothayo kwenxeba kunye nokunyuka kwempendulo yokudumba okuye kwaboniswa ukuba inyanyaniswa nokuphazamiseka okuninzi kwe-metabolic syndrome []. Okubalulekileyo, oku kuthetha ukuba ukugula kokumelana ne-insulin kuqhutywa lutshintsho kwimpendulo yokuvuvukala eyimveliso yenguqu yokuziphatha, hayi ngenxa ye-insulin ngokwayo. Ukuba oku kuyinyani, kunempembelelo enzulu kulawulo lweklinikhi lokunganyangeki kwe-insulin kunye nokukhuluphala. Ugxininiso ekulawuleni utshintsho lwe-immunological oluza ne-metabolic syndrome lunokwenza okungakumbi ukunciphisa isifo kunye nokufa kunokuzama ukunyanga ukutyeba kakhulu okanye ukumelana ne-insulin ngokwabo [].

I-hypothesis yokutshintsha indlela yokuziphatha ichaza ubhubhani wale mihla wezifo ze-metabolic njengoko zibangelwa kukunyanzeliswa kokusingqongileyo okugqithisileyo: ukuxinana kwabantu, ukufudukela kwabantu ezidolophini, ukhuphiswano lwezentlalo, ukufikelela kwiikhalori, kunye nendlela yokuphila eyondlekileyo ngendlela engazange ibonwe kwimbali yoluntu []. Njengoko kusapho "oluqilimayo" lweengcinga, iimpendulo zomzimba eziguquguqukayo kwixesha elidlulileyo ziye zaba buthathaka kwiimeko zanamhlanje. Oku kuthetha isicwangciso solawulo lweklinikhi kunye ne-epidemiological esahluke kakhulu kwizikhokelo zokhathalelo oluqhelekileyo. I-hypothesis icebisa ngamandla ukuba uhlaziyo lwentlalo luya kubaluleka ekulweni ukutyeba kunye nesifo se-metabolic njengobhubhane. I-hypothesis iqikelela ukuba ukutyeba kakhulu kunye nesifo seswekile kufuneka kuxhaphake kakhulu kwiindawo ezinabantu abaninzi kunye nokhuphiswano olukhulu lwentlalo-ntle []. Ukunciphisa ingxinano kwiindawo zasezidolophini kunye nokunciphisa ukhuphiswano lwentlalo ngokunciphisa izikhewu zobutyebi kunye nokwenza uluntu lube nokulingana kunokuchaphazela le mpendulo ye-insulin engaphandle kolawulo.

Iimvelaphi ezingezizo eziziqhelanisayo zokutyeba

Ngelixa zonke ezinye iinkcazo ukuza kuthi ga ngoku ezibonelelweyo kolu hlaziyo zixhomekeke kwingcinga yokuba ukutyeba kwakukhe kwayindlela yokuguquguquka kwexesha elidlulileyo lethu, isazi ngebhayoloji uJohn Speakman sixoxa “kwi-hypothesis yakhe yofuzo” ngokuchaseneyo: ukuba ukutyeba kakhulu akuguquki kwaye kuye kwatshintsha. anyukele kumaza aphezulu ngokungathathi cala (oko kukuthi, ngokungakhethiyo, ngokungakhethiyo) iinkqubo zendaleko [,,].

Ingqikelelo kaSpeakman inikezelwa njengenye indlela ethe ngqo kwingqikelelo kaNeel. Ngokusebenzisa imodeli yamanani, uthi ukuba umjikelo womthendeleko / wendlala "uhlala ukho" amandla okuqhuba indaleko yabantu, njengoko i-TGH yasekuqaleni yaxoxa, nokuba iingenelo ezincinci ezikhethiweyo zokwanda kwe-adiposity ziya kubangela ukulungiswa kufutshane kubo bonke abantu ngaphezulu kwe-2. iminyaka ezizigidi ngendaleko yabantu []. Ukuba olu guqulelo lwe-TGH luchanekile, uSpeakman uphikisa ngelithi, bonke abantu baya kuba batyebe ngokugqithiseleyo. Nangona kunjalo, nakwiindawo ezityebileyo kakhulu kumazwe ahambele phambili kwezoshishino, kuphela iqhezu labantu abatyebe kakhulu, ngelixa abanye bebonakala bengaxhathisi ukutyeba []. Ewe, njengoko bekutshiwo ngaphambili, izinga lokutyeba e-United States liye layeka kutshanje []. Ingcaciso enokwenzeka yeyokuba bonke abantu abatyekele ekutyebeni sele betyebe ngokugqithiseleyo, nto leyo eshiya indawo yokukhula ngakumbi. Kungenjalo, uSpeakman uxoxa ngelithi ukuba ukonga kukuziqhelanisa nasemva kwezolimo, njengoko uPrentice nabanye bexoxa [], akukabikho xesha laneleyo lokuchaza ubungakanani bobhubhani banamhlanje bokutyeba, kunikwe igalelo elincinane kwi-adiposity enikezelwa yimizila yemfuza eyayanyaniswa nokutyeba echongiweyo ukuza kuthi ga ngoku.

U-Speakman ukwaxoxa ukuba umjikelo wesidlo/indlala ye-TGH awuchanekanga ngokwembali. Uphawula ukuba ngoxa amaxesha okunqongophala kokutya okungephi eqhelekile ngokwentelekiso, la maxesha awabangeli ukwanda kokufa kwabantu. Indlala yokwenyani ekhokelela ekufeni kwabantu abaninzi ibinqabile ngokwentelekiso kwimbali yoluntu, kwaye ngala maxesha okona kufa kwabantu kuphakathi kwabantu abadala kakhulu nabancinci kakhulu kwaye ke akunakufane kwenzeke ukuba ibe ngamandla anamandla endaleko [].

USpeakman uxoxa ngelithi inkululeko ekuthinteleni okukhethiweyo ngaphezulu kokutyeba okuphezulu, hayi ukuziqhelanisa, ngumzekelo ongcono wokucacisa ukuxhaphaka kwangoku kokutyeba kuluntu lwanamhlanje. Ukucacisa ukuba yintoni enokuthi ivumele le nkululeko kwisithintelo esikhethiweyo, i-Speakman inikezela ngengcamango "yokukhululwa kwangaphambili". Kuye kwaboniswa ukuba ukoyikiswa-ngozi kunempembelelo ekulawuleni ubunzima kwizilwanyana ezizixhoba. Izilwanyana ezincancisayo zinciphisa ubungakanani bomzimba kunye nexesha lokutya xa kukho amarhamncwa [,]. Xa amarhamncwa ekhutshelwa ngaphandle kwindawo, ibhanki kunye ne-prairie voles zonyusa ubunzima bomzimba wazo xa kuthelekiswa nolawulo []. Kwilabhoratri, kwa ezi zilwanyana zinye zinciphisa ubunzima bemizimba yazo xa zisesichengeni selindle lerhamncwa, kodwa hayi ilindle lesilwanyana esingengomaxhoba [,]. Oku kucingelwa ukuba kukukhusela ekuzingeleni, kuba izilwanyana ezincinci ziyakwazi ukuhamba ngokukhawuleza, ukungena kwinani elikhulu leendawo zokufihla, kwaye zenze iithagethi zexhoba elincinci [].

Ngaphambili, abantu bakudala babephantsi koxinzelelo olunamandla []. Nangona kunjalo, ukuqala malunga nezigidi ezi-2 kwiminyaka eyadlulayo ngokunyuka kohlobo lwe-Homo, abantu bakudala bakhula ubungakanani bomzimba omkhulu, ukwanda kobukrelekrele, ukusetyenziswa kwezixhobo, kwaye ubukhulu becala babengasenaxinzelelo kuxinzelelo.]. USpeakman uxoxa ngelithi ngenxa yokuba ukuxhwaleka kwakungasabalulekanga, kwakungasekho xinzelelo lunamandla lokuhlala utyebile. Ngaloo ndlela, imizila yemfuza elawula umlinganiselo ophakamileyo wobunzima bomzimba ebantwini aye akhululwa kumbandela okhethayo kwaye axhomekeke kumzila wemfuza. Oku kuvumele iinguqu zenzeke ngokukhululekileyo kule mizila yemfuza, ibangele ukuba umsebenzi wazo ulahleke okanye ucuthwe kubantu abathile kunye nabemi []. USpeakman uxoxa ngelithi ukukhukuliseka kwemfuza yingcaciso engcono yomahluko obonwa kubunzima bomzimba womntu kunemifuziselo esekwe kuhlengahlengiso.

Ingqikelelo kaSpeakman iye yagxekwa kumanqaku ambalwa, ngakumbi ngokusilela ukuthathela ingqalelo impembelelo enkulu indlala enayo ekuchumeni. Ngokuchasene ngqo ne-Speakman's hypothesis, uPrentice et al. (2008) [] bavumelana no-Speakman ukuba ukufa ngexesha lendlala bekungekuko ngokwaneleyo ukuba kuqhubele phambili ukuvela kwe-genotype eyongayo, kodwa endaweni yoko waxoxa ngelithi impembelelo enkulu indlala enayo ekuchumeni kwabasetyhini iqhube ukukhethwa kokonga kwe-metabolic. Babonisa ukuba ukunyanzeliswa okusondeleyo kokuzala kuye kwabonwa kwiindlala ezinzima zembali kwaye ukuchuma kunokuncitshiswa ngama-30 ukuya kuma-50 ekhulwini ngamaxesha aqhelekileyo endlala kule mihla yaseGambia naseBangladesh []. Ke, i-TGH isenokuthi isebenze, kuba ukonga kwe-metabolic konyusa ukomelela okubandakanyayo. USpeakman uzichasile ezi mpikiswano ngokuqaphela ukuba emva kwamaxesha endlala, kudla ngokubakho “ukubuyisela umva” ekuchumeni, kunye nokwanda kokumitha okwenzekayo ukwenza ixesha lokuzala okuphantsi ngexesha lendlala [,].

Nangona kukho impikiswano, le ngcamango ineempembelelo ezibangela umdla kuphononongo lokutyeba kwabantu. Ukuba iindlela bezikhe zabakho ebantwini abacinezela ubunzima ekuphenduleni amarhamncwa, ukufumana iindlela ezifanayo kwizilwanyana kunokukhokelela ekuchongweni kofuzo lwabantu kunye neendlela zemetabolism ezinoxanduva lokulawula ubunzima bomzimba kunye nokwahluka esikubonayo kubantu. Yinyani okanye akunjalo, i-hypothesis ka-Speakman igxininisa imfuneko yokuqonda ngcono ukulawulwa kobunzima bomzimba kwezinye izilwanyana ezinoluhlu lweembali zendaleko ukuze siqonde ngokwenene imvelaphi yokutyeba komntu.

Ngokweziphumo zeklinikhi, ukuba ukutyeba kakhulu kusisiphumo soguquko olucimayo kunye nemfuzo, endaweni yendlela elungelelanisiweyo, inokuphathwa njengesifo se-heterogenic. Ukuqonda ngokufunda indlela abantu abatyebileyo (kunye nezinye izilwanyana) abalawula ngayo ubunzima bomzimba wabo kunganceda ukuchonga ukuba zeziphi iijini eziye zatshintshwa kubantu abatyebe kakhulu. Ingqikelelo ka-Speakman ingaqikelela ukuba iinkqubo ezininzi ezahlukeneyo kulawulo lobunzima zinokuba nelahleko-yokusebenza kweenguqu ngenxa yemfuzo, kwaye iinkqubo ezahlukeneyo zinokuchaphazeleka kubantu abohlukeneyo. Inzululwazi yanamhlanje isondela ngokukhawuleza kwixesha lemfuza yomntu. Ukuba i-genetics yolawulo lomlinganiselo wobunzima bomzimba yayiqondwa kakuhle, ungenelelo lokulawula ubunzima bunokwenziwa kumntu ngamnye ngokusekelwe kwiprofayili yakhe yofuzo. Umzekelo, izicwangciso zokulawula ubunzima ziya kwahluka kakhulu kumntu otyebe kakhulu kubangelwe yingxaki yofuzo ephantsi kolawulo lokutya ngokuchasene nomntu onesiphene sofuzo kwireyithi ye-metabolic.

izigqibo

Kolu phononongo, ndixoxe ngeengqikelelo ezininzi ezikhuphisanayo malunga nemvelaphi yokuzivelela kobhubhani wokutyeba. Zishwankathelwe ngaphakathi 1 Table, kunye neengqikelelo ezongezelelweyo ezidweliswe umdla womfundi. Ezi ngcamango zibonakala zahlukile, kodwa azihambelani. Ingqikelelo ye-epigenome eyongayo yibhulorho phakathi kwemfuza eyongayo kunye nengqikelelo ye-phenotype. Inika indlela apho iiphenotypes ezityebileyo zisebenza ngayo ukubumba imetabolism utero, ngelixa usenza iingcamango ezifanayo malunga namandla e-evolution kwi-genome ebekwa yi-TGH. I-hypothesis yokutshintsha kokuziphatha nayo ayihambelani nentsapho eyongayo yeengcamango. Uxinzelelo lokunqongophala kokutya (okanye ukungabikho kwayo) yinto ebalulekileyo ekulungelelaniseni utshintsho phakathi kwezicwangciso zokuzala kunye nendlela yokuphila. Ukunqongophala kokutya kuthanda indlela yokuphila “yamajoni”, ngelixa intabalala yokutya ithanda indlela yokuphila “yonozakuzaku”. I-Metabolic thriftiness isengamandla abalulekileyo endaleko kwi-hypothesis yokutshintsha kokuziphatha. Okokugqibela, ngaphandle kwento yokuba i-hypothesis yemfuza ekhukulisiweyo yasekwa ukucela umngeni ngokuthe ngqo kwi-TGH, kuyenzeka ukuba izakhi zazo zombini zichaneke. Ukukhethwa kwemfuza eyongayo bekunokukhawuleziswa kukhupho lwangaphambili/inkululeko kwimeko yothintelo olukhethiweyo. Kwixesha elidlulileyo, ulungelelwaniso lunokuba lukhona phakathi koqoqosho lwemetabolism kunye nokulawulwa kobunzima ukunqanda ukuhlaselwa kwangaphambili, okunokuba nokhetho olulinganiselweyo lwemfuza eyongayo. Nje ukuba isoyikiso lesidlwengu sipheliswe kwaye akusekho kukhethwa kokubhitya, kuya kuba lula ukukhetha ukonga ukuba kuqale.

1 Table 

Isishwankathelo seengqikelelo zokuzivelela kwe-metabolic syndrome.

Nangona kukho indawo yokuba ngaphezulu kwe-hypothesis enye ichanekile, kusabalulekile ukumisela imvelaphi echanekileyo yemvelaphi yokutyeba. Ngaphandle kophando oluncinci kakhulu lokuyixhasa, bobabini abaphandi kunye noluntu ngokubanzi baye bayamkela i-TGH. Ngenxa yoko, iingcamango ezininzi zenziwe malunga nezizathu zokutyeba ngokusekelwe kwi-TGH, eziye zachaphazela kakhulu uphando kunye nolawulo lweklinikhi lokutyeba kunye nesifo sikashukela. Iimali zophando ezinkulu ziye zagalelwa ekufumaneni imfuza "eyongayo" enokuthi ichaze ubungakanani bobhubhani bokutyeba, kodwa ezo zifunyenweyo zinokuchaza ukutyeba kwiqhezu elincinane kakhulu labemi okanye ukonyusa umngcipheko wokutyeba ngokuncinci kakhulu. amanyathelo. Uvavanyo olungqongqo ngakumbi lokuqinisekiswa kwe-TGH kunokukhokelela kwindlela echanekileyo nesebenzayo kwi-etiology yokukhuluphala. Ingqikelelo nganye endiyixubileyo icebisa izicwangciso zophando ezahluke kakhulu.

Finally, the evolutionary mechanisms that allow for obesity are highly relevant to clinical and public health management of the epidemic. The TGH suggests that simple changes in diet and exercise should prevent obesity, and while this intuitively makes sense, we know that this strategy is easier said than done. Although correction of the “mismatch” between the environment in which humans evolved and our modern environment could conceivably combat the obesity epidemic according to most of the hypotheses discussed, other hypotheses provide much different and more specific strategies into the treatment and prevention of obesity then does the TGH. The drifty gene hypothesis implies that a more disease-based strategy focusing on individual genetic history is needed to treat obesity. Both the thrifty phenotype and thrifty epigenome hypotheses put emphasis on utero isondlo kwaye kuthetha ukuba utshintsho lwendlela yokuphila olwenziwa ngexesha lokukhula alunamsebenzi. Ezi ngqikelelo zibaluleke ngokukodwa ukulwa nokunyuka kokutyeba kumazwe asakhasayo. Ekugqibeleni, i-hypothesis yokutshintshwa kokuziphatha iphakamisa isicwangciso sonyango esahlukileyo kakhulu sohlobo lwe-2 yeswekile kunye nokukhuluphala, kugxininiswa kakhulu ekulweni impendulo yokuvuvukala, kunokuba ezi ngxaki ngokwazo. Ukongeza, i-hypothesis yokutshintsha kokuziphatha icebisa ukuba uhlaziyo olukhulu lwentlalo noqoqosho luya kunciphisa oonobangela bobhubhane bokutyeba kwaye kumise ukukhula kwayo.

Ngelixa zonke ezi zicwangciso zolawulo lweklinikhi zingahambelani kwaye ngokuqinisekileyo zinokusetyenziswa ngokufanayo, ngokunikezelwa kwezibonelelo ezinqongopheleyo zamaziko okhathalelo lwempilo yehlabathi, kucacile ukuba uphando olongezelelweyo luyafuneka ukuze kulungiswe unyango kunye nokufumana ezo ziya kubonakala zisebenza kakhulu. Kunokuba ibe lusukelo olulula lwemfundo, ukufunda ngendaleko yabantu kubaluleke kakhulu kwimpilo yabantu banamhlanje.

izifinyezo

TGHthrifty gene hypothesis
SNPenye i-nucleotide polymorphism
GWAunxulumano olubanzi lwegenome
 

Inqaku lombhali

Inkxaso-mali ebonelelwa ngeNkqubo yeSizwe yoQeqesho lweSidanga soPhando lweSayensi.

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