THE INJURED HOMO OBESUS: DOES TRAUMA AFFECT THIS CREATURE DIFFERENTLY TO WILD TYPE HOMO SAPIENS?
Stephen R. Manning (UK)
Abstract
Homo obesus (Man the obese) is known to have differences in cardiometabolic profile compared to wild type H. sapiens (Man the wise). To explore the differences in the affect of trauma upon H. obesus a thorough literature search was performed. In this review evidence is brought together to show the differences in injury patterns seen between H. obesus and wild type H. sapiens, the differences in outcome following trauma and how the altered adipokine and osteokine profile of H. obesus influences his bone structure. We see that the obese state is a risk factor for both increasing severity of limb trauma and increased mortality, critical care length of stay and death following blunt trauma. This risk may be influenced by the abnormal adipokine profile. In particular the roles of adiponectin, leptin, PPARγ, TNF-α and IL-6 are considered. The effect of chronic inflammatory insult prior to trauma in the obese adult is considered and its potential influence over the outcome is debated. Following major blunt trauma the robust appearing physique of H. obesus shows it’s fragility with an increased risk of death and longer hospital stay.
Adipobiology 2010; 2:57-66
Key words: adipokines, bone mineral density, obesity, osteokines, PPARγ, trauma
Received 10 December 2010, accepted 21 December 2010.
Correspondence: Dr Stephen R. Manning, 30 Pennyroyal Close, Tamebridge, Walsall, West Midlands, WS5 4SJ, UK.
Tel.: 0044 (0)1922 641727,
E-mail: stephen.manning@doctors.org.uk
