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Recent studies have reported a significant increase in the incidence of type 2 diabetes in the past 30 years. They also predict that this trend will continue. This is related to a change in lifestyle, which results in a parallel increase in the incidence of overweight and obesity. However, symptoms of the metabolic syndrome, so far closely related to abdominal obesity, are relatively common among people with normal body mass index (BMI) and waist circumference. The aim of the study is to present the TOFI phenotype (thin outside, fat inside) as an important factor in pathogenesis of type 2 diabetes. In the 1980s, the first study of the MONW (metabolic obese normal weight), a phenotype that is characterized by metabolic diseases in people with normal body weight. Since then, no uniform criteria have been established for MONW deployment, which has created difficulties in identifying affected individuals. Recent work has appeared describing the TOFI phenotype, which seems to lead to the appearance of MONW. People affected by this problem, in spite of undersized fatty tissue, have an increased amount of adipose tissue surrounding the internal organs, which increases the risk of insulin resistance and type 2 diabetes. In the diagnostics of the TOFI phenotype, magnetic resonance imaging is of paramount importance. Previous studies did not provide clear answers about the pathogenesis of TOFI nor which factors stimulate its development. Prophylaxis and treatment of the syndrome include increased physical activity, the promotion of correct eating habits, and a use of metformin., (© Polish Society for Pediatric Endocrinology and Diabetology.)

Obestatin is a 23 amino acid peptide, isolated from the rat stomach. Obestatin and ghrelin are both encoded by the same gene. Obestatin is derived from preproghrelin and plays a functional role in the regulation of energy balance, foot intake, obesity and metabolic syndrome. Obestatin inhibits thirst in rat and alters sleep and is able to cross the blood-brain barrier. So far it has been thought that the GPR 39 receptor is the major modulator in food intake, but recently a survey appeared indicating that it only plays a supportive role. Most of the experiments regarding ghrelin and obestatin are conducted on animal models. It is supposed that obestatin and ghrelin are not independent factors modifying the body's energy economy, but rather elements of a more complicated system requiring a lot of research to understand and describe. [ABSTRACT FROM AUTHOR]