Purpose of review: It had been thought for a long time that thyroid hormones were the only ones to regulate energy production within mitochondria. Recent findings show that other hormones (steroids, leptin, insulin) regulate the efficiency of mitochondrial adenosine triphosphate production. Furthermore, a mismatch between oxygen consumption and energy intake may not be sufficient to understand body weight regulation. It appears that the efficiency of adenosine triphosphate production may play a role.
Recent findings: Over the past 2 years a series of results argued that glucocorticoids influence energy balance, the efficiency of adenosine triphosphate production, and are thermogenic. The sites for this effect are discussed, probably both the liver and muscle. Evidence of the genes involved in this regulation is substantial for muscle but remains to be studied in the liver. On the other hand, leptin could be a thermogenic hormone, especially in situations of calorie restriction. Finally, recent data and opinions suggest that mitochondria and adenosine triphosphate production could be central in the pathogenesis of both insulin resistance and beta cell deficiency.
Summary: The adaptation of mitochondrial adenosine triphosphate production appears to play a role in both diabetes and weight loss (voluntary and involuntary). Hormonal and nutritional manipulation could be a therapeutic possibility for weight management.