Changes in the functional activity of the melanocortin signal system of the hypothalamus, which is involved in regulating feeding behavior and peripheral homeostasis, play an important role in the etiology and pathogenesis of type 2 diabetes mellitus and metabolic syndrome. This review discusses current concepts of the structural-functional organization of the melanocortin signal system and its interactions with other hypothalamic signal systems. Data on impairments to melanocortin signal cascades in hypothalamic neurons are presented – these may be the primary causes of type 2 diabetes mellitus and metabolic syndrome or the result of hormonal changes arising in the conditions of these metabolic disorders. Recently developed approaches to restoring the functions of the melanocortin signal system are discussed as one pathway to the treatment and prophylaxis of type 2 diabetes mellitus and metabolic syndrome.
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