Van Gaal Luc F, Mertens Ilse L, Abrams Pascale J
Department of Diabetology, Metabolism and Clinical Nutrition, University Hospital Antwerp, Antwerp, Belgium.
Growth Horm IGF Res. 2003 Aug;13 Suppl A:S4-9. doi: 10.1016/s1096-6374(03)00046-7.
Lipodystrophy (LD) is a well-recognised clinical syndrome of peripheral fat atrophy and central adiposity, often associated with laboratory abnormalities such as dyslipidemia and glucose intolerance, and probably linked to insulin resistance. The long-term consequences of LD and its potential association with cardiovascular disease remain unknown. The visceral fat accumulation is characterised by the increased, abundant secretion of a number of peptides such as leptin, insulin-like growth factor (IGF), adiponectin and the recently reported resistin and visfatin hormones. Elevated resistin and tumour necrosis factor (TNF-alpha) levels and low levels of adiponectin secretion may have implications for the risk of development of type 2 diabetes and cardiovascular disease. LD is observed not only in rare autosomal syndromes, but also in patients positive for the human immunodeficiency virus (HIV) who have been treated with protease inhibitors. Both the origin of LD and its treatment deserve more attention and further research in clinical settings.
脂肪营养不良（LD）是一种公认的临床综合征，表现为外周脂肪萎缩和中心性肥胖，常伴有血脂异常和葡萄糖耐量异常等实验室检查异常，可能与胰岛素抵抗有关。LD的长期后果及其与心血管疾病的潜在关联尚不清楚。内脏脂肪堆积的特征是多种肽类物质分泌增加且丰富，如瘦素、胰岛素样生长因子（IGF）、脂联素以及最近报道的抵抗素和内脂素激素。抵抗素和肿瘤坏死因子（TNF-α）水平升高以及脂联素分泌水平降低可能与2型糖尿病和心血管疾病的发生风险有关。LD不仅在罕见的常染色体综合征中可见，在接受蛋白酶抑制剂治疗的人类免疫缺陷病毒（HIV）阳性患者中也可观察到。LD的病因及其治疗在临床环境中都值得更多关注和进一步研究。
