Bays Harold
L-MARC Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA.
Expert Rev Cardiovasc Ther. 2005 May;3(3):393-404. doi: 10.1586/14779072.3.3.393.
Excessive fat (adiposity) and dysfunctional fat (adiposopathy) constitute the most common worldwide epidemics of our time -- and perhaps of all time. Ongoing efforts to explain how the micro (adipocyte) and macro (body organ) biologic systems interact through function and dysfunction in promoting Type 2 diabetes mellitus, hypertension and dyslipidemia are not unlike the mechanistic and philosophical thinking processes involved in reconciling the micro (quantum physics) and macro (general relativity) theories in physics. Currently, the term metabolic syndrome refers to a constellation of consequences often associated with excess body fat and is an attempt to unify the associations known to exist between the four fundamental metabolic diseases of obesity, hyperglycemia (including Type 2 diabetes mellitus), hypertension and dyslipidemia. However, the association of adiposity with these metabolic disorders is not absolute and the metabolic syndrome does not describe underlying causality, nor does the metabolic syndrome necessarily reflect any reasonably related pathophysiologic process. Just as with quantum physics, general relativity and the four fundamental forces of the universe, the lack of an adequate unifying theory of micro causality and macro consequence is unsatisfying, and in medicine, impairs the development of agents that may globally improve both obesity and obesity-related metabolic disease. Emerging scientific and clinical evidence strongly supports the novel concept that it is not adiposity alone, but rather it is adiposopathy that is the underlying cause of most cases of Type 2 diabetes mellitus, hypertension and dyslipidemia. Adiposopathy is a plausible Theory of Everything for mankind's greatest metabolic epidemics.
过多的脂肪(肥胖)和功能失调的脂肪(脂肪病变)构成了我们这个时代乃至可能有史以来最常见的全球性流行病。目前正在努力解释微观(脂肪细胞)和宏观(身体器官)生物系统如何通过功能和功能失调相互作用,从而引发2型糖尿病、高血压和血脂异常,这与调和物理学中的微观(量子物理学)和宏观(广义相对论)理论所涉及的机械和哲学思维过程并无不同。目前,代谢综合征一词指的是一系列通常与体内脂肪过多相关的后果,旨在统一肥胖、高血糖(包括2型糖尿病)、高血压和血脂异常这四种基本代谢疾病之间已知的关联。然而,肥胖与这些代谢紊乱之间的关联并非绝对,代谢综合征并未描述潜在的因果关系,也不一定反映任何合理相关的病理生理过程。就像量子物理学、广义相对论和宇宙的四种基本力一样,缺乏一个足够统一的微观因果关系和宏观后果理论令人不满,在医学上,这会阻碍可能全面改善肥胖及肥胖相关代谢疾病的药物的研发。新出现的科学和临床证据有力地支持了这一新颖观点,即2型糖尿病、高血压和血脂异常的大多数病例的根本原因并非仅仅是肥胖,而是脂肪病变。脂肪病变是人类最严重的代谢性流行病的一个看似合理的万物理论。