Paquot N, Tappy L
Service de Diabétologie, Nutrition et Maladies Métaboliques, CHU Sart-Tilman, 4000 Liège.
Rev Med Liege. 2005 May-Jun;60(5-6):369-73.
Adipose tissue, in addition to the storage of lipids function for lipids, plays active roles in normal metabolic homeostasis and in the development of several diseases, such as type 2 diabetes, dyslipaemia and atherosclerosis. These roles are mediated by adipocytokines, factors secreted by adipose tissue. These include tumor necrosis factors (TNF)-alpha, leptin, resistin, adiponectin or visfatin. Adipocytokines act in an autocrine, paracrine and endocrine manner. Adiponectin is a peculiar adipocytokine because in contrast to the markedly increased levels of leptin, resistin or TNF-alpha in obesity, its level is negatively correlated with body mass index, and is decreased in presence of insulin resistance and in type 2 diabetes. Adiponectin may play a crucial role in the development of diabetes mellitus and high adiponectin levels should protect against impairment of glucose metabolism. Moreover, adipocytokines are involved in the pathogenesis of vascular diseases and may represent a link between obesity, diabetes, inflammation and atherosclerosis. Weight loss, exercise and some antidiabetic drugs also influence plasma adipocytokines levels. For instance, thiazolidinediones treatment in patients with type 2 diabetes resulted in an increased in plasma adiponectin levels and a decrease in circulating TNF-alpha concentrations.
脂肪组织除了具有储存脂质的功能外，还在正常代谢稳态以及多种疾病（如2型糖尿病、血脂异常和动脉粥样硬化）的发生发展中发挥积极作用。这些作用是由脂肪细胞因子介导的，脂肪细胞因子是脂肪组织分泌的因子。其中包括肿瘤坏死因子（TNF）-α、瘦素、抵抗素、脂联素或内脂素。脂肪细胞因子以自分泌、旁分泌和内分泌的方式发挥作用。脂联素是一种特殊的脂肪细胞因子，因为与肥胖时瘦素、抵抗素或TNF-α水平显著升高相反，其水平与体重指数呈负相关，并且在存在胰岛素抵抗和2型糖尿病时会降低。脂联素可能在糖尿病的发生发展中起关键作用，高脂联素水平应能预防葡萄糖代谢受损。此外，脂肪细胞因子参与血管疾病的发病机制，可能代表肥胖、糖尿病、炎症和动脉粥样硬化之间的联系。体重减轻、运动和一些抗糖尿病药物也会影响血浆脂肪细胞因子水平。例如，2型糖尿病患者使用噻唑烷二酮类药物治疗后，血浆脂联素水平升高，循环TNF-α浓度降低。
