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单纯性肥胖中的促炎细胞因子与心脏异常:与腹部脂肪沉积的关系

Proinflammatory cytokines and cardiac abnormalities in uncomplicated obesity: relationship with abdominal fat deposition.

作者信息

Malavazos Alexis E, Corsi Massimiliano M, Ermetici Federica, Coman Calin, Sardanelli Francesco, Rossi Antonio, Morricone Lelio, Ambrosi Bruno

机构信息

Endocrinology Unit, Department of Medical and Surgical Sciences, University of Milano, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2007 May;17(4):294-302. doi: 10.1016/j.numecd.2006.01.001. Epub 2006 Mar 31.

Abstract

BACKGROUND AND AIM

Obesity can be considered a state of chronic, low-grade inflammation. Particularly, visceral adipose tissue (VAT) seems to be an active compartment in pro-inflammatory molecule secretion. The possible existence of a correlation between circulating cytokines, their soluble receptors, abdominal fat accumulation and echocardiographic abnormalities in uncomplicated obesity was investigated.

METHODS AND RESULTS

Echocardiographic parameters, C-reactive protein (CRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6-R), tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptor I (TNFR-I) were assessed in 27 normotensive obese women (age 33.3+/-8.3 years; BMI 43.5+/-4.8 kg/m2) and 15 normal-weight controls (age 36.8+/-8.2 years; BMI 22.6+/-1.7 kg/m2). VAT was assessed by CT. The obese patients had higher serum IL-6 (p<0.01), sIL-6-R (p<0.0001), sIL-6-R/IL-6 complex (p<0.05), TNF-alpha (p<0.02), sTNF-alpha-RI (p<0.03) and CRP (p<0.0001) levels than normal women. Moreover, end-diastolic septum thickness (SW), end-diastolic posterior wall thickness (PW), absolute and indexed left ventricular mass, deceleration time (DT), myocardial performance index (MPI) and isovolumetric relaxation time (IVRT) were correlated with sIL-6-R, sIL-6-R/IL-6 complex and CRP levels. Interestingly, sIL-6-R, sIL-6-R/IL-6 complex, CRP, SW, PW, DT and MPI were higher in patients with a VAT area >130 cm2 than those with <130 cm2.

CONCLUSION

In normotensive obese women several pro-inflammatory molecules correlate with both echocardiographic abnormalities and the amount of intra-abdominal fat; these results may support a role for visceral fat in predisposing to cardiac dysfunction, possibly through a low-grade state of inflammation.

摘要

背景与目的

肥胖可被视为一种慢性低度炎症状态。特别是,内脏脂肪组织(VAT)似乎是促炎分子分泌的活跃部位。本研究调查了单纯性肥胖患者循环细胞因子、其可溶性受体、腹部脂肪堆积与超声心动图异常之间可能存在的相关性。

方法与结果

对27名血压正常的肥胖女性(年龄33.3±8.3岁;体重指数43.5±4.8kg/m²)和15名体重正常的对照者(年龄36.8±8.2岁;体重指数22.6±1.7kg/m²)进行了超声心动图参数、C反应蛋白(CRP)、白细胞介素-6(IL-6)、可溶性IL-6受体(sIL-6-R)、肿瘤坏死因子-α(TNF-α)和可溶性TNF受体I(TNFR-I)的评估。通过CT评估VAT。肥胖患者的血清IL-6(p<0.01)、sIL-6-R(p<0.0001)、sIL-6-R/IL-6复合物(p<0.05)、TNF-α(p<0.02)、sTNF-α-RI(p<0.03)和CRP(p<0.0001)水平高于正常女性。此外,舒张末期室间隔厚度(SW)、舒张末期后壁厚度(PW)、绝对和指数化左心室质量、减速时间(DT)、心肌性能指数(MPI)和等容舒张时间(IVRT)与sIL-6-R、sIL-6-R/IL-6复合物和CRP水平相关。有趣的是,VAT面积>130cm²的患者的sIL-6-R、sIL-6-R/IL-6复合物、CRP、SW、PW、DT和MPI高于VAT面积<130cm²的患者。

结论

在血压正常的肥胖女性中,几种促炎分子与超声心动图异常和腹部脂肪量均相关;这些结果可能支持内脏脂肪在易患心脏功能障碍中起作用,可能是通过低度炎症状态。

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