Blüher M
Department of Medicine, University of Leipzig, Leipzig, Germany.
Exp Clin Endocrinol Diabetes. 2009 Jun;117(6):241-50. doi: 10.1055/s-0029-1192044. Epub 2009 Apr 8.
The incidence of obesity has increased dramatically during recent decades. Obesity will cause a decline in life expectancy for the first time in recent history due to numerous co-morbid disorders. Adipocyte and adipose tissue dysfunction belong to the primary defects in obesity and may link obesity to several health problems including increased risk of insulin resistance, type 2 diabetes, fatty liver disease, hypertension, dyslipidemia, atherosclerosis, dementia, airway disease and some cancers. However, not all obese individuals develop obesity related metabolic or cardiovascular disorders potentially due to a preserved normal adipose tissue architecture and function. The majority of patients with obesity have an impaired adipose tissue function caused by the interaction of genetic and environmental factors which lead to adipocyte hypertrophy, hypoxia, a variety of stresses and inflammatory processes within adipose tissue. Ectopic fat accumulation including visceral obesity may be considered as a consequence of adipose tissue dysfunction, which is further characterized by changes in the cellular composition, increased lipid storage and impaired insulin sensitivity in adipocytes, and secretion of a proinflammatory, atherogenic, and diabetogenic adipokine pattern. This review focuses on the discussion of mechanisms causing or maintaining impaired adipose tissue function in obesity and potentially linking obesity to its associated disorders. A model is proposed how different pathogenic factors and mechanisms may cause dysfunction of adipose tissue.
近几十年来，肥胖症的发病率急剧上升。由于多种合并症，肥胖将导致预期寿命在近代史上首次下降。脂肪细胞和脂肪组织功能障碍是肥胖的主要缺陷，可能将肥胖与多种健康问题联系起来，包括胰岛素抵抗、2型糖尿病、脂肪肝疾病、高血压、血脂异常、动脉粥样硬化、痴呆、气道疾病和某些癌症的风险增加。然而，并非所有肥胖个体都会出现与肥胖相关的代谢或心血管疾病，这可能是由于脂肪组织结构和功能保持正常。大多数肥胖患者的脂肪组织功能受损，这是由遗传和环境因素相互作用导致的，这些因素会导致脂肪细胞肥大、缺氧、多种应激和脂肪组织内的炎症过程。包括内脏肥胖在内的异位脂肪堆积可能被视为脂肪组织功能障碍的结果，其进一步特征是细胞组成的变化、脂肪细胞中脂质储存增加和胰岛素敏感性受损，以及促炎、致动脉粥样硬化和致糖尿病的脂肪因子分泌模式。本综述重点讨论肥胖中导致或维持脂肪组织功能受损的机制，以及潜在地将肥胖与其相关疾病联系起来的机制。本文提出了一个模型，说明不同的致病因素和机制如何可能导致脂肪组织功能障碍。
