Diabetes and Cardiovascular Center of Excellence, University of Missouri, Columbia, MO 65212, USA.
Curr Hypertens Rep. 2010 Apr;12(2):93-8. doi: 10.1007/s11906-010-0095-5.
The cardiometabolic syndrome comprises a cluster of risk factors, including abdominal obesity, dyslipidemia, hypertension, insulin resistance/glucose intolerance, and proteinuria. This syndrome is due, in part, to the accumulation of visceral fat, which promotes synthesis of proinflammatory adipokines resulting in a visceral adipose tissue-specific increase in reactive oxygen species derived from NADPH oxidase. Adipose tissue oxidative stress results in the development of systemic oxidative stress and inflammation, which further lead to development of metabolic dyslipidemia, impaired glucose metabolism, renal disease, and hypertension. Importantly, visceral-not subcutaneous-fat is the significant source of the circulating adipokines that promote these systemic abnormalities. Chronic low-grade inflammation develops within adipose tissue because of the additional infiltration and accumulation of inflammatory macrophages. There is evidence that lifestyle changes, bariatric surgery, and/or administration of insulin-sensitizing, anti-inflammatory, or antihypertensive drugs that address the risk factors promoting the cardiometabolic syndrome act, in part, by promoting an anti-inflammatory adipokine profile in visceral fat.
代谢心血管综合征包括一系列的风险因素，包括腹部肥胖、血脂异常、高血压、胰岛素抵抗/葡萄糖耐量不良和蛋白尿。这种综合征部分是由于内脏脂肪的积累，促进了促炎脂肪因子的合成，导致来自 NADPH 氧化酶的活性氧在内脏脂肪组织中特异性增加。脂肪组织氧化应激导致全身氧化应激和炎症的发展，进一步导致代谢性血脂异常、葡萄糖代谢受损、肾脏疾病和高血压的发生。重要的是，内脏脂肪而不是皮下脂肪是促进这些全身异常的循环脂肪因子的重要来源。由于炎症巨噬细胞的额外浸润和积累，脂肪组织内发生慢性低度炎症。有证据表明，生活方式的改变、减肥手术和/或使用胰岛素增敏、抗炎或降压药物来解决促进代谢心血管综合征的风险因素，部分是通过促进内脏脂肪中的抗炎脂肪因子谱来实现的。
