Koleva Daniela Iv, Orbetzova Maria M, Atanassova Pepa K
Clinic of Endocrinology and Metabolic Diseases, St George University Hospital, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 2013 Jan-Mar;55(1):25-32. doi: 10.2478/folmed-2013-0002.
Impaired sensitivity to insulin (the so called insulin resistance, IR) occurs in a number of genetic and acquired conditions, including obesity, non-insulin dependent diabetes mellitus, polycystic ovary syndrome (PCOS) and metabolic syndrome (MS). In this review we discuss the correlation between IR, the adipose tissue hormones and appetite and body weight regulators. Leptin acts as a major adipostat: it suppresses food intake and activates catabolic pathways associated with increased energy production. It improves the peripheral insulin sensitivity and affects beta-cell function. Adiponectin is the only adipocytokine discovered so far that has anti-atherogenic properties. There is a reverse correlation between the serum adiponectin levels and the degree of obesity, IR, impaired glucose tolerance, dyslipidemia and atherosclerosis. Ghrelin stimulates food intake; of all circulating orexigenic hormones ghrelin is the most thoroughly studied. Ghrelin levels are decreased in MS and PCOS patients as this hormone is negatively correlated with body mass. Resistin is a hormone secreted by adipose tissues; a growing body of evidence suggests that it might be implicated in the link between obesity and diabetes. It has been found that the hormone's levels are significantly higher in obese people than those in normal body mass people. The recently discovered adipose tissue hormones, vaspin, visfatin, omentin-1 and their effect on IR development, have been increasingly researched.
胰岛素敏感性受损（即所谓的胰岛素抵抗，IR）发生于多种遗传和后天性疾病中，包括肥胖症、非胰岛素依赖型糖尿病、多囊卵巢综合征（PCOS）和代谢综合征（MS）。在本综述中，我们讨论了IR、脂肪组织激素与食欲及体重调节因子之间的相关性。瘦素是一种主要的脂肪稳态调节因子：它抑制食物摄入并激活与能量产生增加相关的分解代谢途径。它能改善外周胰岛素敏感性并影响β细胞功能。脂联素是迄今为止发现的唯一具有抗动脉粥样硬化特性的脂肪细胞因子。血清脂联素水平与肥胖程度、IR、糖耐量受损、血脂异常和动脉粥样硬化程度呈负相关。胃饥饿素刺激食物摄入；在所有循环的促食欲激素中，胃饥饿素是研究最为深入的。MS和PCOS患者的胃饥饿素水平降低，因为这种激素与体重呈负相关。抵抗素是一种由脂肪组织分泌的激素；越来越多的证据表明，它可能与肥胖和糖尿病之间的联系有关。研究发现，肥胖者体内这种激素的水平明显高于正常体重者。最近发现的脂肪组织激素、内脏脂肪素、内脂素、网膜素-1及其对IR发展的影响，已受到越来越多的研究。
