Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University, School of Medicine, 650 Albany St., EBRC-810, Boston, MA 02118, USA.
Curr Atheroscler Rep. 2013 Oct;15(10):361. doi: 10.1007/s11883-013-0361-5.
Adipose tissue modifies the development of cardiovascular disease in a complex manner: obesity is a major risk factor, especially when accompanied by a central fat distribution. For that reason the characteristics of visceral adipose tissue have attracted most of the research interest thus far, and measurement of waist circumference is now recommended for everyday clinical practice. However, the direct, causative role of visceral fat in cardiometabolic disease remains to be established. Epidemiological and clinical studies show that accumulation of fat subcutaneously, in the gluteofemoral area, is protective against cardiovascular disease, but the exact molecular mechanisms remain unclear. In the last few years, imaging has allowed the study of smaller fat depots that may interact locally with important tissues: epicardial fat with the myocardium, perivascular fat with the vessel wall and the developing atherosclerotic plaque, and renal sinus fat with the renal artery. Unraveling the heterogeneous fat distribution and metabolic phenotypes in human obesity will facilitate optimal assessment of cardiovascular risk in overweight and obese individuals.
肥胖是一个主要的风险因素，尤其是当伴有中心性脂肪分布时。出于这个原因，内脏脂肪组织的特征迄今引起了大多数研究兴趣，目前建议在日常临床实践中测量腰围。然而，内脏脂肪在代谢性心血管疾病中的直接因果作用仍有待确定。流行病学和临床研究表明，臀部和股部的皮下脂肪堆积对心血管疾病具有保护作用，但确切的分子机制尚不清楚。在过去的几年中，影像学技术已经可以研究更小的脂肪蓄积，这些脂肪蓄积可能与重要组织局部相互作用：心外膜脂肪与心肌，血管壁和正在形成的动脉粥样硬化斑块之间的血管周围脂肪，以及肾窦脂肪与肾动脉之间的脂肪。阐明人类肥胖症中不均匀的脂肪分布和代谢表型将有助于对超重和肥胖个体的心血管风险进行最佳评估。
