Balsan Guilherme Ardenghi, Vieira José Luiz da Costa, Oliveira Aline Marcadenti de, Portal Vera Lúcia
Cardiology University Foundation, Porto Alegre, RS, Brazil.
Medical Residency Outpatient Clinic, Institute of Cardiology, FUC-RS, Porto Alegre, RS, Brazil.
Rev Assoc Med Bras (1992). 2015 Jan-Feb;61(1):72-80. doi: 10.1590/1806-9282.61.01.072. Epub 2015 Jan 1.
the conditions of obesity and overweight pose a major risk for a number of comorbidities, including clinical syndromes resulting from atherosclerotic disease. Recent studies strongly indicate that adipose tissue is an active endocrine organ that secretes bioactive factors such as adipokines. Adiponectin appears to have a regulatory role in the mechanism of insulin resistance and in the development of atherosclerosis. This systematic review aims to evaluate the anti-atherogenic effects of adiponectin and its properties to improve and mimic metabolic and vascular actions of insulin and its influence on endothelial function.
a qualitative, exploratory and literature review was performed in the PubMed, Portal Capes and Scielo databases using as key-words "adiponectin", "obesity", "insulin resistance", "anti-inflammatory", "therapeutic strategies" and "future prospects".
evidence suggests that adiponectin has anti-atherogenic properties with anti-inflammatory effects on the vascular wall. Moreover, it modifies the vascular intracellular signaling and has indirect antioxidant effects on the human myocardium. On the other hand, there are studies suggesting that increased levels of adiponectin are paradoxically associated with a worse prognosis in heart failure syndrome, although the mechanisms are not clear.
it is not clear whether adiponectin levels have any clinical significance for risk stratification in cardiovascular disease or if they simply reflect the activation of complex underlying mechanisms. Changes in lifestyle and some drug treatments for hypertension and coronary heart disease have shown significant effect to increase adiponectin levels, and simultaneously decrease in insulin resistance and endothelial dysfunction.
肥胖和超重状况对多种合并症构成重大风险，包括动脉粥样硬化疾病导致的临床综合征。近期研究有力表明，脂肪组织是一个分泌诸如脂联素等生物活性因子的活跃内分泌器官。脂联素似乎在胰岛素抵抗机制以及动脉粥样硬化发展过程中发挥调节作用。本系统评价旨在评估脂联素的抗动脉粥样硬化作用及其改善和模拟胰岛素代谢及血管作用的特性，以及其对内皮功能的影响。
在PubMed、Portal Capes和Scielo数据库中进行了定性、探索性文献综述，使用“脂联素”“肥胖”“胰岛素抵抗”“抗炎”“治疗策略”和“未来前景”作为关键词。
有证据表明脂联素具有抗动脉粥样硬化特性，对血管壁有抗炎作用。此外，它可改变血管细胞内信号传导，对人类心肌有间接抗氧化作用。另一方面，有研究表明，脂联素水平升高与心力衰竭综合征预后较差存在矛盾关联，尽管其机制尚不清楚。
脂联素水平对于心血管疾病风险分层是否具有临床意义尚不清楚，或者它们是否仅仅反映了复杂潜在机制的激活。生活方式的改变以及一些治疗高血压和冠心病的药物治疗已显示出显著效果，可提高脂联素水平，同时降低胰岛素抵抗和内皮功能障碍。
