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肥胖中炎症诱导的微血管功能障碍——一种转化医学方法。

Inflammation-induced microvascular dysfunction in obesity - A translational approach.

作者信息

das Graças Coelho de Souza Maria, Kraemer-Aguiar Luiz Guilherme, Bouskela Eliete

机构信息

Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil.

Ambulatório de Obesidade, Policlínica Piquet Carneiro, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Centro Biomédico, Universidade do Estado do Rio de Janeiro, RJ, Brazil.

出版信息

Clin Hemorheol Microcirc. 2016;64(4):645-654. doi: 10.3233/CH-168018.

Abstract

Obesity is a crescent epidemic in the world, affecting more than half a billion of adults worldwide. Obesity is associated to main cardiovascular risk factors, such as insulin resistance, type 2 diabetes mellitus, high blood pressure and dyslipidemia. The excessive adiposity causes a dysregulation of adipokines secretion by adipose tissue, upregulating the expression of pro-inflammatory adipokines and downregulating the anti-inflammatory ones. This scenario contributes for the appearance of atherosclerosis. Since endothelium dysfunction is considered the earliest known marker of the atherosclerotic process, several methods to assess precociously the manifestations of endothelial dysfunction in microvessels, such as venous occlusion plethysmography, laser Doppler flowmetry and nailfold videocapillaroscopy, have been developed. Clinical and experimental studies have shown an impairment of microvascular function, capillary rarefaction and increase in inflammatory status in obesity and the introduction of lifestyle modifications, mainly physical activity and diet, constitute effective interventions to restore microvascular function in obesity.

摘要

肥胖是全球范围内日益严重的流行病,影响着全球超过5亿成年人。肥胖与主要的心血管危险因素相关,如胰岛素抵抗、2型糖尿病、高血压和血脂异常。过多的脂肪组织导致脂肪因子分泌失调,促炎脂肪因子的表达上调,而抗炎脂肪因子的表达下调。这种情况促使动脉粥样硬化的出现。由于内皮功能障碍被认为是动脉粥样硬化过程中最早已知的标志物,因此已经开发了几种方法来早期评估微血管内皮功能障碍的表现,如静脉阻塞体积描记法、激光多普勒血流仪和甲襞微血管镜检查。临床和实验研究表明,肥胖患者存在微血管功能受损、毛细血管稀疏和炎症状态增加的情况,而引入生活方式的改变,主要是体育活动和饮食,是恢复肥胖患者微血管功能的有效干预措施。

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