Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts and Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts.
Ann N Y Acad Sci. 2018 Jan;1411(1):5-20. doi: 10.1111/nyas.13398. Epub 2017 Aug 1.
Obesity is an excess accumulation of adipose tissue mass, and, together with its sequelae, in particular type II diabetes and metabolic syndrome, obesity presents a major health crisis. Although obesity is simply caused by increased adipose mass, the heterogeneity of adipose tissue in humans means that the response to increased energy balance is highly complex. Individual subjects with similar phenotypes may respond very differently to the same treatments; therefore, obesity may benefit from a personalized precision medicine approach. The variability in the development of obesity is indeed driven by differences in sex, genetics, and environment, but also by the various types of adipose tissue as well as the different cell types that compose it. By describing the distinct cell populations that reside in different fat depots, we can interpret the complex effect of these various players in the maintenance of whole-body energy homeostasis. To further understand adipose tissue, adipogenic differentiation and the transcriptional program of lipid accumulation must be investigated. As the cell- and depot-specific functions are described, they can be placed in the context of energy excess to understand how the heterogeneity of adipose tissue shapes individual metabolic status and condition.
肥胖是指脂肪组织质量的过度积累,而肥胖及其后遗症,特别是 II 型糖尿病和代谢综合征,构成了主要的健康危机。尽管肥胖仅仅是由于脂肪质量的增加引起的,但人类脂肪组织的异质性意味着对能量平衡增加的反应非常复杂。具有相似表型的个体可能对相同的治疗方法有非常不同的反应;因此,肥胖可能受益于个性化的精准医疗方法。肥胖的发展的可变性确实是由性别、遗传和环境的差异驱动的,但也与各种类型的脂肪组织以及构成它的不同细胞类型有关。通过描述存在于不同脂肪储存部位的不同细胞群体,我们可以解释这些不同参与者在维持全身能量平衡中的复杂作用。为了进一步了解脂肪组织,必须研究脂肪生成分化和脂质积累的转录程序。随着细胞和储存部位特异性功能的描述,可以将其置于能量过剩的背景下,以了解脂肪组织的异质性如何塑造个体的代谢状态和状况。