Akoumianakis Ioannis, Akawi Nadia, Antoniades Charalambos
Division of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom.
Korean Circ J. 2017 Sep;47(5):670-685. doi: 10.4070/kcj.2017.0041. Epub 2017 Sep 21.
Obesity is a clinical entity critically involved in the development and progression of cardiovascular disease (CVD), which is characterised by variable expansion of adipose tissue (AT) mass across the body as well as by phenotypic alterations in AT. AT is able to secrete a diverse spectrum of biologically active substances called adipocytokines, which reach the cardiovascular system via both endocrine and paracrine routes, potentially regulating a variety of physiological and pathophysiological responses in the vasculature and heart. Such responses include regulation of inflammation and oxidative stress as well as cell proliferation, migration and hypertrophy. Furthermore, clinical observations such as the "obesity paradox," namely the fact that moderately obese patients with CVD have favourable clinical outcome, strongly indicate that the biological "quality" of AT may be far more crucial than its overall mass in the regulation of CVD pathogenesis. In this work, we describe the anatomical and biological diversity of AT in health and metabolic disease; we next explore its association with CVD and, importantly, novel evidence for its dynamic crosstalk with the cardiovascular system, which could regulate CVD pathogenesis.
肥胖是一种在心血管疾病（CVD）的发生和发展中起关键作用的临床实体，其特征是全身脂肪组织（AT）质量的不同程度增加以及AT的表型改变。AT能够分泌多种被称为脂肪细胞因子的生物活性物质，这些物质通过内分泌和旁分泌途径到达心血管系统，可能调节血管和心脏中的各种生理和病理生理反应。这些反应包括炎症和氧化应激的调节以及细胞增殖、迁移和肥大。此外，诸如“肥胖悖论”等临床观察结果，即患有CVD的中度肥胖患者具有良好临床结局这一事实，强烈表明在CVD发病机制的调节中，AT的生物学“质量”可能远比其总体质量更为关键。在这项工作中，我们描述了健康和代谢疾病中AT的解剖学和生物学多样性；接下来，我们探讨其与CVD的关联，重要的是，探讨其与心血管系统动态相互作用的新证据，这种相互作用可能调节CVD的发病机制。
