a Metabolic Research Laboratory , Clínica Universidad de Navarra , Pamplona , Spain.
b CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) , Instituto de Salud Carlos III , Pamplona , Spain.
Adipocyte. 2018 Jan 2;7(1):57-62. doi: 10.1080/21623945.2017.1402151. Epub 2017 Dec 5.
Obesity is currently the most extended metabolic disturbance worldwide favoring the development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. Obesity and the metabolic syndrome (MS) are characterized by an increase in circulating leptin concentrations, in parallel to a decrease in blood levels of adiponectin. Consequently, the adiponectin/leptin ratio has been suggested as a maker of adipose tissue dysfunction. This emerging biomarker correlates with insulin resistance better than adiponectin or leptin alone, or even HOMA and is decreased with increasing number of metabolic risk factors having been proposed as a predictive marker for the MS. Moreover, the adiponectin/leptin ratio is negatively correlated with markers of low-grade chronic inflammation. In this sense, an increase in this ratio has been related with reduced atherosclerosis risk as well as with a decreased risk of some types of cancer in epidemiological studies. In this commentary we propose new cutoffs to estimate obesity- and MS-associated cardiometabolic risk according to the adiponectin/leptin ratio and discuss different therapeutic strategies to increase this promising biomarker of metabolic risk.
肥胖症是目前全球最广泛的代谢紊乱疾病，易引发 2 型糖尿病、高血压和血脂异常等代谢异常。肥胖症和代谢综合征（MS）的特征是循环瘦素浓度增加，而脂联素水平降低。因此，脂联素/瘦素比值被认为是脂肪组织功能障碍的标志物。这种新兴的生物标志物与胰岛素抵抗的相关性优于单独的脂联素或瘦素，甚至优于 HOMA，并且随着代谢危险因素数量的增加而降低，因此被提出作为 MS 的预测标志物。此外，脂联素/瘦素比值与低度慢性炎症标志物呈负相关。从这个意义上说，该比值的增加与动脉粥样硬化风险降低以及流行病学研究中某些类型癌症风险降低有关。在这篇评论中，我们根据脂联素/瘦素比值提出了新的切点来评估肥胖症和 MS 相关的心血管代谢风险，并讨论了增加这种有前途的代谢风险生物标志物的不同治疗策略。
