Barazzoni Rocco, Gortan Cappellari Gianluca, Ragni Maurizio, Nisoli Enzo
Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy.
Eat Weight Disord. 2018 Apr;23(2):149-157. doi: 10.1007/s40519-018-0481-6. Epub 2018 Feb 3.
Obesity is a major health risk factor, and obesity-induced morbidity and complications account for huge costs for affected individuals, families, healthcare systems, and society at large. In particular, obesity is strongly associated with the development of insulin resistance, which in turn plays a key role in the pathogenesis of obesity-associated cardiometabolic complications, including metabolic syndrome components, type 2 diabetes, and cardiovascular diseases. Insulin sensitive tissues, including adipose tissue, skeletal muscle, and liver, are profoundly affected by obesity both at biomolecular and functional levels. Altered adipose organ function may play a fundamental pathogenetic role once fat accumulation has ensued. Modulation of insulin sensitivity appears to be, at least in part, related to changes in redox balance and oxidative stress as well as inflammation, with a relevant underlying role for mitochondrial dysfunction that may exacerbate these alterations. Nutrients and substrates as well as systems involved in host-nutrient interactions, including gut microbiota, have been also identified as modulators of metabolic pathways controlling insulin action. This review aims at providing an overview of these concepts and their potential inter-relationships in the development of insulin resistance, with particular regard to changes in adipose organ and skeletal muscle.
肥胖是一个主要的健康风险因素，肥胖引发的发病率和并发症给受影响的个人、家庭、医疗保健系统以及整个社会带来了巨大的成本。特别是，肥胖与胰岛素抵抗的发展密切相关，而胰岛素抵抗又在肥胖相关的心脏代谢并发症（包括代谢综合征成分、2型糖尿病和心血管疾病）的发病机制中起关键作用。胰岛素敏感组织，包括脂肪组织、骨骼肌和肝脏，在生物分子和功能水平上都受到肥胖的深刻影响。一旦出现脂肪堆积，脂肪器官功能的改变可能起着根本性的致病作用。胰岛素敏感性的调节似乎至少部分与氧化还原平衡和氧化应激以及炎症的变化有关，线粒体功能障碍在其中起着相关的潜在作用，可能会加剧这些改变。营养物质和底物以及参与宿主-营养相互作用的系统，包括肠道微生物群，也已被确定为控制胰岛素作用的代谢途径的调节因子。本综述旨在概述这些概念及其在胰岛素抵抗发展中的潜在相互关系，特别关注脂肪器官和骨骼肌的变化。
