Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Nat Rev Cardiol. 2019 Feb;16(2):83-99. doi: 10.1038/s41569-018-0097-6.
Accumulating knowledge on the biology and function of the adipose tissue has led to a major shift in our understanding of its role in health and disease. The adipose tissue is now recognized as a crucial regulator of cardiovascular health, mediated by the secretion of several bioactive products, including adipocytokines, microvesicles and gaseous messengers, with a wide range of endocrine and paracrine effects on the cardiovascular system. The adipose tissue function and secretome are tightly controlled by complex homeostatic mechanisms and local cell-cell interactions, which can become dysregulated in obesity. Systemic or local inflammation and insulin resistance lead to a shift in the adipose tissue secretome from anti-inflammatory and anti-atherogenic towards a pro-inflammatory and pro-atherogenic profile. Moreover, the interplay between the adipose tissue and the cardiovascular system is bidirectional, with vascular-derived and heart-derived signals directly affecting adipose tissue biology. In this Review, we summarize the current knowledge of the biology and regional variability of adipose tissue in humans, deciphering the complex molecular mechanisms controlling the crosstalk between the adipose tissue and the cardiovascular system, and their possible clinical translation. In addition, we highlight the latest developments in adipose tissue imaging for cardiovascular risk stratification and discuss how therapeutic targeting of the adipose tissue can improve prevention and treatment of cardiovascular disease.
对脂肪组织的生物学和功能的认识不断积累，导致我们对其在健康和疾病中的作用的理解发生了重大转变。脂肪组织现在被认为是心血管健康的重要调节剂，这是通过几种生物活性产物的分泌介导的，包括脂肪细胞因子、微泡和气体信使，它们对心血管系统具有广泛的内分泌和旁分泌作用。脂肪组织的功能和分泌组受复杂的体内平衡机制和局部细胞-细胞相互作用的严格控制，这些机制在肥胖症中可能会失调。全身或局部炎症和胰岛素抵抗导致脂肪组织分泌组从抗炎和抗动脉粥样硬化转变为促炎和促动脉粥样硬化特征。此外，脂肪组织和心血管系统之间的相互作用是双向的，血管来源和心脏来源的信号直接影响脂肪组织的生物学。在这篇综述中，我们总结了人类脂肪组织生物学和区域性变异性的最新知识，解析了控制脂肪组织与心血管系统之间串扰的复杂分子机制，以及它们可能的临床转化。此外，我们还强调了脂肪组织成像在心血管风险分层方面的最新进展，并讨论了如何通过靶向脂肪组织来改善心血管疾病的预防和治疗。
