Division of Metabolism Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Biointerfaces Institute, University of Michigan, Ann Arbor, MI.
Diabetes. 2019 Jan;68(1):45-56. doi: 10.2337/db18-0209. Epub 2018 Oct 25.
Respiratory dysfunction is a common complication of obesity, conferring cardiovascular morbidity and increased mortality and often necessitating mechanical ventilatory support. While impaired lung expansion in the setting of increased adipose mass and reduced central response to hypercapnia have been implicated as pathophysiological drivers, the impact of obesity on respiratory muscles-in particular, the diaphragm-has not been investigated in detail. Here, we demonstrate that chronic high-fat diet (HFD) feeding impairs diaphragm muscle function, as assessed in vivo by ultrasonography and ex vivo by measurement of contractile force. During an HFD time course, progressive adipose tissue expansion and collagen deposition within the diaphragm parallel contractile deficits. Moreover, intradiaphragmatic fibro-adipogenic progenitors (FAPs) proliferate with long-term HFD feeding while giving rise to adipocytes and type I collagen-depositing fibroblasts. Thrombospondin 1 (THBS1), a circulating adipokine, increases with obesity and induces FAP proliferation. These findings suggest a novel role for FAP-mediated fibro-adipogenic diaphragm remodeling in obesity-associated respiratory dysfunction.
呼吸功能障碍是肥胖的常见并发症,可导致心血管发病率和死亡率增加,通常需要机械通气支持。虽然肥胖症患者脂肪量增加和对高碳酸血症的中枢反应降低导致肺扩张受损被认为是病理生理驱动因素,但肥胖对呼吸肌(特别是膈肌)的影响尚未详细研究。在这里,我们证明慢性高脂肪饮食(HFD)喂养会损害膈肌肌肉功能,通过超声检查进行体内评估,并通过收缩力测量进行体外评估。在 HFD 时间过程中,脂肪组织的进行性扩张和膈肌内胶原沉积与收缩功能缺陷平行。此外,膈肌内纤维脂肪祖细胞(FAP)在长期 HFD 喂养时增殖,同时产生脂肪细胞和沉积 I 型胶原的成纤维细胞。血栓素 1(THBS1),一种循环脂肪因子,随着肥胖而增加,并诱导 FAP 增殖。这些发现表明 FAP 介导的纤维脂肪性膈肌重塑在肥胖相关呼吸功能障碍中具有新的作用。