Ashraf Hamid, Laway Bashir Ahmad, Afroze Dil, Wani Arshad Iqbal
Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.
Department of Immunology and Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.
Indian J Endocrinol Metab. 2018 Nov-Dec;22(6):751-756. doi: 10.4103/ijem.IJEM_206_18.
Obesity is one of the most common yet neglected public health problems in both the developed and developing countries. Metabolic syndrome (MS) is a multiplex of risk factor for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD) and it reflects the clustering of multiple risk factors resulting from obesity and insulin resistance. Despite its predominance in obese individuals, MS does occur in non-obese individuals. Many individuals characterised as normal weight as per their body mass index (BMI), have increased visceral adiposity thereby leading to an unfavourable inflammatory cytokine profile. There are limited studies from India with respect to inflammatory cytokines in obesity and MS in general and non-obese patients with MS in particular.
An observational cross-sectional study was carried out in patients with MS with or without obesity. Anthropometric parameters such as height, weight and waist girth were measured and BMI was calculated. Serum levels of TNF-α, IL-6 and adiponectin were measured by using the enzyme-linked immunosorbent assay.
A significant proportion of individuals categorised as normal weight had an increased waist circumference which correlated with BMI, acanthosis nigricans (AN) and fatty liver. There was no statistically significant difference in the cytokine levels in obese and non-obese patients with MS; similarly among non-obese patients with MS, cytokine levels were comparable in patients with or without abdominal obesity. However, triglycerides inversely correlated with adiponectin levels and there was no significant correlation between the cytokines and other parameters of MS.
There was no significant difference in various metabolic and inflammatory parameters between obese and non-obese patients with MS. Even in non-obese group, there were no differences in metabolic and inflammatory markers between individuals with or without abdominal obesity. This finding indicates that apart from adipose tissue, other factors are also responsible for the development of MS and its associated proinflammatory profile. There could be a significant contribution of genetic and epigenetic factors which needs to be further explored.
肥胖是发达国家和发展中国家最常见但却被忽视的公共卫生问题之一。代谢综合征(MS)是2型糖尿病(T2D)和心血管疾病(CVD)发生的多种风险因素的组合,它反映了由肥胖和胰岛素抵抗导致的多种风险因素的聚集。尽管MS在肥胖个体中占主导地位,但在非肥胖个体中也确实存在。许多根据体重指数(BMI)被归类为体重正常的个体,其内脏脂肪增多,从而导致不良的炎症细胞因子谱。在印度,关于肥胖和MS总体情况,尤其是非肥胖MS患者炎症细胞因子的研究有限。
对患有或未患有肥胖症的MS患者进行了一项观察性横断面研究。测量身高、体重和腰围等人体测量参数,并计算BMI。采用酶联免疫吸附测定法测量血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和脂联素水平。
相当一部分被归类为体重正常的个体腰围增加,这与BMI、黑棘皮病(AN)和脂肪肝相关。肥胖和非肥胖MS患者的细胞因子水平无统计学显著差异;同样,在非肥胖MS患者中,有或无腹部肥胖患者的细胞因子水平相当。然而,甘油三酯与脂联素水平呈负相关,且细胞因子与MS的其他参数之间无显著相关性。
肥胖和非肥胖MS患者在各种代谢和炎症参数方面无显著差异。即使在非肥胖组中,有或无腹部肥胖个体的代谢和炎症标志物也无差异。这一发现表明,除脂肪组织外,其他因素也与MS的发生及其相关的促炎特征有关。遗传和表观遗传因素可能有重大贡献,有待进一步探索。