Nephrology Department, Hospital Clínico Universitario, INCLIVA, University of Valencia, 46010 Valencia, Spain.
Physiologic Sciences Department, School of Health Sciences, Universidad de Oriente, Bolívar 5110, Venezuela.
Int J Mol Sci. 2020 Feb 1;21(3):978. doi: 10.3390/ijms21030978.
The importance of cardiometabolic factors in the inception and progression of atherosclerotic cardiovascular disease is increasingly being recognized. Beyond diabetes mellitus and metabolic syndrome, other factors may be responsible in patients with chronic kidney disease (CKD) for the high prevalence of cardiovascular disease, which is estimated to be 5- to 20-fold higher than in the general population. Although undefined uremic toxins are often blamed for part of the increased risk, visceral adipose tissue, and in particular epicardial adipose tissue (EAT), have been the focus of intense research in the past two decades. In fact, several lines of evidence suggest their involvement in atherosclerosis development and its complications. EAT may promote atherosclerosis through paracrine and endocrine pathways exerted via the secretion of adipocytokines such as adiponectin and leptin. In this article we review the current knowledge of the impact of EAT on cardiovascular outcomes in the general population and in patients with CKD. Special reference will be made to adiponectin and leptin as possible mediators of the increased cardiovascular risk linked with EAT.
心血管代谢因素在动脉粥样硬化性心血管疾病的发生和进展中的重要性日益受到重视。除了糖尿病和代谢综合征外，其他因素可能在慢性肾脏病（CKD）患者中导致心血管疾病的高发，其患病率估计比普通人群高 5 至 20 倍。尽管未定义的尿毒症毒素常被归咎于部分风险增加，但内脏脂肪组织，特别是心外膜脂肪组织（EAT），在过去二十年中一直是研究的焦点。事实上，有几条证据表明它们参与了动脉粥样硬化的发展及其并发症。EAT 可能通过旁分泌和内分泌途径通过分泌脂联素和瘦素来促进动脉粥样硬化。本文综述了目前关于 EAT 对普通人群和 CKD 患者心血管结局影响的知识。特别提到了脂联素和瘦素作为与 EAT 相关的增加心血管风险的可能介导物。
