Yamamoto Asako, Kikuchi Yoshinao, Kusakabe Toru, Takano Hideyuki, Sakurai Keita, Furui Shigeru, Oba Hiroshi
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan.
Department of Pathology, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo, 173-8606, Japan.
Insights Imaging. 2020 Feb 13;11(1):24. doi: 10.1186/s13244-019-0833-4.
Adipose tissue plays multiple and complex roles not only in mechanical cushioning and energy storage but also as an important secretory organ that regulates energy balance and homeostasis multilaterally. Fat tissue is categorized into subcutaneous fat tissue (SCAT) or visceral fat tissue (VSA) depending on its distribution, with the two having different metabolic functions. Near-total lack of fat in congenital/acquired generalized lipodystrophy, cachexia, or any other severe malnutrition condition induces severe multi-organ dysfunction due to lack of production of leptin and other adipokines. Increased visceral fat tissue secondary to obesity, hypercortisolism, or multiple symmetric lipomatosis raises the risk of insulin resistance, cardiac complications, and airway or spinal canal stenosis, although the fat distribution pattern differs in each condition. Partial abnormal fat distribution conditions such as HIV/HAART therapy-associated lipodystrophy, familial partial lipodystrophies, and acquired partial lipodystrophy frequently show a mixture of lipoatrophy and lipohypertrophy with metabolic dysfunction. Characteristic imaging features in conditions with local abnormal fat distribution can provide information about a patient's co-existent/unrecognized disease(s), past medical history, or lifestyle. Knowledge of characteristic abnormal fat distribution patterns can contribute to proper and timely therapeutic decision-making and patient education.
脂肪组织不仅在机械缓冲和能量储存方面发挥多种复杂作用，而且作为一个重要的分泌器官，从多方面调节能量平衡和体内稳态。脂肪组织根据其分布可分为皮下脂肪组织（SCAT）或内脏脂肪组织（VSA），两者具有不同的代谢功能。在先天性/获得性全身性脂肪营养不良、恶病质或任何其他严重营养不良状况下，几乎完全缺乏脂肪会因缺乏瘦素和其他脂肪因子的产生而导致严重的多器官功能障碍。肥胖、皮质醇增多症或多发性对称性脂肪瘤继发的内脏脂肪组织增加会提高胰岛素抵抗、心脏并发症以及气道或椎管狭窄的风险，尽管每种情况的脂肪分布模式有所不同。部分异常脂肪分布情况，如HIV/高效抗逆转录病毒治疗相关脂肪营养不良、家族性部分脂肪营养不良和获得性部分脂肪营养不良，常表现为脂肪萎缩和脂肪肥大混合并伴有代谢功能障碍。局部异常脂肪分布情况下的特征性影像学表现可提供有关患者并存/未被认识的疾病、既往病史或生活方式的信息。了解特征性异常脂肪分布模式有助于做出恰当及时的治疗决策和患者教育。
