Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Upper Maudlin Street, Bristol BS2 8HW, U.K.
Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy.
Clin Sci (Lond). 2020 Apr 30;134(8):1031-1048. doi: 10.1042/CS20200220.
Global trends in the prevalence of overweight and obesity put the adipocyte in the focus of huge medical interest. This review highlights a new topic in adipose tissue biology, namely the emerging pathogenic role of fat accumulation in bone marrow (BM). Specifically, we summarize current knowledge about the origin and function of BM adipose tissue (BMAT), provide evidence for the association of excess BMAT with diabetes and related cardiovascular complications, and discuss potential therapeutic approaches to correct BMAT dysfunction. There is still a significant uncertainty about the origins and function of BMAT, although several subpopulations of stromal cells have been suggested to have an adipogenic propensity. BM adipocytes are higly plastic and have a distinctive capacity to secrete adipokines that exert local and endocrine functions. BM adiposity is abundant in elderly people and has therefore been interpreted as a component of the whole-body ageing process. BM senescence and BMAT accumulation has been also reported in patients and animal models with Type 2 diabetes, being more pronounced in those with ischaemic complications. Understanding the mechanisms responsible for excess and altered function of BMAT could lead to new treatments able to preserve whole-body homeostasis.
全球超重和肥胖流行趋势使脂肪细胞成为医学研究的焦点。本综述强调了脂肪组织生物学中的一个新课题，即脂肪在骨髓（BM）中积累的致病作用正在显现。具体而言，我们总结了目前关于骨髓脂肪组织（BMAT）的起源和功能的知识，提供了过多的 BMAT 与糖尿病和相关心血管并发症相关的证据，并讨论了纠正 BMAT 功能障碍的潜在治疗方法。尽管已经提出了几种基质细胞亚群具有成脂倾向，但关于 BMAT 的起源和功能仍然存在很大的不确定性。BM 脂肪细胞具有高度的可塑性，并且具有独特的分泌脂肪因子的能力，这些脂肪因子具有局部和内分泌功能。BM 脂肪过多在老年人中很常见，因此被解释为全身衰老过程的一个组成部分。在 2 型糖尿病患者和动物模型中也已经报道了 BM 衰老和 BMAT 积累，在伴有缺血性并发症的患者中更为明显。了解导致 BMAT 过度和功能改变的机制可能会导致新的治疗方法，以维持全身的平衡。
