Division of Medical Andrology and Endocrinology of Reproduction, University of Perugia and "S. Maria" Hospital, Terni, Italy.
Protein Pept Lett. 2020;27(12):1204-1230. doi: 10.2174/0929866527666200505214555.
Obesity represents one of the most important health problems worldwide with increasing morbidity and mortality. Widespread prevalence of this disease justifies its actual definition of a "global epidemic". Adipose tissue is nowadays considered a complex organ with lots of endocrine and metabolic functions. In addition to fulfilling its task for energy storage and thermal regulation, by virtue of its constituent white and brown cells, adipose tissue represents, considering its size, the biggest endocrine gland in the body. Both adipocytes and surrounding resident cells (macrophages, endothelial cells and others) produce a huge number of molecules, or adipokines, with endocrine or paracrine functions, that regulate various aspects of metabolism whose clinical relevance is emerging. By balancing pro-inflammatory and anti-inflammatory effects, the adipokines control insulin sensitivity and related glucose metabolism changes, lipid accumulation in the liver and other organs, and finally gonadal function. Collectively, literature data remains cloudy because of still conflicting results of pre-clinical and clinical studies. The aim of this review was to summarize scientific evidence about adipokines' effects on human metabolism, by focusing on their role on either Metabolic Syndrome and NAFLD, or insulin-resistance in pregnancy, or finally, reproductive function disorders.
肥胖是全球最重要的健康问题之一,其发病率和死亡率不断上升。这种疾病的广泛流行证明了它实际上是一种“全球流行病”。脂肪组织如今被认为是一个具有多种内分泌和代谢功能的复杂器官。除了履行其储能和调节体温的任务外,脂肪组织还通过其组成的白色和棕色细胞,在考虑其大小的情况下,成为体内最大的内分泌腺。脂肪细胞和周围的常驻细胞(巨噬细胞、内皮细胞等)产生大量具有内分泌或旁分泌功能的分子,即脂肪因子,调节代谢的各个方面,其临床相关性正在显现。通过平衡促炎和抗炎作用,脂肪因子控制胰岛素敏感性和相关的葡萄糖代谢变化、肝脏和其他器官的脂质积累,以及最终的性腺功能。总的来说,由于临床前和临床研究的结果仍然存在冲突,文献数据仍然不清楚。本综述的目的是总结有关脂肪因子对人体代谢影响的科学证据,重点关注它们在代谢综合征和非酒精性脂肪性肝病、妊娠胰岛素抵抗或生殖功能障碍中的作用。