Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu, China.
Department of Pathology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu, China.
Obesity (Silver Spring). 2021 Jun;29(6):976-984. doi: 10.1002/oby.23155. Epub 2021 May 4.
Morphological alterations including adipocyte hypertrophy and fibrosis deposition are important surrogate markers of visceral adipose tissue function, but the relationships between these morphological changes and type 2 diabetes mellitus (T2DM) and impaired insulin sensitivity are poorly defined.
Omental adipose tissue was obtained from 66 individuals with obesity but without T2DM (OB group), 93 individuals with both obesity and T2DM (T2DM group), and 15 individuals with normal BMI and normal glucose tolerance (NGT group). Adipocyte diameter and volume were measured through pathological section analysis. Pericellular and perilobular fibrosis was determined through picrosirius red staining and immunochemistry, while fibrosis-related genes were tested through gene expression and hydroxyproline content.
Compared with the NGT and OB groups, individuals from the T2DM group displayed increased adipocyte diameter and volume levels. Increased adipocyte size (diameter and volume) was positively associated with hyperglycemia and insulin resistance and inversely correlated with insulin sensitivity (using the Matsuda whole-body insulin sensitivity index assessment of insulin sensitivity) and β-cell function (disposition index 30 and disposition index 120). The fibrosis levels of the OB group were the highest out of the three groups, whereas the fibrosis levels of T2DM individuals were lower than the OB group but higher than the NGT group. Although fibrosis was negatively correlated with T2DM, fibrosis deposition was not remarkably associated with impaired systemic insulin sensitivity and glucose metabolism.
Compared with fibrosis deposition, adipocyte hypertrophy is more closely associated with T2DM and impaired systemic insulin sensitivity.
脂肪细胞肥大和纤维化沉积等形态改变是内脏脂肪组织功能的重要替代标志物，但这些形态变化与 2 型糖尿病（T2DM）和胰岛素敏感性受损之间的关系尚未明确。
从 66 名肥胖但无 T2DM 的个体（OB 组）、93 名肥胖且合并 T2DM 的个体（T2DM 组）和 15 名 BMI 正常且糖耐量正常的个体（NGT 组）中获取网膜脂肪组织。通过病理切片分析测量脂肪细胞直径和体积。通过天狼星红染色和免疫化学法测定细胞周和细胞周旁纤维化，通过基因表达和羟脯氨酸含量检测纤维化相关基因。
与 NGT 和 OB 组相比，T2DM 组个体的脂肪细胞直径和体积增加。脂肪细胞增大（直径和体积）与高血糖和胰岛素抵抗呈正相关，与胰岛素敏感性（使用 Matsuda 全身胰岛素敏感性指数评估胰岛素敏感性）和β细胞功能（处理指数 30 和处理指数 120）呈负相关。三组中，OB 组的纤维化程度最高，而 T2DM 个体的纤维化程度低于 OB 组但高于 NGT 组。尽管纤维化与 T2DM 呈负相关，但纤维化沉积与全身胰岛素敏感性和葡萄糖代谢受损并无显著相关性。
与纤维化沉积相比，脂肪细胞肥大与 T2DM 和全身胰岛素敏感性受损的关系更为密切。
