Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland.
Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-211 Gdańsk, Poland.
Nutrients. 2022 Mar 31;14(7):1457. doi: 10.3390/nu14071457.
Obesity is a disease which leads to the development of many other disorders. Excessive accumulation of lipids in adipose tissue (AT) leads to metabolic changes, including hypertrophy of adipocytes, macrophage migration, changes in the composition of immune cells, and impaired secretion of adipokines. Adipokines are cytokines produced by AT and greatly influence human health. Obesity and the pro-inflammatory profile of adipokines lead to the development of chronic kidney disease (CKD) through different mechanisms. In obesity and adipokine profile, there are gender differences that characterize the male gender as more susceptible to metabolic disorders accompanying obesity, including impaired renal function. The relationship between impaired adipokine secretion and renal disease is two-sided. In the developed CKD, the concentration of adipokines in the serum is additionally disturbed due to their insufficient excretion by the excretory system caused by renal pathology. Increased levels of adipokines affect the nutritional status and cardiovascular risk (CVR) of patients with CKD. This article aims to systematize the current knowledge on the influence of obesity, AT, and adipokine secretion disorders on the pathogenesis of CKD and their influence on nutritional status and CVR in patients with CKD.
肥胖是一种会导致多种其他疾病的疾病。脂肪组织（AT）中脂质的过度积累会导致代谢变化，包括脂肪细胞肥大、巨噬细胞迁移、免疫细胞组成的变化以及脂联素分泌受损。脂联素是由 AT 产生的细胞因子，对人体健康有很大影响。肥胖和脂联素的促炎表型通过不同的机制导致慢性肾脏病（CKD）的发展。在肥胖和脂联素表型中，存在性别差异，男性更容易发生伴随肥胖的代谢紊乱，包括肾功能受损。脂联素分泌受损与肾脏疾病之间的关系是双向的。在已发展的 CKD 中，由于肾脏病理导致排泄系统不足，血清中脂联素的浓度由于其不足而被扰乱。脂联素水平的升高会影响 CKD 患者的营养状况和心血管风险（CVR）。本文旨在系统地阐述肥胖、AT 和脂联素分泌紊乱对 CKD 发病机制的影响及其对 CKD 患者营养状况和 CVR 的影响。
