Department of Internal Medicine & Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands.
Department of Medical Imaging, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands.
J Clin Endocrinol Metab. 2023 Sep 18;108(10):2537-2549. doi: 10.1210/clinem/dgad193.
Adipose tissue (AT) inflammation predisposes to insulin resistance and metabolic syndrome in obesity.
To investigate the association between adipocyte size, AT inflammation, systemic inflammation, and metabolic and atherosclerotic complications of obesity in a sex-specific manner.
Cross-sectional cohort study.
University hospital in the Netherlands.
A total of 302 adult subjects with a body mass index (BMI) ≥ 27 kg/m2.
We obtained subcutaneous abdominal fat biopsies and systematically assessed, in a sex-specific manner, associations of several parameters of AT inflammation (including adipocyte size, macrophage content, crown-like structures, and gene expression) to biomarkers of systemic inflammation, leukocyte number and function, and to the presence of metabolic syndrome, insulin resistance, and carotid atherosclerotic plaques, assessed with ultrasound.
Adipocyte size was associated with metabolic syndrome and AT macrophage content with insulin resistance. In contrast, none of the AT parameters was associated with carotid atherosclerosis, although mRNA expression of the anti-inflammatory IL-37 was associated with a lower intima-media thickness. We revealed profound sex-specific differences, with an association between BMI and adipocyte size, and between adipocyte size and metabolic syndrome in men only. Also, only men showed an association between adipocyte size, AT expression of leptin and MCP-1, and AT macrophage numbers, and between AT inflammation (crown-like structure number) and several circulating inflammatory proteins, including high specificity C-reactive protein, and IL-6.
Inflammation in abdominal subcutaneous adipose tissue is more related to the metabolic than the atherosclerotic complications of obesity, and there are profound sex-specific differences in the association between BMI, adipocyte size, AT inflammation, and systemic inflammation, which are much stronger in men than women.
脂肪组织（AT）炎症会导致肥胖患者出现胰岛素抵抗和代谢综合征。
以性别特异性的方式研究脂肪细胞大小、AT 炎症、全身炎症与肥胖的代谢和动脉粥样硬化并发症之间的关系。
横断面队列研究。
荷兰的一家大学医院。
共纳入 302 名 BMI≥27kg/m2 的成年受试者。
我们获取了腹部皮下脂肪活检，并以性别特异性的方式系统评估了 AT 炎症的几个参数（包括脂肪细胞大小、巨噬细胞含量、冠状结构和基因表达）与全身炎症生物标志物、白细胞数量和功能以及代谢综合征、胰岛素抵抗和颈动脉粥样硬化斑块的相关性，这些都通过超声进行评估。
脂肪细胞大小与代谢综合征相关，AT 巨噬细胞含量与胰岛素抵抗相关。相反，尽管抗炎因子 IL-37 的 mRNA 表达与内膜-中层厚度较低相关，但没有任何 AT 参数与颈动脉粥样硬化相关。我们揭示了深刻的性别特异性差异，即 BMI 与脂肪细胞大小、脂肪细胞大小与男性代谢综合征之间存在关联。此外，只有男性表现出脂肪细胞大小、AT 中瘦素和 MCP-1 的表达以及 AT 巨噬细胞数量之间的关联，以及 AT 炎症（冠状结构数量）与几种循环炎症蛋白（包括高敏 C 反应蛋白和 IL-6）之间的关联。
腹部皮下脂肪组织的炎症与肥胖的代谢并发症的相关性更高，而 BMI、脂肪细胞大小、AT 炎症和全身炎症之间的关联在性别之间存在明显的差异，这种差异在男性中比女性中更为明显。
