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从脂肪到患病肾脏:脂质代谢在肥胖相关慢性肾脏病中的作用

From Adipose to Ailing Kidneys: The Role of Lipid Metabolism in Obesity-Related Chronic Kidney Disease.

作者信息

Xu Wenchao, Zhu Yuting, Wang Siyuan, Liu Jihong, Li Hao

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Antioxidants (Basel). 2024 Dec 16;13(12):1540. doi: 10.3390/antiox13121540.

Abstract

Obesity has emerged as a significant public health crisis, closely linked to the pathogenesis and progression of chronic kidney disease (CKD). This review explores the intricate relationship between obesity-induced lipid metabolism disorders and renal health. We discuss how excessive free fatty acids (FFAs) lead to lipid accumulation in renal tissues, resulting in cellular lipotoxicity, oxidative stress, and inflammation, ultimately contributing to renal injury. Key molecular mechanisms, including the roles of transcriptional regulators like PPARs and SREBP-1, are examined for their implications in lipid metabolism dysregulation. The review also highlights the impact of glomerular and tubular lipid overload on kidney pathology, emphasizing the roles of podocytes and tubular cells in maintaining kidney function. Various therapeutic strategies targeting lipid metabolism, including pharmacological agents such as statins and SGLT2 inhibitors, as well as lifestyle modifications, are discussed for their potential to mitigate CKD progression in obese individuals. Future research directions are suggested to better understand the mechanisms linking lipid metabolism to kidney disease and to develop personalized therapeutic approaches. Ultimately, addressing obesity-related lipid metabolism disorders may enhance kidney health and improve outcomes for individuals suffering from CKD.

摘要

肥胖已成为一个重大的公共卫生危机,与慢性肾脏病(CKD)的发病机制和进展密切相关。本综述探讨了肥胖诱导的脂质代谢紊乱与肾脏健康之间的复杂关系。我们讨论了过量的游离脂肪酸(FFA)如何导致肾组织中的脂质积累,从而导致细胞脂毒性、氧化应激和炎症,最终导致肾损伤。研究了关键的分子机制,包括转录调节因子如过氧化物酶体增殖物激活受体(PPARs)和固醇调节元件结合蛋白-1(SREBP-1)在脂质代谢失调中的作用。该综述还强调了肾小球和肾小管脂质过载对肾脏病理的影响,强调了足细胞和肾小管细胞在维持肾脏功能中的作用。讨论了针对脂质代谢的各种治疗策略,包括他汀类药物和钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂等药物制剂以及生活方式的改变,探讨了它们在减轻肥胖个体CKD进展方面的潜力。提出了未来的研究方向,以更好地理解将脂质代谢与肾脏疾病联系起来的机制,并开发个性化的治疗方法。最终,解决与肥胖相关的脂质代谢紊乱可能会改善肾脏健康,并改善CKD患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbf6/11727289/beca2b6f4e6b/antioxidants-13-01540-g001.jpg

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