McDonnell Jake M, Darwish Stacey, Butler Joseph S, Buckley Conor T
National Spinal Injuries Unit Mater Misericordiae University Hospital Dublin Ireland.
Trinity Centre for Biomedical Engineering Trinity Biomedical Sciences Institute, Trinity College Dublin, the University of Dublin Dublin Ireland.
JOR Spine. 2025 Jun 3;8(2):e70083. doi: 10.1002/jsp2.70083. eCollection 2025 Jun.
Adipokines are bioactive molecules secreted by adipose tissue that influence both local and systemic physiological processes. Although adipokine dysregulation has been widely implicated in the pathogenesis of cardiovascular, gastrointestinal, nervous, immune, and musculoskeletal disorders- especially osteoarthritis, rheumatoid arthritis, and osteoporosis- their involvement in spinal pathology remains comparatively underinvestigated. Recent evidence indicates that certain adipokines may influence spinal disease progression by affecting bone, intervertebral discs, musculature, and neural structures.
A comprehensive literature review was conducted to evaluate preclinical and clinical studies investigating the role of adipokines in spinal pathology. PubMed and related databases were searched for studies reporting associations between adipokine expression and structural or functional changes in spinal tissues, including vertebral bone, intervertebral discs, paraspinal muscles, spinal ligaments, and the spinal cord. Particular attention was given to mechanistic insights and translational relevance.
The review identified emerging evidence implicating several adipokines, including leptin, adiponectin, resistin, and visfatin, in degenerative and inflammatory changes across various spinal structures. Adipokines were found to influence matrix degradation, bone turnover, muscle atrophy, and neural inflammation through cytokine signaling, oxidative stress, and metabolic dysregulation. However, findings are often heterogeneous and context-dependent, with limited longitudinal or interventional data.
Adipokines represent a promising yet underexplored avenue in spinal disease research. Their diverse functions in both structural and metabolic regulation highlight their potential as both biomarkers and therapeutic targets. Further mechanistic and clinical studies are needed to elucidate causal relationships and therapeutic efficacy, particularly in degenerative spine disorders.
脂肪因子是脂肪组织分泌的生物活性分子，可影响局部和全身的生理过程。尽管脂肪因子失调已被广泛认为与心血管、胃肠道、神经、免疫和肌肉骨骼疾病的发病机制有关，尤其是骨关节炎、类风湿性关节炎和骨质疏松症，但其在脊柱病理学中的作用仍相对研究不足。最近的证据表明，某些脂肪因子可能通过影响骨骼、椎间盘、肌肉组织和神经结构来影响脊柱疾病的进展。
进行了一项全面的文献综述，以评估研究脂肪因子在脊柱病理学中作用的临床前和临床研究。在PubMed和相关数据库中搜索了报告脂肪因子表达与脊柱组织（包括椎骨、椎间盘、椎旁肌肉、脊柱韧带和脊髓）结构或功能变化之间关联的研究。特别关注了机制见解和转化相关性。
该综述发现了新出现的证据，表明包括瘦素、脂联素、抵抗素和内脂素在内的几种脂肪因子与各种脊柱结构的退行性和炎症性变化有关。发现脂肪因子通过细胞因子信号传导、氧化应激和代谢失调影响基质降解、骨转换、肌肉萎缩和神经炎症。然而，研究结果往往具有异质性且依赖于具体情况，纵向或干预性数据有限。
脂肪因子在脊柱疾病研究中是一个有前景但尚未充分探索的领域。它们在结构和代谢调节方面的多种功能突出了它们作为生物标志物和治疗靶点的潜力。需要进一步的机制和临床研究来阐明因果关系和治疗效果，特别是在退行性脊柱疾病方面。
