Obesity and inflammation:: Evidence for an elementary lesion
Obesity and inflammation:: Evidence for an elementary lesion
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DOI：
10.1542/peds.2004-2854
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发表时间：
2006-01-01
期刊：
影响因子：
8
通讯作者：
Maffeis, C
中科院分区：
文献类型：
--
作者：
Sbarbati, A;Osculati, F;Maffeis, C
在肥胖症中，脂肪组织的炎症过程已被假设。然而，仍然缺乏组织病变的直接证据。肥胖个体脂肪组织中的巨噬细胞浸润似乎已得到证实，但组织的其他改变尚未得到证实。此外，在人类中，炎症是否是肥胖的早期特征尚未明确，因为没有肥胖儿童的数据。在本研究中，我们评估了脂肪组织的炎症参与情况，并确定了一组肥胖儿童的基本“炎症”病变。对儿童的研究使我们有机会研究肥胖早期阶段的脂肪组织。在所有肥胖受试者中，脂肪组织的超显微分析显示有炎症参与，病变范围似乎取决于体重指数的 SD 评分。原发性病变是微肉芽肿，伴有脂肪细胞碎片，并发展为纤维化。在血管周围位置发现了巨噬细胞（以及较少见的淋巴细胞或粒细胞）。在非肥胖儿童中未发现病变。我们的研究证明，肥胖儿童的脂肪组织中存在“炎症”过程，证实了之前在动物和肥胖成人中的发现，并证明这是人类的早期改变。然而，巨噬细胞的积聚只是炎症病变的组成部分之一，还涉及脂肪细胞变性、纤维化，以及较小程度的粒细胞/淋巴细胞积聚。在原发性病变中发现脂肪细胞碎片表明，在该过程开始时，脂肪细胞可能会退化，并且该过程产生的物质可以招募巨噬细胞和其他白细胞。这些初步结果表明，应该设计更多的研究来阐明肥胖儿童脂肪细胞脆性的原因。
In obesity, an inflammatory process of the adipose tissue has been hypothesized; however, direct evidence for a tissue lesion is still lacking. Macrophage infiltration in the adipose tissue of obese individuals seems to be proven, but other alterations of the tissue have not been demonstrated.Moreover, in humans it has not been clarified whether inflammation is an early characteristic of obesity, because no data from obese children are available. In the present study, we assessed the inflammatory involvement of the adipose tissue and identified the elementary "inflammatory" lesion in a group of obese children. The study of children gives us the chance to investigate adipose tissue during early phases of obesity. In all the obese subjects, ultramicroscopic analysis of the adipose tissue demonstrated inflammatory involvement, and the extent of the lesions seemed to depend on the SD score of body mass index. The elementary lesion is a microgranuloma, with fragments of adipocytes, that evolves to fibrosis. Macrophages (and less frequently, lymphocytes or granulocytes) were found in perivascular positions. The lesions were not found in nonobese children. Our study proved that an "inflammatory" process exists in the adipose tissue of obese children, confirming previous findings in animals and obese adults and demonstrating that it is an early alteration in humans. However, the accumulation of macrophages was just one of the components of the inflammatory lesion, which also involved adipocyte degeneration, fibrosis, and, to a lesser extent, granulocyte/lymphocyte accumulation. The finding of fragments of adipocytes in the elementary lesion suggests that, at the beginning of the process, adipocytes may degenerate and that the materials generated by this process can recruit macrophages and other leukocytes. These preliminary results suggest that additional studies should be designed to clarify the cause of adipocyte fragility in obese children.