Subcutaneous and visceral adipose tissue: structural and functional differences
Subcutaneous and visceral adipose tissue: structural and functional differences
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DOI：
10.1111/j.1467-789x.2009.00623.x
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发表时间：
2010-01-01
期刊：
影响因子：
8.9
通讯作者：
Ibrahim, M. Mohsen
中科院分区：
文献类型：
--
作者：
Ibrahim, M. Mohsen
肥胖是一种异质性疾病。肥胖个体的体脂分布、代谢状况以及相关心血管和代谢风险程度各不相同。腹部肥胖比外周肥胖或臀股肥胖有更大的患糖尿病和未来心血管事件的风险。存在于皮下脂肪组织（SCAT）和内脏脂肪组织（VAT）存在于腹腔之间的差异。这些差异包括解剖、细胞、分子、生理、临床和预后差异。解剖上，VAT主要存在于肠系膜和网膜，并直接通过门静脉循环流入肝脏。与SCAT相比，VAT更具有细胞性、血管性、神经支配，含有更多的炎症和免疫细胞，前脂肪细胞分化能力较弱，大脂肪细胞的百分比更高。VAT比SCAT有更多的糖皮质激素和雄激素受体。VAT脂肪细胞比SCAT脂肪细胞代谢更活跃，对脂肪分解更敏感，胰岛素抵抗更强。VAT比SCAT产生游离脂肪酸和摄取葡萄糖的能力更大，对肾上腺素能刺激更敏感，而SCAT对循环游离脂肪酸和甘油三酯的吸收更强烈。VAT比SCAT更能预测死亡率。
P>Obesity is a heterogeneous disorder. Obese individuals vary in their body fat distribution, their metabolic profile and degree of associated cardiovascular and metabolic risk. Abdominal obesity carries greater risk of developing diabetes and future cardiovascular events than peripheral or gluteofemoral obesity. There are differences between adipose tissue present in subcutaneous areas (SCAT) and visceral adipose tissue (VAT) present in the abdominal cavity. These include anatomical, cellular, molecular, physiological, clinical and prognostic differences. Anatomically, VAT is present mainly in the mesentery and omentum, and drains directly through the portal circulaion to the liver. VAT compared with SCAT is more cellular, vascular, innervated and contains a larger number of inflammatory and immune cells, lesser preadipocyte differentiating capacity and a greater percentage of large adipocytes. There are more glucocorticoid and androgen receptors in VAT than in SCAT. VAT adipocytes are more metabolically active, more sensitive to lipolysis and more insulin-resistant than SCAT adipocytes. VAT has a greater capacity to generate free fatty acids and to uptake glucose than SCAT and is more sensitive to adrenergic stimulation, while SCAT is more avid in absorption of circulating free fatty acids and triglycerides. VAT carries a greater prediction of mortality than SCAT.