What distinguishes adipose tissue of severely obese humans who are insulin sensitive and resistant?
What distinguishes adipose tissue of severely obese humans who are insulin sensitive and resistant?
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DOI：
10.1097/mol.0b013e32835b465b
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发表时间：
2013-02
影响因子：
4.4
通讯作者：
Ruderman NB
中科院分区：
文献类型：
--
作者：
Xu XJ;Pories WJ;Dohm LG;Ruderman NB
尽管肥胖和胰岛素抵抗之间存在很强的相关性，但25%的严重肥胖者（BMI为40）对胰岛素敏感。在这篇综述中，我们将研究脂肪组织中区分这两组的因素，以及相信胰岛素敏感组更不容易患病的原因。与皮下脂肪相比，肥胖与代谢综合征有关，内脏（腹腔内）脂肪增加。最近对胰岛素敏感和胰岛素抵抗的严重肥胖患者的脂肪组织进行比较的研究表明，胰岛素抵抗组还以氧化应激增加和amp活化蛋白激酶（AMPK）活性降低为特征。相比之下，SIRT1、炎症因子、线粒体生物发生和功能基因以及AMPK的两个α-亚型的表达变化更为明显。关于脂肪组织的这些和其他变化对减肥手术的反应的研究仍处于起步阶段。现有数据表明，氧化应激的增加，AMPK活性和SIRT1基因表达的降低，炎症、线粒体等基因的特异性变化，将胰岛素抵抗的脂肪组织与胰岛素敏感的严重肥胖个体区分出来。
Despite a strong correlation between obesity and insulin resistance, 25% of severely obese (BMI >40) individuals are insulin sensitive. In this review, we will examine the factors in adipose tissue that distinguish the two groups, as well as reasons for believing the insulin-sensitive group will be less disease prone. Obesity has been linked to the metabolic syndrome with an increase in visceral (intra-abdominal) compared to subcutaneous fat. Recent studies in which adipose tissue of insulin-sensitive and insulin-resistant patients with severe obesity were compared indicate that the insulin-resistant group is also distinguished by increases in oxidative stress and decreases in AMP-activated protein kinase (AMPK) activity. In contrast, changes in the expression of genes for SIRT1, inflammatory cytokines, mitochondrial biogenesis and function, and the two α-isoforms of AMPK showed more depot variation. Studies of how these and other changes in adipose tissue respond to bariatric surgery are still in their infancy. Available data suggest that increases in oxidative stress, decreases in AMPK activity and SIRT1 gene expression, depot-specific changes in inflammatory, mitochondrial and other genes distinguish adipose tissue of insulin resistant from insulin-sensitive individuals with severe obesity.