Intra-abdominal adiposity, abdominal obesity, and cardiometabolic risk
Intra-abdominal adiposity, abdominal obesity, and cardiometabolic risk
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DOI：
10.1093/eurheartj/sum042
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发表时间：
2008-03-01
影响因子：
1.6
通讯作者：
Gastaldelli, Amalia
中科院分区：
文献类型：
--
作者：
Ferrannini, Ele;Sironi, Anna Maria;Gastaldelli, Amalia
腹部（内脏之间和内脏内部）的优先脂肪沉积与心脏代谢风险有关。我们回顾了肥胖和/或糖尿病受试者体内获得的数据，使用磁共振成像（量化脂肪库）和正电子发射断层扫描来量化正常血糖高胰岛素血症条件下的葡萄糖摄取（（18）FDG）和血流量（（H2O）-O-15）（钳夹技术）。腹部内脏脂肪组织（VAT）的数量很少，取决于性别、体重指数和年龄，并且与腰围有不同的相关性。增值税本质上比皮下脂肪对胰岛素更敏感；两者都显示在全身胰岛素抵抗的情况下葡萄糖摄取受损。此外，在增值税中，胰岛素敏感性随着质量的增加而下降，并且与血流量直接相关，可能反映了肥大脂肪组织的细胞表型。然而，在肥胖症中，增加的脂肪量对总体葡萄糖处理做出了更大的贡献，从而为葡萄糖代谢的胰岛素抵抗提供了补偿机制。脂肪堆积会损害靶组织对胰岛素的反应能力。另一方面，它为多余的卡路里和葡萄糖提供了一个安全的储存库。两者之间的平衡可能会设定个体的疾病风险。 “禁止”部位（增值税、肝脏）的脂肪沉积所发出的信号远远超出了脂肪量本身的风险。
Preferential fat deposition in the abdomen-between and within viscera-has been linked with cardiometabotic risk. We review data obtained in vivo in subjects with obesity and/or diabetes using magnetic resonance imaging (to quantify fat depots), and positron emitting tomography to quantify glucose uptake ((18)FDG) and blood flow ((H2O)-O-15) under conditions of euglycaemic hyperinsulinaemia (clamp technique). Abdominal visceral adipose tissue (VAT) is small in amount, is dependent on sex, body mass index, and age and is variably related to waist circumference. VAT is inherently more insulin-sensitive than subcutaneous fat; both show impaired glucose uptake in conditions of whole-body insulin resistance. Furthermore, in VAT, insulin sensitivity declines with mass and is directly related to blood flow, possibly reflecting the cellular phenotype of hypertrophic adipose tissue. Nevertheless, in obesity the expanded fat mass makes a greater contribution to overall glucose disposal, thereby providing a compensatory mechanism to the insulin resistance of glucose metabolism. Fat accumulation impairs the ability of target tissues to respond to insulin. On the other hand, it provides a safe repository for excess calories and glucose. The balance between the two sides may set individual disease risk. Fat deposition in 'forbidden' sites (VAT, liver) signals risk well beyond the amount of fat itself.