肥胖和代谢综合征相关机制和研究进展
Mechanisms and Research Progress Relatedto Obesity and Metabolic Syndrome
摘要: 肥胖症和代谢综合征(Metabolic syndrome, MetS)的发病率正在不断上升,炎症通路的激活通常被用作是宿主的一种防御手段,提醒人们该疾病的严重性。导致炎症激活的原因可能不止一个。代谢超负荷会引起应激反应,如氧化应激、炎症反应、细胞器和细胞肥大,从而产生恶性循环。脂肪细胞肥大会导致细胞破裂,从而引发炎症反应。脂肪组织的发育无法吞噬细胞破裂产生的脂肪,导致脂肪沉积在其他器官(主要是肝脏),从而诱发胰岛素抵抗。人们进食时也会产生氧化应激,尤其摄入过多的脂肪和/或其他营养素时却没有同时摄入富含抗氧化剂的食物的情况下,可能导致肥胖引起炎症。此外,有关微生物群与食物和肥胖相互作用的数据为肥胖/脂肪饮食与炎症的关系提出了新的假设。除此之外,其他现象,如心理和/或昼夜节律紊乱,也同样可能导致氧化/炎症状态。肥胖症/代谢综合征的治疗难度与它们的多因素性质有关,环境、遗传和社会心理因素通过复杂的网络相互作用。
Abstract: The prevalence of obesity and Metabolic syndrome (MetS) is increasing, and the activation of in-flammatory pathways is often used as a host defense and a reminder of the severity of the disease. There may be more than one cause of inflammatory activation. Metabolic overload induces a vicious cycle of stress responses such as oxidative stress, inflammatory responses, and organelle and cellu-lar hypertrophy. Adipocyte hypertrophy leads to cellular rupture, which triggers an inflammatory response. The development of adipose tissue is unable to phagocytose the fat produced by cell rup-ture, leading to fat deposition in other organs (mainly the liver), thus inducing insulin resistance. Oxidative stress also occurs when people eat, especially if they consume too much fat and/or other nutrients without also consuming antioxidant-rich foods, which can lead to obesity-induced in-flammation. In addition, data on microbiota interactions with food and obesity suggest new hy-potheses for the relationship between obesity/fat diets and inflammation. In addition to this, other phenomena, such as psychological and/or circadian rhythm disturbances, may likewise contribute to the oxidative/inflammatory state. The difficulty in treating obesity/metabolic syndrome is re-lated to their multifactorial nature, where environmental, genetic and psychosocial factors interact through a complex network.
文章引用:熊昱鹏, 刘文清, 祁海燕, 米娜瓦尔·胡加艾合买提. 肥胖和代谢综合征相关机制和研究进展[J]. 临床医学进展, 2023, 13(9): 14560-14568. https://doi.org/10.12677/ACM.2023.1392036

参考文献

[1] Li, W., Song, F., Wang, X., et al. (2018) Prevalence of Metabolic Syndrome among Middle-Aged and Elderly Adults in China: Current Status and Temporal Trends. Annals of Medicine, 50, 345-353. [Google Scholar] [CrossRef] [PubMed]
[2] Guo, H., Gao, X., Ma, R., et al. (2017) Prevalence of Meta-bolic Syndrome and Its Associated Factors among Multi-Ethnic Adults in Rural Areas in Xinjiang, China. Scientific Re-ports, 7, Article No. 17643. [Google Scholar] [CrossRef] [PubMed]
[3] Yao, F., Bo, Y., Zhao, L., et al. (2021) Prevalence and Influenc-ing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017. Nutrients, 13, Article 4475. [Google Scholar] [CrossRef] [PubMed]
[4] Fahed, G., Aoun, L., Bou Zerdan, M., et al. (2022) Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. International Journal of Molecular Sciences, 23, Article 786. [Google Scholar] [CrossRef] [PubMed]
[5] Alkhulaifi, F. and Darkoh, C. (2022) Meal Timing, Meal Frequency and Metabolic Syndrome. Nutrients, 14, Article 1719. [Google Scholar] [CrossRef] [PubMed]
[6] Blüher, M. (2020) Metabolically Healthy Obesity. Endocrine Reviews, 41, bnaa004. [Google Scholar] [CrossRef] [PubMed]
[7] Mathis, B.J., Tanaka, K. and Hiramatsu, Y. (2022) Factors of Obesity and Metabolically Healthy Obesity in Asia. Medicina, 58, Article 1271. [Google Scholar] [CrossRef] [PubMed]
[8] Lin, L., Zhang, J., Jiang, L., et al. (2020) Transition of Metabolic Phenotypes and Risk of Subclinical Atherosclerosis according to BMI: A Prospective Study. Diabetologia, 3, 1312-1323. [Google Scholar] [CrossRef] [PubMed]
[9] Zhang, Y., Fu, J., Yang, S., et al. (2017) Prevalence of Metabol-ically Obese But Normal Weight (MONW) and Metabolically Healthy But Obese (MHO) in Chinese Beijing Urban Subjects. Bioscience Trends, 11, 418-426. [Google Scholar] [CrossRef] [PubMed]
[10] Aguilar-Salinas, C.A., García, E.G., Robles, L., et al. (2008) High Adiponectin Concentrations Are Associated with the Metabolically Healthy Obese Phenotype. The Journal of Clinical Endocrinology and Metabolism, 93, 4075-4079. [Google Scholar] [CrossRef] [PubMed]
[11] Welsh, P., Polisecki, E., Robertson, M., et al. (2010) Unraveling the Di-rectional Link between Adiposity and Inflammation: A Bidirectional Mendelian Randomization Approach. The Journal of Clinical Endocrinology and Metabolism, 95, 93-99. [Google Scholar] [CrossRef] [PubMed]
[12] Ma, L., Xu, Y., Zhang, Y., Ji, T. and Li, Y. (2020) Lower Levels of Circulating Adiponectin in Elderly Patients with Metabolic Inflam-matory Syndrome: A Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity, 13, 591-596. [Google Scholar] [CrossRef
[13] Cobos-Palacios, L., Ruiz-Moreno, M.I., Vilches-Perez, A., et al. (2022) Metabolically Healthy Obesity: Inflammatory Biomarkers and Adipokines in Elderly Population. PLOS ONE, 17, e0265362. [Google Scholar] [CrossRef] [PubMed]
[14] Gomez-Huelgas, R., Ruiz-Nava, J., Santamaria-Fernandez, S., et al. (2019) Impact of Intensive Lifestyle Modification on Levels of Adipokines and Inflammatory Biomarkers in Metabol-ically Healthy Obese Women. Mediators of Inflammation, 2019, Article ID: 4165260. [Google Scholar] [CrossRef] [PubMed]
[15] Celik, O. and Yildiz, B.O. (2021) Obesity and Physical Exercise. Mi-nerva Endocrinology, 46, 131-144.
[16] Kahleova, H., Rembert, E., Alwarith, J., et al. (2020) Effects of a Low-Fat Ve-gan Diet on Gut Microbiota in Overweight Individuals and Relationships with Body Weight, Body Composition, and Insulin Sensitivity. A Randomized Clinical Trial. Nutrients, 12, Article 2917. [Google Scholar] [CrossRef] [PubMed]
[17] Kolb, H. (2022) Obese Visceral Fat Tissue Inflammation: From Protec-tive to Detrimental? BMC Medicine, 20, Article No. 494. [Google Scholar] [CrossRef] [PubMed]
[18] Serhan, C.N. (2007) Resolution Phase of Inflammation: Novel Endogenous Anti-Inflammatory and Proresolving Lipid Mediators and Pathways. Annual Review of Immunology, 25, 101-137. [Google Scholar] [CrossRef] [PubMed]
[19] Panigrahy, D., Gilligan, M.M., Serhan, C.N. and Kashfi, K. (2021) Resolution of Inflammation: An Organizing Principle in Biology and Medicine. Pharmacology & Therapeutics, 227, Article ID: 107879. [Google Scholar] [CrossRef] [PubMed]
[20] Segawa, K. and Nagata, S. (2015) An Apoptotic ‘Eat Me’ Signal: Phosphatidylserine Exposure. Trends in Cell Biology, 25, 639-650. [Google Scholar] [CrossRef] [PubMed]
[21] Huynh, M.L., Fadok, V.A. and Henson, P.M. (2002) Phosphatidyl-serine-Dependent Ingestion of Apoptotic Cells Promotes TGF-β1 Secretion and the Resolution of Inflammation. The Journal of Clinical Investigation, 109, 41-50. [Google Scholar] [CrossRef
[22] Gilroy, D. and De Maeyer, R. (2015) New Insights into the Resolution of Inflammation. Seminars in Immunology, 27, 161-168. [Google Scholar] [CrossRef] [PubMed]
[23] Nijhuis, J., Rensen, S.S., Slaats, Y., et al. (2009) Neutrophil Activation in Morbid Obesity, Chronic Activation of Acute Inflamma-tion. Obesity, 17, 2014-2018. [Google Scholar] [CrossRef] [PubMed]
[24] Jukic, A., Bakiri, L., Wagner, E.F., et al. (2021) Calprotectin: From Biomarker to Biological Function. Gut, 70, 1978-1988. [Google Scholar] [CrossRef] [PubMed]
[25] Pellegrinelli, V., Carobbio, S. and Vidal-Puig, A. (2016) Adipose Tissue Plasticity: How Fat Depots Respond Differently to Pathophysiological Cues. Diabetologia, 59, 1075-1088. [Google Scholar] [CrossRef] [PubMed]
[26] 林泽明. 脂肪营养不良综合征的临床表型和分子遗传学研究[D]: [博士学位论文]. 北京: 北京协和医学院, 2017.
[27] Wang, R., Sun, Q., Wu, X., et al. (2022) Hypoxia as a Double-Edged Sword to Combat Obesity and Comorbidities. Cells, 11, Article 3735. [Google Scholar] [CrossRef] [PubMed]
[28] Al Mahri, S., Malik, S.S., Al Ibrahim, M., et al. (2022) Free Fatty Acid Receptors (FFARs) in Adipose: Physiological Role and Therapeutic Outlook. Cells, 11, Article 750. [Google Scholar] [CrossRef] [PubMed]
[29] Mccracken, E., Monaghan, M. and Sreenivasan, S. (2018) Pathophysi-ology of the Metabolic Syndrome. Clinics in Dermatology, 36, 14-20. [Google Scholar] [CrossRef] [PubMed]
[30] Fitzgerald, K.A. and Kagan, J.C. (2020) Toll-Like Recep-tors and the Control of Immunity. Cell, 180, 1044-1066. [Google Scholar] [CrossRef] [PubMed]
[31] Artemniak-Wojtowicz, D., Kucharska, A.M. and Pyrżak, B. (2020) Obesity and Chronic Inflammation Crosslinking. Central-European Journal of Immunology, 45, 461-468. [Google Scholar] [CrossRef] [PubMed]
[32] Li, D. and Wu, M. (2021) Pattern Recognition Receptors in Health and Diseases. Signal Transduction and Targeted Therapy, 6, Article No. 291. [Google Scholar] [CrossRef] [PubMed]
[33] Eguchi, K., Manabe, I., Oishi-Tanaka, Y., et al. (2012) Saturated Fatty Acid and TLR Signaling Link β Cell Dysfunction and Islet Inflammation. Cell Metabolism, 15, 518-533. [Google Scholar] [CrossRef] [PubMed]
[34] Qatanani, M. and Lazar, M.A. (2007) Mechanisms of Obesi-ty-Associated Insulin Resistance: Many Choices on the Menu. Genes & Development, 21, 1443-1455. [Google Scholar] [CrossRef] [PubMed]
[35] Shi, H., Kokoeva, M.V., Inouye, K., et al. (2006) TLR4 Links Innate Immunity and Fatty Acid-Induced Insulin Resistance. The Journal of Clinical Investigation, 116, 3015-3025. [Google Scholar] [CrossRef
[36] Li, B., Leung, J.C.K., Chan, L.Y.Y., et al. (2020) A Global Perspective on the Crosstalk between Saturated Fatty Acids and Toll-Like Receptor 4 in the Etiology of Inflammation and Insulin Re-sistance. Progress in Lipid Research, 77, Article ID: 101020. [Google Scholar] [CrossRef] [PubMed]
[37] Lee, J.Y., Sohn, K.H., Rhee, S.H. and Hwang, D. (2001) Satu-rated Fatty Acids, But Not Unsaturated Fatty Acids, Induce the Expression of Cyclooxygenase-2 Mediated through Toll-Like Receptor 4. The Journal of Biological Chemistry, 276, 16683-16689. [Google Scholar] [CrossRef
[38] Hwang, D.H, Kim, J.A. and Lee, J.Y. (2016) Mechanisms for the Activation of Toll-Like Receptor 2/4 by Saturated Fatty Acids and Inhibition by Docosahexaenoic Acid. European Jour-nal of Pharmacology, 785, 24-35. [Google Scholar] [CrossRef] [PubMed]
[39] Wang, Y., Qian, Y., Fang, Q., et al. (2017) Saturated Palmitic Acid Induces Myocardial Inflammatory Injuries through Direct Binding to TLR4 Accessory Protein MD2. Nature Communications, 8, Article No. 13997. [Google Scholar] [CrossRef] [PubMed]
[40] Lemmer, I.L., Willemsen, N., Hilal, N., et al. (2021) A Guide to Un-derstanding Endoplasmic Reticulum Stress in Metabolic Disorders. Molecular Metabolism, 47, Article ID: 101169. [Google Scholar] [CrossRef] [PubMed]
[41] Lafontan, M. and Berlan, M. (2003) Do Regional Differences in Adipocyte Biology Provide New Pathophysiological Insights? Trends in Pharmacological Sciences, 24, 276-283. [Google Scholar] [CrossRef
[42] Chartrand, D.J., Larose, E., Poirier, P., et al. (2020) Visceral Adiposity and Liver Fat as Mediators of the Association between Cardiorespiratory Fitness and Plasma Glucose-Insulin Homeostasis. American Journal of Physiology Endocrinology and Metabolism, 319, E548-E556. [Google Scholar] [CrossRef] [PubMed]
[43] Ahn, N., Baumeister, S.E., Amann, U., et al. (2019) Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Product of Triglycerides and Glucose (TyG) to Dis-criminate Prediabetes and Diabetes. Scientific Reports, 9, Article No. 9693. [Google Scholar] [CrossRef] [PubMed]
[44] Leite, N.N., Cota, B.C., Gotine, A., et al. (2021) Visceral Adi-posity Index Is Positively Associated with Blood Pressure: A Systematic Review. Obesity Research & Clinical Practice, 15, 546-556. [Google Scholar] [CrossRef] [PubMed]
[45] Jabłonowska-Lietz, B., Wrzosek, M., Włodarczyk, M., et al. (2017) New Indexes of Body Fat Distribution, Visceral Adiposity Index, Body Adiposity Index, Waist-to-Height Ratio, and Metabolic Disturbances in the Obese. Kardiologia Polska, 75, 1185-1191. [Google Scholar] [CrossRef
[46] Ibrahim, M.M. (2010) Subcutaneous and Visceral Adipose Tissue: Structural and Functional Differences. Obesity Reviews, 11, 11-18. [Google Scholar] [CrossRef
[47] Fain, J.N. (2010) Release of Inflammatory Mediators by Human Adipose Tissue Is Enhanced in Obesity and Primarily by the Nonfat Cells: A Review. Mediators of Inflammation, 2010, Article 513948. [Google Scholar] [CrossRef] [PubMed]
[48] Barnard, S.A., Pieters, M. and De Lange, Z. (2016) The Contribution of Different Adipose Tissue Depots to Plasma Plasminogen Activator Inhibitor-1 (PAI-1) Levels. Blood Reviews, 30, 421-429. [Google Scholar] [CrossRef] [PubMed]
[49] You, T., Nicklas, B.J., Ding, J., et al. (2008) The Metabolic Syn-drome Is Associated with Circulating Adipokines in Older Adults across a Wide Range of Adiposity. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences, 63, 414-419. [Google Scholar] [CrossRef] [PubMed]
[50] Cnop, M., Havel, P.J., Utzschneider, K.M., et al. (2003) Relationship of Adiponectin to Body Fat Distribution, Insulin Sensitivity and Plasma Lipoproteins: Evidence for Independent Roles of Age and Sex. Diabetologia, 46, 459-469. [Google Scholar] [CrossRef] [PubMed]
[51] Bahceci, M., Gokalp, D., Bahceci, S., et al. (2007) The Correlation between Adiposity and Adiponectin, Tumor Necrosis Factor α, Interleukin-6 and High Sensitivity C-Reactive Protein Levels. Is Adipocyte Size Associated with Inflammation in Adults? Journal of Endocrinological Investigation, 30, 210-214. [Google Scholar] [CrossRef
[52] Bennett, N.R., Ferguson, T.S., Bennett, F.I., et al. (2014) High-Sensitivity C-Reactive Protein Is Related to Central Obesity and the Number of Metabolic Syndrome Components in Jamaican Young Adults. Frontiers in Cardiovascular Medicine, 1, Article 12. [Google Scholar] [CrossRef] [PubMed]
[53] Laforest, S., Labrecque, J., Michaud, A., Cianflone, K. and Tchernof, A. (2015) Adipocyte Size as a Determinant of Metabolic Disease and Adipose Tissue Dysfunction. Critical Reviews in Clinical Laboratory Sciences, 52, 301-313. [Google Scholar] [CrossRef] [PubMed]
[54] Ju, L., Han, J., Zhang, X., et al. (2019) Obesity-Associated Inflammation Triggers an Autophagy-Lysosomal Response in Adipocytes and Causes Degradation of Perilipin 1. Cell Death & Disease, 10, Article No. 121. [Google Scholar] [CrossRef] [PubMed]
[55] Finucane, O.M., Reynolds, C.M., Mcgillicuddy, F.C. and Roche, H.M. (2012) Insights into the Role of Macrophage Migration Inhibitory Factor in Obesity and Insulin Resistance. The Proceedings of the Nutrition Society, 71, 622-633. [Google Scholar] [CrossRef
[56] Okamoto, Y., Folco, E.J., Minami, M., et al. (2008) Adiponectin Inhibits the Production of CXC Receptor 3 Chemokine Ligands in Macrophages and Reduces T-Lymphocyte Recruit-ment in Atherogenesis. Circulation Research, 102, 218-225. [Google Scholar] [CrossRef
[57] Johnston, E.K. and Abbott, R.D. (2023) Adipose Tissue Paracrine-, Autocrine-, and Matrix-Dependent Signaling during the Development and Progression of Obesity. Cells, 12, Article 407. [Google Scholar] [CrossRef] [PubMed]
[58] Varela, J.E., Hinojosa, M. and Nguyen, N. (2009) Correla-tions between Intra-Abdominal Pressure and Obesity-Related Co-Morbidities. Surgery for Obesity and Related Diseases, 5, 524-528. [Google Scholar] [CrossRef] [PubMed]
[59] Ghaben, A.L. and Scherer, P.E. (2019) Adipogenesis and Metabolic Health. Nature Reviews Molecular Cell Biology, 20, 242-258. [Google Scholar] [CrossRef] [PubMed]
[60] Wang, B., Wood, I.S. and Trayhurn, P. (2008) Hypoxia Induces Leptin Gene Expression and Secretion in Human Preadipocytes: Differential Effects of Hypoxia on Adipokine Expres-sion by Preadipocytes. The Journal of Endocrinology, 198, 127-134. [Google Scholar] [CrossRef
[61] Eltzschig, H.K. and Carmeliet, P. (2011) Hypoxia and Inflammation. The New England Journal of Medicine, 364, 656-665. [Google Scholar] [CrossRef
[62] Ruth, M.R., Port, A.M., Shah, M., et al. (2013) Consuming a Hypocaloric High Fat Low Carbohydrate Diet for 12 Weeks Lowers C-Reactive Protein, and Raises Serum Adiponectin and High Density Lipoprotein-Cholesterol in Obese Subjects. Metab-olism: Clinical and Experimental, 62, 1779-1787. [Google Scholar] [CrossRef] [PubMed]
[63] Peairs, A.T. and Rankin, J.W. (2008) Inflammatory Response to a High-Fat, Low-Carbohydrate Weight Loss Diet: Effect of Antioxi-dants. Obesity, 16, 1573-1578. [Google Scholar] [CrossRef] [PubMed]
[64] Lee, I.S., Shin, G. and Choue, R. (2010) Shifts in Diet from High Fat to High Carbohydrate Improved Levels of Adipokines and Pro-Inflammatory Cytokines in Mice Fed a High-Fat Diet. Endocrine Journal, 57, 39-50. [Google Scholar] [CrossRef
[65] Pinart, M., Dötsch, A., Schlicht, K., et al. (2021) Gut Microbiome Composition in Obese and Non-Obese Persons: A Systematic Review and Meta-Analysis. Nutrients, 14, Article 12. [Google Scholar] [CrossRef] [PubMed]
[66] Chávez-Carbajal, A., Nirmalkar, K., Pérez-Lizaur, A., et al. (2019) Gut Microbiota and Predicted Metabolic Pathways in a Sample of Mexican Women Affected by Obesity and Obesity plus Metabolic Syndrome. International Journal of Molecular Sciences, 20, Article 438. [Google Scholar] [CrossRef] [PubMed]
[67] Org, E., Blum, Y., Kasela, S., et al. (2017) Relationships between Gut Microbiota, Plasma Metabolites, and Metabolic Syndrome Traits in the METSIM Cohort. Genome Biology, 18, Article No. 70. [Google Scholar] [CrossRef] [PubMed]
[68] Rahat-Rozenbloom, S., Fernandes, J., Gloor, G.B. and Wolever, T.M.S. (2014) Evidence for Greater Production of Colonic Short-Chain Fatty Acids in Overweight than Lean Humans. International Journal of Obesity, 38, 1525-1531. [Google Scholar] [CrossRef] [PubMed]
[69] Torres-Fuentes, C., Schellekens, H., Dinan, T.G. and Cryan, J.F. (2017) The Microbiota-Gut-Brain Axis in Obesity. The Lancet Gastroenterology & Hepatology, 2, 747-756. [Google Scholar] [CrossRef
[70] Tan, R., Dong, H., Chen, Z., et al. (2021) Intestinal Microbi-ota Mediates High-Fructose and High-Fat Diets to Induce Chronic Intestinal Inflammation. Frontiers in Cellular and In-fection Microbiology, 11, Article 654074. [Google Scholar] [CrossRef] [PubMed]