不同脂肪库与动脉粥样硬化的研究进展
Research Progress of Different Fat Pools and Atherosclerosis
DOI: 10.12677/acm.2025.1551536, PDF,   
作者: 张 真, 向 波*:重庆医科大学附属永川医院放射科,重庆
关键词: 肥胖异位脂肪动脉粥样硬化心血管疾病Obesity Ectopic Fat Atherosclerosis Cardiovascular Disease
摘要: 超重和肥胖是指人体脂肪堆积过多和/或分布异常,已被充分证实是冠状动脉粥样硬化、高血压、心力衰竭等心血管疾病的独立危险因素。相较于脂肪组织的总体含量,脂肪组织的异位分布情况与疾病的发生发展关系更为密切。在这篇综述中,我们重点关注不同脂肪库在心脏代谢和血管风险中的作用和临床意义。
Abstract: Overweight and obesity refer to excessive accumulation and/or abnormal distribution of body fat, which has been fully proven to be an independent risk factor for cardiovascular diseases such as coronary atherosclerosis, hypertension and heart failure. Compared with the total content of adipose tissue, the ectopic distribution of adipose tissue is more closely related to the occurrence and development of disease. In this review, we focus on the role and clinical significance of different fat pools in cardiometabolic and vascular risk.
文章引用:张真, 向波. 不同脂肪库与动脉粥样硬化的研究进展[J]. 临床医学进展, 2025, 15(5): 1628-1634. https://doi.org/10.12677/acm.2025.1551536

参考文献

[1] 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2023概要[J]. 中国循环杂志, 2024, 39(7): 625-660.
[2] Global Obesity Observatory (2023) World Obesity Atlas 2023.
https://data.worldobesity.org/publications/?cat=19
[3] Flint, A.J., Hu, F.B., Glynn, R.J., Caspard, H., Manson, J.E., Willett, W.C., et al. (2010) Excess Weight and the Risk of Incident Coronary Heart Disease among Men and Women. Obesity, 18, 377-383. [Google Scholar] [CrossRef] [PubMed]
[4] Hu, G., Barengo, N.C., Tuomilehto, J., Lakka, T.A., Nissinen, A. and Jousilahti, P. (2004) Relationship of Physical Activity and Body Mass Index to the Risk of Hypertension: A Prospective Study in Finland. Hypertension, 43, 25-30. [Google Scholar] [CrossRef] [PubMed]
[5] Khot, U.N. (2003) Prevalence of Conventional Risk Factors in Patients with Coronary Heart Disease. JAMA, 290, 898-904. [Google Scholar] [CrossRef] [PubMed]
[6] Després, J. (2012) Body Fat Distribution and Risk of Cardiovascular Disease: An Update. Circulation, 126, 1301-1313. [Google Scholar] [CrossRef] [PubMed]
[7] Lim, S. and Meigs, J.B. (2014) Links between Ectopic Fat and Vascular Disease in Humans. Arteriosclerosis, Thrombosis, and Vascular Biology, 34, 1820-1826. [Google Scholar] [CrossRef] [PubMed]
[8] Wang, W. and Seale, P. (2016) Control of Brown and Beige Fat Development. Nature Reviews Molecular Cell Biology, 17, 691-702. [Google Scholar] [CrossRef] [PubMed]
[9] 李雁鸣, 沈成兴, 申锷. 心外膜脂肪组织与心血管疾病的研究进展[J]. 中华心血管病杂志, 2022, 50(7): 723-727.
[10] Gastaldelli, A. and Basta, G. (2010) Ectopic Fat and Cardiovascular Disease: What Is the Link? Nutrition, Metabolism and Cardiovascular Diseases, 20, 481-490. [Google Scholar] [CrossRef] [PubMed]
[11] Roden, M. (2006) Mechanisms of Disease: Hepatic Steatosis in Type 2 Diabetes—Pathogenesis and Clinical Relevance. Nature Clinical Practice Endocrinology & Metabolism, 2, 335-348. [Google Scholar] [CrossRef] [PubMed]
[12] Manolopoulos, K.N., Karpe, F. and Frayn, K.N. (2010) Gluteofemoral Body Fat as a Determinant of Metabolic Health. International Journal of Obesity, 34, 949-959. [Google Scholar] [CrossRef] [PubMed]
[13] Lee, M., Wu, Y. and Fried, S.K. (2013) Adipose Tissue Heterogeneity: Implication of Depot Differences in Adipose Tissue for Obesity Complications. Molecular Aspects of Medicine, 34, 1-11. [Google Scholar] [CrossRef] [PubMed]
[14] Abraham, T.M., Pedley, A., Massaro, J.M., Hoffmann, U. and Fox, C.S. (2015) Association between Visceral and Subcutaneous Adipose Depots and Incident Cardiovascular Disease Risk Factors. Circulation, 132, 1639-1647. [Google Scholar] [CrossRef] [PubMed]
[15] Diaz, A.A., Young, T.P., Kurugol, S., Eckbo, E., Muralidhar, N., Chapman, J.K., et al. (2015) Abdominal Visceral Adipose Tissue Is Associated with Myocardial Infarction in Patients with COPD. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 2, 8-16. [Google Scholar] [CrossRef] [PubMed]
[16] Manolis, A.A., Manolis, T.A., Vouliotis, A. and Manolis, A.S. (2025) Metabolic Dysfunction-Associated Steatotic Liver Disease and the Cardiovascular System. Trends in Cardiovascular Medicine, 35, 258-265. [Google Scholar] [CrossRef] [PubMed]
[17] Henin, G., Loumaye, A., Leclercq, I.A. and Lanthier, N. (2024) Myosteatosis: Diagnosis, Pathophysiology and Consequences in Metabolic Dysfunction-Associated Steatotic Liver Disease. JHEP Reports, 6, Article 100963. [Google Scholar] [CrossRef] [PubMed]
[18] Patel, V.B., Shah, S., Verma, S. and Oudit, G.Y. (2017) Epicardial Adipose Tissue as a Metabolic Transducer: Role in Heart Failure and Coronary Artery Disease. Heart Failure Reviews, 22, 889-902. [Google Scholar] [CrossRef] [PubMed]
[19] Ibrahim, M.M. (2009) Subcutaneous and Visceral Adipose Tissue: Structural and Functional Differences. Obesity Reviews, 11, 11-18. [Google Scholar] [CrossRef] [PubMed]
[20] Mosalmanzadeh, N. and Pence, B.D. (2024) Oxidized Low-Density Lipoprotein and Its Role in Immunometabolism. International Journal of Molecular Sciences, 25, Article 11386. [Google Scholar] [CrossRef] [PubMed]
[21] Scott, D.A., Ponir, C., Shapiro, M.D. and Chevli, P.A. (2024) Associations between Insulin Resistance Indices and Subclinical Atherosclerosis: A Contemporary Review. American Journal of Preventive Cardiology, 18, Article 100676. [Google Scholar] [CrossRef] [PubMed]
[22] Hotamisligil, G.S., Shargill, N.S. and Spiegelman, B.M. (1993) Adipose Expression of Tumor Necrosis Factor-Α: Direct Role in Obesity-Linked Insulin Resistance. Science, 259, 87-91. [Google Scholar] [CrossRef] [PubMed]
[23] Lim, S. and Meigs, J.B. (2013) Ectopic Fat and Cardiometabolic and Vascular Risk. International Journal of Cardiology, 169, 166-176. [Google Scholar] [CrossRef] [PubMed]
[24] Smith, S.R. and Wilson, P.W.F. (2006) Free Fatty Acids and Atherosclerosis—Guilty or Innocent? The Journal of Clinical Endocrinology & Metabolism, 91, 2506-2508. [Google Scholar] [CrossRef] [PubMed]
[25] Van Gaal, L.F., Mertens, I.L. and De Block, C.E. (2006) Mechanisms Linking Obesity with Cardiovascular Disease. Nature, 444, 875-880. [Google Scholar] [CrossRef] [PubMed]
[26] Stamler, J., Stamler, R., Neaton, J.D., Wentworth, D., Daviglus, M.L., Garside, D., et al. (1999) Low Risk-Factor Profile and Long-Term Cardiovascular and Noncardiovascular Mortality and Life Expectancy: Findings for 5 Large Cohorts of Young Adult and Middle-Aged Men and Women. JAMA, 282, 2012-2018. [Google Scholar] [CrossRef] [PubMed]
[27] Brunt, E.M. (2001) Nonalcoholic Steatohepatitis: Definition and Pathology. Seminars in Liver Disease, 21, 3-16. [Google Scholar] [CrossRef] [PubMed]
[28] Younossi, Z.M., Koenig, A.B., Abdelatif, D., Fazel, Y., Henry, L. and Wymer, M. (2016) Global Epidemiology of Nonalcoholic Fatty Liver Disease—Meta‐Analytic Assessment of Prevalence, Incidence, and Outcomes. Hepatology, 64, 73-84. [Google Scholar] [CrossRef] [PubMed]
[29] Diehl, A.M. and Day, C. (2017) Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis. New England Journal of Medicine, 377, 2063-2072. [Google Scholar] [CrossRef] [PubMed]
[30] Stefan, N., Häring, H. and Cusi, K. (2019) Non-Alcoholic Fatty Liver Disease: Causes, Diagnosis, Cardiometabolic Consequences, and Treatment Strategies. The Lancet Diabetes & Endocrinology, 7, 313-324. [Google Scholar] [CrossRef] [PubMed]
[31] Allen, A.M., Therneau, T.M., Larson, J.J., Coward, A., Somers, V.K. and Kamath, P.S. (2018) Nonalcoholic Fatty Liver Disease Incidence and Impact on Metabolic Burden and Death: A 20 Year‐Community Study. Hepatology, 67, 1726-1736. [Google Scholar] [CrossRef] [PubMed]
[32] Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stål, P., Kechagias, S., et al. (2015) Fibrosis Stage Is the Strongest Predictor for Disease‐Specific Mortality in NAFLD after up to 33 Years of Follow‐Up. Hepatology, 61, 1547-1554. [Google Scholar] [CrossRef] [PubMed]
[33] Castillo-Núñez, Y., Almeda-Valdes, P., González-Gálvez, G. and Arechavaleta-Granell, M.R. (2024) Metabolic Dysfunction-Associated Steatotic Liver Disease and Atherosclerosis. Current Diabetes Reports, 24, 158-166. [Google Scholar] [CrossRef] [PubMed]
[34] Ma, G., Xu, G. and Huang, H. (2025) Correlation between Metabolic Dysfunction-Associated Steatotic Liver Disease and Subclinical Coronary Atherosclerosis in Eastern China. Diabetology & Metabolic Syndrome, 17, Article No. 16. [Google Scholar] [CrossRef] [PubMed]
[35] Platek, A.E. and Szymanska, A. (2023) Metabolic Dysfunction-Associated Steatotic Liver Disease as a Cardiovascular Risk Factor. Clinical and Experimental Hepatology, 9, 187-192. [Google Scholar] [CrossRef] [PubMed]
[36] Iacobellis, G. (2015) Local and Systemic Effects of the Multifaceted Epicardial Adipose Tissue Depot. Nature Reviews Endocrinology, 11, 363-371. [Google Scholar] [CrossRef] [PubMed]
[37] Bodenstab, M.L., Varghese, R.T. and Iacobellis, G. (2024) Cardio-Lipotoxicity of Epicardial Adipose Tissue. Biomolecules, 14, Article 1465. [Google Scholar] [CrossRef] [PubMed]
[38] Corradi, D., Maestri, R., Callegari, S., Pastori, P., Goldoni, M., Luong, T.V., et al. (2004) The Ventricular Epicardial Fat Is Related to the Myocardial Mass in Normal, Ischemic and Hypertrophic Hearts. Cardiovascular Pathology, 13, 313-316. [Google Scholar] [CrossRef] [PubMed]
[39] Ansaldo, A.M., Montecucco, F., Sahebkar, A., Dallegri, F. and Carbone, F. (2019) Epicardial Adipose Tissue and Cardiovascular Diseases. International Journal of Cardiology, 278, 254-260. [Google Scholar] [CrossRef] [PubMed]
[40] Chen, H., Liu, L., Li, M., Zhu, D. and Tian, G. (2023) Epicardial Adipose Tissue-Derived Leptin Promotes Myocardial Injury in Metabolic Syndrome Rats through PKC/NADPH Oxidase/ROS Pathway. Journal of the American Heart Association, 12, e029415. [Google Scholar] [CrossRef] [PubMed]
[41] Mahabadi, A.A., Massaro, J.M., Rosito, G.A., Levy, D., Murabito, J.M., Wolf, P.A., et al. (2008) Association of Pericardial Fat, Intrathoracic Fat, and Visceral Abdominal Fat with Cardiovascular Disease Burden: The Framingham Heart Study. European Heart Journal, 30, 850-856. [Google Scholar] [CrossRef] [PubMed]
[42] Tachibana, M., Miyoshi, T., Osawa, K., Toh, N., Oe, H., Nakamura, K., et al. (2016) Measurement of Epicardial Fat Thickness by Transthoracic Echocardiography for Predicting High-Risk Coronary Artery Plaques. Heart and Vessels, 31, 1758-1766. [Google Scholar] [CrossRef] [PubMed]
[43] Aprigliano, G., Scuteri, L., Iafelice, I., Li Volsi, L., Cuko, B., Palloshi, A., et al. (2015) Epicardial Adipose Tissue Thickness and Acute Coronary Syndrome: A Matter of How Much or How? International Journal of Cardiology, 199, 8-9. [Google Scholar] [CrossRef] [PubMed]
[44] Nogajski, Ł., Mazuruk, M., Kacperska, M., Kurpias, M., Mączewski, M., Nowakowski, M., et al. (2024) Epicardial Fat Density Obtained with Computed Tomography Imaging—More Important than Volume? Cardiovascular Diabetology, 23, Article No. 389. [Google Scholar] [CrossRef] [PubMed]
[45] Oikonomou, E.K., Marwan, M., Desai, M.Y., Mancio, J., Alashi, A., Hutt Centeno, E., et al. (2018) Non-Invasive Detection of Coronary Inflammation Using Computed Tomography and Prediction of Residual Cardiovascular Risk (The CRISP CT Study): A Post-Hoc Analysis of Prospective Outcome Data. The Lancet, 392, 929-939. [Google Scholar] [CrossRef] [PubMed]
[46] Alberti, K.G.M.M., Zimmet, P. and Shaw, J. (2006) Metabolic Syndrome—A New World‐Wide Definition. a Consensus Statement from the International Diabetes Federation. Diabetic Medicine, 23, 469-480. [Google Scholar] [CrossRef] [PubMed]