脓毒症中的“肥胖悖论”:临床证据、 潜在机制与应用挑战
The “Obesity Paradox” in Sepsis: Clinical Evidence, Underlying Mechanisms, and Research Challenges
DOI: 10.12677/acm.2026.1641575, PDF,   
作者: 李文琦, 曹 炬*:重庆医科大学附属第一医院检验科,重庆
关键词: 脓毒症肥胖肥胖悖论脂肪因子Sepsis Obesity Obesity Paradox Adipokines
摘要: 脓毒症是由感染引发的宿主免疫反应失调所致的危及生命的器官功能障碍,大量观察性研究发现,在脓毒症患者中存在“肥胖悖论”现象:超重或肥胖状态与较低的短期死亡率相关。本文系统综述了支持该现象的临床流行病学证据,并深入探讨了其潜在的病理生理学机制,主要包括:代谢储备与能量缓冲、免疫代谢重组与器官保护。同时,本文也指出了当前脓毒症中“肥胖悖论”现象的研究面临的挑战及脂肪因子的应用前景。最后,对未来研究方向提出展望,强调需要采用更精确的身体成分测量方法、开展更多前瞻性研究并深化脂肪因子的机制探索,以期为脓毒症的精准诊疗提供新思路。
Abstract: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host immune response to infection. Numerous observational studies have identified the “obesity paradox” in septic patients, wherein overweight or obese status is associated with lower short-term mortality. This article systematically reviews the clinical epidemiological evidence supporting this phenomenon and delves into its underlying pathophysiological mechanisms, primarily including: metabolic reserve and energy buffering, immunometabolic reprogramming and organ protection. It also highlights the challenges in current research and the potential application of adipokines. Finally, future research directions are proposed, emphasizing the need for more precise body composition measurements, additional prospective studies, and deeper exploration of adipokine mechanisms, aiming to provide new insights for the precise diagnosis and treatment of sepsis.
文章引用:李文琦, 曹炬. 脓毒症中的“肥胖悖论”:临床证据、 潜在机制与应用挑战[J]. 临床医学进展, 2026, 16(4): 3163-3171. https://doi.org/10.12677/acm.2026.1641575

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