脂质异位沉积的组织特异性代谢

Maengkyu Kim
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引用次数: 2

摘要

脂质异位沉积的组织特异性代谢现在已知甘油三酯在非脂肪组织如肝脏、骨骼肌、胰腺和心脏中蓄积。异位脂肪的过度积累导致器官内功能和机制的异常病理生理变化。例如,肝细胞和骨骼肌细胞内过多的异位脂肪积累通过诱导胰岛素的信息传递受损而导致胰岛素抵抗。异位脂肪积聚在心外膜和心肌细胞内与胰岛素抵抗和收缩功能障碍有关。活检、超声心动图和质子磁共振波谱评估的异位脂肪含量与特定组织和全身胰岛素抵抗密切相关。异位脂肪被认为比内脏脂肪组织更能预测胰岛素抵抗。因此,肝脏、胰腺、骨骼肌和心脏的甘油三酯升高可能是代谢异常导致胰岛素抵抗,进而发展为2型糖尿病的一部分。最近的研究表明,运动、饮食和药物可以通过改变异位脂肪含量来降低胰岛素抵抗。根据这些研究,运动、饮食和药物影响脂肪基因表达的机制是不同的,尤其是脂质代谢产物,包括二酰基甘油和神经酰胺。随着与异位脂肪组织特异性相关的新型生化标志物的开发,代谢性疾病的预防和治疗有望在不久的将来实现。
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Tissue Specific-Metabolism of Lipids for Ectopic Deposition
Tissue Specific-Metabolism of Lipids for Ectopic Deposition It is now known that triglyceride accumulates in non-adipose tissues as in liver, skeletal muscle, pancreas, and heart. Excessive accumulation of ectopic fat causes abnormal pathophysiological changes in function and mechanism within the organ. For example, excessive ectopic fat accumulation within the hepatic cells and skeletal muscle cells results in insulin resistance by inducing impairment of information transport of insulin. Ectopic fats accumulated within the cardiac epicardium and cardiac cells are associated with insulin resistance and systolic dysfunction. The ectopic fat content assessed by biopsy, echocardiograph, and proton magnetic resonance spectroscopy correlates closely with specific tissues and overall systemic insulin resistance. Ectopic fat is considered a better and a stronger predictor of insulin resistance than visceral adipose tissue. Therefore, increased triglycerides in liver, pancreas, skeletal muscle, and heart may be a part of metabolic abnormality leading to insulin resistance, and subsequent development of Type 2 diabetes mellitus. Recent studies showed that exercise, diet, and medication, decreased insulin resistance by changing the ectopic fat contents. According to these studies, the mechanisms by which exercise, diet, and medication influence lipogenic gene expressions toward intramyocellular fat contents are different, in particular, lipid metabolites including diacylglycerols and ceramides. Prevention and treatment of metabolic disease may be expected in the near future with the development of novel biochemical markers that have specific correlation to ectopic fat tissues.
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