Metabolic Syndrome Pathophysiology: The Role of Adipose Tissue

Laclaustra, M. ; Corella, D. ; Ordovas, J. M.

Resumen: Several pathophysiological explanations for the metabolic syndrome have been proposed involving insulin resistance, chronic inflammation and ectopic fat accumulation following adipose tissue saturation. However, current concepts create several paradoxes, including limited cardiovascular risk reduction with intensive glucose control in diabetics, therapies that result in weight gain (PPAR agonists), and presence of some of the metabolic traits among some lipodystrophies. We propose the functional failure of an organ, in this case, the adipose tissue as a model to interpret its manifestations and to reconcile some of the apparent paradox. A cornerstone of this model is the failure of the adipose tissue to buffer postprandial lipids. In addition, homeostatic feedback loops guide physiological and pathological adipose tissue activities. Fat turnover is determined by a complex equilibrium in which insulin is a main factor but not the only one. Chronically inadequate energy balance may be a key factor, stressing the system. In this situation, an adipose tissue functional failure occurs resulting in changes in systemic energy delivery, impaired glucose consumption and activation of self-regulatory mechanisms that extend their influence to whole body homeostasis system. These include changes in adipokines secretion and vascular effects. The functional capacity of the adipose tissue varies among subjects explaining the incomplete overlap- ping among the metabolic syndrome and obesity. Variations at multiple gene loci will be partially responsible for these interindividual differences. Two of those candidate genes, the adiponectin (APM1) and the perilipin (PLIN) genes, are discussed in more detail

Idioma: Inglés

DOI: 10.1016/j.numecd.2006.10.005

Año: 2007

Publicado en: Nutrition, Metabolism and Cardiovascular Diseases 17, 2 (2007), 125-139
ISSN: 0939-4753

Factor impacto JCR: 3.174 (2007)

Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 17 / 75 = 0.227 (2007) - Q1 - T1
Categ. JCR: NUTRITION & DIETETICS rank: 10 / 56 = 0.179 (2007) - Q1 - T1
Categ. JCR: ENDOCRINOLOGY & METABOLISM rank: 35 / 91 = 0.385 (2007) - Q2 - T2

Tipo y forma: Artículo (Versión definitiva)