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Le tissu adipeux est-il une cible thérapeutique pertinente de l’obésité?

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Physiologie et physiopathologie du tissu adipeux

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Résumé

Les conséquences physiopathologiques de l’excès de tissu adipeux (TA) sont schématiquement de deux ordres: 1) mécaniques, elles concernent les obésités sévères; 2) métaboliques, au sens large, leur prévalence et leur sévérité sont influencées par de nombreux facteurs innés ou acquis que nous allons analyser ici. Si l’on veut judicieusement définir les cibles thérapeutiques, il est donc important de pouvoir caractériser les personnes obèses à risque ou non de complications métaboliques [1–3]. Le sexe masculin, l’âge, la corpulence et la distribution androïde du TA sont des facteurs bien connus [4, 5]. De nouveaux concepts ont été proposés depuis une dizaine d’années comme l’hypothèse de la capacité d’expansion limitée du TA, la dysfonction adipocytaire, les anomalies du trafic des acides gras non estérifiés (AGNE), le rôle spécifique du TA viscéral (TAV), les dépôts ectopiques de lipides, l’inflammation de faible intensité du TA, les lipodystrophies acquises ou la lipotoxicité [2, 5–20]. En d’autres termes, le TA apparaît comme « malade ou non fonctionnel » dans certaines circonstances que nous nous proposons d’analyser.

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Authors and Affiliations

  1. Faculté de Médecine, Université de Lorraine. Service de diabétologie, maladies métaboliques, nutrition, CHRU de Nancy, Hôpital Brabois Adultes, Rue du Morvan, 54500, Vandœuvre-lès-Nancy, France

    O. Ziegler

  2. Service d’endocrinologie — maladies métaboliques et nutrition, Hôpital Nord Laennec, boulevard Jacques-Monod, Saint-Herblain, 44093, Nantes Cedex 1, France

    M. Krempf

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Ziegler, O., Krempf, M. (2013). Le tissu adipeux est-il une cible thérapeutique pertinente de l’obésité?. In: Physiologie et physiopathologie du tissu adipeux. Springer, Paris. https://doi.org/10.1007/978-2-8178-0332-6_26

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