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Biologie des viszeralen Fetts

The biology of visceral fat

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Zusammenfassung

Viszerale Adipositas ist ein unabhängiger Risikofaktor für die Entstehung kardiovaskulärer Erkrankungen und des Typ-2-Diabetes. Diesem Zusammenhang liegen sehr wahrscheinlich biologische Eigenschaften des viszeralen Fettgewebes zugrunde, die es grundlegend vom subkutanen Fettgewebe unterscheiden. Dabei spielt die anatomische Lokalisation des viszeralen Fettgewebes eine besondere Rolle, da Metaboliten und Adipokine aus dem viszeralen Fett in das Pfortadersystem freigesetzt werden und damit unverdünnt in der Leber wirken. Zusätzlich unterscheidet sich das viszerale vom subkutanen Fettgewebe durch eine niedrigere Insulinsensitivität, eine höhere Katecholaminempfindlichkeit und damit eine höhere Lipolyserate, die zur verstärkten Freisetzung freier Fettsäuren führt. Zu den molekularen Mechanismen, die den Zusammenhang zwischen viszeraler Adipositas und erhöhtem kardiometabolischen Risiko erklären, gehören spezifische Eigenschaften viszeraler Fettzellen, die sich in der Expression beziehungsweise Sekretion von Rezeptoren, Signalproteinen und direkt oder indirekt atherogen wirkender Adipokine von Adipozyten anderer Fettgewebslokalisationen unterscheiden.

Abstract

Visceral obesity is an independent risk factor for the development of cardiovascular diseases and type 2 diabetes. This is likely to be due to biological characteristics of visceral tissue, which are different from those of subcutaneous adipose tissue in terms of decreased insulin sensitivity and increased lipolytic activity. In addition, the anatomical site of visceral fat could be one potential reason for the increased cardio-metabolic risk associated with visceral obesity. Visceral adipose tissue drains into the portal vein and therefore the liver is exposed to the undiluted metabolites and adipokines released from visceral fat. There are profound differences between visceral and subcutaneous adipocytes in the metabolism, expression of specific receptors and secretion of a specific adipokine pattern, which could contribute to the adverse consequences of visceral obesity.

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Literatur

  1. Arner P, Hellstrom L, Wahrenberg H et al. (1990) Beta-adrenorezeptor expression in human fat cells from different regions. J Clin Invest 86: 1595–1600

    Article  PubMed  CAS  Google Scholar 

  2. Berndt J, Klöting N, Kralisch S et al. (2005) Plasma visfatin concentrations and fat depot-specific mRNA expression in humans. Diabetes 54: 2911–2916

    Article  PubMed  CAS  Google Scholar 

  3. Blüher M, Paschke R (2003) Visceral adipose tissue and metabolic syndrome. Dtsch Med Wochenschr 128: 2319–2323

    Article  PubMed  Google Scholar 

  4. Blüher M, Engeli, S, Klöting, N et al. (2006) Dysregulation of the Peripheral and Adipose-Tissue Endocannabinoid System in Human Abdominal Obesity. Diabetes 55: 3053–3060

    Article  PubMed  CAS  Google Scholar 

  5. Bouchard C, Tremblay A, Depres JP et al. (1990) The response to long-term overfeeding in identical twins. N Engl J Med 322: 1477–1482

    Article  PubMed  CAS  Google Scholar 

  6. Fain JN, Madan AK, Hiler ML et al. (2004) Comparison of the release of adipokines by adipose tissue, adipose tissue matrix and adipocytes from visceral and subcutaneous abdominal adipose tissue of obese humans. Endocrinology 145: 2273–2282

    Article  PubMed  CAS  Google Scholar 

  7. Frayn KN (2000) Visceral fat and insulin resistance – causative or correlative? Br J Nutr 83: S71–S77

    Article  PubMed  CAS  Google Scholar 

  8. Flier JS, Cook KS, Usher P et al. (1987) Severely impaired adipsin expression in genetic and acquired obesity. Science 237: 405–408

    Article  PubMed  CAS  ADS  Google Scholar 

  9. Fujioka S, Matsuzawa Y, Tokunaga K et al. (1987) Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism 36: 54–59

    Article  PubMed  CAS  Google Scholar 

  10. Fukuhara A, Matsuda M, Nishizawa M et al. (2005) Visfatin: a protein secreted by visceral fat that mimics the effects of insulin. Science 307: 426–430

    Article  PubMed  CAS  ADS  Google Scholar 

  11. Gesta S, Blüher M, Yamamoto Y et al. (2006) Evidence for a role of developmental genes in the origin of obesity and body fat distribution. Proc Natl Acad Sci USA 103: 6676–6681

    Article  PubMed  CAS  ADS  Google Scholar 

  12. Goodpaster BH, Thaete FL, Simoneau JA et al. (1997) Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat. Diabetes 46: 1579–1585

    Article  PubMed  CAS  Google Scholar 

  13. Graham TE, Yang Q, Blüher M et al. (2006) Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 354: 2552–2563

    Article  PubMed  CAS  Google Scholar 

  14. Harman-Boehm I, Blüher M, Redel H et al. Macrophage infiltration into omental versus subcutaneous fat: effect of regional adiposity and the co-morbidities of obesity. J Clin Endocrinol Metab (in press)

  15. Hauner H, Wabitsch M, Pfeiffer EF (1988) Differentiation of adipocyte precursor cells from obese and nonobese adult women and from different adipose tissue sites. Horm Metab Res 19: 35–39

    CAS  Google Scholar 

  16. Hellmer J, Marcus C, Sonnenfeld T et al. (1992) Mechanisms for differences in lipolysis between human fat cells from different regions. J Clin Endocrinol Metab 75: 15–20

    Article  PubMed  CAS  Google Scholar 

  17. Hida K, Wada J, Eguchi J et al. (2005) Visceral adipose tissue-derived serine protease inhibitor: a unique insulin-sensitizing adipocytokine in obesity. Proc Natl Acad Sci USA 102: 10610–10615

    Article  PubMed  CAS  ADS  Google Scholar 

  18. Janke J, Engeli S, Boschmann M et al. (2006) Retinol-binding protein 4 in human obesity. Diabetes 55: 2805–2810

    Article  PubMed  CAS  Google Scholar 

  19. Kadowaki T, Yamauchi T, Kubota N et al. (2006) Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J Clin Invest 116: 1784–1792

    Article  PubMed  CAS  Google Scholar 

  20. Kershaw EE, Flier JS (2004) Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 89: 2548–2556

    Article  PubMed  CAS  Google Scholar 

  21. Klein S, Fontana L, Young VL et al. (2004) Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350: 2549–2557

    Article  PubMed  CAS  Google Scholar 

  22. Klöting N, Berndt J, Kralisch S et al. (2006) Vaspin gene expression in human adipose tissue: association with obesity and type 2 diabetes. Biochem Biophys Res Commun 339: 430–436

    Article  PubMed  CAS  Google Scholar 

  23. Montague CT, O’Rahilly S (2000) The perils of portliness causes and consequences of visceral adiposity. Diabetes 49: 883–888

    Article  PubMed  CAS  Google Scholar 

  24. Ohlson LO, Larsson B, Svardsudd K et al. (1985) The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes 34: 1055–1058

    Article  PubMed  CAS  Google Scholar 

  25. Perusse L, Depres J-P, Lemieux S et al. (1996) Familial aggregation of abdominal viszeral fat: results from the Quebec family study. Metabolism 45: 378–382

    Article  PubMed  CAS  Google Scholar 

  26. Rice T, Despres JP, Daw EW et al. (1997) Familial resemblance for abdominal visceral fat: the HERITAGE Family Study. Int J Obes 21: 1024–1031

    Article  CAS  Google Scholar 

  27. Ruge T, Sukonina V, Myrnas T et al. (2006) Lipoprotein lipase activity/mass ratio is higher in omental than in subcutaneous adipose tissue. Eur J Clin Invest 36: 16–21

    Article  PubMed  CAS  Google Scholar 

  28. Siiteri PK (1987) Adipose tissue as a source of hormones. Am J Clin Nutr 45: 277–282

    PubMed  CAS  Google Scholar 

  29. Sjöstrom L, Kvist H, Cederblad A et al. (1986) Determination of total adipose tissue and body fat in women by computed tomography, 40 K, and tritium. Am J Physiol 250: E736–745

    PubMed  Google Scholar 

  30. Smith SR, Zachwieja JJ (1999) Visceral adipose tissue: a critical review of intervention strategies. Int J Obes 23: 329–335

    Article  CAS  Google Scholar 

  31. Thörne A, Lönnqvist F, Apelman J et al. (2002) A pilot study of long-term effects of a novel obesity treatment: omentectomy in connection with adjustable gastric banding. Int J Obes Relat Metab Disord 26: 193–199

    Article  PubMed  Google Scholar 

  32. Wajchenberg BL (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21: 697–738

    Article  PubMed  CAS  Google Scholar 

  33. Yang Q, Graham TE, Mody N et al. (2005) Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 436: 356–362

    Article  PubMed  CAS  ADS  Google Scholar 

  34. Yusuf S, Hawken S, Ounpuu S et al.; INTERHEART Study Investigators (2005) Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 366: 1640–1649

    Article  PubMed  Google Scholar 

  35. Zhang Y, Proenca R, Maffei M et al. (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372: 425–432

    Article  PubMed  CAS  ADS  Google Scholar 

  36. Zierath JR, Livingston JN, Thörne A et al. (1998) Regional difference in insulin inhibition of non-esterified fatty acid release from human adipocytes: relation to insulin receptor phosphorylation and intracellular signalling through the insulin receptor substrate-1 pathway. Diabetologia 41: 1343–1354

    Article  PubMed  CAS  Google Scholar 

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Danksagung

Diese Publikation wurde durch die Deutsche Forschungsgemeinschaft (DFG), BL 580/3–1, sowie durch die Klinische Forschergruppe, KFO 152 (Teilprojekt 3, BL 833/1–1), unterstützt.

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Klöting, N., Stumvoll, M. & Blüher, M. Biologie des viszeralen Fetts. Internist 48, 126–133 (2007). https://doi.org/10.1007/s00108-006-1781-x

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