脂肪组织血管重塑及其与慢性炎症的相互作用

肥胖机体胰岛素抵抗会引起血管并发症已得到认同,但新近关于肥胖机体慢性炎症的研究发现,在出现胰岛素抵抗前脂肪组织脉管系统已发生功能障碍。本研究分析脂肪组织毛细血管发生变化与缺氧的关系和缺氧与慢性炎症的关系,认为肥胖机体脂肪组织毛细血管发生变化,引起脂肪组织缺氧;缺氧诱导慢性炎症,肥胖关联的炎症又引起脂肪组织血管重塑,加剧脂肪组织功能障碍和胰岛素抵抗;提出在肥胖者体内,脂肪组织血管重塑能够调控慢性炎症和全身胰岛素敏感性。     

脂肪组织功能紊乱与肥胖和糖尿病

脂肪组织是机体的重要器官,主要负责能量的储存和代谢,同时分泌多种激素和细胞因子,参与机体生理功能的调控。近年来的研究表明脂肪组织的功能紊乱与肥胖和糖尿病密切相关,为进一步探讨两者的关系,综述了脂肪组织的生理和内分泌功能以及脂肪组织功能紊乱与胰岛素抵抗、肥胖和糖尿病发生、发展的关系。     

Adipokine在肥胖症及胰岛素抵抗中的作用（综述）

从Adipokines与胰岛素抵抗的关系,Adipokines与肥胖者脂肪组织巨噬细胞浸润,炎症与胰岛素抵抗信号转导,内质网应激与胰岛素抵抗等方面综述了Adipokines在肥胖症及胰岛素抵抗中的作用;并着重探讨了肥胖,adipokines,炎症,胰岛素抵抗四者之间的关系。     

Macrophage-specific PPARgamma controls alternative activation and improves insulin resistance

Obesity and insulin resistance, the cardinal features of metabolic syndrome, are closely associated with a state of low-grade inflammation. In adipose tissue chronic overnutrition leads to macrophage infiltration, resulting in local inflammation that potentiates insulin resistance. For instance, transgenic expression of Mcp1 (also known as chemokine ligand 2, Ccl2) in adipose tissue increases macrophage infiltration, inflammation and insulin resistance. Conversely, disruption of Mcp1 or its receptor Ccr2 impairs migration of macrophages into adipose tissue, thereby lowering adipose tissue inflammation and improving insulin sensitivity. These findings together suggest a correlation between macrophage content in adipose tissue and insulin resistance. However, resident macrophages in tissues display tremendous heterogeneity in their activities and functions, primarily reflecting their local metabolic and immune microenvironment. While Mcp1 directs recruitment of pro-inflammatory classically activated macrophages to sites of tissue damage, resident macrophages, such as those present in the adipose tissue of lean mice, display the alternatively activated phenotype. Despite their higher capacity to repair tissue, the precise role of alternatively activated macrophages in obesity-induced insulin resistance remains unknown. Using mice with macrophage-specific deletion of the peroxisome proliferator activated receptor-gamma (PPARgamma), we show here that PPARgamma is required for maturation of alternatively activated macrophages. Disruption of PPARgamma in myeloid cells impairs alternative macrophage activation, and predisposes these animals to development of diet-induced obesity, insulin resistance, and glucose intolerance. Furthermore, gene expression profiling revealed that downregulation of oxidative phosphorylation gene expression in skeletal muscle and liver leads to decreased insulin sensitivity in these tissues. Together, our findings suggest that resident alternatively activated macrophages have a beneficial role in regulating nutrient homeostasis and suggest that macrophage polarization towards the alternative state might be a useful strategy for treating type 2 diabetes.     

Recent advances in brown adipose tissue biology

In mammals, white adipose tissue （WAT） store energy, whereas brown adipose tissue （BAT） burns energy. As a thermogenic organ, BAT can help maintain body temperature during cold exposure. Owing to its important roles in energy metabolism and regulating triacylglycerol levels, BAT has received great attention in treating obesity and its related diseases. Recent studies have suggested that BAT may secrete factor（s）—batokines—to regulate whole- body energy metabolism. In this review, we summarize the recent advances in the formation and function of BAT, as well as molecules that regulate the activity of BAT and beige fat.     

Dysfunction of lipid sensor GPR120 leads to obesity in both mouse and human

Free fatty acids provide an important energy source as nutrients, and act as signalling molecules in various cellular processes. Several G-protein-coupled receptors have been identified as free-fatty-acid receptors important in physiology as well as in several diseases. GPR120 (also known as O3FAR1) functions as a receptor for unsaturated long-chain free fatty acids and has a critical role in various physiological homeostasis mechanisms such as adipogenesis, regulation of appetite and food preference. Here we show that GPR120-deficient mice fed a high-fat diet develop obesity, glucose intolerance and fatty liver with decreased adipocyte differentiation and lipogenesis and enhanced hepatic lipogenesis. Insulin resistance in such mice is associated with reduced insulin signalling and enhanced inflammation in adipose tissue. In human, we show that GPR120 expression in adipose tissue is significantly higher in obese individuals than in lean controls. GPR120 exon sequencing in obese subjects reveals a deleterious non-synonymous mutation (p.R270H) that inhibits GPR120 signalling activity. Furthermore, the p.R270H variant increases the risk of obesity in European populations. Overall, this study demonstrates that the lipid sensor GPR120 has a key role in sensing dietary fat and, therefore, in the control of energy balance in both humans and rodents.     

Adipose-selective targeting of the GLUT4 gene impairs insulin action in muscle and liver

The earliest defect in developing type 2 diabetes is insulin resistance, characterized by decreased glucose transport and metabolism in muscle and adipocytes. The glucose transporter GLUT4 mediates insulin-stimulated glucose uptake in adipocytes and muscle by rapidly moving from intracellular storage sites to the plasma membrane. In insulin-resistant states such as obesity and type 2 diabetes, GLUT4 expression is decreased in adipose tissue but preserved in muscle. Because skeletal muscle is the main site of insulin-stimulated glucose uptake, the role of adipose tissue GLUT4 downregulation in the pathogenesis of insulin resistance and diabetes is unclear. To determine the role of adipose GLUT4 in glucose homeostasis, we used Cre/loxP DNA recombination to generate mice with adipose-selective reduction of GLUT4 (G4A-/-). Here we show that these mice have normal growth and adipose mass despite markedly impaired insulin-stimulated glucose uptake in adipocytes. Although GLUT4 expression is preserved in muscle, these mice develop insulin resistance in muscle and liver, manifested by decreased biological responses and impaired activation of phosphoinositide-3-OH kinase. G4A-/- mice develop glucose intolerance and hyperinsulinaemia. Thus, downregulation of GLUT4 and glucose transport selectively in adipose tissue can cause insulin resistance and thereby increase the risk of developing diabetes.     

Dynamics of human adipose lipid turnover in health and metabolic disease

Adipose tissue mass is determined by the storage and removal of triglycerides in adipocytes. Little is known, however, about adipose lipid turnover in humans in health and pathology. To study this in vivo, here we determined lipid age by measuring (14)C derived from above ground nuclear bomb tests in adipocyte lipids. We report that during the average ten-year lifespan of human adipocytes, triglycerides are renewed six times. Lipid age is independent of adipocyte size, is very stable across a wide range of adult ages and does not differ between genders. Adipocyte lipid turnover, however, is strongly related to conditions with disturbed lipid metabolism. In obesity, triglyceride removal rate (lipolysis followed by oxidation) is decreased and the amount of triglycerides stored each year is increased. In contrast, both lipid removal and storage rates are decreased in non-obese patients diagnosed with the most common hereditary form of dyslipidaemia, familial combined hyperlipidaemia. Lipid removal rate is positively correlated with the capacity of adipocytes to break down triglycerides, as assessed through lipolysis, and is inversely related to insulin resistance. Our data support a mechanism in which adipocyte lipid storage and removal have different roles in health and pathology. High storage but low triglyceride removal promotes fat tissue accumulation and obesity. Reduction of both triglyceride storage and removal decreases lipid shunting through adipose tissue and thus promotes dyslipidaemia. We identify adipocyte lipid turnover as a novel target for prevention and treatment of metabolic disease.     

A role for brown adipose tissue in diet-induced thermogenesis

Measurement of energy balance during voluntary overeating in rats unequivocally establishes the quantitative importance of diet-induced thermogenesis in energy balance. Like cold-induced thermogenesis, this form of heat production involves changes in the activity of the sympathetic nervous system and brown adipose tissue which suggest that this tissue may determine metabolic efficiency and resistance to obesity.     

肥胖／糖尿病过程中大鼠不同部位脂肪细胞大小的比较

为比较大鼠肥胖／糖尿病过程中脂肪分布及脂肪细胞大小的变化,初步阐明脂肪细胞大小与2型糖尿病发生相关性。将Wistar雄性大鼠随机分为3组,每组12只：普通饮食组（正常对照）,高脂饮食组（肥胖）,高脂饮食＋链脲佐菌素组（糖尿病组）。第0周随机抽取6只大鼠处死后,取皮下脂肪及腹膜内脂肪,用2．5％甲醛乙醇溶液固定,进行石蜡包埋,HE染色,制成切片。在400倍光学显微镜下随机选取10个视野检测统计脂肪细胞数量及面积大小（mm^2）。在饲养过程中分别选取第6、9、12、14周等4个时间点,每个时间点各组随机处死2只大鼠,取皮下脂肪及腹膜内脂肪进行相同处理。同时,在各个时间点对大鼠体重、血糖进行检测。各组大鼠皮下脂肪细胞与腹膜内脂肪细胞大小差异均有统计学意义（F=9．653,P=0．001;F=160．605,P=0．000）,其中正常组与肥胖组、正常组与糖尿病组差异都有统计学意义,而肥胖组与糖尿病组差异无统计学意义。不同部位脂肪细胞大小的差异无统计学意义。脂肪细胞的体积增大,与大鼠体重及血糖变化相平行。大鼠脂肪细胞的体积增大与肥胖／糖尿病的演进过程相平行,大鼠脂肪组织的分布与脂肪细胞的大小无明显相关性。     

PPAR-γ is a major driver of the accumulation and phenotype of adipose tissue Treg cells

Obesity and type-2 diabetes have increased markedly over the past few decades, in parallel. One of the major links between these two disorders is chronic, low-grade inflammation. Prolonged nutrient excess promotes the accumulation and activation of leukocytes in visceral adipose tissue (VAT) and ultimately other tissues, leading to metabolic abnormalities such as insulin resistance, type-2 diabetes and fatty-liver disease. Although invasion of VAT by pro-inflammatory macrophages is considered to be a key event driving adipose-tissue inflammation and insulin resistance, little is known about the roles of other immune system cell types in these processes. A unique population of VAT-resident regulatory T (Treg) cells was recently implicated in control of the inflammatory state of adipose tissue and, thereby, insulin sensitivity. Here we identify peroxisome proliferator-activated receptor (PPAR)-γ, the 'master regulator' of adipocyte differentiation, as a crucial molecular orchestrator of VAT Treg cell accumulation, phenotype and function. Unexpectedly, PPAR-γ expression by VAT Treg cells was necessary for complete restoration of insulin sensitivity in obese mice by the thiazolidinedione drug pioglitazone. These findings suggest a previously unknown cellular mechanism for this important class of thiazolidinedione drugs, and provide proof-of-principle that discrete populations of Treg cells with unique functions can be precisely targeted to therapeutic ends.     

Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes

In obesity and type 2 diabetes, expression of the GLUT4 glucose transporter is decreased selectively in adipocytes. Adipose-specific Glut4 (also known as Slc2a4) knockout (adipose-Glut4(-/-)) mice show insulin resistance secondarily in muscle and liver. Here we show, using DNA arrays, that expression of retinol binding protein-4 (RBP4) is elevated in adipose tissue of adipose-Glut4(-/-) mice. We show that serum RBP4 levels are elevated in insulin-resistant mice and humans with obesity and type 2 diabetes. RBP4 levels are normalized by rosiglitazone, an insulin-sensitizing drug. Transgenic overexpression of human RBP4 or injection of recombinant RBP4 in normal mice causes insulin resistance. Conversely, genetic deletion of Rbp4 enhances insulin sensitivity. Fenretinide, a synthetic retinoid that increases urinary excretion of RBP4, normalizes serum RBP4 levels and improves insulin resistance and glucose intolerance in mice with obesity induced by a high-fat diet. Increasing serum RBP4 induces hepatic expression of the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) and impairs insulin signalling in muscle. Thus, RBP4 is an adipocyte-derived 'signal' that may contribute to the pathogenesis of type 2 diabetes. Lowering RBP4 could be a new strategy for treating type 2 diabetes.     

Partial leptin deficiency and human adiposity.

The adipocyte-derived hormone leptin is crucial for energy homeostasis in mammals; mice and humans without it suffer from a voracious appetite and extreme obesity. The effect on energy balance of variations in plasma leptin above a minimal threshold is uncertain, however, particularly in humans. Here we examine a group of individuals who are genetically partially deficient in leptin, and show that differences in circulating leptin levels within the range found in normal human populations can directly influence the laying down of fat tissue (adiposity).     

Regulation of circadian behaviour and metabolism by synthetic REV-ERB agonists

Synchronizing rhythms of behaviour and metabolic processes is important for cardiovascular health and preventing metabolic diseases. The nuclear receptors REV-ERB-α and REV-ERB-β have an integral role in regulating the expression of core clock proteins driving rhythms in activity and metabolism. Here we describe the identification of potent synthetic REV-ERB agonists with in vivo activity. Administration of synthetic REV-ERB ligands alters circadian behaviour and the circadian pattern of core clock gene expression in the hypothalami of mice. The circadian pattern of expression of an array of metabolic genes in the liver, skeletal muscle and adipose tissue was also altered, resulting in increased energy expenditure. Treatment of diet-induced obese mice with a REV-ERB agonist decreased obesity by reducing fat mass and markedly improving dyslipidaemia and hyperglycaemia. These results indicate that synthetic REV-ERB ligands that pharmacologically target the circadian rhythm may be beneficial in the treatment of sleep disorders as well as metabolic diseases.     

辣椒碱调节机体糖脂代谢的机理研究

辣椒碱是辣椒中含有的一类具有辛辣刺激口感的生物碱,主要成分是辣椒素和二氢辣椒素。许多研究表明辣椒碱具有镇痛、抗癌、减肥、降糖、降脂和抗炎症的作用。血脂血糖代谢异常是导致肥胖、高脂血症和糖尿病的主要因素之一,辣椒碱在动物和人体实验中均表现出良好的控糖、降脂、减肥功效,其作用效果和作用机理引起广泛关注。综述了辣椒碱在调节机体糖脂代谢方面的作用效果,以及辣椒碱作用辣椒素受体TRPV1通道、膳食糖脂的消化吸收、肠道菌群组成以及肝脏、胰腺、脂肪组织、神经系统中与糖脂代谢相关酶、基因调控糖脂代谢的可能机理,以期为辣椒碱的深度开发利用和科学消费提供参考。