Biologie des viszeralen Fetts

Der Internist (Impact Factor: 0.31). 02/2007; 48(2):126-133. DOI: 10.1007/s00108-006-1781-x


Viszerale Adipositas ist ein unabhngiger Risikofaktor fr die Entstehung kardiovaskulrer 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 unverdnnt in der Leber wirken. Zustzlich unterscheidet sich das viszerale vom subkutanen Fettgewebe durch eine niedrigere Insulinsensitivitt, eine hhere Katecholaminempfindlichkeit und damit eine hhere Lipolyserate, die zur verstrkten Freisetzung freier Fettsuren fhrt. Zu den molekularen Mechanismen, die den Zusammenhang zwischen viszeraler Adipositas und erhhtem kardiometabolischen Risiko erklren, gehren 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.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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