人体白色脂肪组织：一种高度动态的代谢器官,Journal of Internal Medicine

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人体白色脂肪组织：一种高度动态的代谢器官
Journal of Internal Medicine ( IF 9.0 ) Pub Date : 2021-12-16 , DOI: 10.1111/joim.13435
Peter Arner ₁ , Mikael Rydén ₁

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最近的技术发展允许确定成年人脂肪细胞的年龄及其脂质。与之前的观点相反，这表明脂肪细胞（10%/年）及其单房脂滴（6 次/10 年）的高周转率。肥胖和脂肪组织由许多但很小的脂肪细胞组成（增生，一种良性脂肪表型）时，脂肪细胞更新增加。虽然脂肪量增加会增加脂肪细胞的数量和大小，但只有后者在减肥后会改变（减少），这可能会促进体重反弹。体脂过多的受试者的脂肪细胞脂质周转减弱。在皮下区域，这种失调已经发生在超重状态中，而在内脏仓库中，仅在严重肥胖中观察到。这可以解释为什么后者在超重/肥胖状态下特别有害，因为它允许内脏脂肪和肝脏之间更快的脂质流动。由于储存的甘油三酯的分解（脂肪分解）受损，脂肪脂质周转率在衰老过程中减少。如果这种下降没有通过减少脂肪细胞脂质摄取来补偿，体重会随着时间的推移而增加。与此一致，低脂解率是未来体重增加和葡萄糖不耐受的风险因素。在胰岛素抵抗和某些形式的血脂异常中，脂肪脂质周转率也会降低。总之，成年人的脂肪组织处于高度动态的状态。因此，脂肪细胞及其脂质更新的变化是常见代谢紊乱的病理生理学中需要考虑的新因素。

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Human white adipose tissue: A highly dynamic metabolic organ

Recent technological developments have allowed determination of the age of fat cells and their lipids in adult humans. In contrast to prior views, this has demonstrated a high turnover rate of the fat cells (10%/year) and their unilocular lipid droplets (six times/10 years). Fat cell turnover is increased in obesity and when adipose tissue is composed of many but small adipocytes (hyperplasia, a benign adipose phenotype). While fat mass gain increases adipocyte number and size, only the latter is altered (decreased) after weight loss, which may facilitate weight regain. Fat cell lipid turnover is attenuated in subjects with excess body fat. In the subcutaneous region, this dysregulation occurs already in the overweight state while in the visceral depot, it is only observed in severe obesity. This may explain why the latter depot is particularly pernicious in the overweight/obese state as it allows for more rapid lipid fluxes between visceral fat and the liver. Adipose lipid turnover decreases during ageing due to impaired breakdown (lipolysis) of stored triglycerides. If this decline is not compensated by reduced adipocyte lipid uptake, bodyweight will increase over time. In concordance with this, low lipolysis rates are a risk factor for future weight gain and glucose intolerance. Adipose lipid turnover is also decreased in insulin resistance and certain forms of dyslipidemia. Altogether, adult human adipose tissue is in a highly dynamic state. Alterations in the turnover of fat cells and their lipids are therefore novel factors to consider in the pathophysiology of common metabolic disorders.

更新日期：2021-12-16

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