RESUMEN
Adiposopathy, or sick fat, refers to adipose tissue dysfunction that can lead to several complications such as dyslipidemia, insulin resistance, and hyperglycemia. The relative contribution of adiposopathy in predicting insulin resistance remains unclear. We investigated the relationship between adiposopathy, as assessed as a low plasma adiponectin/leptin ratio, with anthropometry, body composition (hydrostatic weighing), insulin sensitivity (hyperinsulinemic-euglycemic clamp), inflammation, and fitness level (ergocycle VO2max, mL/kgFFM/min) in 53 men (aged 34-53 years) from four groups: sedentary controls without obesity (body mass index [BMI] <25 kg/m2), sedentary with obesity (BMI > 30 kg/m2), sedentary with obesity and glucose intolerance, and endurance trained active without obesity. The adiponectin/leptin ratio was the highest in trained men (4.75 ± 0.82) and the lowest in glucose intolerant subjects with obesity (0.27 ± 0.06; ANOVA p < 0.0001) indicating increased adiposopathy in those with obesity. The ratio was negatively associated with adiposity (e.g., waist circumference, r = −0.59, p < 0.01) and positively associated with VO2max (r = 0.67, p < 0.01) and insulin sensitivity (M/I, r = 0.73, p < 0.01). Multiple regression analysis revealed fitness as the strongest independent predictor of insulin sensitivity (partial R2 = 0.61). While adiposopathy was also an independent and significant contributor (partial R2 = 0.10), waist circumference added little power to the model (partial R2 = 0.024). All three variables remained significant independent predictors when trained subjects were excluded from the model. Plasma lipids were not retained in the model. We conclude that low fitness, adiposopathy, as well as adiposity (and in particular abdominal obesity) are independent contributors to insulin resistance in men without diabetes (AU)
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Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Adiposidad , Tolerancia al Ejercicio , Resistencia a la Insulina , Obesidad Abdominal/complicaciones , Paniculitis/metabolismo , Envejecimiento , Aptitud Física , Adiponectina/sangre , Índice de Masa Corporal , Conducta Sedentaria , Circunferencia de la Cintura , Estudios de Cohortes , Estudios Transversales , Intolerancia a la Glucosa/complicaciones , Leptina/sangre , Consumo de OxígenoRESUMEN
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Asunto(s)
Femenino , Humanos , Paniculitis/sangre , Paniculitis/metabolismo , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/enzimología , Coagulación Sanguínea/genética , Biopsia/métodos , Biopsia/enfermería , Paniculitis/genética , Paniculitis/patología , Enfermedades Inflamatorias del Intestino/genética , Enfermedades Inflamatorias del Intestino/metabolismo , Coagulación Sanguínea/fisiología , BiopsiaRESUMEN
The authors analyze insulin resistance, the metabolic syndrome and endothelial dysfunction as consequence of a common antecedent, a low grade inflammation, indicating that in obesity there is a chronically activated inflammatory state of the adipose tissue. Furthermore, the inflammatory signaling is discussed according to the adipose tissue depot, visceral or subcutaneous.
Os autores analisam a resistência à insulina, a síndrome metabólica e a disfunção endotelial como consequência de um antecedente comum, a inflamação de baixo nível, o que mostra que a obesidade é um estado inflamatório cronicamente ativado do tecido adiposo. Discute-se, aqui, a sinalização inflamatória de acordo com a localização do tecido adiposo subcutâneo ou visceral.
Asunto(s)
Animales , Humanos , Tejido Adiposo/fisiología , Aterosclerosis/fisiopatología , Resistencia a la Insulina/fisiología , Síndrome Metabólico/fisiopatología , Obesidad/fisiopatología , Paniculitis/fisiopatología , Adipoquinas/metabolismo , Tejido Adiposo/metabolismo , Aterosclerosis/etiología , Endotelio Vascular/metabolismo , Mediadores de Inflamación/metabolismo , Grasa Intraabdominal/metabolismo , Síndrome Metabólico/etiología , Obesidad/complicaciones , Obesidad/metabolismo , Paniculitis/metabolismo , Grasa Subcutánea/metabolismoRESUMEN
Presentamos el caso de una mujer de 30 años, diagnosticada hacía 2 años de necrobiosis lipoídica por la presencia de lesiones típicas en su pierna izquierda. Consultó en nuestro servicio por la aparición durante el último mes de lesiones nodulares eritematosas muy similares al eritema nodoso en ambos muslos y pierna izquierda. La biopsia cutánea reveló una paniculitis por necrobiosis lipoídica.No se encontró ninguna patología asociada y la respuesta al tratamiento fue favorable (AU)