The metabolic syndrome: common origins of a multifactorial disorder
Tóm tắt
The metabolic syndrome (MetS) represents a combination of cardiometabolic risk determinants including obesity (central adiposity), insulin resistance, glucose intolerance, dyslipidaemia, non-alcoholic fatty liver disease and hypertension. MetS is rapidly increasing in prevalence worldwide as a consequence of the continued obesity “epidemic”, and as a result will have a considerable impact on the global incidence of cardiovascular disease and type 2 diabetes. Currently, there is debate concerning whether the risk of cardiovascular disease is greater in patients diagnosed with MetS than that of the sum of the individual risk factors. At present, no unifying origin that can explain the pathogenesis of MetS has been identified and therefore no unique pharmacological treatment is available. This review summarises and critically evaluates the current clinical and scientific evidence supporting the existence of MetS as a multifactorial endocrine disease, for which maternal nutrition may be a common pathogenic mechanism. In addition, we suggest that ectopic fat accumulation (such as visceral and hepatic fat accumulation) and the proinflammatory state are central to the development of the MetS.
Từ khóa
Tài liệu tham khảo
Reaven, 1988, Banting lecture 1988. Role of insulin resistance in human disease, Diabetes, 37, 1595, 10.2337/diab.37.12.1595
Grundy, Metabolic syndrome: therapeutic considerations, Handb Exp Pharmacol, 107
Ferrannini, 2007, Metabolic syndrome: a solution in search of a problem, J Clin Endocrinol Metab, 92, 396, 10.1210/jc.2006-0944
Reaven, 2006, The metabolic syndrome: is this diagnosis necessary?, Am J Clin Nutr, 83, 1237, 10.1093/ajcn/83.6.1237
Kahn, 2005, The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes, Diabetologia, 48, 1684, 10.1007/s00125-005-1876-2
Schindler, 2007, The metabolic syndrome as an endocrine disease: is there an effective pharmacotherapeutic strategy optimally targeting the pathogenesis?, Ther Adv Cardiovasc Dis, 1, 7, 10.1177/1753944707082662
Poole, 2005, The metabolic syndrome and type 2 diabetes, Minerva Endocrinol, 30, 139
Pladevall, 2006, A single factor underlies the metabolic syndrome: a confirmatory factor analysis, Diabetes Care, 29, 113, 10.2337/diacare.29.01.06.dc05-0862
World Health Organization, 1999, WHO consultation: definition, diagnosis and clasification of diabetes mellitus and its complications
Balkau, 1999, Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR), Diabet Med, 16, 442, 10.1046/j.1464-5491.1999.00059.x
2001, Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III), JAMA, 285, 2486, 10.1001/jama.285.19.2486
Alberti, The metabolic syndrome: a new worldwide definition, Lancet, 366, 1059, 10.1016/S0140-6736(05)67402-8
Ritchie, 2007, The link between abdominal obesity, metabolic syndrome and cardiovascular disease, Nutr Metab Cardiovasc Dis, 17, 319, 10.1016/j.numecd.2006.07.005
Houston, 2005, Addressing the global cardiovascular risk of hypertension, dyslipidemia, and insulin resistance in the southeastern United States, Am J Med Sci, 329, 276, 10.1097/00000441-200506000-00008
Weiss, 2004, Obesity and the metabolic syndrome in children and adolescents, N Engl J Med, 350, 2362, 10.1056/NEJMoa031049
Must, 1999, The disease burden associated with overweight and obesity, JAMA, 282, 1523, 10.1001/jama.282.16.1523
Grandinetti, 1998, Prevalence of glucose intolerance among Native Hawaiians in two rural communities. Native Hawaiian Health Research (NHHR) Project, Diabetes Care, 21, 549, 10.2337/diacare.21.4.549
Grandinetti, 2007, Prevalence of diabetes and glucose intolerance in an ethnically diverse rural community of Hawaii, Ethn Dis, 17, 250
Suvd, 2002, Glucose intolerance and associated factors in Mongolia: results of a national survey, Diabet Med, 19, 502, 10.1046/j.1464-5491.2002.00737.x
Jonsson, 2002, Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22,025 men from an urban Swedish population, Int J Obes Relat Metab Disord, 26, 1046, 10.1038/sj.ijo.0802060
Carey, 1997, Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses’ Health Study, Am J Epidemiol, 145, 614, 10.1093/oxfordjournals.aje.a009158
Bays, 2007, Adiposopathy: treating pathogenic adipose tissue to reduce cardiovascular disease risk, Curr Treat Options Cardiovasc Med, 9, 259, 10.1007/s11936-007-0021-6
Bays, 2008, Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity, Expert Rev Cardiovasc Ther, 6, 343, 10.1586/14779072.6.3.343
Bays, “Sick fat,” metabolic disease, and atherosclerosis, Am J Med, S26
Hubert, 1983, Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study, Circulation, 67, 968, 10.1161/01.CIR.67.5.968
Urbina, 1999, Association of fasting blood sugar level, insulin level, and obesity with left ventricular mass in healthy children and adolescents: The Bogalusa Heart Study, Am Heart J, 138, 122, 10.1016/S0002-8703(99)70256-5
Haffner, 1987, Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids, and lipoproteins, Diabetes, 36, 43, 10.2337/diab.36.1.43
Han, 1995, Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample, BMJ, 311, 1401, 10.1136/bmj.311.7017.1401
Fontana, 2007, Visceral fat adipokine secretion is associated with systemic inflammation in obese humans, Diabetes, 56, 1010, 10.2337/db06-1656
McNeill, 2005, The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study, Diabetes Care, 28, 385, 10.2337/diacare.28.2.385
Hansson, 2004, Atherosclerosis and the immune system, Acta Paediatr Suppl, 93, 63, 10.1111/j.1651-2227.2004.tb00241.x
Aljada, 2004, Increase in intranuclear nuclear factor kappaB and decrease in inhibitor kappaB in mononuclear cells after a mixed meal: evidence for a proinflammatory effect, Am J Clin Nutr, 79, 682, 10.1093/ajcn/79.4.682
Dandona, 2005, Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation, Circulation, 111, 1448, 10.1161/01.CIR.0000158483.13093.9D
Gill, 2005, The key role of insulin resistance in the cardiometabolic syndrome, Am J Med Sci, 330, 290, 10.1097/00000441-200512000-00006
Hu, 2004, Plasma insulin and cardiovascular mortality in non-diabetic European men and women: a meta-analysis of data from eleven prospective studies, Diabetologia, 47, 1245, 10.1007/s00125-004-1433-4
Kondo, 2002, Association of adiponectin mutation with type 2 diabetes: a candidate gene for the insulin resistance syndrome, Diabetes, 51, 2325, 10.2337/diabetes.51.7.2325
Matsuzawa, The metabolic syndrome and adipocytokines, FEBS Lett, 580, 2917, 10.1016/j.febslet.2006.04.028
Diamant, 2005, The association between abdominal visceral fat and carotid stiffness is mediated by circulating inflammatory markers in uncomplicated type 2 diabetes, J Clin Endocrinol Metab, 90, 1495, 10.1210/jc.2004-1579
Arner, 2005, Insulin resistance in type 2 diabetes: role of the adipokines, Curr Mol Med, 5, 333, 10.2174/1566524053766022
Trujillo, 2005, Adiponectin: journey from an adipocyte secretory protein to biomarker of the metabolic syndrome, J Intern Med, 257, 167, 10.1111/j.1365-2796.2004.01426.x
Lindsay, 2002, Adiponectin and development of type 2 diabetes in the Pima Indian population, Lancet, 360, 57, 10.1016/S0140-6736(02)09335-2
Hotta, 2000, Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients, Arterioscler Thromb Vasc Biol, 20, 1595, 10.1161/01.ATV.20.6.1595
Weyer, 2001, Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia, J Clin Endocrinol Metab, 86, 1930, 10.1210/jcem.86.5.7463
Combs, 2001, Endogenous glucose production is inhibited by the adipose-derived protein Acrp30, J Clin Invest, 108, 1875, 10.1172/JCI14120
Fruebis, 2001, Proteolytic cleavage product of 30-kDa adipocyte complement-related protein increases fatty acid oxidation in muscle and causes weight loss in mice, Proc Natl Acad Sci USA, 98, 2005, 10.1073/pnas.98.4.2005
Yamauchi, 2001, The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity, Nat Med, 7, 941, 10.1038/90984
Hotta, 2000, Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients, Arterioscler Thromb Vasc Biol, 20, 1595, 10.1161/01.ATV.20.6.1595
Iwashima, 2004, Hypoadiponectinemia is an independent risk factor for hypertension, Hypertension, 43, 1318, 10.1161/01.HYP.0000129281.03801.4b
Tilg, 2006, Adipocytokines: mediators linking adipose tissue, inflammation and immunity, Nat Rev Immunol, 6, 772, 10.1038/nri1937
Sowers, 1994, Role of insulin resistance and hyperinsulinemia in development of hypertension and atherosclerosis, J Lab Clin Med, 123, 647
Clough, 2009, Muscle microvascular dysfunction in central obesity is related to muscle insulin insensitivity but is not reversed by high-dose statin treatment, Diabetes, 58, 1185, 10.2337/db08-1688
Banerji, 1997, Relationship of visceral adipose tissue and glucose disposal is independent of sex in black NIDDM subjects, Am J Physiol, 273, E425
Tchernof, 1996, The dense LDL phenotype. Association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men, Diabetes Care, 19, 629, 10.2337/diacare.19.6.629
Jensen, Role of body fat distribution and the metabolic complications of obesity, J Clin Endocrinol Metab, S57
Wyne, 2003, Free fatty acids and type 2 diabetes mellitus, Am J Med, 115, 29S, 10.1016/j.amjmed.2003.09.004
Angulo, 2007, The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD, Hepatology, 45, 846, 10.1002/hep.21496
Bedogni, 2005, Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study, Hepatology, 42, 44, 10.1002/hep.20734
Browning, 2004, Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity, Hepatology, 40, 1387, 10.1002/hep.20466
Fan, 2005, Prevalence of and risk factors for fatty liver in a general population of Shanghai, China, J Hepatol, 43, 508, 10.1016/j.jhep.2005.02.042
Holt, 2006, Non-esterified fatty acid concentrations are independently associated with hepatic steatosis in obese subjects, Diabetologia, 49, 141, 10.1007/s00125-005-0070-x
Kotronen, 2007, Liver fat in the metabolic syndrome, J Clin Endocrinol Metab, 92, 3490, 10.1210/jc.2007-0482
Cortez-Pinto, 1999, Alterations in liver ATP homeostasis in human nonalcoholic steatohepatitis: a pilot study, JAMA, 282, 1659, 10.1001/jama.282.17.1659
Marceau, 1999, Liver pathology and the metabolic syndrome X in severe obesity, J Clin Endocrinol Metab, 84, 1513, 10.1210/jcem.84.5.5661
Marchesini, 2001, Nonalcoholic fatty liver disease: a feature of the metabolic syndrome, Diabetes, 50, 1844, 10.2337/diabetes.50.8.1844
Targher, 2008, Increased risk of cardiovascular disease in non-alcoholic fatty liver disease: causal effect or epiphenomenon?, Diabetologia, 51, 1947, 10.1007/s00125-008-1135-4
Kotronen, 2008, Fatty liver: a novel component of the metabolic syndrome, Arterioscler Thromb Vasc Biol, 28, 27, 10.1161/ATVBAHA.107.147538
Cinti, 2005, Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans, J Lipid Res, 46, 2347, 10.1194/jlr.M500294-JLR200
Kolak, 2007, Adipose tissue inflammation and increased ceramide content characterize subjects with high liver fat content independent of obesity, Diabetes, 56, 1960, 10.2337/db07-0111
Kanda, 2006, MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis in obesity, J Clin Invest, 116, 1494, 10.1172/JCI26498
Cai, 2005, Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB, Nat Med, 11, 183, 10.1038/nm1166
Tilg, 2008, Insulin resistance, inflammation, and non-alcoholic fatty liver disease, Trends Endocrinol Metab, 19, 371, 10.1016/j.tem.2008.08.005
Donnelly, 2005, Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease, J Clin Invest, 115, 1343, 10.1172/JCI23621
Byrne, 2009, Metabolic disturbances in non-alcoholic fatty liver disease, Clin Sci (Lond), 116, 539, 10.1042/CS20080253
Bruce, 2009, Maternal high fat feeding primes the development of progressive non alchoholic fatty liver disease in adult offspring
Begriche, 2006, Mitochondrial dysfunction in NASH: causes, consequences and possible means to prevent it, Mitochondrion, 6, 1, 10.1016/j.mito.2005.10.004
Caldwell, 1999, Mitochondrial abnormalities in non-alcoholic steatohepatitis, J Hepatol, 31, 430, 10.1016/S0168-8278(99)80033-6
Machado, 2006, Non-alcoholic steatohepatitis and metabolic syndrome, Curr Opin Clin Nutr Metab Care, 9, 637, 10.1097/01.mco.0000241677.40170.17
Perez-Carreras, 2003, Defective hepatic mitochondrial respiratory chain in patients with nonalcoholic steatohepatitis, Hepatology, 38, 999, 10.1002/hep.1840380426
Pessayre, 2007, Role of mitochondria in non-alcoholic fatty liver disease, J Gastroenterol Hepatol, 22, S20, 10.1111/j.1440-1746.2006.04640.x
Serviddio, 2008, Alterations of hepatic ATP homeostasis and respiratory chain during development of non-alcoholic steatohepatitis in a rodent model, Eur J Clin Invest, 38, 245, 10.1111/j.1365-2362.2008.01936.x
Skulachev, 1997, Membrane-linked systems preventing superoxide formation, Biosci Rep, 17, 347, 10.1023/A:1027344914565
Raffaella, 2008, Alterations in hepatic mitochondrial compartment in a model of obesity and insulin resistance, Obesity (Silver Spring), 16, 958, 10.1038/oby.2008.10
Taylor, 2005, Impaired glucose homeostasis and mitochondrial abnormalities in offspring of rats fed a fat-rich diet in pregnancy, Am J Physiol Regul Integr Comp Physiol, 288, R134, 10.1152/ajpregu.00355.2004
Dillin, 2002, Rates of behavior and aging specified by mitochondrial function during development, Science, 298, 2398, 10.1126/science.1077780
ACOG Committee, 2005, Opinion number 315, September 2005. Obesity in pregnancy, Obstet Gynecol, 106, 671
King, 2006, Maternal obesity, metabolism, and pregnancy outcomes, Annu Rev Nutr, 26, 271, 10.1146/annurev.nutr.24.012003.132249
Jones, 2009, High-fat diet before and during pregnancy causes marked up-regulation of placental nutrient transport and fetal overgrowth in C57/BL6 mice, FASEB J, 23, 271, 10.1096/fj.08-116889
Ozanne, 2002, Pre- and early postnatal nongenetic determinants of type 2 diabetes, Expert Rev Mol Med, 4, 1, 10.1017/S1462399402005240
Samuelsson, 2008, Diet-induced obesity in female mice leads to offspring hyperphagia, adiposity, hypertension, and insulin resistance: a novel murine model of developmental programming, Hypertension, 51, 383, 10.1161/HYPERTENSIONAHA.107.101477
Srinivasan, 2006, Maternal high-fat diet consumption results in fetal malprogramming predisposing to the onset of metabolic syndrome-like phenotype in adulthood, Am J Physiol Endocrinol Metab, 291, E792, 10.1152/ajpendo.00078.2006
Taylor, 2007, Developmental programming of obesity in mammals, Exp Physiol, 92, 287, 10.1113/expphysiol.2005.032854
Barker, 1990, Fetal and placental size and risk of hypertension in adult life, BMJ, 301, 259, 10.1136/bmj.301.6746.259
Barker, 1993, Fetal nutrition and cardiovascular disease in adult life, Lancet, 341, 938, 10.1016/0140-6736(93)91224-A
Bispham, 2005, Maternal nutritional programming of fetal adipose tissue development: differential effects on messenger ribonucleic acid abundance for uncoupling proteins and peroxisome proliferator-activated and prolactin receptors, Endocrinology, 146, 3943, 10.1210/en.2005-0246
Boujendar, 2002, Taurine supplementation to a low protein diet during foetal and early postnatal life restores a normal proliferation and apoptosis of rat pancreatic islets, Diabetologia, 45, 856, 10.1007/s00125-002-0833-6
Lewis, 1986, Preweaning food intake influences the adiposity of young adult baboons, J Clin Invest, 78, 899, 10.1172/JCI112678