Intra-abdominal adiposity, inflammation, and cardiovascular risk: New insight in the global cardiometabolic risk
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Corresponding author Paolo Calabro, MD, FESC Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy. E-mail: [email protected] Current Cardiovascular Risk Reports 2007, 1:32 –38 Current Medicine Group LLC ISSN 1932-9520 Copyright © 2007 by Current Medicine Group LLC
Increasing evidence supports the role of adipose tissue in the development of a systemic inflammatory state, which contributes to obesity-associated vasculopathy and cardiovascular risk. In addition to storing calories as triglycerides, adipocytes secrete a large variety of proteins, including cytokines, chemokines, and hormone-like factors (eg, leptin, adiponectin, resistin). This production of pro chemokines by adipose tissue is of particular interest, because their local secretion by perivascular adipose depots may provide a new mechanistic link between obesity and its associated vascular complications. Insulin resistance, in subjects with or without diabetes, is frequently associated with obesity, particularly with an excess of intra-abdominal fat. Recently, the endocannabinoid system, among others, has been shown to be involved in the pathophysiology of visceral obesity and global cardiometabolic risk, as represented by the overall risk of developing type 2 diabetes or cardiovascular diseases.
Introduction The metabolic syndrome is a group of abnormalities, which includes abdominal obesity, high blood glucose, impaired glucose tolerance, dyslipidemia, and high blood pressure, that increases the risk of overt diabetes mellitus and cardiovascular disease (CVD). A variety of data indicates that glucose intolerance plays a central role in coronary artery disease (CAD) risk. Abdominal obesity, measured by the waist circumference, is an indicator of intra-abdominal adiposity (IAA) that drives the progression of multiple risk factors directly [1•]. Until recently, the adipocyte was thought to be an
inert storage cell that mainly stored excess energy in the form of triglycerides. Adipocytes are now thought to have a more complex role in the organism. Adipocytes produce a large number of hormones, peptides, and smaller molecules that affect metabolism and cardiovascular function, not only through endocrine influences but also through autocrine and paracrine influences [1•]. One of the key vasoactive substances produced by adipocytes is leptin, which is an important regulator of food intake [2•]. Other adipocyte-derived molecules, including prostaglandins, adiponectin, and the more recently discovered resistin, affect metabolic function and might play a role in causing cardiovascular end-organ damage. Obese individuals also have high circulating levels of inflammatory markers produced by adipose tissue, including tumor necrosis factor B (TNF-B), interleukin (IL) 1, and IL-6 [3]. These factors, whose levels can be reduced by weight loss, are likely to contribute to vascular damage in obese individuals.
IAA is a Major Contributor to Increased Cardiometabolic Risk Obesity is the most prevalent nutritio
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