Nature Medicine:棕色脂肪或有利于心血管代谢!

2021-01-17 MedSci原创 MedSci原创

棕色脂肪组织对心脏代谢健康有潜在重要作用,并提示其对人类具有治疗潜力。

人体内存在棕色和白色两种脂肪。白色脂肪堆积在皮下,负责储存多余热量;棕色脂肪则负责分解引发肥胖的白色脂肪,将后者转化成二氧化碳、水和热量,本身不储存热量。其中,哺乳动物大多数脂肪细胞都属于白色脂肪,小动物和人类新生儿有大量棕色脂肪,这些细胞拥有大量线粒体,比白色脂肪更能高效地消耗能量物质产生热量。

因此在2020年,发表在《科学·转化医学》(Science Translational Medicine)杂志上的研究认为,治疗肥胖一个潜在的治疗方法就是将未完全发育为人类白色脂肪的阶段使用CRISPR-Cas9基因编辑技术(没错,就是荣获2020年诺贝尔化学奖殊荣的“魔剪”)进行基因改造称棕色脂肪,然后将棕色样脂肪细胞进行移植,从而促进能量消耗。

通常情况下,肥胖会增加血管疾病和代谢性疾病的患病风险,但“棕色脂肪”是个例外。早在2003年,有研究就报道了正电子发射断层扫描(PET)上标记的葡萄糖类似物18F-氟脱氧葡萄糖(18F-FDG)在计算机断层扫描(CT)上对应锁骨上脂肪的区域的摄取量增加,表明成年人类存在代谢活跃的棕色脂肪。这种组织引起了研究人员的强烈兴趣。

因此,来自美国洛克菲勒大学的研究人员探讨了棕色脂肪与心血管代谢健康的关系,结果发表在最新的《自然·医学》(Nature Medicine)杂志上。

研究人员回顾了20096月至20183月在美国凯特琳癌症中心(MSKCC)对53475名患者进行的13922418F-FDG PET/CT报告(18F-FDG PET/CT用于癌症诊断、分期、监测治疗反应和监测,MSKCC的协议是报告每项研究中的棕色脂肪的状态)。

结果发现,5070名(9.5%)患者的79235.7%)份18F-FDG PET/CT扫描结果上存在棕色脂肪。为了评估报告的准确性,研究人员对2016年进行的所有扫描与报告的棕色脂肪结果进行了人工审核。在2016年报告棕色脂肪的1139次扫描中,1132次(99.4%PET扫描显示,确认的棕色脂肪存在典型位置(颈部、锁骨上、腋下、纵隔、脊柱旁和腹部)区域18F-FDG摄取增加。

随后,研究人员根据有无棕色脂肪并结合性别、年龄、BMI和室外温度等因素,分析了棕色脂肪和疾病之间的关系。

结果表明,体内检测到棕色脂肪的人,只有4.6%的人患有2糖尿病、有18.9%的人胆固醇异常;而没有棕色脂肪的人有9.5%的人患有2型糖尿病,有22.2%的人胆固醇异常。多变量分析显示,检测到棕色脂肪的人群中,2型糖尿病的发生几率降低56%。

此外,棕色脂肪增加还与血糖、甘油三酸酯和高密度脂蛋白胆固醇水平的显著改善有关。其中,较之普通人,检测到棕色脂肪的人群冠状动脉疾病风险低32%,脑血管疾病风险低23%,充血性心衰风险低38%,高血压风险低15%。

更令人惊喜的是,棕色脂肪上述心血管保护风险在肥胖人群中似乎作用更大。同样是肥胖,体内检测到棕色脂肪的人2型糖尿病发病率不到一半(7.5% vs 20.3%)。为此,研究人员指出,棕色脂肪可能减轻了肥胖对健康的负面影响。

综上,并非所有的脂肪都是有害的。至少,目前的结果表明,棕色脂肪组织对心脏代谢健康有潜在重要作用,并提示其对人类具有治疗潜力。

 

参考文献:

Becher T, et al. Brown adipose tissue is associated with cardiometabolic health. Nat Med. 2021 Jan;27(1):58-65. doi:10.1038/s41591-020-1126-7.

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    2021-04-01 jeanqiuqiu
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    2021-05-28 kalseyzl
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encryptionId=ba056261635, topicName=棕色脂肪)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Jan 18 10:05:47 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1884906, encodeId=6b9a188490688, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Fri May 28 17:16:46 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1859102, encodeId=14f1185910231, content=<a href='/topic/show?id=e0a9593596' target=_blank style='color:#2F92EE;'>#DIC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5935, encryptionId=e0a9593596, topicName=DIC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, 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createdTime=Sun Jan 24 21:06:46 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577763, encodeId=200015e776364, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Jan 19 10:16:46 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610862, encodeId=710e1610862a8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, 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encryptionId=ba056261635, topicName=棕色脂肪)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Jan 18 10:05:47 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
    2021-04-14 ms2000001361349190

    学习了

    0

  6. 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createdTime=Sun Jan 24 21:06:46 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577763, encodeId=200015e776364, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Jan 19 10:16:46 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610862, encodeId=710e1610862a8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Jan 19 10:16:46 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=917941, encodeId=9d5191e941cb, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Tue Jan 19 07:41:26 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=917686, encodeId=b7a291e6869f, content=<a href='/topic/show?id=ba056261635' target=_blank style='color:#2F92EE;'>#棕色脂肪#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62616, encryptionId=ba056261635, topicName=棕色脂肪)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Jan 18 10:05:47 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
    2021-01-24 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

  7. 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  8. 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  9. 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encryptionId=ba056261635, topicName=棕色脂肪)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Mon Jan 18 10:05:47 CST 2021, time=2021-01-18, status=1, ipAttribution=)]
    2021-01-19 Aidy

    学习

    0

  10. 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