肥胖对动脉粥样硬化的影响

肥胖是一种由多种因素引起的慢性代谢性疾病,表现为体内脂肪堆积过多和(或)脂肪分布异常。动脉粥样硬化的主要病变特征是动脉内膜下脂质沉积,伴有平滑肌细胞和胶原纤维增多,逐步发展形成动脉粥样硬化性斑块。大量的基础和临床研究表明,肥胖能够加剧动脉粥样硬化的发生危险,其可能的机制包括脂代谢异常、胰岛素抵抗、炎症、内皮功能障碍等,但是迄今为止肥胖对动脉粥样硬化的影响机制尚未完全清楚。本文将重点从心外膜及血管周围的异位脂肪沉积、新型脂肪因子、脂肪组织相关外泌体、脂肪棕色化等新的观点阐述肥胖对动脉粥样硬化的影响,为肥胖致动脉粥样硬化的防治提供一些新的思路。

The impact of obesity on atherosclerosis

Obesity is a chronic metabolic disease caused by a variety of factors, manifested by excessive accumulation of body fat and/or abnormal fat distribution. The main pathogenesis of atherosclerosis is lipid accumulation within the artery walls, the proliferation of smooth muscle cell and fibrous matrix, and development of atherosclerosis plaques. A large number of basic and clinical studies have shown that obesity is a well-established risk factor for atherosclerosis, and its potential mechanisms include abnormal lipid metabolism, insulin resistance, inflammation, and endothelial dysfunction.However, the mechanistic link between accumulation of adipose tissue and development of atherosclerosis is not clear. This article will focus on the opinions of epicardial adipose tissue and perivascular adipose tissue, new adipokines, adipose-derived exosomes, and adipose browning, in order to state the impact of obesity on atherosclerosis and to provide a new perspective for the study of intervention strategies for atherosclerosis.