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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2019; 13(01): 6-13
DOI: 10.1055/a-0804-6353
Review
© Georg Thieme Verlag KG Stuttgart · New York

Adipokine & klinische Bedeutung

Adipokines – clinical relevance
Matthias Blüher
Klinik und Poliklinik für Endokrinologie und Nephrologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, AöR
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Publication History

Publication Date:
22 February 2019 (online)

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Zusammenfassung

Adipositas führt zu einer gestörten Funktion des Fettgewebes, die sich in ektoper Fettverteilung, Hypertrophie von Adipozyten, Veränderungen der zellulären Zusammensetzung und der intrazellulären Matrix sowie zu einer gestörten endokrinen Funktion manifestiert. Neben den wichtigen Funktionen als Energiespeicher, mechanischer Schutz und Wärmeisolator produziert das Fettgewebe auch Peptidhormone, sogenannte Adipokine, die zu sekundären Veränderungen an Organen wie der Leber, dem Hirn oder dem Gefäßsystem beitragen. Mit der Vermehrung des Fettgewebes bei Adipositas entwickelt sich häufig ein diabetogenes, pro-inflammatorisches und atherogenes Adipokinmuster. Adipokine tragen zumindest zum Teil zum Adipositas-assoziierten Risiko für Typ-2-Diabetes, Fettlebererkrankung, endotheliale Dysfunktion, Arteriosklerose, Bluthochdruck, Fettstoffwechselstörungen und bestimmte Krebserkrankungen bei. Zukünftig könnten Adipokine deshalb als Risikomarker und als Substrat oder Therapeutikum für pharmakologische Therapiestrategien klinisch relevant werden. Im Rahmen dieses Beitrages sollen aktuelle Erkenntnisse zur potentiellen klinischen Bedeutung von Adipokinen vorgestellt und diskutiert werden.

Abstract

Obesity causes adipose tissue dysfunction which manifests as ectopic fat distribution, adipocyte hypertrophy, changes in the cellular composition and intracellular matrix as well as its endocrine function. In addition to its important functions as energy storage organ, mechanical organ protection and insulator, adipose tissue produces peptide hormones, so called adipokines which may contribute to secondary changes of liver, brain, vascular system function. With increasing fat mass, adipokine secretion changes towards a pro-inflammatory, diabetogenic and atherogenic pattern. Adipokines may at least in part underly the increased risk for obesity-related diseases including type 2 diabetes, fatty liver disease, endothelial dysfunction, atherosclerosis, hypertension, dyslipidemia and some types of cancer. In the future, adipokines may become clinically relevant as risk parameters, for the monitoring of obesity treatment and have the potential for pharmacological treatment strategies for obesity and its related diseases. This review focuses on the clinical relevance of adipokines as markers or predictors of obesity related diseases and as potential therapeutic tools or targets in metabolic and cardiovascular diseases.

Schlüsselwörter

Adipokine - Adipositas - Fettgewebe - Insulinresistenz - Leptin - Adiponektin

Key words

Adipokines - obesity - adipose tissue - insulin resistance - leptin - adiponectin
 

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