Das metabolische Syndrom: Bedeutung von Zytokinen als endokrine und metabolische Signalmoleküle

Zusammenfassung

Die Häufigkeit des metabolischen Syndroms (Adipositas, Hypertonie, Fettstoffwechselstörung und gestörter Glukosemetabolismus) nimmt weltweit zu. Welche Mechanismen die verschiedenen Komponenten und Komplikationen des metabolischen Syndroms miteinander verbinden, ist bislang nur unzureichend geklärt. Zytokine könnten zumindest Teile dieser Lücke füllen. Zentral wirksame Zytokine wie Leptin oder Ghrelin sind offensichtlich wichtige Faktoren bei der Aufrechterhaltung der mittel- und langfristigen Energiehomöostase und ihre Dysregulation könnte an der Entstehung der Adipositas beteiligt sein. Adipozytokine wie Resistin oder Adiponectin scheinen an der Entstehung der adipositasassoziierten Insulinresistenz beteiligt zu sein. Es gibt zunehmend Hinweise, dass insbesondere inflammatorisch wirksame Zytokine wie z. B. Interleukin-6 an der Entstehung von Komplikationen des metabolischen Syndroms beteiligt sind. Die Identifizierung von pathogenetisch relevanten Faktoren bei der Entstehung des metabolischen Syndroms bzw. dessen Komplikationen ist nicht nur für die Aufklärung der Pathogenese von großer Bedeutung. Einerseits können möglicherweise neue Marker beschrieben werden, die zur Identifizierung von Risikopersonen genutzt werden können. Andererseits ergeben sich langfristig möglicherweise neue therapeutische Ansätze zur Behandlung des metabolischen Syndroms oder dessen Komplikationen.

Abstract

The incidence of the metabolic syndrome (obesity, hypertension, hyperlipoproteinemia, impaired glucose metabolism) is increasing world-wide. The precise mechanisms linking various components and complications of the metabolic syndrome are unclear yet. Cytokines fulfil some of the required criteria of such a link. Neuroendocrine cytokines (i. e. leptin or ghrelin) appear to be important in maintaining middle- and long-term energy homeostasis. Dysregulation of such factors is likely to be involved in the development of obesity. Adipocytokines (i. e. Adiponectin, Resistin) may link obesity and insulin resistance. There is increasing evidence that inflammatory cytokines such as Interleukin-6 or TNF-α play a central role in the development of type 2 diabetes and atherosclerosis. Various cytokines or even their combination may allow a better identification of individuals at risk to develop the metabolic syndrome or its complications. Additionally some cytokines are promising therapeutic targets and modification of their expression and/or their effects may result in valuable new therapeutic approaches.

Schlüsselwörter

Adipozytokine - Adiponectin - Atherosklerose - Diabetes - Entzündung - metabolisches Syndrom - Fettsucht

Key words

Adipokines - adiponectin - atherosclerosis - diabetes - inflammation - metabolic syndrome - obesity

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