Zusammenfassung
Klinische und tierexperimentelle Untersuchungen haben gezeigt, dass das Fettverteilungsmuster das individuelle metabolische Risiko besser determiniert als die Gesamtkörperfettmasse. Es besteht eine positive Korrelation zwischen viszeraler Fettmasse und Insulinresistenz, metabolischem Syndrom, koronarem Herzkrankheits-Risiko sowie der hepatischen Glukoseproduktion. Die Beziehung zwischen Fettverteilungsmuster und Alter, Geschlecht, Energiehaushalt und mit metabolischen und genetischen Charakteristika wird diskutiert. Dabei werden Unterschiede in der Insulinsensitivität, der lipolytischen Aktivität, dem Glukosestoffwechsel und der endokrinen Regulation in Abhängigkeit von der Fettgewebslokalisation dargestellt. Die klinische Bedeutung einer differenzierten Charakterisierung der viszeral-betonten Adipositas besteht darin, Risikogruppen des Metabolischen Syndroms aufgrund molekularer und genetischer Marker der viszeralen Adipositas zu definieren und daraus Strategien zur Differenzialtherapie der Adipositas abzuleiten.
Summary
Epidemiological and animal studies often reported an association between increased visceral obesity and the prevalence of insulin resistance, type 2 diabetes, the risk of cardiovascular and cerebrovascular diseases and the hepatic glucose production. The correlation of fat distribution with age, gender energy balance and with metabolic and genetic characteristics are discussed. Especially, the differences in insulin sensitivity, lipolytic activity, glucose metabolism, and the endocrine regulation depending on the regional adipose tissue distribution are presented.
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Prof. Dr. med. R. Paschke
Universität Leipzig, Medizinische Klinik und Poliklinik III
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