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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2023; 17(03): 126-132
DOI: 10.1055/a-2079-9158
Review

Erkenntnisse aus der Fettgewebsforschung

Adipose tissue – a treasure box for discoveries
Matthias Blüher
1   Helmholtz-Institut für Metabolismus-, Adipositas- und Gefäßforschung (HI-MAG), Helmholtz Zentrum München an der Universität Leipzig und dem Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
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Zusammenfassung

Das Fettgewebe spielt eine wichtige Rolle bei der Entstehung kardiometabolischer Erkrankungen. Eine Zunahme der Fettgewebsmasse im Rahmen der Adipositas, aber auch Fettverteilungsstörungen (z. B. bei Lipodystrophie) stehen im Zusammenhang mit Stoffwechselkrankheiten wie Typ 2 Diabetes, Fettlebererkrankung oder Lipidstoffwechselstörungen und kardiovaskulären Erkrankungen. Allerdings wird das individuelle Risiko für diese Erkrankungen nicht allein durch die Fettmasse bestimmt, sondern auch durch die Funktion des Gewebes und seine zelluläre Zusammensetzung. Auf der einen Seite gibt es Menschen, die trotz ausgeprägter Adipositas lange kardiometabolisch gesund bleiben, während andererseits auch schlanke Menschen Krankheiten entwickeln können, die als typische Folgen von Adipositas angesehen werden.

Durch die Untersuchung des Fettgewebes von extremen Subphänotypen der Adipositas und Fettverteilung (insulinsensitive Adipositas, Lipodystrophie), Adipositas-chirurgischen Interventionen sowie durch die Charakterisierung der Fettgewebsveränderungen im Rahmen der humanen Fettgewebebank (Leipzig Obesity BioBank, LOBB) mit aktuell mehr als 8.000 Gewebespendern zeigte sich, dass die Fehlfunktion des Fettgewebes im Wesentlichen durch eine Hypertrophie der Adipozyten, eine viszerale, ektope Fettverteilung und veränderte zelluläre Zusammensetzung gekennzeichnet ist. Im Rahmen dieser Übersicht werden aktuelle Erkenntnisse aus der Fettgewebsforschung zusammengefasst und die Rolle des Fettgewebes bei der Entstehung von Endorganschäden diskutiert.

Abstract

Adipose tissue plays an important role in the development of cardio-metabolic diseases.

Increased adipose tissue mass in people with obesity, but also impaired fat distribution (e. g., lipodystrophy) are associated with metabolic diseases including type 2 diabetes, fatty liver disease or lipid metabolism disorders as well as cardiovascular diseases. However, the individual risk to develop cardio-metabolic diseases is not entirely determined by fat mass, but also by the function and cellular composition of adipose tissue. There are people who remain metabolically healthy despite obesity, whereas on the other hand lean people may develop typical obesity diseases.

Analyses of human adipose tissue from people with extreme subphenotypes of obesity and fat distribution (e. g., insulin sensitive obesity, lipodystrophy), upon obesity surgery interventions and in the context of the large human adipose tissue biobank (Leipzig Obesity BioBank, LOBB) with currently more than 8,000 donors demonstrated that adipose tissue dysfunction is characterized by adipocyte hypertrophy, visceral, ectopic fat deposition and alterations in the cellular composition. This overview summarises recent advances in adipose tissue research and how adipose tissue dysfunction may contribute to end-organ damage.

Schlüsselwörter

Fettgewebe - Adipositas - Inflammation - Insulinresistenz - Adipokine

Key words

Adipose tissue - obesity - inflammation - insulin resistance - adipokines


Publication History

Article published online:
04 September 2023

© 2023. Thieme. All rights reserved.

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