內容目錄
WuXi AppTec Content Team Editor
There are two main types of adipose tissue in humans and mammals. Among them, white adipose tissue (WAT) stores excess energy in the body in the form of triglycerides and is used when needed, and is the main storage form of human fat. Brown adipose tissue (BAT) contains more mitochondria, whose main role is to consume calories to maintain body homeostasis.
Recently, the “New England Journal of Medicine” (NEJM) published a major review, summarizing the current medical community’s latest understanding of human adipose tissue, and analyzing the role of different adipose tissue in the endocrine system. key role played.
The paper states that long-term activation of brown adipose tissue may provide broad health benefits to the gastrointestinal, cardiovascular, and musculoskeletal systems. Activating brown adipose tissue, or converting white adipose tissue into brown adipose tissue to increase the body’s energy consumption, is a potentially important direction for the treatment of obesity in the future!
Screenshot source: NEJM
You may not know about fat
The paper highlights that the importance of adipose tissue to the human body has long been overlooked. For the general public who are trying to lose weight, what they most want to see is the reduction of fat, and they do not think that fat is a beneficial part of the human body; for medical professionals, the academic community has long ignored targeting fat Organizational learning and research.
However, discoveries over the past three decades have revolutionized our understanding of adipose tissue. For example, fat is not a single entity, it is a collection of adipose tissue with different anatomical and functional characteristics.
▲Main distribution sites of white adipose tissue and brown adipose tissue (Image source: Reference [1]) strong>
White fat
In lean adults: women with white adipose tissue ranging from 20kg to 30kg (30% to 40% of body weight); men with white adipose tissue ranging from 10kg to 20kg (of body weight). 15%~25%).
At present, we can quickly estimate fat mass through data such as sebum forceps, waist circumference, and BMI. On the basis of bioelectrical impedance analysis, dual energy X-ray absorptiometry, etc., combined with CT and MRI, we can accurately calculate body fat content data.
Adult white adipose tissue is mainly located in certain areas such as the neck, shoulders, back of the chest and abdomen, white adipose tissue in these areas helps warm blood flow more quickly Distributed to other parts of the human body to protect the systemic circulation to play a better role.
Brown fat
It is currently known that the maximum level of brown adipose tissue detectable in the human body is about 1kg, usually 50g~500g for adults aged 20 to 50, accounting for about 0.1% of body weight~ 0.5% (0.2%~3.0% of the total weight of adipose tissue). The measurement of brown adipose tissue content is difficult, and currently mainly relies on imaging methods, such as PET-CT and MRI.
Other
White adipose tissue begins to develop in the second trimester, and both visceral and subcutaneous fat white adipose tissue is formed at birth. Brown adipose tissue, which develops as early as the second and last trimesters, protects the newborn from the cold. It is worth emphasizing that in addition to white adipose tissue and brown adipose tissue, there are beige (beige/brite) adipose tissue between the first two, as well as breast tissue, bone marrow and dermis. Pink adipose tissue, these different types of adipose tissue have different physiological roles.
Fat function is grossly underestimated
Adipose tissue is composed of many different types of cells, including adipocytes as well as vascular matrix components such as fibroblasts, blood/vascular cells, immune cells such as macrophages, neural tissue related cell). The paper points out that the function of adipose tissue to the human body has been seriously underestimated in the past.
The number of fat cells remains the same?
It used to be believed that people were born with all the fat cells, and that these cells could only grow or shrink without changing their numbers. Modern research has confirmed that this view is wrong. Through isotope labeling, scientists have found that people are constantly experiencing fat production throughout their lives. The growth of fat cells can not only be reflected in the increase in cell size, but also in the expression for the proliferation of cells.
Specifically,the human body renews an average of about 8% of its fat cells every year, and every 15 years or so, the fat cells in the body have been replaced once. From this point of view, adipose tissue is a dynamic organ, in which the turnover rate of fat cells is even faster than that of many cardiomyocytes!
Can fat play an endocrine role?
It was previously believed that adipose tissue had three main functions, namely, storing heat, maintaining body temperature, and providing buffer protection.
However, research over the past three decades has found that adipose tissue also functions as an endocrine organ, and can exert regulatory functions through autocrine, paracrine and endocrine means.
Adipose tissue can produce dozens of important active factors such as leptin and adiponectin that affect local or distant physiological regulation. For example, the secretion and regulation of related hormones maintain energy supply before and after pregnancy and the normal function of the reproductive system; lower white adipose tissue levels are associated with anorexia nervosa, lipodystrophy, and menstrual interruption; white adipose tissue levels Too high can lead to early puberty and so on.
This fat may be used to treat obesity!
Current treatments for obesity focus on reducing food intake, reducing energy absorption or increasing energy expenditure, with the ultimate goal of reducing triglyceride levels in white adipose tissue. The paper points out that the most effective way to lose weight and improve metabolism is bariatric surgery. Although bariatric surgery reduces obesity complications through a variety of mechanisms, the main source of efficacy is the substantial reduction in white adipose tissue mass.
Some of the drugs currently used in obesity treatment research are also related to adipose tissue. For example, glucagon-like peptide 1 receptor agonists (such as liraglutide), which can induce weight loss by suppressing appetite (more effectively when combined with exercise), however, may also have beneficial effects by stimulating white adipose tissue Lipolysis and brown adipose tissue thermogenesis are mediated. In addition, potential new therapies such as bimagrumab, a targeted activin type II receptor inhibitor, can promote skeletal muscle growth while reducing white adipose tissue mass.
▲Different types of fat cells and mechanisms of adipose tissue thermogenesis (Image source: Reference[1]) strong>
It is worth noting that long-term activation of brown adipose tissue may contribute to the treatment of obesity and related metabolic diseases, which has been demonstrated in rodent studies. confirmed. The presence of limited brown adipose tissue in adults also appears to have a substantial clinical effect, and there is an inverse correlation between brown adipose tissue activity and BMI, according to the results of retrospective and prospective studies.
A recent study showed that people with higher levels of brown adipose tissue had lower levels of blood sugar, triglycerides, and high-density lipoprotein than those with lower levels of brown adipose tissue. The population is healthier. Not only that, the prevalence of cardiometabolic diseases such as type 2 diabetes, dyslipidemia, coronary artery disease, cerebrovascular disease, congestive heart failure and hypertension among people with higher levels of brown adipose tissue significantly lower.
Currently, the activation of brown adipose tissue or the conversion of white adipose tissue into brown adipose tissue to increase the body’s energy expenditure is considered as a potential direction for the treatment of obesity.
Summary
The paper pointed out that we usually use BMI to assess whether a person is obese, but this method does not reflect the distribution of human white adipose tissue. In the future, we will conduct obesity-related Large epidemiological studies are warranted in conjunction with other indicators (eg waist circumference) to assess and gain a deeper understanding of the role of white adipose tissue distribution in obesity-related metabolic disease.
Current research evidence suggests that obesity is not simply an excess of triglyceride storage in white adipose tissue; Cranial-related diseases with high levels of brown adipose tissue and dysfunctional brown adipose tissue. In addition, the results of genome-wide association studies and others have also revealed potential relationships between obesity and its metabolic complications and genetic influences. Overall, obesity is a complex combination of hundreds of genes, socioeconomic needs, and individual decision-making that ultimately results in chronic caloric intake exceeding energy expenditure.
Obesity is not only an independent health problem, but a risk factor for cardiovascular disease, diabetes, hypertension, stroke and other metabolic diseases and cancer. At a time when the global obesity problem is becoming increasingly prominent, a better understanding of the impact of adipose tissue on obesity will help us address the global obesity epidemic.
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