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Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 35–42 (2006)Cite this article

Abstract

Abdominal fat accumulation has been shown to play crucial roles in the development of metabolic syndrome. Visceral fat accumulation particularly is closely correlated to the development of cardiovascular disease and obesity-related disorders such as diabetes mellitus, hyperlipidemia and hypertension. Given these clinical findings, the functions of adipocytes have been intensively investigated in the past 10 years, and have been revealed to act as endocrine cells that secrete various bioactive substances termed adipocytokines. Among adipocytokines, tumor-necrosis factor-α, plasminogen activator inhibitor type 1 and heparin-binding epidermal growth factor-like growth factor are produced in adipocytes as well as other organs, and contribute to the development of vascular diseases. Visfatin has been identified as a visceral-fat-specific protein that might be involved in the development of obesity-related diseases, such as diabetes mellitus and cardiovascular disease. In contrast to these adipocytokines, adiponectin, which is an adipose-tissue-specific, collagen-like protein, has been noted as an important antiatherogenic and antidiabetic protein, or as an anti-inflammatory protein. The functions of adipocytokine secretion might be regulated dynamically by nutritional state. Visceral fat accumulation causes dysregulation of adipocyte functions, including oversecretion of tumor-necrosis factor-α, plasminogen activator inhibitor type 1 and heparin-binding epidermal growth factor-like growth factor, and hyposecretion of adiponectin, which results in the development of a variety of metabolic and circulatory diseases. In this review, the importance of adipocytokines, particularly adiponectin, is discussed with respect to cardiovascular diseases.

Key Points

  • Intra-abdominal visceral fat accumulation has been recognized as having a major role in the development of cardiovascular disease

  • Adipocytes secrete various bioactive substances, termed adipocytokines, that contribute to metabolic dysregulation, abdominal fat accumulation and the development of vascular disease

  • Approximately 20% of all genes in subcutaneous adipose tissue and about 30% in visceral adipose tissue encode adipocytokine secretion

  • Plasma concentrations of adiponectin, a collagen-like protein, are reduced in individuals with visceral fat accumulation and type 2 diabetes, suggesting protective metabolic effects with high concentrations

  • The reduction of visceral fat, possibly with regulation of adipocytokines, might be a useful preventive measure for metabolic syndrome and related cardiovascular disease

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Figure 1: The distribution of gene groups, classified by function and subcellular localization.
Figure 2: Visceral fat accumulation is related to a variety of diseases, such as insulin resistance, glucose intolerance, dyslipidemia, hypertension, coronary artery disease, cardiac dysfunction and sleep apnea syndrome.
Figure 3: Correlation between plasma levels of adipocytokines and visceral fat area.
Figure 4: Antiatherogenic functions of adiponectin.
Figure 5: Working hypothesis of adiponectin functions in vascular walls.
Figure 6: Concept of metabolic syndrome focused on dysregulation of adipocytokines induced by visceral fat accumulation.

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Acknowledgements

Most of the research discussed in this review, including the clinical and cell-biology studies on adiponectin and visfatin, was done by the Adiposcience Group of Osaka University, Japan.

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  1. Director of Sumitomo Hospital, Osaka, Japan

    Yuji Matsuzawa

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  1. Yuji Matsuzawa
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Correspondence to Yuji Matsuzawa.

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Matsuzawa, Y. Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease. Nat Rev Cardiol 3, 35–42 (2006). https://doi.org/10.1038/ncpcardio0380

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