Abstract

LASTRA G, Guido; MANRIQUE, Camila M  and  LASTRA L, Guido. Cardiometabolic syndrome: Inflammation, adipose tissue, insulin resistance and atherogenesis ­ the puzzle grows. Acta Med Colomb [online]. 2005, vol.30, n.3, pp.100-111. ISSN 0120-2448.

Over the last few decades, from being a purely esthetic problem without any pathological implications, obesity has become a true epidemic affecting more than a third of the Western population, involving an increasing number of people among the younger generations. Obesity is characterized by a myriad of metabolic derangements, in which adipose tissue plays a key role and has shown to be one of the most complex and fascinating endocrine organs discovered recently. Adipose tissue, whose essential role is to store the energy required to support metabolism and contribute to immunologic and reproductive functions, is compromised by genetic and environmental influences, which turn it into a dysfunctional tissue. Visceral adipose tissue in obesity is characterized by morphologic and functional changes that turn it into a source of cytokines directly produced by adipocytes. These are currently known as adipokynes, and lead to a chronic, low-grade inflammatory state. These changes induce insulin resistance, endothelial dysfunction and, ultimately, atherosclerosis, which leads to metabolic and cardiovascular complications including type-2 diabetes mellitus, hypertensive disease, peripheral vascular disease and coronary heart disease. These conditions constitute the main causes of morbidity and mortality in the modern Western world. Paradoxically, the industrialized world has transformed one of the oldest organic systems that allowed human beings to survive in difficult circumstances when there was a need to preserve energy and fight against lethal infections, into the very source of the diseases that most commonly affect us currently. The discovery of the intimate mechanisms of regulation and dysfunction of adipose tissue, and of its relationship with atherosclerosis and cardiovascular disease, will contribute to the future development of management strategies for obesity and its accompanying lethal consequences.

Keywords : inflammation; adipocyte; insulin resistance; atherogenesis.

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