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- May 12, 2008 |
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"Adiponectin - Novel 'Adipokine' with Metabolic and Vascular Effects"Dr. Barry Goldstein (biography)
English - 2005-04-27 - 54 minutes
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Summary :
A number of factors or adipocytokines are secreted from adipose tissue, many of which affect insulin sensitivity and vascular endothelial function. Central abdominal fat in particular has been found to be associated with insulin resistance (1), and ectopic fat deposition in liver and muscle also causes insulin resistance in those tissues. PPARγ agonists such as the thiazolidinediones, which improve insulin sensitivity, affect the secretion and action of adipocytokines and also redistribute fat in the body.
With increased visceral fat there is an increase in free fatty acids and TNFα, and a decrease in adiponectin levels. Adiponectin is an adipose-specific, collagen-like protein which is abundant in the circulation, however its levels are decreased in obesity, type 2 diabetes and coronary artery disease. Adiponectin enhances insulin action, has anti-inflammatory and vascular-protective effects, and its mechanism of action appears to involve AMP kinase.
Low circulating adiponectin levels have been associated with endothelial dysfunction in humans (2). Adiponectin has a number of effects in the vasculature, such as enhanced endothelium-dependent and -independent vasodilation, suppression of atherosclerosis, suppression of adhesion molecule expression, reduced levels of TNFα and several other effects (3). Dr. Goldstein presents evidence for these effects and ends with a discussion on adiponectin multimers in relation to thiazolidinedione treatment in type 2 diabetes.
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
Key discussion points:
- How does increased visceral adiposity lead to insulin resistance and vascular dysfunction?
- What is adiponectin and why is it apparently so important?
- What is the significance of these findings for the action of TZDs?
Bibliographic references :
1. Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ.Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM.Diabetes. 1996 May;45(5):633-8.
2. Michio Shimabukuro, Namio Higa, Tomohiro Asahi, Yoshito Oshiro, Nobuyuki Takasu, Tatsuya Tagawa, Shinichiro Ueda, Iichiro Shimomura, Tohru Funahashi and Yuji Matsuzawa Hypoadiponectinemia Is Closely Linked to Endothelial Dysfunction in Man J Clin Endocrinol Metab. 2003 Jul;88(7):3236-40.
3. Barry J. Goldstein and Rosario Scalia Adiponectin: A Novel Adipokine Linking Adipocytes and Vascular Function J Clin Endocrinol Metab. 2004 Jun;89(6):2563-8.
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