Metabolic Syndrome Insulin Resistance and Roles of Inflammation-Mechanisms and Therapeutic Targets

摘要

Obesity and its co-morbidities, including type 2 diabetes (T2D) and cardiovascular disease (CVD), are associated with a state of chronic low-grade inflammation that can be detected both systemically and within specific tissues. Areas of active investigation focus on the molecular bases of ‘metabolic’ inflammation and potential pathogenic roles in insulin resistance, T2D and CVD. An increased accumulation of macrophages occurring in obese adipose tissue has emerged as a key process in ‘metabolic’ inflammation. Recent studies have also begun to unravel the heterogeneity of adipose tissue macrophages, and their physical and functional interactions with adipocytes, endothelial cells and other immune cells within the adipose tissue microenvironment. Translating the information gathered in experimental models of insulin resistance and T2D into meaningful therapeutic interventions is a tantalizing goal with long-term global health implications. In this context, ongoing clinical studies are testing the effects of targeting inflammation systemically on metabolic and cardiovascular outcomes.