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Titolo:
Obesity and free fatty acids: Double trouble
Autore:
Cabezas, MC; Halkes, CJM; Erkelens, DW;
Indirizzi:
Dept Internal Med, Utrecht, Netherlands Dept Internal Med Utrecht Netherlands nternal Med, Utrecht, Netherlands Dept Endocrinol, Utrecht, Netherlands Dept Endocrinol Utrecht Netherlands pt Endocrinol, Utrecht, Netherlands
Titolo Testata:
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
fascicolo: 2, volume: 11, anno: 2001,
pagine: 134 - 142
SICI:
0939-4753(200104)11:2<134:OAFFAD>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACYLATION-STIMULATING PROTEIN; CORONARY-ARTERY DISEASE; LOW-DENSITY-LIPOPROTEIN; TRIGLYCERIDE-RICH LIPOPROTEINS; FAMILIAL COMBINED HYPERLIPIDEMIA; CHYLOMICRON REMNANT CLEARANCE; POSTPRANDIAL LIPID-METABOLISM; DEPENDENT DIABETES-MELLITUS; RECEPTOR-RELATED PROTEIN; HEART-DISEASE;
Keywords:
postprandial lipemia; atherosclerosis; chylomicron remnants; insulin resistance;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
100
Recensione:
Indirizzi per estratti:
Indirizzo: Cabezas, MC Univ Utrecht Hosp, Dept Internal Med, F02126,POB 85500, NL-3508 GA Utrecht, Netherlands Univ Utrecht Hosp F02126,POB 85500 Utrecht Netherlands NL-3508 GA
Citazione:
M.C. Cabezas et al., "Obesity and free fatty acids: Double trouble", NUTR MET CA, 11(2), 2001, pp. 134-142

Abstract

The socio-economic impact of obesity, one of the most prevalent medical disorders in Western society is mainly due to its association with a higher risk of coronary heart disease. It is likely that atherosclerosis develops against a background of obesity as a result of the insulin resistance that is invariably present in overweight and obese subjects. Fasting plasma lipids may be normal in obese subjects, bur they are usually affected by postprandial hyperlipidemia. which is probably due to competition between chylomicrons and VLDL for the same metabolic pathways. The basis for the impaired clearance of atherogenic chylomicron remnants is the fact that obesity causes hepatic apo B-VLDL overproduction, and thus leads to competition with chylomicrons and their remnants at the lipolytic pathway (lipoprotein lipase and hepatic lipase) and receptor level (LDL-receptor and remnant-receptor). The overproduction of VLDL is probably caused by an enhanced hepatic flu offree fatty acids in both the postprandial (front the lipolysis of triglyceride rich particles) and postabsorptive stares (from adipocytes). Weight reduction by means of life-style changes, supported by medical interventions with inhibitors of intestinal fat absorption (eg Orlistat) or appetite suppressants (eg Sibutramine), is essential in order to decrease the risk of atherosclerosis. Furthermore, improvement of risk factors can be achieved bt means of fibrate treatment to modulate fasting and postprandial triglyceride levels. Treatment with cholesterol synthesis inhibitors ("statins") may reduce hepatic VLDL production and increase the clearance of atherogenic remnants by upregulating LDL-receptors, thus leading to improved fasting lipidlevels and enhanced clearance of chylomicron remnants. Finally, the use ofthiazolidinedione derivatives to improve insulin sensitivity may be one ofthe options for reducing the risk of atherosclerosis in obese subjects. (C) 2001, Medical Press.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 14:24:05