CAJ | 학술논문

目的探讨内脏脂肪切除术的作用及研究现状。方法对相关文献进行综述分析。结果内脏脂肪增加可导致胰岛素抵抗，糖脂代谢紊乱，脂肪因子及炎性因子过分泌和全身慢性炎性反应状态，是2型糖尿病、心脑血管疾病、血脂异常、代谢综合征等代谢相关并发症的关键因素。同时，肥胖和内脏脂肪也可增加多种恶性肿瘤的发生，缩短无瘤生存时间和总体生存期，增加复发和死亡风险。内脏脂肪与恶性肿瘤的关系与其诱导的胰岛素抵抗、脂肪因子及炎性因子过分泌和全身慢性炎性反应状态密切相关。因此内脏脂肪也就成为了治疗和预防这些疾病的靶点，直接切除部分内脏脂肪即是方法之一。手术直接切除部分内脏脂肪有改善胰岛素抵抗，增加胰岛素敏感性，减少脂肪因子、炎性因子分泌和预防肿瘤发生的作用，已在动物实验中获得多数研究的认可。但在人体内脏脂肪切除实验中，由于受到解剖和医学伦理的限制，只能切除大网膜，大多数相关研究也未发现类似积极作用。结论在动物实验中，已证实内脏脂肪切除可能对改善糖脂代谢和预防肿瘤发生发挥一定作用，但在人体实验中大网膜切除并没有发现类似改变，可能与脂肪切除量不足有关，具体原因有待进一步研究。
목적탐토내장지방절제술적작용급연구현상。방법대상관문헌진행종술분석。결과내장지방증가가도치이도소저항，당지대사문란，지방인자급염성인자과분비화전신만성염성반응상태，시2형당뇨병、심뇌혈관질병、혈지이상、대사종합정등대사상관병발증적관건인소。동시，비반화내장지방야가증가다충악성종류적발생，축단무류생존시간화총체생존기，증가복발화사망풍험。내장지방여악성종류적관계여기유도적이도소저항、지방인자급염성인자과분비화전신만성염성반응상태밀절상관。인차내장지방야취성위료치료화예방저사질병적파점，직접절제부분내장지방즉시방법지일。수술직접절제부분내장지방유개선이도소저항，증가이도소민감성，감소지방인자、염성인자분비화예방종류발생적작용，이재동물실험중획득다수연구적인가。단재인체내장지방절제실험중，유우수도해부화의학윤리적한제，지능절제대망막，대다수상관연구야미발현유사적겁작용。결론재동물실험중，이증실내장지방절제가능대개선당지대사화예방종류발생발휘일정작용，단재인체실험중대망막절제병몰유발현유사개변，가능여지방절제량불족유관，구체원인유대진일보연구。
Objective To summarize the function and research status of visceral fat (VF) removal.Methods The related literatures were reviewed.Results Increased VF can result in insulin resistance (IR), excessive adipocytokines and inlfammatory cytokines secretion, and glucolipid metabolism disorders, and is the key factor of type 2 diabetes, dyslipidemia, cardiovascular diseases, metabolic syndrome and other metabolic complications. Obesity and visceral fat, both can increase the incidence of malignant tumor, shorten the disease-free and overall survival, increase the risk of recurrence and death. The relationship between visceral fat and malignant tumor is also related with insulin resistance, excessive adipocytokines and inflammatory cytokines secretion, and systemic chronic inflammatory response status, which all induced by the VF. So the VF became the target of the treatments and preventions of these diseases andsurgical removal of part of VF directly is one way of them. In most of animal experiments, surgical removal of part of VF directly has been shown to improve IR, increase insulin sensitivity, glucolipid metabolism, reduce adipocytokines and inflammatory cytokines secretion and prevent tumorigenesis. But in human, due to the limitation of anatomical and medical ethics, only great omentum can be removed in similar experiments, and most of the studies have not found similar positive roles.Conclusions Many animal experiments have conifrmed that visceral fat resection can improve glucolipid metabolism and prevent tumorigenesis, but in clinical trials, the omentectomy, found no similar changes, which may be associated with insufifcient excised fat mass, the speciifc reason need further study.