2004, Número S2
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Gac Med Mex 2004; 140 (S2)
Obesidad y esteatohepatitis. Aspectos histológicos
Pichardo-Bahena R, Paz-Gómez FJ, Estrada-Villaseñor EG
Idioma: Español
Referencias bibliográficas: 43
Paginas: 33-40
Archivo PDF: 838.85 Kb.
RESUMEN
El concepto arcaico de considerar al tejido adiposo como
un reservorio pasivo para el depósito de energía no es
válido en la actualidad debido a que se ha demostrado que
es un órgano endocrino esencial y altamente metabólico
que no responde únicamente a señales aferentes de sistemas
hormonales tradicionales y del sistema nervioso central,
sino que también expresa y secreta factores con funciones
endocrinas importantes. Estos factores incluyen leptina y
otras citocinas. El tejido adiposo es también el sitio más
importante en el metabolismo de esteroides sexuales y
glucocorticoides. Su importante función endocrina se
demuestra por las consecuencias metabólicas adversas
asociadas a su exceso como a su deficiencia. El exceso de
tejido adiposo principalmente en el compartimiento visceral
se asocia a resistencia a la insulina, hiperglicemia,
dislipidemia, hipertensión arterial y estados protrombóticos
y pro inflamatorios. El hígado es uno de los órganos
directamente afectados mediante mecanismos que
involucran la activación de las vías de apoptosis por medio
del factor de necrosis tumoral-α y activación de caspasas
además del aumento de la formación de especies reactivas
de oxígeno por activación del estrés oxidativo y cadenas
enzimáticas como las que involucran el citocromo P450,
CYP2E1 y CYP3A4 causando un espectro de lesiones que
van desde un síndrome metabólico de hígado graso no
relacionado a alcohol, esteatohepatitis no alcohólica con
o sin fibrosis hasta cirrosis hepática.. Esta revisión presenta
un panorama de las funciones endocrinas del tejido adiposo
y su influencia en los mecanismos asociados al daño
hepático.
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