Abstract | Pretilost je kronična upala niskog intenziteta raširena diljem svijeta. Značajan porast u
učestalosti ove bolesti javlja se nakon industrijske revolucije, zbog čega je započela masovna
proizvodnja sada lako dostupne hrane. Bijelo adipozno tkivo u visceralnom području glavno je
skladište energije i mjesto oslobađanja slobodnih masnih kiselina, a time i središte upale. Upala
započinje infiltracijom makrofaga u tkivo uz lučenje različitih niskomolekularnih proteina (npr.
TNF-α, IL-1β i IL-6), citokina, čime se pojačava upala. Iako se akumulacija u najvećoj mjeri
odvija u visceralnom adipoznom tkivu, pro-upalni citokini odande cirkulacijom dospijevaju u
druga tkiva i organe. Njihovo djelovanje općenito se temelji se na povećavanju ili smanjivanju
aktivnosti različitih signalnih putova, npr. NF-κB, a osim upale izazivaju i oksidativni stres. Na
taj način mogu nastati brojne kronične bolesti, od kojih većina ima u podlozi otpornost na
inzulin koja je posljedica pretilosti. Bolesti koje su obrađene su otpornost na inzulin, aterogena
dislipidemija, bolest masne jetre, upala mišića, upala kostiju, kronična bolest bubrega,
poremećaj u sastavu mikrobnih zajednica crijeva, poremećaj vida i reproduktivnog zdravlja
žena, starenje stanica te rak. Osim navedenoga, razrađen je i utjecaj pretilosti na središnji
živčani sustav s eventualnim posljedicama poput anksioznosti i depresije. Također, u citokine
se ubrajaju i oni anti-upalni koji održavaju homeostazu i umanjuju učinak upale, npr.
adiponektin. Oni, uz uravnoteženu prehranu (i antioksidanse u svom sastavu) i redovitu
tjelovježbu pridonose smanjenju indeksa tjelesne mase, ali i sprječavanju značajnog povećanja
istoga. |
Abstract (english) | Obesity is chronic low-grade inflammation spread accros the world. A significant
increase in the incidence of this disease occurs after the industrial revolution, which is why
mass food production began, now easily accessible. The white adipose tissue in the visceral
area is the main energy store and place of free fatty acid release, and thus the center of
inflammation. The inflammation begins with the infiltration of macrophages into the tissue and
secreting various low molecular weight proteins (e. g. TNF-α, IL-1β and IL-6), cytokines,
which increase inflammation. Although accumulation occurs to the greatest extent in visceral
adipose tissue, pro-inflammatory cytokines come from circulation to other tissues and organs.
Their action is generally based on increasing or decreasing the activity of different signal paths,
e.g. NF-κB, and besides inflammation, cause oxidative stress. In this way, many chronic
diseases can occur, most of which mean an insulin resistance that is a consequence of obesity.
The diseases that are discussed are insulin resistance, atherogenic dyslipidemia, fatty liver
disease, muscle inflammation, bone inflammation, chronic kidney disease, disorder in the
composition of microbial joints of the gut, vision disorders, reproductive health of women
disorders, cell aging and cancer. In addition, the influence of obesity on the central nervous
system with possible consequences such as anxiety and depression has been elaborated.
Furthermore, there are also anti-inflammatory cytokines that maintain homeostasis and reduce
the effect of inflammation, e.g. adiponectin. They contribute to a decrease in the body mass
index, but also prevent a significant increase in the body mass index along with a balanced diet
(and antioxidants in their composition) and regular exercise. |