Adiponectin: a manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease?

摘要: Adiponectin is the most abundant peptide secreted by adipocytes, being a key component in interrelationship between adiposity, insulin resistance and inflammation. Central obesity accompanied factor development of metabolic syndrome (MS) future macrovascular complications. Moreover, remarkable correlation coronary artery disease (CAD) alterations glucose metabolism has raised likelihood that atherosclerosis type 2 diabetes mellitus (T2DM) may share common biological background. We summarize here current knowledge about influence adiponectin on sensitivity endothelial function, discussing its forthcoming prospects potential role as therapeutic target for MS, T2DM, cardiovascular disease. present circulation dimer, trimer or protein complex high molecular weight hexamers, >400 kDa. AdipoR1 AdipoR2 are major receptors vivo mediating actions. stimulates phosphorylation AMP (adenosin mono phosphate) kinase activation, exerting direct effects vascular endothelium, diminishing inflammatory response to mechanical injury enhancing endothelium protection cases apolipoprotein E deficiency. Hypoadiponectinemia consistently associated with obesity, atherosclerosis, CAD, T2DM. Lifestyle correction helps favorably modify plasma levels. Low adiponectinemia obese patients via continued loss programs both diabetic nondiabetic individuals also reductions pro-inflammatory factors. Diet modifications, like intake fish, omega-3 supplementation, adherence Mediterranean dietary pattern coffee consumption increase Antidiabetic pharmacological agents, glitazones, glimepiride, angiotensin converting enzyme inhibitors receptor blockers able improve concentration. Fibric acid derivatives, bezafibrate fenofibrate, have been reported enhance levels well. T-cadherin, membrane-associated adiponectin-binding lacking intracellular domain seems be main mediator antiatherogenic The finding novel pharmacologic agents proficient should exhaustive research. Interesting approaches could adiponectin-targeted drugs chemically designed induce activaton and/or postreceptor signaling pathways, specific agonists.