Жировая ткань и функция надпочечников: механизмы взаимного влияния

Механизмы взаимного влияния жировой ткани и гипоталамо-гипофизарно-надпочечниковой системы (ГГНС) включают регуляцию метаболизма адипоцитов гормонами коры надпочечников, с одной стороны, и влияние адипоцитов и адипоцито-кинов на секрецию, метаболизм и действие стероидных гормонов в клетках-мишенях - с другой.

Глюкокортикоиды способствуют дифференцировке преадипоцитов в зрелые адипоциты, под действием ГКС бурая жировая ткань трансформируется в белую. Минералокортикоиды также участвуют в процессе дифференцировки адипоцитов, регулируют экспрессию адипокинов, индуцируют оксидативный стресс в жировой ткани. Имеются данные, подтверждающие наличие зависимости между циркулирующим дегидроэпиандростерон-сульфатом (ДГЭА-С), ожирением, чувствительностью к инсулину и сердечно-сосудистыми заболеваниями.

В качестве возможных механизмов активации ГГНС при ожирении рассматриваются орексигенные нейропептиды и медиаторы воспаления, являющиеся триггерами синтеза кортикотропин-рилизинг гормона (КРГ) в гипоталамических паравентрикулярных ядрах. Экспрессия 11р-гидроксистероиддегидрогеназы 1-го типа (11Р-ГСД1) в жировой ткани и образование кортизола из кортизона на тканевом уровне могут рассматриваться как один из факторов формирования инсулинорезистентности. Следствием продукции альдостерона и ароматизации андрогенов жировой тканью является аутокринное и паракринное регуляторное действие этих гормонов на функцию адипоцитов.

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