vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2025.3.MORPH.3vmireaviz-1294Research ArticleМорфология, патологияMorphology, pathologyМорфология и функциональная организация подкожной жировой ткани: современные представления о структурно-функциональной гетерогенности и возрастных изменениях (систематический обзор литературы)Morphology and functional organization of subcutaneous adipose tissue: modern concepts of structural and functional heterogeneity and age-related changes (systematic literature review)ШиршаковаМ. А.ShirshakovaM. A.

Ширшакова Мария Александровна - Канд. мед. наук, основатель клиники NBMC и учебного центра «Бьюти Практикум» Вклад автора: концепция и дизайн исследования, анализ литературы, написание статьи.

Садовая-Кудринская ул., д. 7, стр. 13, г. Москва, 123242

Mariya A. Shirshakova - Cand. Sci. (Med.), founder of the NBMC clinic and the Beauty Praktikum educational center. Author's contribution: study concept and design, literature analysis, article writing.

7, Sadovaya-Kudrinskaya St., building 13, Moscow, 123242

mariashishakova@yandex.ruhttps://orcid.org/0000-0001-6272-3026ШемяковС. Е.ShemyakovS. E.

Шемяков Сергей Евгеньевич - Д-р мед. наук, профессор, заместитель директора, Институт анатомии и морфологии имени академика Ю.М Лопухина, заведующий кафедрой Вклад автора: методология исследования, анализ литературы, редактирование статьи.

ул. Островитянова, д. 1, г. Москва, 117997

Sergey E. Shemyakov - Dr. Sci. (Med.), Professor, Deputy Director, Yu.M. Lopukhin Institute of Anatomy and Morphology, Head of Department Author's contribution: study methodology, literature analysis, article editing.

1, Ostrovityanova St., Moscow, 117997

shemyakov_se@rsmu.ruhttps://orcid.org/0000-0002-1350-0704СупильниковА. А.Supil'nikovA. A.

Супильников Алексей Александрович - Канд. мед. наук, доцент, заместитель директора Института анатомии и морфологии имени академика Ю.М. Лопухина; первый проректор по научной деятельности Вклад автора: методология исследования, анализ литературы, редактирование статьи.

ул. Островитянова, д. 1, г. Москва, 117997;ул. Чапаевская, д. 227, г. Самара, 443001

Aleksey A. Supilnikov - Cand. Sci. (Med.), Associate Professor, Deputy Director, Yu.M. Lopukhin Institute of Anatomy and Morphology. Lopukhina; First Vice-Rector for Research Author's contribution: research methodology, literature analysis, article editing.

1, Ostrovityanova St., Moscow, 117997;Chapaevskaya St., 227, Samara, 443001

a.a.supilnikov@reaviz.onlinehttps://orcid.org/0000-0001-8773-520XМельниковаЮ. Е.Mel'nikovaYu. E.

Мельникова Юлия Евгеньевна - Врач-дерматовенеролог, косметолог клиники NBMC Вклад автора: поиск и анализ литературы, систематизация данных, подготовка рукописи.

Садовая-Кудринская ул., д. 7, стр. 13, г. Москва, 123242

Yuliya E. Mel'nikova - Dermatovenerologist, cosmetologist at the NBMC clinic. Author's contribution: literature search and analysis, data systematization, manuscript preparation.

7, Sadovaya-Kudrinskaya St., building 13, Moscow, 123242

yuliyamelnikova25@gmail.comNBMC Медицинский центр естественной красотыРоссияNBMC Medical Center of Natural BeautyRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Медицинский университет «Реавиз»РоссияPirogov Russian National Research Medical University; Medical University "Reaviz"Russian Federation202501082025153156164Copyright © Ширшакова М.А., Шемяков С.Е., Супильников А.А., Мельникова Ю.Е., 20252025Ширшакова М.А., Шемяков С.Е., Супильников А.А., Мельникова Ю.Е.Shirshakova M.A., Shemyakov S.E., Supil'nikov A.A., Mel'nikova Y.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1294

Введение. Подкожная жировая ткань представляет собой сложную многокомпонентную систему, играющую ключевую роль в метаболических, иммунологических и терморегуляторных процессах организма. Современные представления о структурнофункциональной гетерогенности жировой ткани кардинально изменили понимание её роли в патогенезе метаболических заболеваний и процессах старения. Цель исследования: провести систематический анализ современных данных о морфологической организации подкожной жировой ткани, её слоистой структуре и возрастных изменениях с акцентом на клиническое значение для эстетической медицины. Материалы и методы. Выполнен систематический поиск литературы в базах данных PubMed, Scopus, Web of Science, РИНЦ за период 2015–2024 гг. Использованы ключевые слова: "subcutaneous adipose tissue", "dermal white adipose tissue", "superficial fascia", "aging", "morphology". Проанализировано 89 источников, из которых 52 включены в окончательный анализ согласно критериям включения. Результаты. Подкожная жировая ткань характеризуется выраженной морфологической гетерогенностью и может быть разделена на дермальную белую жировую ткань (dWAT) и поверхностную белую жировую ткань (sWAT). dWAT локализуется в нижних слоях дермы в виде дискретных жировых скоплений, тогда как sWAT образует непрерывный слой, отделённый от dWAT поверхностной фасцией. Клетки dWAT характеризуются меньшими размерами (30–50 мкм), высокой экспрессией маркеров UCP1 и PRDM16, активным участием в процессах заживления ран и терморегуляции. sWAT содержит крупные адипоциты (80–130 мкм), организованные в дольки, разделённые фиброзными перегородками. Возрастные изменения включают прогрессивное уменьшение объёма dWAT (до 40% к 60 годам), изменение соотношения коллагена I/III типов, снижение васкуляризации и лимфодренажа. Молекулярные механизмы старения связаны с подавлением экспрессии PPARγ, CEBPα, снижением активности сигнального пути Wnt/β-катенин. Заключение. Понимание морфологической гетерогенности подкожной жировой ткани критически важно для разработки персонализированных подходов в эстетической медицине. Дальнейшие исследования должны сосредоточиться на изучении молекулярных механизмов дифференцировки различных популяций адипоцитов и разработке таргетных методов коррекции возрастных изменений.

Introduction. Subcutaneous adipose tissue represents a complex multi-component system playing a pivotal role in metabolic, immunological, and thermoregulatory processes. Contemporary understanding of structural and functional heterogeneity of adipose tissue has fundamentally changed our perception of its role in metabolic disease pathogenesis and aging processes. Objective. To conduct a systematic analysis of current data on morphological organization of subcutaneous adipose tissue, its layered structure, and age-related changes with emphasis on clinical significance for aesthetic medicine. Materials and methods. A systematic literature search was performed in PubMed, Scopus, Web of Science, and RSCI databases for the period 2015-2024. Keywords included: "subcutaneous adipose tissue", "dermal white adipose tissue", "superficial fascia", "aging", "morphology". Of 89 sources analyzed, 52 were included in the final analysis according to inclusion criteria. Results. Subcutaneous adipose tissue is characterized by pronounced morphological heterogeneity and can be divided into dermal white adipose tissue (dWAT) and superficial white adipose tissue (sWAT). dWAT is localized in the lower dermis as discrete adipose clusters, while sWAT forms a continuous layer separated from dWAT by the superficial fascia. dWAT cells are characterized by smaller size (30-50 μm), high expression of UCP1 and PRDM16 markers, and active participation in wound healing and thermoregulation. sWAT contains large adipocytes (80-130 μm) organized into lobules separated by fibrous septa. Age-related changes include progressive reduction in dWAT volume (up to 40% by age 60), altered collagen I/III ratio, decreased vascularization and lymphatic drainage. Molecular aging mechanisms are associated with suppressed PPARγ and CEBPα expression and reduced Wnt/β-catenin signaling pathway activity. Conclusion. Understanding the morphological heterogeneity of subcutaneous adipose tissue is critically important for developing personalized approaches in aesthetic medicine. Future research should focus on studying molecular mechanisms of different adipocyte population differentiation and developing targeted methods for age-related change correction.

подкожная жировая ткань [D050151]дермальная белая жировая ткань [D000273]поверхностная белая жировая ткань [D000273]морфология [D009024]старение [D000375]адипогенез [D050156]адипоциты [D017667]внеклеточный матрикс [D005109]коллаген [D003094]фиброз [D005355]васкуляризация [D018919]термогенез [D022722]эстетическая медицина [D003357]регенеративная медицина [D044968]клеточное старение [D016922]воспаление [D007249]subcutaneous adipose tissue [D050151]dermal white adipose tissue [D000273]superficial white adipose tissue [D000273]morphology [D009024]aging [D000375]adipogenesis [D050156]adipocytes [D017667]extracellular matrix [D005109]collagen [D003094]fibrosis [D005355]vascularization [D018919]thermogenesis [D022722]aesthetic medicine [D003357]regenerative medicine [D044968]cellular senescence [D016922]inflammation [D007249]ReferencesRydén M., Arner P. Subcutaneous adipocyte lipolysis contributes to circulating lipid levels. Arterioscler. Thromb. Vasc. 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The authors declare that there are no conflicts of interest present.