Diabetes Metab J.  2023 Sep;47(5):595-611. 10.4093/dmj.2023.0011.

Adipose Tissue and Metabolic Health

• An SM
• Cho SH
• Yoon JC

• KMID: 2546119
• DOI: http://doi.org/10.4093/dmj.2023.0011

Abstract

In this review, we provide a brief synopsis of the connections between adipose tissue and metabolic health and highlight some recent developments in understanding and exploiting adipocyte biology. Adipose tissue plays critical roles in the regulation of systemic glucose and lipid metabolism and secretes bioactive molecules possessing endocrine, paracrine, and autocrine functions. Dysfunctional adipose tissue has a detrimental impact on metabolic health and is intimately involved in key aspects of metabolic diseases such as insulin resistance, lipid overload, inflammation, and organelle stress. Differences in the distribution of fat depots and adipose characteristics relate to divergent degrees of metabolic dysfunction found in metabolically healthy and unhealthy obese individuals. Thermogenic adipocytes increase energy expenditure via mitochondrial uncoupling or adenosine triphosphate-consuming futile substrate cycles, while functioning as a metabolic sink and participating in crosstalk with other metabolic organs. Manipulation of adipose tissue provides a wealth of opportunities to intervene and combat the progression of associated metabolic diseases. We discuss current treatment modalities for obesity including incretin hormone analogs and touch upon emerging strategies with therapeutic potential including exosome-based therapy, pharmacological activation of brown and beige adipocyte thermogenesis, and administration or inhibition of adipocyte-derived factors.

Keyword

Adipose tissue; Inflammation; Metabolism; Obesity; Thermogenesis

Figure

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  Fig. 1. Differences between white, brown, and beige adipocytes. Created with BioRender.com. UCP1, uncoupling protein 1; WAT, white adipose tissue; BAT, brown adipose tissue; FGF21, fibroblast growth factor 21; IL-6, interleukin 6; SLIT-2, slit guidance ligand 2.

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  Fig. 2. Transformation of the adipocyte in obesity. Created with BioRender.com. UCP1, uncoupling protein 1; PCr, phosphocreatine; Cr, creatine; ETC, electron transport chain; ATP, adenosine triphosphate; ADP, adenosine diphosphate; AAC, ADP/ATP carrier; G3P, glycerol-3-phosphate; FA-CoA, fatty-acyl-coenzyme A; FFA, free fatty acid; SERCA, sarco/endoplasmic reticulum Ca2+-ATPase; ER, endoplasmic reticulum.

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  Fig. 3. Adipocyte thermogenic mechanisms. Created with BioRender.com. ER, endoplasmic reticulum.

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