The perfect storm: obesity, adipocyte dysfunction, and metabolic consequences.

Area of Science:

• Metabolic and Molecular Pathophysiology
• Obesity and Disease Linkages

Background:

• Rising global adiposity rates highlight strong links to diseases like cardiovascular disease, diabetes, and cancer.
• Excess adipose tissue triggers complex cellular, hormonal, and molecular changes contributing to adverse health outcomes.

Purpose of the Study:

• Review adipocyte metabolism and function in energy imbalance.
• Discuss systemic consequences and implications for clinical care, including lifestyle modifications.

Main Methods:

• Review of cellular processes in chronic energy imbalance.
• Examination of adipocyte hypertrophy, hyperplasia, and dysfunction.
• Analysis of systemic consequences including adipokine and free fatty acid release.

Main Results:

• Chronic energy imbalance leads to adipocyte endoplasmic reticulum and mitochondrial stress.
• This stress increases release of adipokines, free fatty acids, and inflammatory mediators.
• Adipocyte dysfunction impacts liver, pancreatic beta-cells, skeletal muscle, heart, and vasculature.

Conclusions:

• Adipocyte stress and associated mediator release are central to obesity's adverse health effects.
• Future research should target these pathways and address underlying lifestyle behaviors.