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The "adipose tissue expandability" hypothesis: a potential mechanism for insulin resistance in obese youth
Sonia Caprio1, Bridget Pierpont1, Romy Kursawe2
1Department of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
Insights
Pediatric obesity is a growing concern linked to type 2 diabetes and cardiovascular issues. This review explores how fat distribution, not just total fat, impacts metabolic risk in youth.
Area of Science:
- Metabolic Health
- Pediatric Endocrinology
- Obesity Research
Background:
- Obesity is a significant global health challenge, particularly in children, increasing the risk of type 2 diabetes (T2D) and cardiovascular disease (CVD).
- The precise causes of pediatric obesity are not fully understood, despite extensive research.
- While obesity is a risk factor for chronic diseases, not all obese individuals develop comorbidities, suggesting other factors are involved.
Purpose of the Study:
- To review the role of altered fat partitioning in youth-onset obesity.
- To examine the relationship between fat distribution and metabolic complications like fatty liver and T2D in adolescents.
Main Methods:
- This is a review article, synthesizing existing research on pediatric obesity, fat partitioning, and metabolic health.
- The review focuses on etiological pathways and the impact of lipid distribution in different fat depots.
Main Results:
- Altered fat partitioning, rather than total body fat, may be a key determinant of metabolic risk in obese youth.
- Specific fat depots and their lipid composition are hypothesized to influence the development of comorbidities.
Conclusions:
- Understanding fat distribution is crucial for identifying metabolic risks in obese adolescents.
- Further research into fat partitioning may reveal new strategies for preventing obesity-related complications in youth.
Abstract:
Obesity has become a major global health challenge of the 21st century, as it is associated with the onset of type 2 diabetes (T2D) and cardiovascular complications, even at a very early age in life. The root causes of pediatric obesity remain incompletely understood. The obesity epidemic together with the relationship of obesity to the growing population burden of chronic disease presents unprecedented research opportunities and challenges. Decades of obesity-related research funded by governments around the world have yielded many important discoveries about both etiological pathways and preventive or therapeutic interventions. Yet, there is a sense that the problem is outpacing these research efforts. Obesity poses a significant risk for the development of cardiovascular disease (CVD) , diabetes and certain cancers thereby shortening life expectancy. Nevertheless, many obese individuals do not develop any of these comorbidities. One hypothesis explaining this dilemma is that total body fat is not the culprit of adverse health in obesity rather the relative proportion of lipids in various fat depots is what determines the metabolic risk. In this review, we describe the role of altered fat partitioning in youth onset obesity and its relation to fatty liver and T2D during adolescence.