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by José J. Fuster, Noriyuki Ouchi, Noyan Gokce, and Kenneth Walsh

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1 by José J. Fuster, Noriyuki Ouchi, Noyan Gokce, and Kenneth Walsh
Obesity-Induced Changes in Adipose Tissue Microenvironment and Their Impact on Cardiovascular Disease by José J. Fuster, Noriyuki Ouchi, Noyan Gokce, and Kenneth Walsh Circulation Research Volume 118(11): May 27, 2016 Copyright © American Heart Association, Inc. All rights reserved.

2 Adipose tissue depots occur throughout the body.
Adipose tissue depots occur throughout the body. Studies suggest that visceral adipose tissue accumulation is a major risk factor for cardiometabolic disease, whereas subcutaneous fat seems to be neutral or protective. Other adipose tissue depots of note include the epicardium, the perivascular space, and bone marrow, but the functional significance of these tissues is largely unknown. Brown adipose tissue occurs in the supraclavicular and paraspinal regions. In contrast to white adipose tissue, brown adipose tissue is metabolically active, and it functions to utilize fuel to produce heat. In addition, ectopic lipid can accumulate in tissues, such as liver, in metabolically dysfunctional organisms. José J. Fuster et al. Circ Res. 2016;118: Copyright © American Heart Association, Inc. All rights reserved.

3 Functional adipose tissue (left), predominantly found in lean organisms, tends to express anti-inflammatory adipokines that protect against cardiovascular disease. Functional adipose tissue (left), predominantly found in lean organisms, tends to express anti-inflammatory adipokines that protect against cardiovascular disease. In contrast, excess adipose tissue expansion promotes dysfunction (right), leading to the expression of proinflammatory adipokines that promote cardiovascular disease. Dysfunctional adipose tissue is characterized by enlarged adipocytes, vascular rarefaction, increased inflammatory cell infiltrate, and the appearance of crown-like structures. José J. Fuster et al. Circ Res. 2016;118: Copyright © American Heart Association, Inc. All rights reserved.

4 Obesity leads to adipose tissue dysfunction, triggering the release of proinflammatory adipokines that can directly act on cardiovascular tissues to promote disease. Obesity leads to adipose tissue dysfunction, triggering the release of proinflammatory adipokines that can directly act on cardiovascular tissues to promote disease. The adipokine imbalance can also affect the function of metabolically important tissues and the microvasculature, promoting insulin resistance and indirectly contributing to cardiovascular disease. José J. Fuster et al. Circ Res. 2016;118: Copyright © American Heart Association, Inc. All rights reserved.

5 Selected anti- and proinflammatory adipokines with summaries of their regulation and actions in the cardiovascular system. Selected anti- and proinflammatory adipokines with summaries of their regulation and actions in the cardiovascular system. CAD indicates coronary artery disease; I/R, ischemia/reperfusion; and MI, myocardial infarction. José J. Fuster et al. Circ Res. 2016;118: Copyright © American Heart Association, Inc. All rights reserved.


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