“Adipose tissue (WAT-white adipose tissue) is no longer considered to be an inert tissue that stores fat. This tissue is capable of expanding to accommodate increased lipids through hypertrophy of existing adipocytes and by initiating the differentiation of pre-adipocytes. Adipose tissue metabolism exerts an impact on whole-body metabolism.
As an endocrine organ, adipose tissue is responsible for the synthesis and secretion of several hormones and closely tied into immune system activity through inflammatory process mediators”.
These are active in a range of processes, such as control of nutritional intake (leptin, angiotensin), control of sensitivity to insulin and inflammatory process mediators (tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), resistin, visfatin, adiponectin, among others) and pathways (plasminogen activator inhibitor 1 (PAI-1) and acylation stimulating protein (ASP) for example).”. (Marisa Coelho,1,2 Teresa Oliveira,2 and Ruben Fernandes
WAT has normalizing balancing effects on endocrine system homeostasis and metabolism in general, but if in a dysfunctional hypertrophic phase termed as obesity, it can then be considered an endocrinopathy.
When in this state of tissue excess and imbalance of its own endogenously created hormones, there appears generated an under-recognized low-grade inflammation resulting in chronic activation of the immune system which secondarily can lead to insulin resistance, impaired glucose tolerance, and even diabetes.
Now, more than ever as the population ages, we are recognizing the epidemiological connection between diabetes, obesity, and even dementia.
And bringing this to address the current COVID pandemic, obesity, and diabetes considered as major risk factors for increased risk of morbidity and mortality from this deadly virus.
The key intersection of these three diseases in common is insulin resistance which is described to occur in peripheral tissues in diabetes and obesity and has recently also been to develop in Alzheimer’s disease.
