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Submitted on June 14, 2006
Accepted on November 29, 2006
(PPAR
) and adipose tissue -- understanding obesity-related changes in regulation of lipid and glucose metabolism
Canada Research Chair for Cardiovascular Obesity Research and Management, McMaster University, Hamilton, ON; Institut Pasteur de Lille, Département d'Athérosclérose, Lille, F-59019 France; Inserm U545, Lille, F-509019 France; Université de Lille 2, Lille, F-59006 France
* To whom correspondence should be addressed. E-mail: sharma{at}cardio.on.ca.
Context: Adipose tissue is a metabolically dynamic organ, serving as a buffer to control fatty acid flux and a regulator of endocrine function. In obese subjects, and those with type 2 diabetes or the metabolic syndrome, adipose tissue function is altered -- adipocytes display morphological differences alongside aberrant endocrine and metabolic function and low-grade inflammation.
Evidence Acquisition: Articles on the role of PPAR
in adipose tissue of healthy individuals and those with obesity, metabolic syndrome, or type 2 diabetes were sourced using MEDLINE (1990-2006).
Evidence Synthesis: Articles were assessed to provide a comprehensive overview of how PPAR
activating ligands improve adipose tissue function and how this links to improvements in insulin resistance and the progression to type 2 diabetes and atherosclerosis.
Conclusions: PPAR
is highly expressed in adipose tissue, where its activation with thiazolidinediones alters fat topography, adipocyte phenotype, and upregulates genes involved in fatty acid metabolism and triglyceride storage. Furthermore, PPAR
activation is associated with potentially beneficial effects on the expression and secretion of a range of factors including adiponectin, resistin, IL-6, TNF
, PAI-1, MCP-1 and angiotensinogen, as well as a reduction in plasma NEFA supply. The effects of PPAR
also extend to macrophages, where they suppress production of inflammatory mediators. As such, PPAR
activation appears to have a beneficial effect on the relationship between the macrophage and adipocyte that is distorted in obesity. Thus, PPAR
activating ligands improve adipose tissue function and may have a role in preventing progression of insulin resistance to diabetes and endothelial dysfunction to atherosclerosis.
adipose tissue
thiazolidinediones
lipid metabolism
glucose metabolism
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