Papel de la célula grasa en el riesgo cardiovascular / Role of the fat cell in cardiovascular risk

Resumen La obesidad es una enfermedad crónica, no transmisible, que recientemente ha tenido una connotación especial debido al aumento de su prevalencia en países en vía de desarrollo. Este incremento está relacionado con un aumento en la aparición de enfermedades metabólicas y el riesgo cardiovascular. Si bien la prevalencia de obesidad está aumentando en todos los países del mundo, existen diferencias regionales tanto en la prevalencia como en las tendencias de la obesidad. Por consiguiente, comprender los impulsores de estas diferencias regionales podría ayudar a proporcionar orientación para las estrategias de intervención más prometedoras. A pesar de considerarse una eventualidad simple en una proporción de lo que se ingiere y lo que se gasta, existen muchos factores que regulan esta enfermedad. No es sencillo encontrar medidas terapéuticas para la obesidad, pues sus causas son múltiples. En forma reciente, ha despertado un especial interés la caracterización funcional de los adipocitos, específicamente de los adipocitos beige, dado que su función está íntimamente relacionada con las circunstancias externas del ambiente y tienen una flexibilidad que les permite producir energía y mejorar muchos de los parámetros metabólicos en los individuos. En este manuscrito se hará énfasis en las características de las células adiposas y su influencia en el riesgo cardiovascular.

Abstract Obesity is a chronic non-transmissible disease that has recently had a special connotation due to the increase of its prevalence in developing countries. The increase in obesity is related to an expansion in the appearance of metabolic diseases and cardiovascular risk. Although the prevalence of obesity is increasing in all countries of the world, there are regional differences in both the prevalence and trends of obesity. Therefore, understanding the circumstances of these regional differences could help provide guidance for the most promising intervention strategies. Despite being considered a simple outcome in a proportion of what is ingested and what is spent, there are many factors that regulate this disease. It is not easy to find therapeutic measures for obesity, because their causes are multiple. Recently, the functional characterization of adipocytes, especially Beige adipocytes, has been of particular interest since their function is intimately related to the external circumstances of the environment and they have a flexibility that allows them to produce energy and improve many of the metabolic parameters in individuals. In the present manuscript we will focus on the characteristics of fat cells and their influence on cardiovascular risk.

Role of brown adipose tissue in metabolic syndrome, aging, and cancer cachexia / 医学前沿

Brown adipose tissue (BAT) plays a fundamental role in maintaining body temperature by producing heat. BAT that had been know to exist only in mammals and the human neonate has received great attention for the treatment of obesity and diabetes due to its important function in energy metabolism, ever since it is recently reported that human adults have functional BAT. In addition, beige adipocytes, brown adipocytes in white adipose tissue (WAT), have also been shown to take part in whole body metabolism. Multiple lines of evidence demonstrated that transplantation or activation of BAT or/and beige adipocytes reversed obesity and improved insulin sensitivity. Furthermore, many genes involved in BATactivation and/or the recruitment of beige cells have been found, thereby providing new promising strategies for future clinical application of BAT activation to treat obesity and metabolic diseases. This review focuses on recent advances of BAT function in the metabolic aspect and the relationship between BAT and cancer cachexia, a pathological process accompanied with decreased body weight and increased energy expenditure in cancer patients. The underlying possible mechanisms to reduce BAT mass and its activity in the elderly are also discussed.

The dark side of browning

The induction of brown-like adipocyte development in white adipose tissue (WAT) confers numerous metabolic benefits by decreasing adiposity and increasing energy expenditure. Therefore, WAT browning has gained considerable attention for its potential to reverse obesity and its associated co-morbidities. However, this perspective has been tainted by recent studies identifying the detrimental effects of inducing WAT browning. This review aims to highlight the adverse outcomes of both overactive and underactive browning activity, the harmful side effects of browning agents, as well as the molecular brake-switch system that has been proposed to regulate this process. Developing novel strategies that both sustain the metabolic improvements of WAT browning and attenuate the related adverse side effects is therefore essential for unlocking the therapeutic potential of browning agents in the treatment of metabolic diseases.

Brown Fat and Browning for the Treatment of Obesity and Related Metabolic Disorders

Brown fat is a specialized fat depot that can increase energy expenditure and produce heat. After the recent discovery of the presence of active brown fat in human adults and novel transcription factors controlling brown adipocyte differentiation, the field of the study of brown fat has gained great interest and is rapidly growing. Brown fat expansion and/or activation results in increased energy expenditure and a negative energy balance in mice and limits weight gain. Brown fat is also able to utilize blood glucose and lipid and results in improved glucose metabolism and blood lipid independent of weight loss. Prolonged cold exposure and beta adrenergic agonists can induce browning of white adipose tissue. The inducible brown adipocyte, beige adipocyte evolving by thermogenic activation of white adipose tissue have different origin and molecular signature from classical brown adipocytes but share the characteristics of high mitochondria content, UCP1 expression and thermogenic capacity when activated. Increasing browning may also be an efficient way to increase whole brown fat activity. Recent human studies have shown possibilities that findings in mice can be reproduced in human, making brown fat a good candidate organ to treat obesity and its related disorders.