Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar 5;2(3):e30.
doi: 10.1038/nutd.2012.3.

Relation of depot-specific adipose inflammation to insulin resistance in human obesity

Affiliations

Relation of depot-specific adipose inflammation to insulin resistance in human obesity

S J Bigornia et al. Nutr Diabetes. .

Abstract

Background: A low-grade state of adipose tissue inflammation associated with obesity has been linked to mechanisms of systemic metabolic dysfunction. However, the relation of clinical phenotypes to depot-specific inflammation has not been well examined in human obesity.

Objective: To characterize the inflammatory status of subcutaneous and visceral fat depots, as assessed by tissue presence of macrophage crown-like structures (CLS) as a hallmark of chronic inflammation, and determine the relation of systemic insulin resistance to inflammatory abnormalities in subcutaneous and visceral fat.

Methods: We collected adipose tissue simultaneously from subcutaneous and visceral (omental and mesenteric) depots in 92 obese participants (age 42±11 years; BMI30 kg m(-2)) during planned bariatric surgery. Using immunohistochemistry, we categorized individuals as CLS(+) or CLS(-) based on the presence or absence, respectively, of macrophage CLS in subcutaneous (CLSs), omental (CLSo) and mesenteric (CLSm) adipose depots.

Results: The majority of participants exhibited adipose tissue inflammation manifest by the presence of CLS (CLS(+)) in both subcutaneous and intra-abdominal visceral depots. CLS status in subcutaneous fat was highly sensitive and modestly specific for inflammation of visceral fat. In multivariable models, plasma insulin and homeostatis model assessment levels were positively associated with CLS(+) status in all depots independent of age, waist circumference, BMI and type 2 diabetes, and worsened with the increasing number of adipose regions involved.

Conclusions: In severely obese participants, systemic insulin resistance is linked to adipose inflammation in both subcutaneous and visceral depots. The findings suggest that examination of subcutaneous regions that are more easily accessible by transcutaneous biopsy may prove useful in clinical studies designed to investigate adipose phenotypes in relation to human disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Representative histological illustration of inflamed adipose tissue as demonstrated by light microscopy. CD68+ macrophages (brown color) are organized into two separate ‘crown-like structures' (indicated by arrows) surrounding individual adipocytes. (a) × 20 Power; (b) × 40 Power.
Figure 2
Figure 2
(a-d) Relation of subcutaneous, omental and mesenteric adipose tissue crown-like structures (CLS) status to plasma (a) HOMA (b) insulin (c) glucose and (d) HbA1c. Data are adjusted for age, WCR, BMI and prevalent T2DM. Data are presented as means±s.e., *P<0.05 or P=0.05 for CLS+ vs CLS within each specific depot. ln=natural logarithm.
Figure 3
Figure 3
(a, b) Relation of plasma measures of insulin resistance and glycemic parameters to adipose inflammation by combined analyses of (a) subcutaneous-omental and (b) subcutaneous-mesenteric CLS status. Data are adjusted for age, WCR, BMI and prevalent T2DM. Data are presented as mean±s.e., *P<0.05 or P=0.05 for comparisons with the CLSs/CLSo or CLSs/CLSm groups. ln=natural logarithm.

References

    1. Samuel VT, Petersen KF, Shulman GI. Lipid-induced insulin resistance: unravelling the mechanism. Lancet. 2010;375:2267–2277. - PMC - PubMed
    1. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. - PMC - PubMed
    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303:235–241. - PubMed
    1. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA. 2010;303:242–249. - PubMed
    1. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378:815–825. - PubMed