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
Review
. 2020 Dec;21(12):e13085.
doi: 10.1111/obr.13085. Epub 2020 Jul 1.

White adipose tissue browning in critical illness: A review of the evidence, mechanisms and future perspectives

Elham Alipoor  1 , Mohammad Javad Hosseinzadeh-Attar  2   3 , Mahsa Rezaei  2 , Shima Jazayeri  1 , Marianne Chapman  4   5   6
Affiliations
Review

White adipose tissue browning in critical illness: A review of the evidence, mechanisms and future perspectives

Elham Alipoor et al. Obes Rev. 2020 Dec.

Abstract

Observational studies suggest better clinical outcomes following critical illness in patients with overweight and obesity (obesity paradox). An understanding of the morphologic, physiologic and metabolic changes in adipose tissue in critical illness may provide an explanation. Recent studies have demonstrated the transformation of white to brown-like adipocytes due to the "browning process," which has been of interest as a potential novel therapy in obesity during the last decade. The characteristics of the browning of white adipose tissue (WAT) include the appearance of smaller, multilocular adipocytes, increased UCP1 mRNA expression, mitochondrial density and respiratory capacity. These changes have been identified in some critical illnesses, which specifically refers to burns, sepsis and cancer cachexia in this study. The pathophysiological nature of WAT browning, underlying mechanisms, main regulators and potential benefits and harms of this process are interesting new areas that warrants further investigations. In this review, we discuss emerging scientific discipline of adipose tissue physiology in metabolic stress, available data, gaps of knowledge and future perspectives. Future investigations in this field may provide insights into the underlying mechanisms and clinical aspects of browning that may further our understanding of the proposed obesity paradox following critical illness, which may in turn open up opportunities for novel therapies to save lives and improve recovery.

Keywords: brown adipose tissue; critical illness; obesity; white adipose tissue.

PubMed Disclaimer

References

REFERENCES

    1. Van den Berghe G. Endocrine evaluation of patients with critical illness. Endocrinol Metab Clin North Am. 2003;32(2):385-410.
    1. Vanhorebeek I, Langouche L, Van den Berghe G. Endocrine aspects of acute and prolonged critical illness. Nat Clin Pract Endocrinol Metab. 2006;2(1):20-31.
    1. Knaus WA, Wagner DP, Zimmerman JE, Draper EA. Variations in mortality and length of stay in intensive care units. Ann Intern Med. 1993;118(10):753-761.
    1. Mayr VD, Dünser MW, Greil V, et al. Causes of death and determinants of outcome in critically ill patients. Crit Care. 2006;10(6):R154.
    1. Fahy BG, Sheehy AM, Coursin DB. Glucose control in the intensive care unit. Crit Care Med. 2009;37(5):1769-1776.

LinkOut - more resources