Journal
JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION
Volume 34, Issue 3, Pages 244-254Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/07315724.2014.933685
Keywords
insulin resistance, metabolism, obesity, type 2 diabetes, body composition
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Funding
- Polish Ministry of Science and Higher Education [N402 383538]
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Inflammation plays a crucial role in the development and destabilization of atherosclerotic plaques in coronary vessels. Adipose tissue is considered to act in paracrine manner, which modulates a number of physiological and pathophysiological processes. Perivascular adipose tissue has developed specific properties that distinguish it from the fat in other locations. Interestingly, its activity depends on several metabolic conditions associated with insulin resistance and weight gain. Particularly in obesity perivascular fat seems to change its character from a protective to a detrimental one. The present review analyzes literature in terms of the pathophysiology of atherosclerosis, with particular emphasis on inflammatory processes. Additionally, the authors summarize data about confirmed paracrine activity of visceral adipose tissue and especially about pericoronary fat influence on the vascular wall. The contribution of adiponectin, leptin and resistin is addressed. Experimental and clinical data supporting the thesis of outside-to-inside signaling in the pericoronary milieu are further outlined. Clinical implications of epicardial and pericoronary adipose tissue activity are also evaluated. The role of pericoronary adipose tissue in obesity-related atherosclerosis is highlighted. In conclusion, the authors discuss potential therapeutical implications of these novel phenomena, including adipokine imbalance in pericoronary adipose tissue in the setting of obesity, the influence of lifestyle and diet modification, pharmaceutical interventions and the growing role of microRNAs in adipogenesis, insulin resistance and obesity. Key teaching points: center dot adipose tissue as a source of inflammatory mediators center dot changes in the vascular wall as a result of outside-to-inside signaling center dot anatomy, physiology, and clinical implications of epicardial and pericoronary adipose tissue activity center dot adipokines and their role in obesity-related atherosclerosis center dot therapeutic perspectives and future directions
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