Novel aspects on the role of white adipose tissue in type 2 diabetes

White adipose tissue (WAT) is a highly dynamic organ that can vary considerably in mass depending on energy balance. Data from recent cross-sectional and prospective clinical studies have revealed a set of mechanisms that link WAT dysfunction to type 2 diabetes. This review focuses on three of the most important pathophysiological processes that distinguish WAT in the insulin resistant state: regional WAT distribution, adipocyte hypertrophy and lipid turnover. Together, these disturbances attenuate the lipid storage capacity of WAT leading to ectopic fat deposition in peripheral tissues such as skeletal muscle, liver and vessels ultimately leading to type 2 diabetes and cardiovascular complications. The possible approachestotherapeuticallytarget dysfunctional WAT are also discussed.