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Adipose Tissue Inflammation and Cardiovascular Disease: An Update

  • Macrovascular Complications in Diabetes (R Shah, Section Editor)
  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The obesity epidemic is on the rise, and while it is well known that obesity is associated with an increase in cardiovascular risk factors such as type 2 diabetes mellitus, hypertension, and obstructive sleep apnea, recent data has highlighted that the degree and type of fat distribution may play a bigger role in the pathogenesis of cardiovascular disease (CVD) than body mass index (BMI) alone. We aim to review updated data on adipose tissue inflammation and distribution and CVD.

Recent Findings

We review the pathophysiology of inflammation secondary to adipose tissue, the association of obesity-related adipokines and CVD, and the differences and significance of brown versus white adipose tissue. We delve into the clinical manifestations of obesity-related inflammation in CVD. We discuss the available data on heterogeneity of adipose tissue-related inflammation with a focus on subcutaneous versus visceral adipose tissue, the differential pathophysiology, and clinical CVD manifestations of adipose tissue across sex, race, and ethnicity. Finally, we present the available data on lifestyle modification, medical, and surgical therapeutics on reduction of obesity-related inflammation.

Summary

Obesity leads to a state of chronic inflammation which significantly increases the risk for CVD. More research is needed to develop non-invasive VAT quantification indices such as risk calculators which include variables such as sex, age, race, ethnicity, and VAT concentration, along with other well-known CVD risk factors in order to comprehensively determine risk of CVD in obese patients. Finally, pre-clinical biomarkers such as pro-inflammatory adipokines should be validated to estimate risk of CVD in obese patients.

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Abbreviations

CVD:

Cardiovascular disease

VAT:

Visceral adipose tissue

SAT:

Subcutaneous adipose tissue

TNF-α:

Tumor necrosis factor-α

IL-6:

Interleukin-6

CRP:

C-reactive protein

LDL:

Low-density lipoprotein

BMI:

Body mass index

CT:

Computed tomography

MRI:

Magnetic resonance imaging

HFpEF:

Heart failure with preserved ejection fraction

AF:

Atrial fibrillation

CI:

Confidence interval

MACE:

Major adverse cardiovascular events

SGLT-2:

Sodium-glucose cotransporter-2

GLP-1:

Glucagon-like peptide-1

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Authors and Affiliations

  1. Department of Medicine, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Mariam N. Rana & Ian J. Neeland

  2. Department of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Ian J. Neeland

  3. Harrington Heart and Vascular Institute, University Hospitals, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Ian J. Neeland

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Rana, M.N., Neeland, I.J. Adipose Tissue Inflammation and Cardiovascular Disease: An Update. Curr Diab Rep 22, 27–37 (2022). https://doi.org/10.1007/s11892-021-01446-9

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