The clinical recognition that adipose tissue, far from being merely a passive energy storage depot, functions as a highly active and complex endocrine organ that secretes a diverse array of signaling molecules known as adipokines. This tissue, particularly the visceral component, plays a critical role in regulating systemic metabolism, inflammation, appetite, and hormonal balance throughout the body. Its functional status is a primary determinant of cardiometabolic health and longevity.
Origin
This term marks a significant paradigm shift in endocrinology, originating from discoveries in the 1990s, such as the identification of leptin, the first major adipokine. The concept formally reclassified fat tissue as an integral part of the endocrine system, moving beyond its traditional classification as connective tissue. This reclassification highlighted its role in inter-organ communication and disease pathology.
Mechanism
The endocrine mechanism of adipose tissue involves the synthesis and secretion of adipokines, including leptin, adiponectin, resistin, and various pro-inflammatory cytokines. Adiponectin, for instance, enhances insulin sensitivity and possesses anti-inflammatory properties, while excessive visceral fat releases inflammatory cytokines that drive systemic insulin resistance and endothelial dysfunction. These adipokines travel through the circulation to act on distant target tissues, including the liver, muscle, and brain, thus influencing global energy homeostasis.
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