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  • Review Article
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Adipose tissue: friend or foe?

Nature Reviews Cardiology volume 9, pages 689–702 (2012)Cite this article

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Abstract

The perception of adipose tissue has changed considerably with the dramatic increase in the incidence of obesity and obesity-related comorbidities over the past 3 decades. Excess fat is no longer associated with wealth, but is instead recognized as a risk factor for many diseases. Adipose tissue is increasingly being identified as a vital, complex endocrine organ, and not simply as a fat store. Not all fat is created equal—regional, developmental, structural, and functional variations exist. Epicardial adipose tissue is a metabolically active organ producing a number of factors that modulate cardiac structure and function. The global epidemic of obesity and metabolic syndrome imposes a major disease burden, particularly of cardiovascular disease. In this Review, we describe the various types of adipose tissue—their developmental biology, differentiation, cell heterogeneity, and functional characteristics. We discuss the link between adipose tissue and inflammation, the signaling factors released by adipose tissue, as well as cardiac adiposity and its relevance to cardiovascular diseases. Finally, we review the myocardial regenerative potential of adipose-tissue-derived stem cells. We believe that a thorough understanding of adipose tissue is of great clinical value.

Key Points

  • Distinct functional types of adipose tissue exist, each with a characteristic origin and pattern of development and differentiation

  • Adipose tissue displays both structural and regional heterogeneity

  • Adipose tissue secretes numerous factors, including cytokines and growth factors, with physiological and pathological roles

  • Cardiac adiposity is a marker of, and contributory factor to, various cardiac diseases

  • Adipose-tissue-derived stem cells might have an important role in myocardial regeneration and repair

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Figure 1: Regulation of thermogenesis.
Figure 2: Origins and development of white and brown adipose tissue.20
Figure 3: Sequential activation of transcription factors controls adipogenesis.33
Figure 4: Ultrastructure of adipose tissue.
Figure 5: Distribution of epicardial AT.

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Authors and Affiliations

  1. Aswan Heart Center, Kasr El Hajjar Street, P. O. Box 81512, Aswan, Egypt

    Mohamed Hassan

  2. Harefield Heart Science Center, Imperial College London, Harefield, UB9 6JH, Middlesex, UK

    Najma Latif & Magdi Yacoub

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  1. Mohamed Hassan
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All the authors contributed substantially to researching data for the article, discussion of its content, writing the article, and reviewing and editing the manuscript before submission.

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Correspondence to Magdi Yacoub.

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Hassan, M., Latif, N. & Yacoub, M. Adipose tissue: friend or foe?. Nat Rev Cardiol 9, 689–702 (2012). https://doi.org/10.1038/nrcardio.2012.148

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