Adipose tissue
Adipose tissue is a loose connective tissue composed mostly of adipocytes. It also contains the stromal vascular fraction of cells including preadipocytes, fibroblasts, vascular endothelial cells and a variety of immune cells such as adipose tissue macrophages. Its main role is to store energy in the form of lipids, although it also cushions and insulates the body.
Previously treated as being hormonally inert, in recent years adipose tissue has been recognized as a major endocrine organ, as it produces hormones such as leptin, estrogen, resistin, and cytokines. In obesity, adipose tissue is implicated in the chronic release of pro-inflammatory markers known as adipokines, which are responsible for the development of metabolic syndromea constellation of diseases including type 2 diabetes, cardiovascular disease and atherosclerosis.
Adipose tissue is derived from preadipocytes and its formation appears to be controlled in part by the adipose gene. The two types of adipose tissue are white adipose tissue, which stores energy, and brown adipose tissue, which generates body heat. Adipose tissuemore specifically brown adipose tissuewas first identified by the Swiss naturalist Conrad Gessner in 1551.
Anatomical features
In humans, adipose tissue is located beneath the skin, around internal organs, in bone marrow, intermuscular, and in the breast. Adipose tissue is found in specific locations, which are referred to as adipose depots. In addition to adipocytes, which comprise the highest percentage of cells within adipose tissue, other cell types are present, collectively termed stromal vascular fraction of cells. SVF includes preadipocytes, fibroblasts, adipose tissue macrophages, and endothelial cells.Adipose tissue contains many small blood vessels. In the integumentary system, which includes the skin, it accumulates in the deepest level, the subcutaneous layer, providing insulation from heat and cold. Around organs, it provides protective padding. However, its main function is to be a reserve of lipids, which can be oxidised to meet the energy needs of the body and to protect it from excess glucose by storing triglycerides produced by the liver from sugars, although some evidence suggests that most lipid synthesis from carbohydrates occurs in the adipose tissue itself. Adipose depots in different parts of the body have different biochemical profiles. Under normal conditions, it provides feedback for hunger and diet to the brain.
Mice
Mice have eight major adipose depots, four of which are within the abdominal cavity. The paired gonadal depots are attached to the uterus and ovaries in females and the epididymis and testes in males; the paired retroperitoneal depots are found along the dorsal wall of the abdomen, surrounding the kidney, and, when massive, extend into the pelvis. The mesenteric depot forms a glue-like web that supports the intestines and the omental depot and - when massive - extends into the ventral abdomen. Both the mesenteric and omental depots incorporate much lymphoid tissue as lymph nodes and milky spots, respectively.The two superficial depots are the paired inguinal depots, which are found anterior to the upper segment of the hind limbs and the subscapular depots, paired medial mixtures of brown adipose tissue adjacent to regions of white adipose tissue, which are found under the skin between the dorsal crests of the scapulae. The layer of brown adipose tissue in this depot is often covered by a "frosting" of white adipose tissue; sometimes these two types of fat are hard to distinguish. The inguinal depots enclose the inguinal group of lymph nodes. Minor depots include the pericardial, which surrounds the heart, and the paired popliteal depots, between the major muscles behind the knees, each containing one large lymph node. Of all the depots in the mouse, the gonadal depots are the largest and the most easily dissected, comprising about 30% of dissectible fat.
Obesity
In an obese person, excess adipose tissue hanging downward from the abdomen is referred to as a panniculus. A panniculus complicates surgery of the morbidly obese individual. It may remain as a literal "apron of skin" if a severely obese person loses large amounts of fat. Obesity is treated through exercises, diet, behavioral therapy, and liposuctions. Reconstructive surgery is one aspect of treatment.Visceral fat
Visceral fat or abdominal fat is located inside the abdominal cavity, packed between the organs. Visceral fat is different from subcutaneous fat underneath the skin, and intramuscular fat interspersed in skeletal muscles. Fat in the lower body, as in thighs and buttocks, is subcutaneous and is not consistently spaced tissue, whereas fat in the abdomen is mostly visceral and semi-fluid. Visceral fat is composed of several adipose depots, including mesenteric, epididymal white adipose tissue, and perirenal depots. Visceral fat is often expressed in terms of its area in cm2.An excess of visceral fat is known as abdominal obesity, or "belly fat", in which the abdomen protrudes excessively. New developments such as the Body Volume Index are specifically designed to measure abdominal volume and abdominal fat. Excess visceral fat is also linked to type 2 diabetes, insulin resistance, inflammatory diseases, and other obesity-related diseases. Likewise, the accumulation of neck fat has been shown to be associated with mortality. Several studies have suggested that visceral fat can be predicted from simple anthropometric measures, and predicts mortality more accurately than body mass index or waist circumference.
Men are more likely to have fat stored in the abdomen due to sex hormone differences. Estrogen causes fat to be stored in the buttocks, thighs, and hips in women. When women reach menopause and the estrogen produced by the ovaries declines, fat migrates from the buttocks, hips and thighs to the waist; later fat is stored in the abdomen.
Visceral fat can be caused by excess cortisol levels. At least 10 MET-hours per week of aerobic exercise leads to visceral fat reduction in those without metabolic-related disorders. Resistance training and caloric restriction also reduce visceral fat, although their effect may not be cumulative. Both exercise and hypocaloric diet cause loss of visceral fat, but exercise has a larger effect on visceral fat versus total fat. High-intensity exercise is one way to effectively reduce total abdominal fat. An energy-restricted diet combined with exercise will reduce total body fat and the ratio of visceral adipose tissue to subcutaneous adipose tissue, suggesting a preferential mobilization for visceral fat over subcutaneous fat.
Epicardial fat
adipose tissue is a particular form of visceral fat deposited around the heart and found to be a metabolically active organ that generates various bioactive molecules, which might significantly affect cardiac function. Marked component differences have been observed in comparing EAT with subcutaneous fat, suggesting a location-specific impact of stored fatty acids on adipocyte function and metabolism.Subcutaneous fat
Most of the remaining nonvisceral fat is found just below the skin in a region called the hypodermis. This subcutaneous fat is not related to many of the classic obesity-related pathologies, such as heart disease, cancer, and stroke, and some evidence even suggests it might be protective. The typically female pattern of body fat distribution around the hips, thighs, and buttocks is subcutaneous fat, and therefore poses less of a health risk compared to visceral fat.Like all other fat organs, subcutaneous fat is an active part of the endocrine system, secreting the hormones leptin and resistin.
The relationship between the subcutaneous adipose layer and total body fat in a person is often modelled by using regression equations. The most popular of these equations was formed by Durnin and Wormersley, who rigorously tested many types of skinfold, and, as a result, created two formulae to calculate the body density of both men and women. These equations present an inverse correlation between skinfolds and body density—as the sum of skinfolds increases, the body density decreases.
Factors such as sex, age, population size or other variables may make the equations invalid and unusable, and, as of 2012, Durnin and Wormersley's equations remain only estimates of a person's true level of fatness. New formulae are still being created.
Marrow fat
Marrow fat, also known as marrow adipose tissue, is a poorly understood adipose depot that resides in the bone and is interspersed with hematopoietic cells as well as bony elements. The adipocytes in this depot are derived from mesenchymal stem cells which can give rise to fat cells, bone cells as well as other cell types. The fact that MAT increases in the setting of calorie restriction/ anorexia is a feature that distinguishes this depot from other fat depots. Exercise regulates MAT, decreasing MAT quantity and diminishing the size of marrow adipocytes. The exercise regulation of marrow fat suggests that it bears some physiologic similarity to other white adipose depots. Moreover, increased MAT in obesity further suggests a similarity to white fat depots.Ectopic fat
Ectopic fat is the storage of triglycerides in tissues other than adipose tissue, that are supposed to contain only small amounts of fat, such as the liver, skeletal muscle, heart, and pancreas. This can interfere with cellular functions and hence organ function and is associated with insulin resistance in type-2 diabetes. It is stored in relatively high amounts around the organs of the abdominal cavity, but is not to be confused with visceral fat.The specific cause for the accumulation of ectopic fat is unknown. The cause is likely a combination of genetic, environmental, and behavioral factors that are involved in excess energy intake and decreased physical activity. Substantial weight loss can reduce ectopic fat stores in all organs and this is associated with an improvement of the function of those organs.
In the latter case, non-invasive weight loss interventions like diet or exercise can decrease ectopic fat in overweight or obese children and adults.