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Metabolic Impact of Adipose Tissue ALYSSA HASTY, PHD ASSISTANT PROFESSOR MOLECULAR PHYSIOLOGY & BIOPHYSICS The Simplified Model Obesity Trends Among U.S. Adults between 1985 and 2002 Definitions: Obesity: having a very high amount of body fat in relation to lean body mass, or Body Mass Index (BMI) of 30 or higher Body Mass Index (BMI): a measure of an adult’s weight in relation to his or her height, specifically the adult’s weight in kilograms divided by the square of his or her height in meters Diseases Associated with Obesity Diabetes: 80% related to obesity Hypertension: prevalence is >40% in obesity Heart disease: 70% related to obesity Cancer: Obesity accounts for 15-20% of cancerrelated deaths Death: Obese individuals have a 50-100% increased risk of death from all causes compared to lean individuals (most of this risk is due to cardiovascular disease) The Metabolic Syndrome Central obesity Glucose intolerance Hypertension Insulin resistance High TG Low HDL-C Small, dense LDL particles ©1998 PPS Prevalence of CHD, MI, and Stroke in Relation to the Presence of Metabolic Syndrome WITH Metabolic Syndrome 30 25 20 All Subjects NGT IFG/IGT Type 2 Diabetes (n=3,928) (n=1,808) (n= 685) (n=1,430) 15 10 5 0 30 CHD Previous MI Previous Stroke 25 Without Metabolic Syndrome 20 15 10 5 0 CHD Previous MI Previous Stroke Isomaa et al. 2001. Diabetes Care. 24:683-689. Traditional CHD Risk Factors Elevated Plasma Cholesterol Reduced Plasma HDL Levels Diabetes Hypertension Smoking Age New Markers Inflammatory Adipokines Lipid Lowering only results in a relative risk reduction of 30% New Inflammatory Markers to assess Risk CRP IL-6 TNFa Serum Amyloid A Non-esterified fatty acids Adipose tissue is an important source of inflammatory cytokine production White Adipose Tissue (WAT) Many different adipose tissue beds throughout the whole organism Many distinct cell types: adipocytes, preadipocytes, fibroblasts, macrophages, vascular cells Heterogeneous metabolic capabilities, depending on visceral or subcutaneous location of fat depot Secrete adipokines with systemic effects Gender Differences in Adipose Tissue Distribution Female Male Original Image SCAT Subcutaneous Adipose Tissue HIGHLIGHTED WHITE VAT Visceral Adipose Tissue HIGHLIGHTED WHITE J. Magn. Reson. Imaging Vol.21, 4 Pages: 455-462 White Adipose Tissue WAT is comprised of 2 Fractions: 1) adipocytes 2) SVF which consists of: preadipocytes endothelial cells macrophages WAT is central to energy storage in the body and the mobilization of this energy store is highly regulated. Basic Adipose Tissue Expansion Preadipocyte Mature adipocyte http://www.hsph.harvard.edu/GSHLAB/adipos.html Adipocyte Growth: Hypertrophy vs. Hyperplasia Hypertrophy (increase in size) “Lipogenesis” Result of excess triglyceride accumulation in existing adipocytes Hyperplasia (increase in number) ‘adipogenesis’ results from the recruitment of new adipocytes from precursor cells in adipose tissue and involves proliferation and differentiation Hausman et al. Obesity Reviews (2001) 2, 239-254 Hormones, Adipokines, enzymes, molecules and other factors reportedly associated with Adipose Tissue a-1 acid glycoprotein (AGP) 3a-hydroxysteroid dehydrogenase (3aHSD) 3-HSD 5a reductase 7a hydroxylase 11HSD 17HSD Acylation-stimulatin protein (ASP or C3adesArg) Adenosine Adipocyte differentiation factor (ADF) Adipogenin Adiponectin Adiponutrin Adipohilin (adipose differentiation-related protein [ADRP]) Adipose protein 2 (aP2 or adipocyte-specific fatty acid-binding protein, otherwise known as 422 protein) Adipose triglyceride lipase (ATGL) Adipsin (ADN; complement factor D, C3 convertase activator and properdin factor D) Agouti protein Androgens Angiotensin I and II Angiotensin-converting enzyme (ACE) Angiotensinogen (AGT) Annexin (lipocortin) Apelin Aoplipoproteins E, C1 and D Aquaporin 7 (AQP7) Autotaxin (lyosphospholipase D) Bone morphogenic protein (BMP) C-reactive protein (CRP) Calumenin Calvasculin Cathepsin D and G Ceramide Cholesteryl ester transfer protein (CETP) Chymase Collagen Type VIa3 Complement factor C3 and B • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Cytochrome p450-dependent aromatase (P450arom) E2F proteins Ecto-nucleotide pyrophosphatase/phosphodiesterase 1 Eicosanoids Endothelin Entactin/nidogen Eotaxin Epidermal growth factor Estrogen Fasting-induced adipose factor Fatty acid translocase Fatty acid transport protein Fibroblast growth factor Free Fatty Acids Galectin-12 Gelsolin Glucose transporter 4 Glutamine Glycerol Haptoglobin Hippocampal cholinergic neurostimulating peptide Hormone-sensitive lipase Insulin-like growth factor Insulin-like growth factor binding protein Interleukin-1, -6, -8, and -10 Interleukin-1 receptor antagonist Lactate Leptin Lipin Lipocalins Lipoprotein lipase Lysophospholipid Macrophage migration inhibitory factor Metalloproteases Metallothionein Monobutyrin Monocyte chemoattractant protein-1 Necdin Nerve growth factor Neuronatin Bays • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Nitric oxide synthase Nuclear factors Omentin Osteonectin (secreted protein, acidic and rich in cystein/SPARC) Pentraxin-3 p85aphosphatidylinositol 3-kinase Perilipins Phosphoenolpyruvate carboxykinase Phospholipid transfer protein Pigment epithelium-derived factor Plasminogen activator inhibitor Pre-adipocyte factor-1 Prolactin Protein kinases Protease inhibitors (e.g., cystatin C and Colligin-1) Prostaglandin E, I2 and F2 prostacyclins (PGI2/PGF2) Regulated on activation, normal T-cell expressed and secreted (RANTES) Renin Resistin (FIZZ3 or serine/cystein-rich adipocyte-specific secretory factor [ADSF]) Resistin-like molecules Retinol Retinol-binding protein Sergin protease inhibitors Serum amyloid A Stearoyl-CoA desaturase Stromal cell-derived factors (e.g., stromal cell-derived factor 1 precursor or pre-B growth stimulating factor) Tissue factor Tonin Transforming growth factor- Tumor necrosis factor-a UDP-glucuronosyltransferase A242B15 Uncoupling proteins Vascular endothelial growth Visceral adipose tissue-derived serpin Visfatin (pre- cell colony-enhancing factor [PBEF]) H & Ballantyne C; Future Lipidol 2006; 1(4): 389 Free Fatty Acids (FFA) Adipose tissue serves as a buffer for FFA levels following feeding (similar to the way liver buffers blood glucose levels) FFA are released from WAT when systemic energy needs are not being met FFA levels are a predictor of future development of type 2 diabetes Effects of elevated plasma FFA levels Insulin resistance in muscle Inhibition of normal function of insulin to suppress hepatic glucose production Impair insulin-stimulated glucose uptake FFA are substrate for hepatic triglyceride synthesis leading to increased plasma VLDL and triglyceride levels Impair endothelial function Control of Release of FFA From White Adipose Tissue Lipid storage Diet WAT Starvation Lipolysis Insulin Resistance Insulin Free Fatty Acid Liver Ketone bodies Phospholipids Triglycerides Hypertriglyceridemia Atherosclerosis Secretory Products of Adipose Tissue Resistin Bone Morphogenic Protein IGF-1 IGFBP TNF-α Interleukins TGF β FGF EGF Adipose Tissue Adiponectin Fatty Acids Lactate Adenosine Prostaglandins Glutamine Unknown Factors Estrogen Ang II Angiotensinogen PAI-1 Leptin Adapted from: Roth, J, et al, Obesity Research, Vol 12, supplement Nov 2004:88S-101S Adipokines Vascular Disease Related Angiotensinogen PAI-1 Insulin Resistance Related ASP (Acylation-stimulating protein) TNFa IL-6 Resistin Leptin Adiponectin Angiotensinogen (AGE) Links obesity with hypertension Positive correlation of blood pressure with AGE levels Primarily produced in liver, but also by WAT Deficiency partially protects against diet-induced obesity Plasminogen Activator Inhibitor 1 (PAI-1) Impairment of fibrinolytic system contributes to cardiovascular complications of obesity WAT is main tissue source of PAI-1 Produced by pre-adipocytes, primarily in visceral WAT Acts to inhibit fibrinolysis (is pro-thrombotic) Also influences cell migration and angiogenesis Could impair pre-adipocyte migration leading to WAT growth TNFa Proinflammatory cytokine Produced by adipocytes and macrophages in WAT Over-expressed in obesity Link between TNFa and insulin resistance Alters insulin signaling and MAPK pathways in vitro and in vivo IL-6 10-30% of circulating IL-6 is from WAT Highly correlated with body mass and inversely related to insulin sensitivity Alters insulin signaling in the liver IL-6 KO mice develop mature-onset obesity and glucose intolerance Resistin Discovered in 2001 Expressed in adipocytes in mice and in macrophages in humans Increased in obesity Recombinant resistin Promotes insulin resistance in mice Decreased insulin stimulated glucose uptake in WAT Visfatin Discovered in 2004 Specifically expressed in visceral fat as opposed to subcutaneous fat Binds to insulin receptor on an allosteric site to insulin Can mimic insulin in down-stream insulin signaling pathways Plasma levels are 1/100th level of insulin and not controlled by nutritional status These original findings were not reproducible, and the paper was later recalled! Leptin Secreted by adipocytes Regulates food intake – satiety factor Leptin receptor is expressed in hypothalamus ob/ob and db/db mouse models Spontaneous mutations first noted in 1950 morbid obesity (3x normal weight) hyperinsulinemia (50-fold increase) hyperglycemia Infertile slightly increased cholesterol Leptin and Leptin Receptor Both ob/ob and db/db mice originally developed from spontaneous mutations The genes mutated in these mice were later identified as leptin and its receptor ob/ob and db/db mice are obese, hyperphagic, hyperglycemic, and hyperinsulinemic and are commonly used models for studies of diabetes ob/ob littermate Parabiosis: ob/ob with wild type Wild Type ob/ob Parabiosis: ob/ob with wild type Wild type Ob/ob Suppressed weight gain in ob/ob mouse Parabiosis between wt and db/db Wild type db/db Parabiosis between wt and db/db Wild type db/db Parabiosis between wt and db/db Wild type db/db Parabiosis between wt and db/db Wild type db/db RIP 1994: Cloning of Leptin 167 aa protein belonging to cytokine family Circulates free or bound soluble receptor Expressed in WAT, stomach and placenta 84% homology between mouse and human leptin Leptin administration to ob/ob mice alleviates all aspect associated with the deficiency in mice Possible Physiologic Roles of Leptin Obesity Glomerulosclerosis Anorexia Hematopoeisis Diabetes Aging Reproduction sweet-sensing modulator Bone Mass Angiogenic activity Immune System Hypertension Adiponectin (Acrp 30, AdipoQ) Discovered in mid-1990’s Protein highly expressed in adipocytes and circulates at high concentrations Collagenous tail and globular head Plasma concentrations are reduced in obesity and insulin resistance TNFa and IL-6 inhibit adiponectin expression Administration of recombinant adiponectin ameliorates IR in obese and lipodystrophic mice Adiponectin is anti-atherogenic Mobilization of Triglycerides Stored in Adipose Tissue Low levels of glucose in the blood trigger the mobilization of triglycerides through the action of epinephrine and glucagon. cAMP pathway activate hormone sensitive lipase to cause hydrolysis of triglycerides into glycerol and FFA Modulators of Triglyceride Synthesis and Storage Insulin – promotes conversion of carbohydrates into triglycerides Epinephrine: activates release of fatty acids from adipose tissue Glucagon: stimulates release of fatty acids from adipose tissue Pituitary Growth Hormone Adrenal Cortical Hormones Lipoprotein Lipase LPL: lipolytic activity in the capillary bed; hydrolyzes NEFA from lipoproteins (chylomicrons and VLDL) Secreted by adipocytes, macrophages, muscle but active in capillary endothelial beds Has catalytic activity, but also functions as ligand for anchoring of lipoproteins to cell surface Hormone Sensitive Lipase lipolytic activity inside adipocytes releases NEFA from storage when energy is needed Hydrolyses TG but also cholesteryl esters, retinyl esters and steroid esters Triglyceride Glycerol backbone with 3 fatty acid chains Fatty acids can be similar or varied Stored in cytosol of adipocytes Carbon atoms are more reduced than sugars – thus provide more energy Lipolysis of TG in WAT Together, ATGL and HSL are responsible for >95% of TG hydrolysis from WAT Perilipins Found within phospholipid monolayer surrounding neutral lipid containing lipid vacuole Phosphorylated by PKA on multiple residues Prevent lipolysis under basal conditions Fatty Acid Binding Proteins (FABP: ap2 and mal-1) Expressed in WAT, liver, intestine, heart, and brain Sequester fatty acids in cytosol to protect cell from harmful effects of intracellular-FFA Interact with HSL to favor translocation of lipid from cytosol to lipid droplet Ap2-/- mice do develop diet-induced obesity, but do not develop IR or diabetes Hormone Stimulated Lipolysis Paradigm Lipolytic stimulation leads to phosphorylation of HSL and perilipin by PKA Phosphorylation of perilipin causes them to lose their lipolysis-blocking capability Phosphorylation of HSL promotes its translocation from the cytosol to the lipid droplet Required for maximal TG storage in WAT Yeaman, Biochem. J 379:11 Hormone Sensitive Lipase deficient mice Mice do NOT become obese Mice have increased Diacylglycerol in their WAT and muscle Adipocytes in BAT were enlarged (5-fold) BAT mass was enlarged Males were sterile WAT retained 40% of TG lipase activity Osuga. 2000. PNAS 97:787 Perilipin Knockout mice Decreased adipose tissue mass High levels of basal lipolysis Resistant to dietinduced obesity Javier Martinez-Botas Nature Genetics 26, 474 - 479 (2000) Mechanism for Hormone-mediated lipolysis Hormones include catecholamines, adrenaline, and noradrenaline Receptors are called G-protein coupled receptors called β-adrenergic receptors When activated, they transmit signals to adenylyl cyclase leading to cAMP production cAMP activates PKA PKA phosphorylates HSL and perilipin Gs/cAMP/PKA/HSL Pathway to Lipolysis Kimmel, Biochimie 87: 45-49 Flex Time: Adipose Tissue Macrophages