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Regulation of human subcutaneous adipose tissue blood flow

Abstract

Subcutaneous adipose tissue represents about 85% of all body fat. Its major metabolic role is the regulated storage and mobilization of lipid energy. It stores lipid in the form of triacylglycerol (TG), which is mobilized, as required for use by other tissues, in the form of non-esterified fatty acids (NEFA). Neither TG nor NEFA are soluble to any extent in water, and their transport to and out of the tissue requires specialized transport mechanisms and adequate blood flow. Subcutaneous adipose tissue blood flow (ATBF) is therefore tightly linked to the tissue’s metabolic functioning. ATBF is relatively high (in the fasting state, similar to that of resting skeletal muscle, when expressed per 100 g tissue) and changes markedly in different physiological states. Those most studied are after ingestion of a meal, when there is normally a marked rise in ATBF, and exercise, when ATBF also increases. Pharmacological studies have helped to define the physiological regulation of ATBF. Adrenergic influences predominate in most situations, but nevertheless the regulation of ATBF is complex and depends on the interplay of many different systems. ATBF is downregulated in obesity (when expressed per 100 g tissue), and its responsiveness to meal intake is reduced. However, there is little evidence that this leads to adipose tissue hypoxia in human obesity, and we suggest that, like the downregulation of catecholamine-stimulated lipolysis seen in obesity, the reduction in ATBF represents an adaptation to the increased fat mass. Most information on ATBF has been obtained from studying the subcutaneous abdominal fat depot, but more limited information on lower-body fat depots suggests some similarities, but also some differences: in particular, marked alpha-adrenergic tone, which can reduce the femoral ATBF response to adrenergic stimuli.

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Acknowledgements

We thank many colleagues who have worked with us on ATBF regulation, including Professor Jean-Luc Ardilouze from the University of Sherbrooke and Dr Gijs Goossens from Maastricht University. We have particularly used data generated by Dr Siobhán McQuaid and Dr Konstantinos Manolopoulos in writing this review. Funding for our work in this area has come from many sources including British Heart Foundation, Biotechnology and Biological Sciences Research Council and Wellcome Trust.

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Frayn, K., Karpe, F. Regulation of human subcutaneous adipose tissue blood flow. Int J Obes 38, 1019–1026 (2014). https://doi.org/10.1038/ijo.2013.200

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