The timing of obesity onset and age have been shown to affect the risk of obesity-related comorbidities, although the impact of each of these factors on markers of adipose tissue function remains unclear.
The aim of this study was to determine whether differences in regional adipose tissue characteristics vary with age and age of obesity onset, and whether these differences are associated with the markers of cardiometabolic health.
Adipose tissue samples were obtained from 80 female bariatric surgery candidates who were classified by age of obesity onset and age into 4 groups: (1) younger adults (<40 y) with childhood-onset obesity (<18 y) (Child-Young); (2) younger adults with adulthood-onset obesity (>18 y) (Adult-Young); (3) older adults (>55 y) with childhood-onset obesity (Child-Old); and (4) older adults with adulthood-onset obesity (Adult-Old). Adipocyte diameter, adipose tissue fibrosis, and macrophage infiltration were determined in subcutaneous (SAT) and visceral adipose tissue (VAT). Clinical parameters were obtained from participants’ medical records.
Visceral adipocyte size in the Child-Young group was the smallest of all the groups. Age affected visceral infiltration of M1-like cells with greater percent of M1-like cells in the Adult-Old and Child-Old groups. Though not significant, a stepwise increase in M2-like macrophages in VAT was observed with Adult-Young having the smallest followed by Adult-Old, Child-Young, and Child-Old having the greatest percent of M2-like macrophages. Pericellular fibrosis accumulation in SAT and VAT varied with both age and onset, particularly in the Child-Old group, which had the lowest fibrosis levels. Markers of cardiometabolic health (fasting glucose, glycated hemoglobin, total, HDL- and LDL-cholesterol and triglyceride concentrations) were positively and well-associated with adipose tissue characteristics of the Child-Old group but not of the Adult-Young group.
Older adults with childhood-onset obesity, who had the greatest duration of obesity exposure, were particularly vulnerable to the cardiometabolic effects associated with perturbations in adipose tissue characteristics. These results suggest that age and age of obesity onset may have independent and cumulative effects on obesity pathology.
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The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.
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Sylvia Santosa holds a Canada Research Chair-Tier 2 in Clinical Nutrition. Laurent Turner is supported by a PERFORM graduate student award. This research was made possible by in-kind equipment support from the PERFORM Center, and funding from a Natural Science and Engineering Research Council of Canada (NSERC) Discovery Grant. The authors thank Dr. Alisa Piekny for her help and guidance in the microscopy analyses, the participants who consented to be tissue donors, and acknowledge the invaluable collaboration of the surgery team, bariatric surgeons and biobank staff of the IUCPQ.
The authors have no competing interests to declare with regards to the content of this study. SS is a member of the Scientific Advisory Panel for Nutritional Fundamentals for Health Inc. AT receives research funding from Johnson & Johnson, Medtronic, and GI Windows for studies on bariatric surgery; and acted as a consultant for Bausch Health, Novo Nordisk, Eli Lilly, and Biotwin.
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Turner, L., Gauthier, MF., Lafortune, A. et al. Adipocyte size, adipose tissue fibrosis, macrophage infiltration and disease risk are different in younger and older individuals with childhood versus adulthood onset obesity. Int J Obes 46, 1859–1866 (2022). https://doi.org/10.1038/s41366-022-01192-2