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The role of ectopic adipose tissue: benefit or deleterious overflow?

European Journal of Clinical Nutrition volume 75, pages 38–48 (2021)Cite this article

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Abstract

Ectopic adipose tissues (EAT) are present adjacent to many organs and have predominantly been described in overweight and obesity. They have been suggested to be related to fatty acid overflow and to have harmful effects. The objective of this semi-comprehensive review is to explore whether EAT may play a supportive role rather than interfering with its function, when the adjacent organ is challenged metabolically and functionally. EAT are present adhered to different tissues or organs, including lymph nodes, heart, kidney, ovaries and joints. In this review, we only focused on epicardial, perinodal, and peritumoral fat since these locations have been studied in more detail. Evidence was found that EAT volume significantly increased, associated with chronic metabolic challenges of the corresponding tissue. In vitro evidence revealed transfer of fatty acids from peritumoral and perinodal fat to the adjacent tissue. Cytokine expression in these EAT is upregulated when the adjacent tissue is challenged. In these tissues, glycolysis is enhanced, whereas fatty acid oxidation is increased. Together with more direct evidence, this shows that glucose is oxidized to a lesser degree, but used to support anabolic metabolism of the adjacent tissue. In these situations, browning occurs, resulting from upregulation of anabolic metabolism, stimulated by uncoupling proteins 1 and 2 and possibly 3. In conclusion, the evidence found is fragmented but the available data support the view that accumulation and browning of adipocytes adjacent to the investigated organs or tissues may be a normal physiological response promoting healing and (patho)physiological growth.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Toon J. I. De Munck & Ger H. Koek

  2. School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands

    Toon J. I. De Munck, Peter B. Soeters & Ger H. Koek

  3. Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands

    Peter B. Soeters

  4. Department of Surgery, Klinikum RWTH Aachen, Aachen, Germany

    Ger H. Koek

Authors
  1. Toon J. I. De Munck
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  2. Peter B. Soeters
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  3. Ger H. Koek
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Contributions

Conception and design of the study: TJIDM, PBS, and GHK. Drafting the article: PBS, TJIDM. Revising it critically for important intellectual content: GHK. Final approval of the version to be submitted: TJIDM, PBS, and GHK.

Corresponding author

Correspondence to Toon J. I. De Munck.

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De Munck, T.J.I., Soeters, P.B. & Koek, G.H. The role of ectopic adipose tissue: benefit or deleterious overflow?. Eur J Clin Nutr 75, 38–48 (2021). https://doi.org/10.1038/s41430-020-00713-4

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  • DOI: https://doi.org/10.1038/s41430-020-00713-4

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