Adipose tissue remodeling in obesity and metabolic complications. During obesity AT grows both by hypertrophy and hyperplasia determining vascular rarefaction. Enhanced enlargement of mature adipocytes and a significant decrease in ASCs occur early in the prediabetic condition and these modifications are also present into overt diabetes, suggesting further expansion mainly by hypertrophy. AT capillaries display marked CBM thickening (black line) only in overt diabetes (AT microangiopathy), suggesting vascular dysfunction and further perfusion reduction. The black squares circumscribe 1 mm2. ob N = patients with obesity and normoglycemia; ob preDM = patients with obesity and prediabetes; ob T2DM = patients with obesity and diabetes.