Adipose Tissue Dysfunction: Clinical Implications and Complications

Adipose tissue (AT) plays a central role in the storage and release of energy, thereby maintaining energy homeostasis. A disruption in energy balance may result in inadequate storage of excess energy, leading to AT dysfunction. This is observed in obesity, a state characterized by a high energy load, as well as in lipodystrophy, a condition characterized by the specific loss of AT. Consequently, systemic metabolism is impaired, resulting in insulin insensitivity, type 2 diabetes mellitus, and metabolic syndrome. The development of these comorbidities is strongly associated with cardiovascular disease (CVD), and the treatment of obesity represents an essential component in the reduction of CVD burden. This chapter describes the pathophysiological mechanisms of AT dysfunction and the pathways that lead to systemic metabolic impairments. Furthermore, we highlight the clinical implications of metabolic comorbidity burden, their association with various CVDs, and modalities for treating obesity as the root of these clinical syndromes.