Physiological Aging: Links Among Adipose Tissue Dysfunction, Diabetes, and Frailty
Open accessAbstract
Advancing age is associated with progressive declines in physiological function that lead to overt chronic disease, frailty, and eventual mortality. Importantly, age-related physiological changes occur in cellularity, insulin-responsiveness, secretory profiles, and inflammatory status of adipose tissue, leading to adipose tissue dysfunction. Although the mechanisms underlying adipose tissue dysfunction are multifactorial, the consequences result in secretion of proinflammatory cytokines and chemokines, immune cell infiltration, an accumulation of senescent cells, and an increase in senescence-associated secretory phenotype (SASP). These processes synergistically promote chronic sterile inflammation, insulin resistance, and lipid redistribution away from subcutaneous adipose tissue. Without intervention, these effects contribute to age-related systemic metabolic dysfunction, physical limitations, and frailty. Thus adipose tissue dysfunction may be a fundamental contributor to the elevated risk of chronic disease, disability, and adverse health outcomes with advancing age.
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Type 2 diabetes is a strong risk factor for cardiovascular disease, and both CVD mortality and the effect of diabetes on CVD risk increase with older age and frailty.
“Type 2 diabetes is a strong risk factor for CVD, and both CVD mortality and the effect of diabetes on the risk of CVD increase sharply with older age and frailty status”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [175]
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- Authors
- Stout, M. B., Justice, J. N., Nicklas, B. J., & Kirkland, J. L.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- Wake Forest University Health Sciences (US)
- Mayo Clinic (US)
- Venue
- Physiology
- Publisher
- American Physiological Society
- Published
- 2017-01
- Volume
- 32
- Issue
- 1
- Pages
- 9-19
- ISSN
- 0886-1714 (ISSN-L)
- 1548-9213
- 1548-9221
- PMC
- PMC5338596
- OpenAlex
- W2560805164
- Cited by
- 272
- References
- 140
- Citations by year
- 2026: 20 · 2025: 25 · 2024: 33 · 2023: 30 · 2022: 40 · 2021: 35 · 2020: 38 · 2019: 21 · 2018: 15 · 2017: 13 · 2016: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Physiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- HHS | NIH | National Institute on Aging (U.S. National Institute on Aging) (T32 AG-33534, P30 AG-21332, K99 AG-51661, R01 AG-13925)
- Connor Group
- The Ted Nash Long Life Foundation
- Noaber Foundation
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- physiological aging, adipose tissue dysfunction, frailty, diabetes mellitus, insulin resistance, chronic inflammation, senescence-associated secretory phenotype, cellular senescence, inflammatory cytokines, chemokines, immune cell infiltration, lipid redistribution, subcutaneous adipose tissue, metabolic dysfunction
- MeSH terms
- Adipose Tissue, Aging, Animals, Chronic Disease, Diabetes Mellitus, Humans, Inflammation, Insulin Resistance, Obesity, Cytokines, Cellular Senescence, Adipocytes
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