Cited by 1,186Adipokines, Inflammation, and Metabolic DiseasesCardiovascular Disease and AdiposityAdipose Tissue and Metabolism

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Chronic Inflammation in Obesity and the Metabolic Syndrome

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Monteiro, Rosário, Azevedo, Isabel·2010·Mediators of Inflammation

DOI 10.1155/2010/289645PMC PMC2913796

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Abstract

The increasing incidence of obesity and the metabolic syndrome is disturbing. The activation of inflammatory pathways, used normally as host defence, reminds the seriousness of this condition. There is probably more than one cause for activation of inflammation. Apparently, metabolic overload evokes stress reactions, such as oxidative, inflammatory, organelle and cell hypertrophy, generating vicious cycles. Adipocyte hypertrophy, through physical reasons, facilitates cell rupture, what will evoke an inflammatory reaction. Inability of adipose tissue development to engulf incoming fat leads to deposition in other organs, mainly in the liver, with consequences on insulin resistance. The oxidative stress which accompanies feeding, particularly when there is excessive ingestion of fat and/or other macronutrients without concomitant ingestion of antioxidant-rich foods/beverages, may contribute to inflammation attributed to obesity. Moreover, data on the interaction of microbiota with food and obesity brought new hypothesis for the obesity/fat diet relationship with inflammation. Beyond these, other phenomena, for instance psychological and/or circadian rhythm disturbances, may likewise contribute to oxidative/inflammatory status. The difficulty in the management of obesity/metabolic syndrome is linked to their multifactorial nature where environmental, genetic and psychosocial factors interact through complex networks.

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Figure 1 Overview of the complex interplay between obesity-inflammation-metabolic syndrome: metabolic overload impacts on adipose tissue, leading to organelle stress with production of ROS and adipokines, as well as activation of kinases that potentiate the transcription of inflammatory genes and interfere with insulin signaling. Hyperthrophy facilitates rupture of adipocytes which attract and activate macrophages that markedly reinforce the inflammatory process through further production of ROS and inflammatory cytokines. Production of adiponectin, an anti-inflammatory cytokine, is reduced. Increase of FFA concentration, namely, SFA, coming both from feeding and adipose tissue overflow, accumulates in the liver, among other organs. Fat accumulation in the liver leads to overproduction of LDLs and, together with IL-6, of CRP. NAFLD is a frequent consequence of these metabolic dysregulations, and all this impacts on insulin sensitivity. SFA activates TOLL-like receptors in adipocytes, contributing to the activation of the inflammatory response. Fat has also effects on intestinal permeability and on the microbiota, with systemic inflammatory consequences. Most excess metabolites and cytokines produced throughout these processes converge on insulin resistance, a central characteristic of the metabolic syndrome. AP-1: activator protein-1; CRP: C-reactive protein; FFA: free (nonesterified) fatty acids; IL-n: interleukins; IKK: inhibitor of NF-κB kinase; IL-6: interleukin-6; Int: intestine; IR: insulin resistance; JNK: c-Jun N-terminal kinase; LDL: low density lipoprotein; M: microbiota; NAFLD: nonalcoholic fatty liver disease; NF-κB: nuclear factor κB; OxS: oxidative stress; ROS: reactive oxygen species; PKC: protein kinase C; SFA: saturated fatty acids; TAG: triacylglycerols; TLR: TOLL-like receptors; TNFalpha: tumour necrosis factor alpha.CC BY · PubMed Central

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Role of Adipose Tissue as an Inflammatory Organ in Human Diseases
Schäffler, A., Müller-Ladner, U., Schölmerich, J., & Büchler, C. (2006) · Endocrine Reviews · doi:10.1210/er.2005-0022 · Cited by 263 · cited 1×
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Adipose tissue as an immunological organ: Toll-like receptors, C1q/TNFs and CTRPs
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Increased Visceral Fat and Serum Levels of Triglyceride Are Associated With Insulin Resistance in Japanese Metabolically Obese, Normal Weight Subjects With Normal Glucose Tolerance
Katsuki, A., Sumida, Y., Urakawa, H., Gabazza, E. C., Murashima, S., Maruyama, N., Morioka, K., Nakatani, K., Yano, Y., & Adachi, Y. (2003) · Diabetes Care · doi:10.2337/diacare.26.8.2341 · Cited by 236 · cited 1×
“glucose tolerance [60], elevated blood pressure [61, 62], and dyslipidemia [58, 63].”
Background
Visceral Adiposity and the Risk of Impaired Glucose Tolerance
Hayashi, T., Boyko, E. J., Leonetti, D. L., McNeely, M. J., Newell‐Morris, L. L., Kahn, S. E., & Fujimoto, W. Y. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.650 · Cited by 217 · cited 1×
“glucose tolerance [60], elevated blood pressure [61, 62], and dyslipidemia [58, 63].”
Background
Adiponectin Inhibits the Production of CXC Receptor 3 Chemokine Ligands in Macrophages and Reduces T-Lymphocyte Recruitment in Atherogenesis
Okamoto, Y., Folco, E. J. E., Minami, M., Wara, A. K., Feinberg, M. W., Sukhova, G. K., Colvin, R. A., Kihara, S., Funahashi, T., Luster, A. D., et al. (2007) · Circulation Research · doi:10.1161/circresaha.107.164988 · Cited by 208 · cited 2×
“Moreover, obese adipose tissue do also contain lymphocytes that participate in and reinforce the inflammatory reaction and consequent insulin resistance [77, 81, 82].”
Background
Metabolic syndrome pathophysiology: The role of adipose tissue
Laclaustra, M., Corella, D., & Ordovás, J. M. (2007) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2006.10.005 · Cited by 198
Effects of marked weight loss on plasma levels of adiponectin, markers of chronic subclinical inflammation and insulin resistance in morbidly obese women
Kopp, H., Krzyżanowska, K., Möhlig, M., Spranger, J., Pfeiffer, A. F. H., & Schernthaner, G.-H. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0802983 · Cited by 190 · cited 2×
“In good agreement with this interpretation of things, weight loss of obese patients is repeatedly verified to be associated with a decrease of inflammation biomarkers [17–21] accompanied by improvement of metabolic parameters, namely, insulin sensitivity [22–26].”
Result
Increased Lipolysis and Decreased Leptin Production by Human Omental as Compared With Subcutaneous Preadipocytes
van Harmelen, V., Dicker, A., Rydén, M., Hauner, H., Lönnqvist, F., Näslund, E. B., & Arner, P. (2002) · Diabetes · doi:10.2337/diabetes.51.7.2029 · Cited by 188 · cited 6×
“susceptible to lipolysis than subcutaneous adipose tissue [64] and is associated with higher production of TNF-α [64, 65],”
BackgroundInfluential
IL-33, a recently identified interleukin-1 gene family member, is expressed in human adipocytes
Wood, I. S., Wang, B., & Trayhurn, P. (2009) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2009.04.081 · Cited by 187 · cited 1×
“As already stated, adipocytes behave as immune cells [72– 75] and are able to synthesize and release a huge amount of proinflammatory adipokines and cytokines including leptin, resistin, PAI-1, IL-6, TNFα, retinol-binding protein 4 (see [16]), IL-1β, monocyte chemoattractant protein-1 (MCP1), CRP, macrophage migration…”
Background
Tumor Necrosis Factor- in Sera of Obese Patients: Fall with Weight Loss
Dandona, P. (1998) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.83.8.2907 · Cited by 176 · cited 2×
“In good agreement with this interpretation of things, weight loss of obese patients is repeatedly verified to be associated with a decrease of inflammation biomarkers [17–21] accompanied by improvement of metabolic parameters, namely, insulin sensitivity [22–26].”
Result
Central obesity as a major determinant of increased high-sensitivity C-reactive protein in metabolic syndrome
Santos, A. C., Lopes, C. M. M., Guimarães, J. T., & Barros, H. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803035 · Cited by 174
Blockade of the renin???angiotensin system decreases adipocyte size with improvement in insulin sensitivity
Kingston, R. (2004) · Journal of Hypertension · doi:10.1097/00004872-200410000-00006 · Cited by 166
The role of interleukin-18 in the metabolic syndrome
Trøseid, M., Seljeflot, I., & Arnesen, H. (2010) · Cardiovascular Diabetology · doi:10.1186/1475-2840-9-11 · Cited by 155 · cited 1×
“As already stated, adipocytes behave as immune cells [72– 75] and are able to synthesize and release a huge amount of proinflammatory adipokines and cytokines including leptin, resistin, PAI-1, IL-6, TNFα, retinol-binding protein 4 (see [16]), IL-1β, monocyte chemoattractant protein-1 (MCP1), CRP, macrophage migration…”
Background
Lifestyle factors and incident metabolic syndrome
Wilsgaard, T., & Jacobsen, B. K. (2007) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2007.03.006 · Cited by 154 · cited 1×
“Increasing incidence of the metabolic syndrome all over the world accompanies adoption of the so-called modern Western lifestyle [37, 38].”
Background
Hypoxia induces leptin gene expression and secretion in human preadipocytes: differential effects of hypoxia on adipokine expression by preadipocytes
Wang, B., Wood, I. S., & Trayhurn, P. (2008) · Journal of Endocrinology · doi:10.1677/joe-08-0156 · Cited by 153 · cited 1×
“This high vascularisation is most probably due to the action of angiogenic/proinflammatory factors, of which leptin constitutes an example [94, 95].”
Background
Blockade of the renin???angiotensin system decreases adipocyte size with improvement in insulin sensitivity
Furuhashi, M., Ura, N., Takizawa, H., Yoshida, D., Moniwa, N., Murakami, H., Higashiura, K., & Shimamoto, K. (2004) · Journal of Hypertension · doi:10.1097/00004872-200410000-00021 · Cited by 149
Thematic review series: Adipocyte Biology. Lipodystrophies: windows on adipose biology and metabolism
Hegele, R. A., JOY, T. R., Al-Attar, S. A., & Rutt, B. K. (2007) · Journal of Lipid Research · doi:10.1194/jlr.r700004-jlr200 · Cited by 141 · cited 1×
“It is well known that the lack of adipose tissue, as evident in lipodystrophy [41], may equally lead to the development of metabolic syndrome.”
Background
Postprandial Variations of Plasma Inflammatory Markers in Abdominally Obese Men
Blackburn, P., Després, J., Lamarche, B., Tremblay, A., Bergeron, J., Lemieux, I., & Couillard, C. (2006) · Obesity · doi:10.1038/oby.2006.201 · Cited by 140 · cited 1×
“An immediate postprandial increase in plasma inflammatory markers after a high-fat meal had been shown in abdominally obese men [98].”
Background
Unraveling the directional link between adiposity and inflammation: A bidirectional Mendelian randomization approach
Welsh, P., Polisecki, E., Robertson, M., Jahn, S., Buckley, B. M., de Craen, A. J. M., Ford, I., Jukema, J. W., Macfarlane, P. W., Packard, C. J., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1064 · Cited by 140
Committed subcutaneous preadipocytes are reduced in human obesity
Tchoukalova, Y. D., Koutsari, C., & Jensen, M. D. (2006) · Diabetologia · doi:10.1007/s00125-006-0496-9 · Cited by 135
The proatherogenic cytokine interleukin-18 is secreted by human adipocytes
Skurk, T., Kolb, H., Müller-Scholze, S., Röhrig, K., Hauner, H., & Herder, C. (2005) · European Journal of Endocrinology · doi:10.1530/eje.1.01897 · Cited by 135 · cited 1×
“As already stated, adipocytes behave as immune cells [72– 75] and are able to synthesize and release a huge amount of proinflammatory adipokines and cytokines including leptin, resistin, PAI-1, IL-6, TNFα, retinol-binding protein 4 (see [16]), IL-1β, monocyte chemoattractant protein-1 (MCP1), CRP, macrophage migration…”
Background
Adhesion Molecule–dependent Mechanisms Regulate the Rate of Macrophage Clearance During the Resolution of Peritoneal Inflammation
Bellingan, G. J., Xu, P., Cooksley, H., Cauldwell, H., Shock, A., Bottoms, S. E., Haslett, C., Mutsaers, S. E., & Laurent, G. J. (2002) · The Journal of Experimental Medicine · doi:10.1084/jem.20011794 · Cited by 131
Dietary intakes of fat and antioxidant vitamins are predictors of subclinical inflammation in overweight Swiss children
Herter‐Aeberli, I., Molinari, L., Spinas, G. A., Lehmann, R., l’Allemand, D., & Zimmermann, M. B. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/84.4.748 · Cited by 129 · cited 1×
“Intakes of total fat and antioxidant vitamins have been shown to be determinants of subclinical inflammation in the same children [102].”
Background
The balance between gluco- and mineralo-corticoid action critically determines inflammatory adipocyte responses
Hoppmann, J., Perwitz, N., Meier, B., Faßhauer, M., Hadaschik, D., Lehnert, H., & Klein, J. C. (2009) · Journal of Endocrinology · doi:10.1677/joe-09-0292 · Cited by 125 · cited 1×
“in determining adipocyte responses implicated in obesityassociated inflammation and cardiovascular complications has recently been demonstrated [93].”
Background
Calprotectin — A Novel Marker of Obesity
Mortensen, O. H., Nielsen, A. R., Erikstrup, C., Plomgaard, P., Fischer, C. P., Krogh‐Madsen, R., Lindegaard, B., Petersen, A. M. W., Taudorf, S., & Pedersen, B. K. (2009) · PLoS ONE · doi:10.1371/journal.pone.0007419 · Cited by 118 · cited 1×
“Recent studies have been confirming the positive association between obesity indices and inflammatory markers, mainly CRP protein in women [34, 35], but also other inflammatory markers, both in women and men [31, 36].”
Background
Plasma levels of tumor necrosis factor-alpha (TNF-alpha) are essentially dependent on visceral fat amount in type 2 diabetic patients.
Bertin, É., Nguyên, P., Guenounou, M., Durlach, V., Potron, G., & Leuténegger, M. (2000) · PubMed · Cited by 109
Adipocytes as Immune Cells: Differential Expression of TWEAK, BAFF, and APRIL and Their Receptors (Fn14, BAFF-R, TACI, and BCMA) at Different Stages of Normal and Pathological Adipose Tissue Development
Alexaki, V. I., Notas, G., Pelekanou, V., Kampa, M., Valkanou, M., Theodoropoulos, P. A., Stathopoulos, E. N., Tsapis, A., & Castanas, E. (2009) · The Journal of Immunology · doi:10.4049/jimmunol.0901186 · Cited by 103
Relationship and Interaction between Sodium and Potassium
Morris, R. C., Schmidlin, O., Frassetto, L. A., & Sebastián, A. (2006) · Journal of the American College of Nutrition · doi:10.1080/07315724.2006.10719576 · Cited by 101 · cited 1×
“Some associations between dietary patterns and resistance to obesity, namely, the importance of the diet acid load [113], nondigestible plant material [114], or the richness in certain minerals [115] may indeed include effects of those elements on the microbiota.”
Background
The Metabolic Syndrome Is Associated With Circulating Adipokines in Older Adults Across a Wide Range of Adiposity
You, T., Nicklas, B. J., Ding, J., Penninx, B. W. J. H., Goodpaster, B. H., Bauer, D. C., Tylavsky, F. A., Harris, T. B., Kritchevsky, S. B., & for the Health, A. A. B. C. S. (2008) · The Journals of Gerontology Series A · doi:10.1093/gerona/63.4.414 · Cited by 101 · cited 7×
“It is apparently more susceptible to lipolysis than subcutaneous adipose tissue [64] and is associated with higher production of TNF-α [64, 65], plasminogen activator inhibitor-1 (PAI-1) [66], IL-6, and CRP [67].”
BackgroundInfluential
Adrenocortical dysregulation as a major player in insulin resistance and onset of obesity
Roberge, C., Carpentier, A. C., Langlois, M., Baillargeon, J., Ardilouze, J., Maheux, P., & Gallo‐Payet, N. (2007) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00516.2007 · Cited by 88 · cited 1×
“Functional relationships between adipocytes and the renin-angiotensin-aldosterone system [91] or between adipocytes and adrenocortex/aldosterone [92] do probably deserve more attention.”
Background
Healthy obesity
Wildman, R. P. (2009) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e32832c6db7 · Cited by 86
Serum C-Reactive Protein and White Blood Cell Count in Morbidly Obese Surgical Patients
Chen, S.-B., Lee, Y.-C., Ser, K., Chen, J., Chen, S. C., Hsieh, H., & Lee, W. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9619-3 · Cited by 82 · cited 2×
“In good agreement with this interpretation of things, weight loss of obese patients is repeatedly verified to be associated with a decrease of inflammation biomarkers [17–21] accompanied by improvement of metabolic parameters, namely, insulin sensitivity [22–26].”
Result
Low Carbohydrate, High Fat Diet Increases C-Reactive Protein during Weight Loss
Rankin, J. W., & Turpyn, A. D. (2007) · Journal of the American College of Nutrition · doi:10.1080/07315724.2007.10719598 · Cited by 79 · cited 1×
“They also showed that the proinflammatory effect of the high-fat diet was not dependent on oxidative stress [104, 105].”
Background
Adipocyte Size and Liability to Cell Death
Monteiro, R., de Castro, P. M. S. T., Calhau, C., & Azevedo, I. (2006) · Obesity Surgery · doi:10.1381/096089206777346600 · Cited by 79 · cited 1×
“We have shown that big adipocytes are more prone to rupture [45], and cell rupture will obviously constitute a focus of inflammation.”
BackgroundSelf-citation
Adipose stress-sensing kinases: linking obesity to malfunction
Rudich, A., Kanety, H., & Bashan, N. (2007) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2007.08.006 · Cited by 76
Association between C-Reactive Protein and Adiposity in Women
Bochud, M., Marquant, F., Marques-Vidal, P. M., Vollenweider, P., Beckmann, J. S., Mooser, V., Paccaud, F. M., & Rousson, V. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-2428 · Cited by 72 · cited 1×
“Recent studies have been confirming the positive association between obesity indices and inflammatory markers, mainly CRP protein in women [34, 35], but also other inflammatory markers, both in women and men [31, 36].”
Background
Dietary supplementation of n‐3 PUFA reduces weight gain and improves postprandial lipaemia and the associated inflammatory response in the obese JCR:LA‐cp rat
Hassanali, Z., Ametaj, B. N., Field, C. J., Proctor, S. D., & Vine, D. F. (2009) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2009.01130.x · Cited by 72 · cited 1×
“Moreover, acute dietary n-3 PUFA dietary supplementation has been shown to improve fasting as well as postprandial lipid metabolism and components of the associated inflammatory response in the JCR:LA-cp rat [100].”
Background
Shifts in Diet from High Fat to High Carbohydrate Improved Levels of Adipokines and Pro-inflammatory Cytokines in Mice Fed a High-fat Diet
Lee, I. S., Shin, G., & Choue, R. (2010) · Endocrine Journal · doi:10.1507/endocrj.k09e-046 · Cited by 70 · cited 1×
“These results are corroborated in a recently published experimental research work in mice, where it has been shown that a shift from a high-fat to a high-carbohydrate diet improved levels of adipokines and proinflammatory cytokines [106].”
Result
Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review
Zimmermann, M. B., & Herter‐Aeberli, I. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.202 · Cited by 67 · cited 1×
“Total dietary fat and saturated fat are associated with insulin resistance and high blood pressure as well as obesityrelated inflammation [97].”
Background
Phosphatidylserine-dependent ingestion of apoptotic cells promotes TGF-β1 secretion and the resolution of inflammation
Huynh, M.-L. N., Fadok, V. A., & Henson, P. M. (2002) · Journal of Clinical Investigation · doi:10.1172/jci200211638 · Cited by 59
Thematic review series: Patient-Oriented Research. What we have learned about VLDL and LDL metabolism from human kinetics studies
Parhofer, K. G., & Barrett, P. H. R. (2006) · Journal of Lipid Research · doi:10.1194/jlr.r600013-jlr200 · Cited by 56
The gut microbiota ecology: a new opportunity for the treatment of metabolic diseases ?
Burcelin, R. (2009) · Frontiers in Bioscience · doi:10.2741/3589 · Cited by 55 · cited 2×
“[107] R.”
Result
Regional abdominal fat distribution in lean and obese thai type 2 diabetic women: relationships with insulin sensitivity and cardiovascular risk factors
Rattarasarn, C., Leelawattana, R., Soonthornpun, S., Setasuban, W., Thamprasit, A., Lim, A., Chayanunnukul, W., Thamkumpee, N., & Daendumrongsub, T. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00257-9 · Cited by 45 · cited 1×
“glucose tolerance [60], elevated blood pressure [61, 62], and dyslipidemia [58, 63].”
Background
Differential association of C-reactive protein with adiposity in men and women in an Aboriginal community in northeast Arnhem Land of Australia
Shemesh, T., Rowley, K., Jenkins, A. J., Brimblecombe, J. K., Best, J. D., & O’Dea, K. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803350 · Cited by 44
Inflammatory Response to a High‐fat, Low‐carbohydrate Weight Loss Diet: Effect of Antioxidants
Peairs, A., & Rankin, J. W. (2008) · Obesity · doi:10.1038/oby.2008.252 · Cited by 39 · cited 1×
“They also showed that the proinflammatory effect of the high-fat diet was not dependent on oxidative stress [104, 105].”
Background
Fasting and postprandial markers of inflammation in lean and overweight children
Alvarez, J. A., Higgins, P. B., Oster, R. A., Fernández, J. R., Darnell, B. E., & Gower, B. A. (2009) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26926 · Cited by 39 · cited 1×
“It must, however, be taken into account that inflammatory markers increase even after a mixed meal, more so in children with central obesity [103].”
Background
Changes in body mass index are associated with changes in inflammatory and endothelial dysfunction biomarkers in obese prepubertal children after 9 months of body mass index SD score loss
Martos, R., Valle, M., Morales, R. M., Cañete, R., Gascón, F., & Urbano, M. M. (2009) · Metabolism · doi:10.1016/j.metabol.2009.03.017 · Cited by 34 · cited 2×
“In good agreement with this interpretation of things, weight loss of obese patients is repeatedly verified to be associated with a decrease of inflammation biomarkers [17–21] accompanied by improvement of metabolic parameters, namely, insulin sensitivity [22–26].”
Result
The increase of fatty acid-binding protein aP2 in overweight and obese children: interactions with dietary fat and impact on measures of subclinical inflammation
Herter‐Aeberli, I., Beljean, N., Lehmann, R., et al. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.128 · Cited by 28 · cited 1×
“Increased central and overall adiposity in children is associated with higher circulating adipocyte protein 2 (aP2) concentrations, high dietary intakes of total fat and saturated fat influencing aP2 association with insulin resistance and inflammation [101].”
Background
Tejido adiposo como diana terapéutica en la obesidad
Medina‐Gómez, G., & Vidal‐Puig, A. (2009) · Endocrinología y Nutrición · doi:10.1016/s1575-0922(09)72710-x · Cited by 13
Comment on: Tchoukalova Y, Koutsari C, Jensen M (2007) Committed subcutaneous preadipocytes are reduced in human obesity. Diabetologia 50:151–157
Monteiro, R., Calhau, C., & Azevedo, I. (2007) · Diabetologia · doi:10.1007/s00125-007-0636-x · Cited by 11 · cited 1×
“The factors involved in this preadipocyte behaviour deserve investigation [88].”
BackgroundSelf-citation
Chronic Inflammation in the Metabolic Syndrome: Emphasis on Adipose Tissue
Monteiro, R. (2009) · Springer eBooks · doi:10.1007/978-1-4020-9701-0_4 · Cited by 11 · cited 2×
“Although this interesting finding needs to be confirmed and extended to other inflammatory markers, it supports the emphasis we are giving to adipose tissue in metabolic syndrome-associated chronic inflammation [15].”
BackgroundSelf-citation
Moléculas solubles de adhesión intercelular tipo 1 y proteína C reactiva tras cirugía bariátrica
Soler, I. O., Gómez, F. I., Ortega, M. G., Tafalla, M. S. A., Paredes, M. P., Almela, M. L. L., Saura, M. H. P., & Díaz, M. P. (2010) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2010.01.008 · Cited by 10
The Metabolic Syndrome
Azevedo, A., Santos, A. C., Ribeiro, L. V. P. T., & Azevedo, I. (2009) · Springer eBooks · doi:10.1007/978-1-4020-9701-0_1 · Cited by 9
Self-citation
Obstructive Sleep Apnoea and Adipocyte Death
Monteiro, R., Calhau, C., & Azevedo, I. (2006) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2006.10.010 · Cited by 6 · cited 2×
“Whereas subcutaneous adipocytes can also become hypertrophic, and most probably do also rupture, visceral adipocytes, besides being supported by much less dense connective tissue in comparison with subcutaneous adipose tissue, are frequently subject to sudden pressure variations associated with cough, physical exercis…”
BackgroundSelf-citation
Abdominal Cavity Compliance: A Participant More in the Building Up of Visceral Obesity
Monteiro, R., Keating, E., Castro, P. T., et al. (2009) · Obesity · doi:10.1038/oby.2009.34 · Cited by 3 · cited 1×
“A state of positive energetic balance, with fat accrual along time, demands plasticity of the adipose tissue, which includes formation of new adipocytes and also physical compliance of the anatomical spaces for adipose tissue expansion [39].”
BackgroundSelf-citation
Obstructive Sleep Apnoea and aDipocyte Death: Authors Reply
Ferreira, S., Winck, J. C., Bettencourt, P., & Rocha‐Gonçalves, F. (2006) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2006.10.004 · Cited by 1 · cited 1×
“Whereas subcutaneous adipocytes can also become hypertrophic, and most probably do also rupture, visceral adipocytes, besides being supported by much less dense connective tissue in comparison with subcutaneous adipose tissue, are frequently subject to sudden pressure variations associated with cough, physical exercis…”
Background
Untitled work
Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7

Research works printed but not linked: 5

2003, Endocrine Practice, 9, 237
2000, Journal of Clinical Endocrinology and Metabolism, 85, 3338
2000, Diabetes and Metabolism, 26, 178
2008, International Journal of Obesity, 32, S11
2006, Journal of the American College of Nutrition, 25, 262S

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Authors: Monteiro, R., & Azevedo, I.
Affiliations: Universidade do Porto (PT)
Corresponding author: Monteiro, Rosário
ORCID: Monteiro, Rosário
Azevedo, Isabel
Venue: Mediators of Inflammation
Publisher: Wiley
Published: 2010
Volume: 2010
Pages: 1-10
ISSN: 0962-9351 (ISSN-L)
1466-1861
DOI: 10.1155/2010/289645
PMC: PMC2913796
OpenAlex: W1997248937
Cited by: 1,186
References: 124
Citations by year: 2026: 40 · 2025: 93 · 2024: 104 · 2023: 99 · 2022: 126 · 2021: 102 · 2020: 120 · 2019: 113 · 2018: 95 · 2017: 68 · 2016: 47 · 2015: 33 · 2014: 29 · 2013: 45 · 2012: 34
FWCI: 4.15
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/3.0/ (unspecified)
Locations: Mediators of Inflammation (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
Keywords: obesity, metabolic syndrome, chronic inflammation, adipocyte hypertrophy, oxidative stress, insulin resistance, hepatic lipid accumulation, gut microbiota, dietary fat, circadian rhythm, psychological factors, adipose tissue
MeSH terms: Animals, Energy Metabolism, Humans, Inflammation, Obesity, Adipocytes, Metabolic Syndrome

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Chronic Inflammation in Obesity and the Metabolic Syndrome

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