Oxygenation of adipose tissue: A human perspective - PubMed
Review
. 2020 Jan;228(1):e13298.
doi: 10.1111/apha.13298. Epub 2019 Jun 2.
Affiliations
- PMID: 31077538
- PMCID: PMC6916558
- DOI: 10.1111/apha.13298
Review
Oxygenation of adipose tissue: A human perspective
Ioannis G Lempesis et al. Acta Physiol (Oxf). 2020 Jan.
Abstract
Obesity is a complex disorder of excessive adiposity, and is associated with adverse health effects such as cardiometabolic complications, which are to a large extent attributable to dysfunctional white adipose tissue. Adipose tissue dysfunction is characterized by adipocyte hypertrophy, impaired adipokine secretion, a chronic low-grade inflammatory status, hormonal resistance and altered metabolic responses, together contributing to insulin resistance and related chronic diseases. Adipose tissue hypoxia, defined as a relative oxygen deficit, in obesity has been proposed as a potential contributor to adipose tissue dysfunction, but studies in humans have yielded conflicting results. Here, we will review the role of adipose tissue oxygenation in the pathophysiology of obesity-related complications, with a specific focus on human studies. We will provide an overview of the determinants of adipose tissue oxygenation, as well as the role of adipose tissue oxygenation in glucose homeostasis, lipid metabolism and inflammation. Finally, we will discuss the putative effects of physiological and experimental hypoxia on adipose tissue biology and whole-body metabolism in humans. We conclude that several lines of evidence suggest that alteration of adipose tissue oxygenation may impact metabolic homeostasis, thereby providing a novel strategy to combat chronic metabolic diseases in obese humans.
Keywords: adipose tissue; hypoxia; inflammation; metabolism; obesity; oxygen.
© 2019 The Authors. Acta Physiologica published by John Wiley & Sons Ltd on behalf of Scandinavian Physiological Society.
Conflict of interest statement
The authors have declared that no conflict of interest exists.
Figures

Characteristics of lean healthy and obese dysfunctional white adipose tissue. Adipose tissue dysfunction is characterized by adipocyte hypertrophy, impaired adipokine secretion, a chronic low‐grade inflammation, apoptosis, extracellular matrix remodelling, hormonal resistance, vascular rarefaction, decreased adipose tissue blood flow and altered metabolic responses, together contributing to insulin resistance and related chronic diseases. ER, endoplasmic reticulum

Adipocyte substrate metabolism, adipocyte gene expression and adipokine secretion are affected by alteration of oxygen partial pressure (pO2). Both the severity and the duration of hypoxia exposure seem to impact cellular processes, as explained in more detail in the text. Panel A shows the effects of acute exposure to severe hypoxia (usually 1% O2 for <24 h), while panel B illustrates the putative effects of prolonged, mild hypoxia exposure (usually 5%‐10% O2 for 7‐14 d) on adipocyte biology. ER, endoplasmic reticulum; FA, fatty acids; FATP/CD36, fatty acid transporters; GLUT, glucose transporter; IR, insulin receptor; MCTs, monocarboxylate transporters; pO2, oxygen partial pressure; TAG, triacylglycerol. ↑, increase; ↓, decrease; ↔, unchanged; ?, not determined

Putative impact of (moderate) hypoxia exposure on whole‐body, skeletal muscle and adipose tissue physiology. O2, oxygen; pO2, oxygen partial pressure
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