How obesity affects adipocyte turnover

Han SM; Nahmgoong H; Yim KM; Kim JB

doi:10.1530/ey.22.11.2

11.2

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ESPE Yearbook of Paediatric Endocrinology (2025) 22 11.2 | DOI: 10.1530/ey.22.11.2

ESPEYB25 11. Obesity and Weight Regulation Adipocytes at the Centre of Action (3 abstracts)

11.2. How obesity affects adipocyte turnover

Han SM , Nahmgoong H , Yim KM & Kim JB

Author affiliations

National Leader Research Initiatives center for Adipocyte Structure and Function, Institute of Molecular Biology and Genetics, School of Biological Sciences, Seoul National University, Seoul 08826, Republic of Korea. [email protected]

Trend in Endocrinology and Metabolism 2025 Feb, 36(2): 147-160. PMID: 39095230 doi: 10.1016/j.tem.2024.07.004. https://pubmed.ncbi.nlm.nih.gov/39095230/

Adipocyte turnover is a crucial process for maintaining adipose tissue homeostasis and metabolic flexibility. This review shows that this process is impaired in the obese state, leading to increased adipocyte death, inflammation and compensatory adipogenesis.

It had been hypothesized that the number of adipocytes is fixed during childhood [1,2]. That view had to be revised. The review provides a comprehensive overview on adipocyte turnover, particularly in the context of obesity. Unlike previous reviews which have focused only on isolated steps, either the adipocyte death, the adipocyte clearance or the generation of new adipocytes, this article summarizes current knowledge about the entire adipocyte turnover process – emphasizing how these steps are orchestrated, how they interplay in maintaining adipose tissue homeostasis and how important the roles of the immune system and inflammatory processes in adipose tissue homeostasis are. By linking impairments in adipocyte turnover like an excessive adipocyte death or a decreased adipogenesis, to metabolic dysfunctions like insulin resistance or inflammation, the review highlights the clinical importance of maintaining adipose tissue homeostasis. One part of the review discusses potential therapeutic strategies, like the selective removal of dysfunctional adipocytes, for example by using senolytic drugs to induce apoptosis of senescent cells or by using a specific type of immune cells, the invariant natural killer T-cells (iNKTs), to ameliorate metabolic complications.

Taken together, this review provides an excellent overview of the physiology and pathophysiology of adipocyte turnover, offering useful insights for both researchers and clinicians.

References: 1. Knittle, JL. Obesity in childhood: A problem of adipose tissue development. J Pediatr; 1972; 81:1048-1059.2. Knittle JL, Ginsberg-Fellner F, Brown, RE. Adipose tissue development in man. Am J Clin Nutr 1977; 30:762-766.