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Liver fat content is linked to inflammatory changes in subcutaneous adipose tissue in type 2 diabetes patients
Author(s) -
Jansen Henry J.,
Vervoort Gerald M.,
Graaf Marinette,
Stienstra Rinke,
Tack Cees J.
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12105
Subject(s) - adipose tissue , medicine , endocrinology , adipokine , adipocyte , adiponectin , adipose tissue macrophages , type 2 diabetes , insulin resistance , fatty liver , chemistry , white adipose tissue , insulin , diabetes mellitus , disease
Summary Background Patients with type 2 diabetes mellitus (T2 DM ) are typically overweight and have an increased liver fat content ( LFAT ). High LFAT may be explained by an increased efflux of free fatty acids from the adipose tissue, which is partly instigated by inflammatory changes. This would imply an association between inflammatory features of the adipose tissue and liver fat content. Objective To analyse associations between inflammatory features of the adipose tissue and liver fat content. Design A cross‐sectional study. Patients Twenty‐seven obese patients with insulin‐treated T2 DM were studied. Measurements LFAT content was measured by proton magnetic resonance spectroscopy. A subcutaneous (sc) fat biopsy was obtained to determine morphology and protein levels within adipose tissue. In addition to fat cell size, the percentage of macrophages and the presence of crown‐like structures ( CLS s) within sc fat were assessed by CD 68‐immunohistochemical staining. Results Mean LFAT percentage was 11·1 ± 1·7% (range: 0·75–32·9%); 63% of the patients were diagnosed with an elevated LFAT (upper range of normal ≤5·5%). Whereas adipocyte size did not correlate with LFAT , 3 of 4 subjects with CLS s in sc fat had elevated LFAT and the percentage of macrophages present in sc adipose tissue was positively associated with LFAT . Protein concentrations of adiponectin within adipose tissue negatively correlated with LFAT . Adipose tissue protein levels of the key inflammatory adipokine plasminogen activator inhibitor‐1 ( PAI ‐1) were positively associated with LFAT . Conclusions Several pro‐inflammatory changes in sc adipose tissue associate with increased LFAT content in obese insulin‐treated patients with T2 DM . These findings suggest that inflammatory changes at the level of the adipose tissue may drive liver fat accumulation.