1 Introduction</h5> The metabolic syndrome comprises a combination of risk factors that increase the risk of developing type-2 diabetes and cardiovascular disease  . Obesity, in particular abdominal obesity, is one of the main risk factors of the metabolic syndrome. The majority of obese individuals (~ 80%) will eventually develop metabolic abnormalities associated with a reduced life expectancy. However, there is a subset of obese individuals who remain relatively insulin sensitive and metabolically healthy throughout life  . The reason why these individuals are unaffected is still not completely understood.</P>The pathological metabolic consequences of obesity are closely linked to the expanding adipose tissue that at a certain level responds with stress signals to the energy overload  . Adipose tissue functions as a metabolic and endocrine organ releasing fatty acids and adipokines, both of which have immune modulatory activities as reviewed in Refs. [4,5] . Obesity induces adipose tissue dysfunction with increased secretion of pro-inflammatory cytokines and chemokines. Adipose tissue acquires a chronic inflammatory state which is characterized by macrophage accumulation in crown like structures that surround stressed and dying adipocytes [6,7] . Adipose tissue inflammation may affect systemic immune responses that contribute to the initiation and progression
Metabolism – Elsevier
Published: Apr 1, 2014
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