Adaptation of adipose tissue to weight-reduction energy-restricted diet in obese individuals

Authors: Vladimír Štich
Authors‘ workplace: Ústav tělovýchovného lékařství 3. LF UK a FN Královské Vinohrady, Praha
Published in: Vnitř Lék 2016; 62(Suppl 4): 123-128
Category: Reviews


Obesity is associated with a number of metabolic disorders that lead to the development of type 2 diabetes, hyperlipidemia and ultimately cardiovascular diseases. An important role in the pathogenesis of metabolic disorders accompanying obesity is probably played by the alterations of adipose tissue characteristics: metabolic, endocrine and immune functions. The key component of obesity treatment, the weight-reduction energy-restricted diet, leads not only to the reduction of weight (specifically fat mass), but also to correction of obesity accompanying metabolic disorders. The mechanisms which mediate the metabolic effect of the weight-reduction energy-restricted diet, are unclear. It can be assumed that the weight-reduction diet “corrects” the impaired functions of the obese individual’s adipose tissue and, subsequently, of the resulting metabolic disorders. The following text presents an overview of the changes of morphological and functional characteristics of adipose tissue that are induced by weight-reduction energy-restricted diets in obese individuals: the energy-restricted diet and the associated weight reduction cause a change in the size and differentiation of adipocytes, a change of metabolic functions, primarily of the regulation of adipose tissue lipolysis and lipogenesis, change in the regulation of endocrine functions and, finally, they lead to the change in the immune function indicators, i.e. adipose tissue infiltration with immune cells and secretion of a spectrum of cytokines. The knowledge about the mechanisms of favourable metabolic effects of energy-restricted diets may lead to an advancement in non-pharmacological procedures of therapy for obesity and its complications, and, in the longer, term to the development of new therapeutic pharmacological procedures.

Key words:
energy-restricted diet – obesity – weight reduction – adipose tissue


1. Klimcakova E, Roussel B, Kovacova Z et al. Macrophage gene expression is related to obesity and the metabolic syndrome in human subcutaneous fat as well as in visceral fat. Diabetologia 2011; 54(4): 876–887. Dostupné z DOI: <–010–2014–3>.

2. Klimcakova E, Roussel B, Marquez-Quinones A et al. Worsening of obesity and metabolic status yields similar molecular adaptations in human subcutaneous and visceral adipose tissue: decreased metabolism and increased immune response. J Clin Endocrinol Metab 2011; 96(1): E73-E82. Dostupné z DOI: <–1575>.

3. Nieto-Vazquez I, Fernandez-Veledo S, Kramer DK et al. Insulin resistance associated to obesity: the link TNF-α. Arch Physiol Biochem 2008; 114(3): 183–194. Dostupné z DOI: <>. Erratum in Arch Physiol Biochem 2009; 115(2): 117.

4. Spalding KL, Arner E, Westermark PO et al. Dynamics of fat cell turnover in humans. Nature 2008; 453(7196): 783–787. Dostupné z DOI: <>.

5. Arner P, Bernard S, Salehpour M et al. Dynamics of human adipose lipid turnover in health and metabolic disease. Nature 2011; 478(7367): 110–113. Dostupné z DOI: <http://dx.doi,org/10.1038/nature10426>.

6. Stich V, Harant I, De Glisezinski I et al. Adipose tissue lipolysis and hormone-sensitive lipase expression during very-low-calorie diet in obese female identical twins. J Clin Endocrinol Metab 1997; 82(3): 739–744.

7. Mauriege P, Imbeault P, Langin D et al. Regional and gender variations in adipose tissue lipolysis in response to weight loss. J Lipid Res 1999; 40(9): 1559–1571.

8. Pasarica M, Tchoukalova YD, Heilbronn LK et al. Differential effect of weight loss on adipocyte size subfractions in patients with type 2 diabetes. Obesity (Silver Spring) 2009; 17(10): 1976–1978. Dostupné z DOI: <>.

9. Guo W, Bigornia S, Leizerman I et al. New scanning electron microscopic method for determination of adipocyte size in humans and mice. Obesity (Silver Spring) 2007; 15(7): 1657–1665.

10. Eriksson-Hogling D, Andersson DP, Backdahl J et al. Adipose tissue morphology predicts improved insulin sensitivity following moderate or pronounced weight loss. Int J Obes (Lond) 2015; 39(6): 893–898. Dostupné z DOI: <>.

11. Hoffstedt J, Arner E, Wahrenberg H et al. Regional impact of adipose tissue morphology on the metabolic profile in morbid obesity. Diabetologia 2010; 53(12): 2496–2503. Dostupné z DOI: <–010–1889–3>.

12. Jacobsson B, Smith U. Effect of cell size on lipolysis and antilipolytic action of insulin in human fat cells. J Lipid Res 1972; 13(5): 651–656.

13. Votruba SB, Jensen MD. Sex differences in abdominal, gluteal, and thigh LPL activity. Am J Physiol Endocrinol Metab 2007; 292(6): E1823-E1828.

14. Roberts R, Hodson L, Dennis AL et al. Markers of de novo lipogenesis in adipose tissue: associations with small adipocytes and insulin sensitivity in humans. Diabetologia 2009; 52(5): 882–890. Dostupné z DOI: <http://dx,–009–1300–4>.

15. Skurk T, Alberti-Huber C, Herder C et al. Relationship between adipocyte size and adipokine expression and secretion. J Clin Endocrinol Metab 2007; 92(3): 1023–1033.

16. Isakson P, Hammarstedt A, Gustafson B et al. Impaired preadipocyte differentiation in human abdominal obesity: role of Wnt, tumor necrosis factor-alpha, and inflammation. Diabetes 2009; 58(7): 1550–1557. Dostupné z DOI: <–1770>.

17. Rossmeislova L, Malisova L, Kracmerova J et al. Weight loss improves the adipogenic capacity of human preadipocytes and modulates their secretory profile. Diabetes 2013; 62(6): 1990–1995. Dostupné z DOI: <–0986>.

18. Lofgren P, Andersson I, Adolfsson B et al. Long-term prospective and controlled studies demonstrate adipose tissue hypercellularity and relative leptin deficiency in the postobese state. J Clin Endocrinol Metab 2005; 90(11): 6207–6213.

19. Lafontan M, Langin D. Lipolysis and lipid mobilization in human adipose tissue. Prog Lipid Res 2009; 48(5): 275–297. Dostupné z DOI: <>.

20. Reynisdottir S, Eriksson M, Angelin B et al. Impaired activation of adipocyte lipolysis in familial combined hyperlipidemia. J Clin Invest 1995; 95(5): 2161–2169.

21. Horowitz JF, Coppack SW, Paramore D et al. Effect of short-term fasting on lipid kinetics in lean and obese women. Am J Physiol 1999; 276(2 Pt 1): E278-E284.

22. Siklova M, Rossmeislova L et al. The effect of 2 days very-low calorie diet on cytokines in adipose tissue and in plasma in obese women. Diabetologia 2014; 57(Suppl 1): S280-S285.

23. Barbe P, Stich V, Galitzky J et al. In vivo increase in beta-adrenergic lipolytic response in subcutaneous adipose tissue of obese subjects submitted to a hypocaloric diet. J Clin Endocrinol Metab 1997; 82(1): 63–69.

24. Sengenes C, Stich V, Berlan M et al. Increased lipolysis in adipose tissue and lipid mobilization to natriuretic peptides during low-calorie diet in obese women. Int J Obes Relat Metab Disord 2002; 26(1): 24–32.

25. Jocken JW, Langin D, Smit E et al. Adipose triglyceride lipase and hormone-sensitive lipase protein expression is decreased in the obese insulin-resistant state. J Clin Endocrinol Metab 2007; 92(6): 2292–2299.

26. Lofgren P, Hoffstedt J, Naslund E et al. Prospective and controlled studies of the actions of insulin and catecholamine in fat cells of obese women following weight reduction. Diabetologia 2005; 48(11): 2334–2342.

27. Eissing L, Scherer T, Todter K et al. De novo lipogenesis in human fat and liver is linked to ChREBP-beta and metabolic health. Nat Commun 2013; 4: 1528. Dostupné z DOI: <>.

28. Siklova-Vitkova M, Klimcakova E, Polak J et al. Adipose tissue secretion and expression of adipocyte-produced and stromavascular fraction-produced adipokines vary during multiple phases of weight-reducing dietary intervention in obese women. J Clin Endocrinol Metab 2012; 97(7): E1176-E1181. Dostupné z DOI: <–2380>.

29. Arvidsson E, Viguerie N, Andersson I et al. Effects of different hypocaloric diets on protein secretion from adipose tissue of obese women. Diabetes 2004; 53(8): 1966–1971.

30. Vidal H, Auboeuf D, De Vos P et al. The expression of ob gene is not acutely regulated by insulin and fasting in human abdominal subcutaneous adipose tissue. J Clin Invest 1996; 98(2): 251–255.

31. Paz-Filho G, Mastronardi C, Wong ML et al. Leptin therapy, insulin sensitivity, and glucose homeostasis. Indian J Endocrinol Metab 2012; 16(Suppl 3): S549-S555. Dostupné z DOI: <–8210.105571>.

32. Garaulet M, Viguerie N, Porubsky S et al. Adiponectin gene expression and plasma values in obese women during very-low-calorie diet. Relationship with cardiovascular risk factors and insulin resistance. J Clin Endocrinol Metab 2004; 89(2): 756–760.

33. Moschen AR, Molnar C, Geiger S et al. Anti-inflammatory effects of excessive weight loss: potent suppression of adipose interleukin 6 and tumour necrosis factor alpha expression. Gut 2010; 59(9): 1259–1264. Dostupné z DOI: <>.

34. Bruun JM, Pedersen SB, Kristensen K et al. Opposite regulation of interleukin-8 and tumor necrosis factor-alpha by weight loss. Obes Res 2002; 10(6): 499–506.

35. Capel F, Klimcakova E, Viguerie N et al. Macrophages and adipocytes in human obesity: adipose tissue gene expression and insulin sensitivity during calorie restriction and weight stabilization. Diabetes 2009; 58(7): 1558–1567. Dostupné z DOI: <–0033>.

36. Franck N, Gummesson A, Jernas M et al. Identification of adipocyte genes regulated by caloric intake. J Clin Endocrinol Metab 2011; 96(2): E413-E418. Dostupné z DOI: <–2534>.

37. Mutch DM, Temanni MR, Henegar C et al. Adipose gene expression prior to weight loss can differentiate and weakly predict dietary responders. PLoS One 2007; 2(12): e1344. Dostupné z DOI: <>.

38. Mutch DM, Pers TH, Temanni MR et al. A distinct adipose tissue gene expression response to caloric restriction predicts 6-mo weight maintenance in obese subjects. Am J Clin Nutr 2011; 94(6): 1399–1409. Dostupné z DOI: <>.

39. Cancello R, Henegar C, Viguerie N et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 2005; 54(8): 2277–2286.

40. Kovacikova M, Sengenes C, Kovacova Z et al. Dietary intervention-induced weight loss decreases macrophage content in adipose tissue of obese women. Int J Obes (Lond) 2011; 35(1): 91–98. Dostupné z DOI: <>.

41. Kosteli A, Sugaru E, Haemmerle G et al. Weight loss and lipolysis promote a dynamic immune response in murine adipose tissue. J Clin Invest 2010; 120(10): 3466–3479. Dostupné z DOI: <>.

42. Aron-Wisnewsky J, Tordjman J, Poitou C et al. Human adipose tissue macrophages: m1 and m2 cell surface markers in subcutaneous and omental depots and after weight loss. J Clin Endocrinol Metab 2009; 94(11): 4619–4623. Dostupné z DOI: <–0925>.

43. Chaston TB, Dixon JB. Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review. Int J Obes (Lond) 2008; 32(4): 619–628. Dostupné z DOI: <>.

Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue Suppl 4

2016 Issue Suppl 4

Most read in this issue
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account