The fat factor: rethinking adipose energetics with obesity, insulin resistance and surgery

Adipose tissue is a complex, misunderstood and poorly studied metabolic organ. This is becoming more and more evident with the advent of single nuclei RNA sequencing, outlining clear discrepancy between subcutaneous and visceral adipocyte transcriptional profiles (Emont et al., 2023), implicated by a series of intrinsic (i.e. age, sex, hormonal status, race/ethnicity) and extrinsic (i.e. circadian rhythms, sleep, diet, medication) factors. Complementing these advances, the metabolic profile of adipose tissue, specifically relating to obesity, has been studied for some time now, with clear evidence outlining the disturbance that increased adiposity plays on disease susceptibility, particularly insulin resistance and type 2 diabetes.