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## IntechOpen Book Series Physiology Volume 4

Leszek Szablewski is a professor of medical sciences. He received his MS in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology, Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and obtained his degree of professor from the President of Poland. Professor Szablewski is the Head of Chair of the Department of General Biology and Parasitology, Medical

University of Warsaw. He has published over 80 peer-reviewed papers in journals such as *Journal of Alzheimer's Disease*, *Biochimica Biophysica Acta Reviews on Cancer*, *Biological Chemistry*, *Journal of Biomedical Science*, *Diabetes/Metabolism Research and Review*, and *Endocrine*. He is the author of two books four book chapters, and the editor of four books. He has written 15 scripts for students, is the ad hoc reviewer of more than 30 peer-reviewed journals, and an editorial member of peer-reviewed journals. His research focuses on cells, physiology, genetics, and pathophysiology.

#### **Editor of Volume 4: Leszek Szablewski**

Medical University of Warsaw, Warsaw, Poland

**Book Series Editor: Angel Catala** National University of La Plata, Argentina

### Scope of the Series

Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the expression, structure, and function of molecular and cellular components. While a daunting task, learning is facilitated by our identification of common, effective signaling pathways employed by nature to sustain life. As a main example, the cellular interplay between intracellular Ca2 increases and changes in plasma membrane potential is integral to coordinating blood flow, governing the exocytosis of neurotransmitters and modulating genetic expression. Further, in this manner, understanding the systemic interplay between the cardiovascular and nervous systems has now become more important than ever as human populations age and mechanisms of cellular oxidative signaling are utilized for sustaining life. Altogether, physiological research enables our identification of clear and precise points of transition from health to development of multi-morbidity during the inevitable aging process (e.g.,

diabetes, hypertension, chronic kidney disease, heart failure, age-related macular degeneration; cancer). With consideration of all organ systems (e.g., brain, heart, lung, liver; gut, kidney, eye) and the interactions thereof, this Physiology Series will address aims of resolve (1) Aging physiology and progress of chronic diseases (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling & (3) how changes in plasma membrane produced by lipid peroxidation products affects aging physiology

Contents

**Section 1**

**Section 2**

**Section 3**

and T2DM

*by Leszek Szablewski*

*by Alina Kurylowicz*

Introductory chapter: Adipose Tissue

*by Dhara Patel and Palash Mandal*

**Preface III**

General Characteristics of Adipose Tissue **1**

**Chapter 1 3**

Physiology of Adipose Tissue **11**

**Chapter 2 13**

**Chapter 3 29**

**Chapter 4 51**

Diseases Due to Disturbances in Adipose Tissue **73**

**Chapter 5 75**

**Chapter 6 87**

**Chapter 7 99** Mediators of Impaired Adipogenesis in Obesity-Associated Insulin Resistance

Role of Sirtuins in Adipose Tissue Development and Metabolism

Novel Aspects of Follistatin/Transforming Growth Factor-β (TGF-β) Signaling in Adipose Tissue Metabolism: Implications in Metabolic Health

*by Felipe Henriques, Alexander H. Bedard and Miguel Luiz Batista Júnior*

*by Shehla Pervin, Wilson Nyah, Srinivasa T. Reddy and Rajan Singh*

Effect of Alcohol on Gut-Liver Axis and Adipose Tissue

Adipose Tissue Inflammation and Metabolic Disorders

*by Sara Al-Ghadban, Karen L. Herbst and Bruce A. Bunnell*

*by Haya Al-Sulaiti, Alexander S. Dömling and Mohamed A. Elrayess*

Lipedema: A Painful Adipose Tissue Disorder

## Contents


Preface

*Adipose Tissue—An Update* is an update to the first volume, which was published by IntechOpen in 2018, and a part of the book series "Physiology." The chapters include information on adipose tissue such as the characterization of this tissue, the role of sirtuins in its metabolism, and its role in diseases. The book also includes a description of adipose tissue as an endocrine organ, as well as a signaling system in this tissue. This book is an important source of information because it describes several aspects of adipose tissue. Based on the interest of readers, IntechOpen decided to continue the publication of books on adipose tissue. Therefore, *Adipose Tissue—*

Adipose tissue is a kind of specialized connective tissue. Depending on its type, adipose tissue plays different and significant roles in humans and animals. For example, brown adipose tissue, which is found in fetuses and newborn, in adult humans is practically absent; in mammals it is involved in the process of thermogenesis, metabolizing fatty acids. White adipose tissue has different functions. It protects against environmental factors that can cause mechanical injury and cold. Other functions include the storage of lipids and triacylglycerol and the synthesis of fatty acids. During fasting, fatty acids are released and in the process of β-oxidation are a source of adenosine triphosphate. White adipose tissue is also a major secretory organ. White adipose tissue secretes bioactive molecules such as cholesterol, retinol, steroid hormones, prostaglandins, and proteins known as "adipokines" that influence human physiology and pathology. These molecules have a beneficial role. Unfortunately, they may also be associated with pathologies and diseases such as obesity and insulin resistance. They may increase the risk of metabolic syndrome, cardiovascular diseases, and others. Obesity, due to visceral accumulation of

adipose tissue, is especially dangerous. It is suggested that release of fatty acids from the visceral depot into the portal vein increases gluconeogenesis and hepatic glucose output, causing insulin resistance. Insulin resistance, on the other hand, may cause type 2 diabetes mellitus. The World Health Organization defined type 2 diabetes mellitus as "a progressive worldwide epidemic." Visceral abdominal obesity reduces life expectancy by about 8 years. Beige adipose tissue histologically is similar to brown adipose tissue. Stimuli, such as cold, exercise, or thyroid hormones, cause differentiation of white adipose tissue into brown adipose tissue. This process is an

In the past several decades, knowledge of adipose tissue has been rapidly growing. This book aims to provide an overview of the topics of adipose tissue and its role in human physiology and pathology. The book is written by authors from different laboratories, yet the editor has tried to arrange the chapters in an issue order to make it easier for readers to find what they need. The authors discuss adipose tissue from different aspects and hope to enhance a clear understanding of this histologi-

This book contains three sections focusing on the topic of adipose tissue. Section 1 contains only one chapter and presents the general characteristics of adipose tissue. Section 2, which includes Chapters 2–4, mainly describes the role of sirtuins,

adaptive and reversible response of white adipose tissue to stimuli.

cal, physiological, and pathological problem.

*An Update* is the result of this continuation.
