Abstrait

Reducing the risk of macrovascular complications of diabetes: focus on visceral fat

Susan Sam & Theodore Mazzone

Macrovascular complications of Type 2 diabetes account for the majority of mortality in this condition and are related to insulin resistance. Abdominal obesity, and especially visceral fat, has proven to be particularly important in these associations. Indeed the risk for Type 2 diabetes and its complications is more closely related to visceral fat than overall obesity. Whether visceral fat by itself is pathogenic or a marker for ectopic accumulation of fat or a combination of both remains unresolved. Inflammation has now been established as a major pathway linking insulin resistance to obesity. Adipose tissue macrophage infiltration has been implicated in the activation of inflammatory pathways and development of insulin resistance. However, the mechanisms leading to these events are not clearly identified and remain active areas of investigation.