Current Diabetes Reports

, Volume 10, Issue 4, pp 306–315 | Cite as

The Role of Adipose Tissue and Lipotoxicity in the Pathogenesis of Type 2 Diabetes

  • Kenneth CusiEmail author


The widespread epidemics of obesity and type 2 diabetes mellitus (T2DM) suggest that both conditions are closely linked. An increasing body of evidence has shifted our view of adipose tissue from a passive energy depot to a dynamic “endocrine organ” that tightly regulates nutritional balance by means of a complex crosstalk of adipocytes with their microenvironment. Dysfunctional adipose tissue, particularly as observed in obesity, is characterized by adipocyte hypertrophy, macrophage infiltration, impaired insulin signaling, and insulin resistance. The result is the release of a host of inflammatory adipokines and excessive amounts of free fatty acids that promote ectopic fat deposition and lipotoxicity in muscle, liver, and pancreatic β cells. This review focuses on recent work on how glucose homeostasis is profoundly altered by distressed adipose tissue. A better understanding of this relationship offers the best chance for early intervention strategies aimed at preventing the burden of T2DM.


Adipose tissue Lipotoxicity NAFLD Type 2 diabetes mellitus Insulin resistance 



Dr. Kenneth Cusi is supported by the American Diabetes Association, the Burroughs Wellcome Fund, the Veterans Affairs Medical Research Fund, and by Award Number UL 1RR025767 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources of the National Institutes of Health.


No potential conflict of interest relevant to this article was reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.The University of Texas Health Science Center at San AntonioSan AntonioUSA

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