Journal of Endocrinological Investigation

, Volume 42, Issue 11, pp 1257–1272 | Cite as

Sick fat: the good and the bad of old and new circulating markers of adipose tissue inflammation

  • I. Barchetta
  • F. A. Cimini
  • G. Ciccarelli
  • M. G. BaroniEmail author
  • M. G. CavalloEmail author


Adipose tissue (AT) is one of the largest endocrine organs contributing to metabolic homeostasis. The functional pleiotropism of AT depends on its ability to secrete a large number of hormones, cytokines, extracellular matrix proteins and growth factors, all influencing many local and systemic physiological and pathophysiological processes. In condition of chronic positive energy balance, adipocyte expansion, hypoxia, apoptosis and stress all lead to AT inflammation and dysfunction, and it has been demonstrated that this sick fat is a main risk factor for many metabolic disorders, such as type 2 diabetes mellitus, fatty liver, cardiovascular disease and cancer. AT dysfunction is tightly associated with aberrant secretion of bioactive peptides, the adipocytokines, and their blood concentrations often reflect the expression in the AT. Despite the existence of an association between AT dysfunction and systemic pro-inflammatory state, most of the circulating molecules detectable in obese and dysmetabolic individuals do not identify specifically the condition of sick fat. Based on this premise, this review provides a concise overview of “classic” and novel promising adipocytokines associated with AT inflammation and discusses possible critical approaches to their interpretation in clinical practice.


Adipose tissue Adipokines Metabolic disease Obesity Visceral fat Inflammation 



Financial support to this work came from Sapienza University of Rome to MG Baroni (grant 2RM11715C3FCB9431) and to MG Cavallo (grant RM1161550687D69B).

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest

Ethical approval

This article does not contain studies with human participants or animals (review).

Informed consent

Not applicable.


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Copyright information

© Italian Society of Endocrinology (SIE) 2019

Authors and Affiliations

  1. 1.Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and EndocrinologySapienza University of RomeRomeItaly

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