Adipotoxicity Revisited: Shifting from Metabolic to Cardiometabolic Risk Profile

REVIEW ARTICLE

Christian H Anderwald^1,2

Affiliations: ¹Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria and ²Mariahilf Community Pharmacy, Arnoldstein, Austria

ABSTRACT

Obesity represents a major challenge to health care systems worldwide. Due to quantitatively and qualitatively unbalanced nutrition, approximately one-half or more of the population in Western societies is overweight or obese. Obese people are more prone to develop specific diseases from the (cardio-) metabolic syndrome; that is, obesity-related diseases, which comprise, among others, type-2 diabetes mellitus, cardiovascular disease, and also cancer.

Thus, more attention is paid to the underlying pathophysiological mechanism of obesity-related diseases (ORD). Whereas Lipotoxicity only refers to the deleterious effects of free fatty acids (FFA), the more novel term Adipotoxicity seeks to describe all harmful actions due to increased fat (a) in the nutrition, (b) in the entire body, (c) on the related hormones and metabolites, and (d) in tissues unrelated to fat storage (muscle and liver).

In conclusion, effective strategies are needed to prevent the obesity pandemic and to develop specific treatment options for patients with ORD.

Keywords: obesity, type-2 diabetes mellitus, free fatty acids, lipids, economic burden

Correspondence: Christian H Anderwald, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Waehringer Guertel 18-20 A-1090, Vienna, Austria. Tel: +43 1 40400 7249; Fax: +43 1 40400 7790; e-mail: christianheinz.anderwald@meduniwien.ac.at