title: Perivascular adipose tissue: An unique fat compartment relevant for the cardiometabolic syndrome.
abstract: Type 2 diabetes and its major risk factor, obesity, are an increasing worldwide health problem. The exact mechanisms that link obesity with insulin resistance, type 2 diabetes, hypertension, cardiovascular complications and renal diseases, are still not clarified sufficiently. Adipose tissue in general is an active endocrine and paracrine organ that may influence the development of these disorders. Excessive body fat in general obesity may also cause quantitative and functional alterations of specific adipose tissue compartments. Beside visceral and subcutaneous fat depots which exert systemic effects by the release of adipokines, cytokines and hormones, there are also locally acting fat depots such as peri- and epicardial fat, perivascular fat, and renal sinus fat. Perivascular adipose tissue is in close contact with the adventitia of large, medium and small diameter arteries, possesses unique features differing from other fat depots and may act also independently of general obesity. An increasing number of studies are dealing with the "good" or "bad" characteristics and functions of normally sized and dramatically increased perivascular fat mass in lean or heavily obese individuals. This review describes the origin of perivascular adipose tissue, its different locations, the dual role of a physiological and unphysiological fat mass and its impact on diabetes, cardiovascular and renal diseases. Clinical studies, new imaging methods, as well as basic research in cell culture experiments in the last decade helped to elucidate the various aspects of the unique fat compartment.
authors.affiliation: Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany. dorothea.axel@med.uni-tuebingen.de.|Institute of Diabetes Research and Metabolic Diseases (IDM), University of Tübingen, Tübingen, Germany. dorothea.axel@med.uni-tuebingen.de.|Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany. dorothea.axel@med.uni-tuebingen.de.|Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller Str.10, D-72076, Tübingen, Germany. dorothea.axel@med.uni-tuebingen.de.
authors.forename: D I
authors.initials: DI
authors.lastname: Siegel-Axel
authors.affiliation: Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, Germany.|Institute of Diabetes Research and Metabolic Diseases (IDM), University of Tübingen, Tübingen, Germany.|Deutsches Zentrum für Diabetesforschung (DZD), Neuherberg, Germany.
authors.forename: H U
authors.initials: HU
authors.lastname: Häring
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D006801:Humans; D024821:Metabolic Syndrome / Q000378:metabolism*; D056128:Obesity, Abdominal / Q000378:metabolism*
keywords: Adipocytes; Adipokines; Adipose tissue; Adventitia; Angiogenic factors; Arterial vessel wall; Cardiovascular diseases; Complications; Cytokines; Perivascular adipose tissue; Perivascular fat; Preadipocytes; Renal diseases; Renal sinus fat; Type 2 diabetes