Adipose tissue fibrosis, hypertrophy, and hyperplasia: Correlations with diabetes in human obesity

TLDR

The link between adipose tissue fibrosis, adipocyte hypertrophy, and preadipocyte hyperplasia and systemic metabolic disease in obesity remains poorly understood. This study aimed to clarify how fibrosis, hypertrophy, and hyperplasia relate in human obesity and how these features associate with diabetes. Researchers examined visceral and subcutaneous adipose samples from bariatric surgery patients using qRT‑PCR, immunohistochemistry, and flow cytometry to quantify collagen, fibrosis proteins, adipocyte size, and preadipocyte frequency, then correlated these data with clinical characteristics including diabetes status. Diabetic subjects exhibited reduced fibrosis, increased hypertrophy, and lower preadipocyte frequency and fibrotic gene expression—especially in visceral fat—supporting the hypothesis that fibrosis limits hypertrophy and promotes hyperplasia, which may benefit systemic metabolism and represents a potential therapeutic target.

Abstract

Objective The relationship between adipose tissue fibrosis, adipocyte hypertrophy, and preadipocyte hyperplasia in the context of obesity and the correlation of these tissue‐based phenomena with systemic metabolic disease are poorly defined. The goal of this study was to clarify the relationship between adipose tissue fibrosis, adipocyte hypertrophy, and preadipocyte hyperplasia in human obesity and determine the correlation of these adipose‐tissue based phenomena with diabetes. Methods Visceral and subcutaneous adipose tissues from humans with obesity collected during bariatric surgery were studied with QRTPCR, immunohistochemistry, and flow cytometry for expression of collagens and fibrosis‐related proteins, adipocyte size, and preadipocyte frequency. Results were correlated with clinical characteristics including diabetes status. Results Fibrosis was decreased, hypertrophy was increased, and preadipocyte frequency and fibrotic gene expression were decreased in adipose tissues from diabetic subjects compared to non‐diabetic subjects. These differences were greater in visceral compared to subcutaneous adipose tissue. Conclusions These data are consistent with the hypothesis that adipose tissue fibrosis in the context of human obesity limits adipocyte hypertrophy and is associated with a reciprocal increase in adipocyte hyperplasia, with beneficial effects on systemic metabolism. These findings suggest adipose tissue fibrosis as a potential target for manipulation of adipocyte metabolism.