The role of adipokines in the development of adipose tissue dysfunction and other metabolic disorders

The role of specific adipokines in the formation of adipose tissue dysfunction is considered. Obesity is a multifactorial disease that is characterized by excessive adipose tissue accumulation in the body and is a risk factor for the development of several other diseases, including type 2 diabetes mellitus, cardiovascular diseases, and non-alcoholic fatty liver disease. Obesity is one of the main causes of chronic diseases and disability in modern society. Adipose tissue takes an active part in cellular reactions and metabolic homeostasis and does not represent inert tissue only for energy storage. In obesity, excessive accumulation of visceral fat causes adipose tissue dysfunction, which greatly contributes to the occurrence of concomitant diseases. Adipose tissue is capable of synthesizing and releasing a large number of hormones, cytokines, extracellular matrix proteins, growth factors, and vasoactive factors, which are collectively called adipokines, affecting various physiological and pathophysiological processes in the body. Perivascular adipose tissue produces cytokines that affect angiogenesis and peripheral vascular resistance. Adiponectin suppresses the production of glucose in the liver and enhances fatty acid oxidation in the skeletal muscles, which together contribute to a favorable metabolic effect in energy homeostasis, protect cells from apoptosis, and reduce inflammation in various cell types through receptor-dependent mechanisms. Leptin modulates vasoconstriction depending on sympathetic activity while resistin is involved in insulin resistance due to inflammation, wherein its high level determines metabolically unhealthy obesity. Additionally, visfatin plays an important role in the pathogenesis of vascular inflammation in obesity and diabetes mellitus while osteopontin regulates the production of inflammatory mediators by immune cells and omentin plays an important anti-inflammatory and insulin-sensitizing role. The production of most inflammatory mediators in adipose tissue dysfunction increases and contributes to the progression of obesity and related metabolic and vascular disorders. Considering adipokines as biological markers of pathological processes is necessary since their study will create prerequisites for preventive measures and will contribute to the positive treatment process.