The metabolic syndrome, a cluster of insulin resistance, elevated blood pressure, and atherogenic dyslipidemia, is a common basis of atherosclerosis. Accumulation of intra-abdominal visceral fat stands upstream of the metabolic syndrome. Adipose tissue expresses a variety of genes for bioactive secretory proteins conceptualized as adipocytokines. We discovered a novel adipose-specific protein named adiponectin from human fat cDNAs. Adiponectin circulates in the plasma and its serum level is decreased in visceral fat accumulation. Results of experimental and clinical researches have demonstrated that hypoadiponectinemia underlies the pathogenesis of multiple diseases related to visceral fat accumulation, including atherosclerosis, hypertension, cardiac failure, insulin resistance, diabetes, hepatic steatosis, inflammatory bowel disease, and cancers. Recently, we revealed fat-derived reactive oxygen species (fat ROS) as an upstream factor in the development of hypoadiponectinemia and metabolic syndrome. Intervention targeting visceral fat accumulation, hypoadiponectinemia and fat ROS should be the way to therapeutically tackle the metabolic syndrome.
Biomedical Reviews 2006; 17: 1-10.
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