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Brief Review

Role of Insulin-Stimulated Adipose Tissue Perfusion in the Development of Whole-Body Insulin ResistanceHighlights

Anna L. Emanuel, Rick I. Meijer, Marcel H.A. Muskiet, Daniël H. van Raalte, Etto C. Eringa, Erik H. Serné
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https://doi.org/10.1161/ATVBAHA.116.308670
Arteriosclerosis, Thrombosis, and Vascular Biology. 2017;37:411-418
Originally published January 26, 2017
Anna L. Emanuel
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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Rick I. Meijer
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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Marcel H.A. Muskiet
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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Daniël H. van Raalte
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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Etto C. Eringa
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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Erik H. Serné
From the Departments of Internal Medicine (A.L.E., R.I.M., M.H.A.M., D.H.v.R., E.H.S.) and Physiology (E.C.E.), VU University Medical Center, Amsterdam.
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    • Abstract
    • Adipose Tissue Perfusion in Healthy Individuals
    • The Physiology of Insulin on Adipose Tissue Perfusion
    • ATBF in Obesity, Insulin Resistance, and Type 2 Diabetes Mellitus
    • Role of Impaired ATBF in the Development of Whole-Body Insulin Resistance
    • Adipose Tissue Perfusion During the Development of Obesity: A Novel Hypothesis
    • Future Perspectives
    • Conclusion
    • Sources of Funding
    • Disclosures
    • References
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    Figure.

    Hypothesis of the influence of overfeeding on insulin-mediated skeletal muscle and adipose tissue perfusion. Left upper corner, skeletal muscle perfusion in lean individuals. Right upper corner, adipose tissue perfusion in lean individuals. Left lower corner, skeletal muscle perfusion in overfed individuals. Right lower corner, adipose tissue perfusion in overfed individuals. ANG II indicates angiotensin 2; EC, endothelial cell; ET-1, endothelin-1; ERK-1/2, extracellular signal–regulated kinase 1/2; FFA, free fatty acids; IRS-1/2, insulin receptor substrate 1/2; HT, hypothalamus; NA, noradrenalin; NO, nitric oxide; PI3K, phosphoinositide 3-kinase; SMC, smooth muscle cell; and TNF-α, tumor necrosis factor-α.

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    Table.

    Methods for Measurements of Adipose Tissue Perfusion in Humans

    MethodOutcomeAbsolute ValuesCostsAdvantagesDisadvantages
    133Xe washoutVolume flowYesLowGold standardRadioactive isotopes (low dose)
    Easy
    133Xe washout with adipose tissue microinfusionVolume flowYesLowATBF response to locally injected pharmacological agentsRadioactive isotopes (low dose)
    Easy
    PET-(CT/MRI)Volume flowYesHighATBF measurements in all fat depots (including visceral AT)High radiation dose
    Complicated
    MicrodialysisVolume flowNoLowMinimally invasiveSlower response compared with gold standard
    EasyLess accurate compared with gold standard
    Laser Doppler fluxmetryVolume flowNoLowCan detect subtle changesMotion artifacts
    Repeated measurementsHigh spatial heterogeneity
    Easy
    Minimally invasive
    Contrast-enhanced ultrasoundBlood volumeNoModerateNo radioactive substancesDifficult to detect subtle changes
    Repeated measurementsSide effects of contrast infusion (minor)
    Not suitable for small fat depots
    • AT indicates adipose tissue; ATBF, adipose tissue blood flow; PET-CT, positron emission tomography–computed tomography; and PET-MRI, positron emission tomography-magnetic resonance imaging.

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Arteriosclerosis, Thrombosis, and Vascular Biology
March 2017, Volume 37, Issue 3
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    • Adipose Tissue Perfusion in Healthy Individuals
    • The Physiology of Insulin on Adipose Tissue Perfusion
    • ATBF in Obesity, Insulin Resistance, and Type 2 Diabetes Mellitus
    • Role of Impaired ATBF in the Development of Whole-Body Insulin Resistance
    • Adipose Tissue Perfusion During the Development of Obesity: A Novel Hypothesis
    • Future Perspectives
    • Conclusion
    • Sources of Funding
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    Role of Insulin-Stimulated Adipose Tissue Perfusion in the Development of Whole-Body Insulin ResistanceHighlights
    Anna L. Emanuel, Rick I. Meijer, Marcel H.A. Muskiet, Daniël H. van Raalte, Etto C. Eringa and Erik H. Serné
    Arteriosclerosis, Thrombosis, and Vascular Biology. 2017;37:411-418, originally published January 26, 2017
    https://doi.org/10.1161/ATVBAHA.116.308670

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    Role of Insulin-Stimulated Adipose Tissue Perfusion in the Development of Whole-Body Insulin ResistanceHighlights
    Anna L. Emanuel, Rick I. Meijer, Marcel H.A. Muskiet, Daniël H. van Raalte, Etto C. Eringa and Erik H. Serné
    Arteriosclerosis, Thrombosis, and Vascular Biology. 2017;37:411-418, originally published January 26, 2017
    https://doi.org/10.1161/ATVBAHA.116.308670
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