Obesity and diabetes – are they always together?

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Abstract

Obesity and type 2 diabetes mellitus (DM 2) are two interrelated metabolic diseases widespread throughout the developed world. However, up to 30% of individuals with a long history of obesity do not have a carbohydrate metabolism disorder. This article presents the results of a multi-year study of adipose tissue biology in obese individuals with DM 2 compared with individuals with the same history of obesity without DM 2. Comparative analysis of hormonal, cellular, and genetic factors in two groups of patients showed that DM 2 occurs in individuals with abnormal proliferation and adipogenic differentiation of mesenchymal stem cells (MSCs) of adipose tissue. It leads to adipocyte hypertrophy and inflammatory infiltration of adipose tissue macrophages, resulting in increased insulin resistance and diabetogenic effects. These disorders are due to abnormal expression of genes responsible for the proliferation and adipogenic differentiation of MSCs. The study of the possible reversibility of abnormal changes in adipose tissue MSCs in obese patients after significant weight loss and DM 2 remission appears to be a promising research direction. The ability to control adipose tissue progenitor cells may represent a new target for treating and preventing metabolic disorders in obesity.

About the authors

Marina V. Shestakova

National Medical Research Center for Endocrinology

Author for correspondence.
Email: shestakova.mv@gmail.com
ORCID iD: 0000-0002-5057-127X

акад. РАН, д-р мед. наук, проф., зав. каф. диабетологии и диетологии, дир. Института диабета, зам. дир. ФГБУ «НМИЦ эндокринологии»

Russian Federation, Moscow

Ekaterina A. Shestakova

National Medical Research Center for Endocrinology

Email: shestakova.mv@gmail.com
ORCID iD: 0000-0001-6612-6851

д-р мед. наук, вед. науч. сотр. ФГБУ «НМИЦ эндокринологии»

Russian Federation, Moscow

Igor A. Sklyanik

National Medical Research Center for Endocrinology

Email: shestakova.mv@gmail.com
ORCID iD: 0000-0002-7768-4717

канд. мед. наук, ст. науч. сотр. отд. прогнозирования и инноваций диабета, эндокринолог отд. ожирения и патологии метаболизма ФГБУ «НМИЦ эндокринологии»

Russian Federation, Moscow

Iurii S. Stafeev

Chazov National Medical Research Center of Cardiology

Email: shestakova.mv@gmail.com
ORCID iD: 0000-0003-3514-3936

канд. биол. наук, ст. науч. сотр. ФГБУ «НМИЦ кардиологии им. акад. Е.И. Чазова»

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Expression of adipogenic differentiation marker genes in visceral adipose tissue of obese patients with and without DM 2.

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3. Fig. 2. Interaction of genetic, cellular, and hormonal factors in obese individuals with and without DM 2 [14].

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