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Exploring Therapeutic Targets to Reverse or Prevent the Transition from Metabolically Healthy to Unhealthy Obesity

1
Medical School, Australian National University, Canberra, ACT 2601, Australia
2
Department of Immunology and Infectious Disease, John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
3
Department of Endocrinology, The Canberra Hospital, Garran, ACT 2605, Australia
*
Author to whom correspondence should be addressed.
Cells 2020, 9(7), 1596; https://doi.org/10.3390/cells9071596
Received: 1 June 2020 / Revised: 24 June 2020 / Accepted: 30 June 2020 / Published: 1 July 2020
(This article belongs to the Special Issue Molecular Mechanisms in Metabolic Disease)
The prevalence of obesity and obesity-related metabolic comorbidities are rapidly increasing worldwide, placing a huge economic burden on health systems. Excessive nutrient supply combined with reduced physical exercise results in positive energy balance that promotes adipose tissue expansion. However, the metabolic response and pattern of fat accumulation is variable, depending on the individual’s genetic and acquired susceptibility factors. Some develop metabolically healthy obesity (MHO) and are resistant to obesity-associated metabolic diseases for some time, whereas others readily develop metabolically unhealthy obesity (MUO). An unhealthy response to excess fat accumulation could be due to susceptibility intrinsic factors (e.g., increased likelihood of dedifferentiation and/or inflammation), or by pathogenic drivers extrinsic to the adipose tissue (e.g., hyperinsulinemia), or a combination of both. This review outlines the major transcriptional factors and genes associated with adipogenesis and regulation of adipose tissue homeostasis and describes which of these are disrupted in MUO compared to MHO individuals. It also examines the potential role of pathogenic insulin hypersecretion as an extrinsic factor capable of driving the changes in adipose tissue which cause transition from MHO to MUO. On this basis, therapeutic approaches currently available and emerging to prevent and reverse the transition from MHO to MUO transition are reviewed. View Full-Text
Keywords: obesity; metabolically healthy and unhealthy obesity; adipocyte dysfunction; reversing obesity; therapeutic targets obesity; metabolically healthy and unhealthy obesity; adipocyte dysfunction; reversing obesity; therapeutic targets
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MDPI and ACS Style

Dagpo, T.D.; Nolan, C.J.; Delghingaro-Augusto, V. Exploring Therapeutic Targets to Reverse or Prevent the Transition from Metabolically Healthy to Unhealthy Obesity. Cells 2020, 9, 1596.

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