| OBSERVATION'S |
SO FAR, only one bioactive molecule from fat cells is known to be exclusively beneficial: Adiponectin inhibits insulin resistance as well as inflammation. According to Osama Hamdy, director of the obesity clinical program at Harvard University's Joslin Diabetes Center, adiponectin and TNF- have opposing effects on insulin sensitivity and cardiovascular risk. High TNF- and low adiponectin are associated with obesity, insulin resistance, and coronary artery disease. Weight loss raises adiponectin, making adiponectin "a very valid future drug candidate" for obesity, insulin resistance, and coronary artery disease, he says. Obese individuals are likely to have the metabolic syndrome and are at high risk for diabetes and cardiovascular disease. But not all obese people have the metabolic syndrome, and being lean does not preclude having the metabolic syndrome. According to Hamdy, even more important than obesity is visceral fat, which is found between the abdominal wall and the organs in the abdomen. The metabolic syndrome is rare among people without visceral fat, he says. "The metabolic syndrome occurs in people who are lean and people who are obese," Hamdy explains. "You will be surprised, but 18% of men and 22% of women who are of normal weight or slightly overweight have the metabolic syndrome. You can be of normal weight but have a high percentage of body fat. And then it matters how much of that fat is visceral and how much is subcutaneous. Fat in the deep visceral area is the most dangerous." Unlike the fat under the skin, visceral fat is more easily mobilized and is a richer source of proinflammatory proteins such as TNF-. When hydrolyzed, visceral fat releases free fatty acids. When these reach the liver, they are converted to triglycerides and stored. According to Hamdy, glycation also releases reactive oxygen radicals, which damage many entities, such as LDL. Oxidized LDL particles, he explains, are very atherosclerotic--that is, they contribute significantly to the formation of plaques in arterial walls. |
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