Adipokines: an overview of its metabolic effects

Abstract

There is a growing body of evidence indicating that adipose tissue is an endocrine organ able to synthesize and secrete substances involved in the pathogenesis of insulin resistance, systemic inflammation and atherogenesis. The purpose of this article is to conduct a review of the adipokines, adipose tissue-derived substances that seem to be the link between obesity and metabolic and cardiovascular diseases. Adipokines manifest their effects through endocrine and paracrine mechanisms. They act as immunomodulators, altering the balance between pro and anti-inflammatory cytokines; influence insulin sensitivity, interfering with glycemic homeostasis; regulate the central mechanism of appetite control and energy expenditure, with direct consequences on body weight. Moreover, they have effects on vascular tone, cell proliferation and atherogenesis, which modify cardiovascular risk, and they influence other determinants of the metabolic syndrome, such as blood pressure, lipid profile and degree of hepatic steatosis and inflammation. Adipokines may be an interesting tool for clinical use. They serve as biomarkers of metabolic and atherosclerotic disorders, enabling early identification of individuals at increased cardiovascular risk. In addition, handling these substances has a therapeutic potential that should not be overlooked, as suggested by the use of inhibitors of dipeptidyl peptidase 4 for the treatment of diabetes or by human recombinant leptin in patients with genetic deficiency of this adipokine. The use of the latter in lipodystrophic patients, as well as administration of visfatin for myocardial reperfusion with proven benefits in experimental models, also appears to be promising.