Obesity has reached epidemic proportions and continues to grow. Yet, the classification of obesity as a disease is not universally agreed. Body Mass Index (BMI) has been the traditional definition; but does not fully capture the metabolic complexities and transformation that occurs at a cellular level.
White Adipose Tissue plays a vital role in energy conversion, thermal regulation and metabolic regulation at a cellular level. However, excess white adipose tissue transforms into a negative metabolic influencer.
Obesogenic conditions leading to adipocyte enlargement (hypertrophy) and adipose tissue accumulation (hyperplasia) have been shown to contribute to several cardiovascular risk factors including insulin resistance, atherogenic dyslipidemia and hypertension. Together the cardiovascular risk factors form the foundational clinical definition of Metabolic Syndrome (MetS). Our intent is now to introduce Excess White Adipose Tissue Syndrome (eWATS) as a clinical entity in which WAT hypertrophy is on the casual pathway of metabolic dysfunctions collectively known as MetS. eWATS provides for a more concise and actionable diagnostic category with clearly define biochemical and physiologic abnormalities that precede the development of MetS risk factors.
“White Adipose Tissue (WAT), while previously regarded as passive lipid storage, is now considered to be a dynamic tissue with endocrine and immune functions.”
Because adipokine dysregulation resulting from the hypertrophy and hyperplasia of WAT appears to precede a series of events leading to several recognized disorders and elevated risk profiles. Dr Martinez team has proposed the definition of Excess White Adipose Tissue Syndrome (eWATS) as an actionable clinical entity for early intervention.
“WAT is a metabolically active organ that secretes several cytokine signaling molecules known as adipokines, into systemic circulation.”