The obesity epidemic has become one of the major challenges for the
modern society, first of all because of its clinical and social consequences. In 1998 the
World Health Organization (WHO) proclaimed obesity a worldwide epidemic
encompassing both adults and children and acknowledged it one of the biggest threats
to the human health. The cause of overweight and obesity is body mass increase as a
result of fat tissue increment. It has been proven that obesity increases the risk of
hypertension, type 2 diabetes (T2DM), as well as leads to cardiovascular complications
such as stroke or heart attack. The fat tissue that is superfluous in obesity is the source
of many hormonally active compounds influencing bodily homeostasis. The recent
research has pointed to the particular importance of abdominal obesity in the
pathogenesis of metabolic disturbances linked with the endocrine activity of the
visceral fat. This visceral fat tissue produces many adipokines, such as tumour necrosis
factor alpha (TNF-alpha), interleukin 6 (IL6), leptin, adiponectin, resistin, omentin,
visfatin, nesfatin, vaspin, chemerin, ghrelin or apelin. Adipocytokines, released into the
bloodstream thanks to specific receptors on the surface of the target cells, act as classic
hormones influencing organ and tissue metabolism. Moreover adipokines may decrease
tissue sensitivity to insulin and induce inflammatory processes, endothelial dysfunction
and atherosclerotic changes. At present much attention is given to determination of
adipokines as contemporary markers of insulin resistance. Research authors suggest
that changes in adipokine concentrations can be seen at least a few years earlier that
first symptoms of improper glucose metabolism. Although there are still many
controversies regarding what is the most important causative factor for T2DM, it
cannot be denied that the endocrine activity of fat tissue as well as the immunological status both play important roles in the pathogenesis of T2DM. Promising research
results point to the necessity of elaborating methods of measuring pro-inflammatory
factors, especially adipokines, that would be both diagnostically sensitive and specific
and that could be implemented in the laboratory diagnostics as well as primary
prevention of diabetes.
Keywords: Obesity, Insulin resistance, Lipid metabolism disorders, Arterial
hypertension, Type 2 diabetes mellitus, Leptin, Adiponectin, Resistin, Retinol
binding protein 4, Visfatin, Omentin, Vaspin, Chemerin, Apelin.
