Issue: 2013 > May > review

Obesity-associated low-grade inflammation in type 2 diabetes mellitus: causes and consequences

M.M.J. van Greevenbroek, C.G. Schalkwijk, C.D.A. Stehouwer


The epidemic of overweight and obesity is a major problem because of the plethora of health and economic issues that it induces. Key among these is the sharply increasing prevalence of type 2 diabetes (T2D) and cardiovascular disease. The development of T2D is characterised by two processes: 1) insulin resistance, resulting from impaired insulin signalling and leading to an increased demand for insulin, which must be met by increased insulin production by pancreatic b-cells (compensatory b-cell function); and 2) b-cell dysfunction, with T2D developing when the amount of insulin that is produced is insufficient to meet the demand. Overweight and obesity, especially in case of abdominal fat accumulation, are associated with systemic low-grade
inf lammation. This low-grade inf lammation is characterised by, among other things, higher levels of
circulating proinflammatory cytokines and fatty acids.
These can interfere with normal insulin function and
thereby induce insulin resistance, and have also been
implicated in b-cell dysfunction. This review focuses on
the known and emerging relations between inflammation
and T2D. We first discuss current views on the effects of fat distribution on adipose tissue inflammation and adipose
tissue dysfunction. Next we focus on the detrimental roles
of proinflammatory cytokines and fatty acids on insulin
signalling and b-cell function. In the last part of this
review we provide some insight into novel players in (the
initiation of) inflammation in overweight and obesity, and
their effects on T2D and vascular dysfunction.