Assessing Obesity-Related Adipose Tissue Disease (OrAD) to Improve Precision Medicine for Patients Living With Obesity

Yair Pincu, Uri Yoel, Yulia Haim, Nataly Makarenkov, Nitzan Maixner, Ruthy Shaco-Levy, Nava Bashan, Dror Dicker, Assaf Rudich

Research output: Contribution to journalReview articlepeer-review

Abstract

Obesity is a heterogenous condition that affects the life and health of patients to different degrees and in different ways. Yet, most approaches to treat obesity are not currently prescribed, at least in a systematic manner, based on individual obesity sub-phenotypes or specifically-predicted health risks. Adipose tissue is one of the most evidently affected tissues in obesity. The degree of adipose tissue changes – “adiposopathy”, or as we propose to relate to herein as Obesity-related Adipose tissue Disease (OrAD), correspond, at least cross-sectionally, to the extent of obesity-related complications inflicted on an individual patient. This potentially provides an opportunity to better personalize anti-obesity management by utilizing the information that can be retrieved by assessing OrAD. This review article will summarize current knowledge on histopathological OrAD features which, beyond cross-sectional analyses, had been shown to predict future obesity-related endpoints and/or the response to specific anti-obesity interventions. In particular, the review explores adipocyte cell size, adipose tissue inflammation, and fibrosis. Rather than highly-specialized methods, we emphasize standard pathology laboratory approaches to assess OrAD, which are readily-available in most clinical settings. We then discuss how OrAD assessment can be streamlined in the obesity/weight-management clinic. We propose that current studies provide sufficient evidence to inspire concerted efforts to better explore the possibility of predicting obesity related clinical endpoints and response to interventions by histological OrAD assessment, in the quest to improve precision medicine in obesity.

Original languageEnglish
Article number860799
JournalFrontiers in Endocrinology
Volume13
DOIs
StatePublished - 29 Apr 2022

Keywords

  • adipocyte
  • adipose tissue
  • cell size
  • fibrosis
  • inflammation
  • obesity
  • precision medicine

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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