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The Cover
September 19, 2012

Neuroendocrine and Endocrine Pathways of Obesity

Author Affiliations

Author Affiliations: Dr Elmquist is Maclin Family Distinguished Professor in Medical Science, in Honor of Dr Roy A. Brinkley, and Carl H. Westcott Distinguished Chair in Medical Research (joel.elmquist@utsouthwestern.edu); and Dr Scherer is Gifford O. Touchstone Jr and Randolph G. Touchstone Distinguished Chair in Diabetes Research (philipp.scherer@utsouthwestern.edu); Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.

JAMA. 2012;308(11):1070-1071. doi:10.1001/jama.2012.3209

At first sight, the adipocyte appears to be fully occupied by a droplet of fat. It is difficult even to see the nucleus or any other structure responsible for the metabolic activity of cells, let alone to suggest that the adipocyte is a professional secretory cell. This benign appearance misled investigators for decades into believing that fat cells were passive storage organs that simply esterify dietary lipids upon consumption of a meal and release free fatty acids upon fasting. Over the past decade, it has become apparent that fat cells are metabolically much more active than anticipated. While the role of the adipocyte in postprandial glucose disposal is well understood, its roles in lipogenesis, glyceroneogenesis, and mitochondrial beta oxidation are increasingly appreciated. Adipose tissue is an important endocrine tissue intricately involved in the regulation of energy balance, as well as in the pathogenesis of diabetes, cardiovascular disease, and cancer, through its ability to sequester potentially toxic lipid species and to secrete a vast array of lipid and hormonal products (referred to as adipokines). This week’s cover and cover story figure feature the special role of adipose tissue among the complex relationships involved in the network of energy balance.