Adipokines: Link between obesity, insulin
resistance and muscle atrophy
Narrative review
Name student
Student number
BGZ2241
Maastricht University
Faculty of Health, Medicine and Life Sciences (FHML)
Bachelor Health Science – Biology track
Submission deadline part 3 – 02/07/2021
, Abstract
Obesity is a growing problem in the western world, which should be taken very seriously. Obesity is
associated with a reduced quality of life, poorer mental health outcomes and very high health care
costs. Obesity diminishes almost every aspect of health. In addition, many diseases as diabetes type
2, hypertension, cancer, and fatty liver disease can be linked to obesity. In obese individuals, the
adipose tissue is expanded a lot and the adipocytes are swelling because of the higher fat storage.
The increase of adipose tissue results in a changed secretion profile of adipokines, which can cause
insulin resistance. Inter-organ cross talk plays an important role in the development of insulin
resistance, which can be eventually caused by the secretion of pro-inflammatory adipokines like
chemerin, MCP-1 and TNF-α. There is more evidence needed to explain the correlation between
insulin resistance and muscle atrophy. However, it is assumed that inter-organ crosstalk also plays
an important role in the decrease of muscle mass. In obese people, the skeletal muscle is negatively
affected by the secretion of pro-inflammatory adipokines. The affection can lead to muscle
breakdown and potential atrophy of the muscle mass. There can be concluded that a different
secretion of the adipokines can lead to inflammation, which can cause muscle atrophy by
degradation of proteins.
Introduction
Obesity is defined as a chronic disease with excessive or abnormal fat accumulation, which can lead
to health risks. The body mass index (BMI) is a formula of height in relation to weight which is used
to classify the weight of individuals. Overweight is considered with a BMI above 25 kg/m2. A body
mass index above 30 kg/m2 is considered as obesity. The BMI is referred as morbid obesity when the
BMI is equal to or greater than 40 kg/m2 [1]. Obesity is caused by an imbalance of energy intake and
physical activity. There is an excessive energy intake which lead to a surplus of carbohydrates and
fats, which is not compensated by physical activity [2]. The complex health issue that is created by
obesity is resulting from a combination of metabolic, hormonal and behavior influences. Physical
activity, dietary patterns, education, environment, the use of medication and other factors can play a
role in development of obesity [2]. Also, some genetic factors like hormones and DNA, play a large
role in the expression of genes that will develop obesity [3].
The World Obesity Organization recognizes obesity as one of the most important public health
problems facing the world today. Moreover, at this moment there is a higher prevalence in obesity
then in under-nutrition [4]. The prevalence of obesity worldwide has nearly tripled between 1975 and
2016. In 2016 there were 1,9 billion adults with obesity over the age of 18. Also, the age of
individuals with obesity is descending [5]. The mortality due to the obesity epidemic is an estimated
2