Here we examine key adipocyte-derived bioactive substances (‘adipokines’) in more detail.

Adiponectin exerts a number of protective actions in the vasculature, including inhibition of foam cell formation and vascular remodelling, both important steps in the formation of an atherosclerotic plaque. This hormone also improves insulin sensitivity and opposes the development of hyperglycaemia, and is therefore anti-diabetic as well as anti-atherosclerotic in nature.

IL-6 is a systemic inflammatory hormone that exerts adverse, pro-atherogenic effects in the vasculature. IL-6 also exacerbates insulin resistance and is therefore both pro-atherogenic and pro-diabetic.

TNFa is a paracrine regulator in adipocytes. TNFa -induced reductions in insulin sensitivity in adipocytes are partly responsible for the increased free fatty acid production and hypertriglyceridaemia characteristic of abdominal obesity.

Increased PAI-1 secretion by intra-abdominal adipocytes shifts the balance of fibrinolysis towards a procoagulant state, increasing the risk of a morbid thromboembolic event