Molecular pathways linking adipose innervation to insulin action in obesity and diabetes mellitus

UMMS Affiliation

Program in Molecular Medicine

Publication Date


Document Type



Endocrine System Diseases | Endocrinology | Hormones, Hormone Substitutes, and Hormone Antagonists | Nutritional and Metabolic Diseases


Adipose tissue comprises adipocytes and many other cell types that engage in dynamic crosstalk in a highly innervated and vascularized tissue matrix. Although adipose tissue has been studied for decades, it has been appreciated only in the past 5 years that extensive arborization of nerve fibres has a dominant role in regulating the function of adipose tissue. This Review summarizes the latest literature, which suggests that adipocytes signal to local sensory nerve fibres in response to perturbations in lipolysis and lipogenesis. Such adipocyte signalling to the central nervous system causes sympathetic output to distant adipose depots and potentially other metabolic tissues to regulate systemic glucose homeostasis. Paracrine factors identified in the past few years that mediate such adipocyte-neuron crosstalk are also reviewed. Similarly, immune cells and endothelial cells within adipose tissue communicate with local nerve fibres to modulate neurotransmitter tone, blood flow, adipocyte differentiation and energy expenditure, including adipose browning to produce heat. This understudied field of neurometabolism related to adipose tissue biology has great potential to reveal new mechanistic insights and potential therapeutic strategies for obesity and type 2 diabetes mellitus.


Adipocytes, Nervous system, Obesity, Type 2 diabetes

DOI of Published Version



Nat Rev Endocrinol. 2019 Apr;15(4):207-225. doi: 10.1038/s41574-019-0165-y. Link to article on publisher's site

Journal/Book/Conference Title

Nature reviews. Endocrinology

Related Resources

Link to Article in PubMed

PubMed ID