Viewpoints on the way to the consensus session: where does insulin resistance start? The adipose tissue

Adipose tissue is a heterogeneous organ
with respect to embryonic origin,
body distribution, and function. In
addition to playing a major role in the regulation
of nutrient and energy homeostasis,
it is involved in the modulation of the
immune response, reproductive function,
hemostasis, mechanical support, bone
mass growth, and thermogenesis.
To postulate that insulin resistance
starts in adipose tissue, there should be
evidence of 1) potential mechanisms for
such a causal relationship, 2) the manifestation
of such mechanisms in insulinresistant
individuals, and 3) their early
occurrence in the development of insulin
resistance.