Stenkula · American journal of physiology. Regulatory, integrative and comparative physiology 2018 · narrative review · n=?

Adipose cell size: importance in health and disease.

Cited 249 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of mechanisms, experimental techniques, and metabolic associations without systematic review methodology or new clinical trial data.

PubMed 29641234 · doi:10.1152/ajpregu.00257.2017 · record verified 2026-08-27

What was done

This review summarized experimental techniques used to measure adipocyte size and synthesized existing literature on the relationship between fat cell size distribution (hypertrophy versus hyperplasia) and metabolic disorders, including insulin resistance, type 2 diabetes, and responses to dietary interventions, physical activity, and bariatric surgery.

What was found

The abstract presents no quantitative data or specific numerical results. It qualitatively describes that hypertrophic adipocytes exhibit impaired cellular function, with intrinsic mechanisms that limit further expansion to prevent cell lysis and inflammation. It notes that both very large fat cells and dysfunctional small fat cells contribute to dysmetabolism, emphasizing that therapeutic interventions should target shrinking large adipocytes, recruiting new adipocytes, and enabling functional expansion of small fat cells.

Why it matters

It highlights that adipose tissue pathology involves not just total fat mass but adipocyte size heterogeneity and impaired cell expansion dynamics, framing fat cell remodeling as a critical target in metabolic disease prevention.

Limits

The paper is a narrative review rather than a systematic review or meta-analysis, providing no original experimental data, quantitative effect sizes, or formal risk-of-bias assessments for cited literature.

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