(Santoro et al) recognizes the essential importance adipocytes which react exquisitely to insulin have played in determining the mechanisms for insulin action on a cellular level on this hundredth anniversary of the discovery of insulin. The understanding of adipose tissue biology has advanced significantly, and it is now clear that adipocytes are far more complicated than simple fat storage depots. A growing amount of evidence demonstrates how adipocytes contribute to the control of glucose homeostasis throughout the body in response to insulin. The review illustrates the plasticity, heterogeneity, and endocrine function of adipocytes, unique characteristics connect the metabolism of adipocytes to the regulation of other important metabolism tissues (e.g., liver, muscle, pancreas).

Results and Discussion

In the review, the author states that “Adipocytes have been a powerhouse for understanding insulin action. While major advances have been made since the discovery of insulin 100 years ago, in defining the molecular events underlying insulin action in adipocytes and the systemic consequences, there are still many unanswered questions. We pointed out how the mechanisms for some of insulin’s effects are still unclear. This is partly because the dominant regulatory pathways for metabolic control in adipose tissue, liver, and muscle differ depending on the metabolic condition. In addition, we are just beginning to
understand how insulin action in adipocytes integrates with other inputs such as neural innervation and activation (Guilherme et al., 2019). The role of brown and beige adipose tissue in the regulation of insulin sensitivity is a very productive research area and how insulin influences the ‘‘browning’’ or ‘‘beige-ing’’ of adipocytes is of high interest. Single-cell RNA sequencing has been extremely informative for many research questions and is particularly useful for the study of adipose tissue. Going forward, a better understanding of the integrated network of cell types and pathways upstream and downstream of insulin in adipose tissue could lead to approaches to enhance systemic insulin sensitivity to prevent and improve the treatment of type 2 diabetes.”


Santoro, A., McGraw, T. E., & Kahn, B. B. (2021). Insulin action in adipocytes, adipose remodeling, and systemic effects. Cell Metabolism, 33(4), 748–757.