Skip to main content
    • Aa
    • Aa

Obesity, inflammation and the immune system

  • Fátima Pérez de Heredia (a1), Sonia Gómez-Martínez (a1) and Ascensión Marcos (a1)

Obesity shares with most chronic diseases the presence of an inflammatory component, which accounts for the development of metabolic disease and other associated health alterations. This inflammatory state is reflected in increased circulating levels of pro-inflammatory proteins, and it occurs not only in adults but also in adolescents and children. The chronic inflammatory response has its origin in the links existing between the adipose tissue and the immune system. Obesity, like other states of malnutrition, is known to impair the immune function, altering leucocyte counts as well as cell-mediated immune responses. In addition, evidence has arisen that an altered immune function contributes to the pathogenesis of obesity. This review attempts to briefly comment on the various plausible explanations that have been proposed for the phenomenon: (1) the obesity-associated increase in the production of leptin (pro-inflammatory) and the reduction in adiponectin (anti-inflammatory) seem to affect the activation of immune cells; (2) NEFA can induce inflammation through various mechanisms (such as modulation of adipokine production or activation of Toll-like receptors); (3) nutrient excess and adipocyte expansion trigger endoplasmic reticulum stress; and (4) hypoxia occurring in hypertrophied adipose tissue stimulates the expression of inflammatory genes and activates immune cells. Interestingly, data suggest a greater impact of visceral adipose tissue and central obesity, rather than total body fat, on the inflammatory process. In summary, there is a positive feedback loop between local inflammation in adipose tissue and altered immune response in obesity, both contributing to the development of related metabolic complications.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Obesity, inflammation and the immune system
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Obesity, inflammation and the immune system
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Obesity, inflammation and the immune system
      Available formats
Corresponding author
*Corresponding author: Dr Fátima Pérez de Heredia, fax +34 915493627, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. GS Hotamisligil (2006) Inflammation and metabolic disorders. Nature 444, 860867.

5. HS Park , JY Park & R Yu (2005) Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-alpha and IL-6. Diabetes Res Clin Pract 69, 2935.

6. M Bulló , P García-Lorda , I Megias (2003) Systemic inflammation, adipose tissue tumor necrosis factor, and leptin expression. Obes Res 11, 525531.

9. BL Wajchenberg (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21, 697738.

11. Z Quijada , M Paoli , Y Zerpa (2008) The triglyceride/HDL-cholesterol ratio as a marker of cardiovascular risk in obese children; association with traditional and emergent risk factors. Pediatr Diabetes 9, 464471.

15. A Gupta , S Ten & H Anhalt (2005) Serum levels of soluble tumor necrosis factor-alpha receptor 2 are linked to insulin resistance and glucose intolerance in children. J Pediatr Endocrinol Metab 18, 7582.

18. RJ Gøbel , SM Jensen , H Frøkiaer (2012) Obesity, inflammation and metabolic syndrome in Danish adolescents. Acta Paediatr 101(2), 192200.

20. D Martínez-Gómez , JC Eisenmann , JA Wärnberg (2010) Associations of physical activity, fitness and fatness with low-grade inflammation in adolescents. The AFINOS study. Int J Obes (London) 34, 15011507.

21. JR Ruiz , FB Ortega , J Warnberg (2007) Associations of low-grade inflammation with physical activity, fitness and fatness in prepubertal children; the European Youth Heart Study. Int J Obes (Lond) 31, 15451551.

22. J Romeo , D Martínez-Gómez , LE Díaz (2011) Changes in cardiometabolic risk factors, appetite-controlling hormones and cytokines after a treatment programme in overweight adolescents: preliminary findings from the EVASYON study. Pediatric Diabetes 12, 372380.

23. A Martí , A Marcos & JA Martínez (2001) Obesity and immune function relationships. Obes Rev 2, 131140.

25. S Caspar-Bauguil , B Cousin , A Galinier (2005) Adipose tissues as an ancestral immune organ: site-specific change in obesity. FEBS Lett 579, 34873492.

26. CH Saely , K Geiger & H Drexel (2010) Brown versus white adipose tissue: a mini-review. Gerontology 58(1), 1523.

27. S Poglio , F de Toni-Costes , E Arnaud (2010) Adipose tissue as a dedicated reservoir of functional mast cell progenitors. Stem Cells 28, 20652072.

28. SP Weisberg , D McCann , M Desai (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112, 17961808.

29. CN Lumeng , JL Bodzin & AR Saltiel (2007) Obesity induces a phenotypic switch in adipose tissue macrophage polarization. J Clin Invest 117, 175184.

33. A Koerner , J Kratzsch & W Kiess (2005) Adipocytokines: leptin – the classical, resistin – the controversial, adiponectin – the promising, and more to come. Best Pract Res Clin Endocrinol Metab 19, 525546.

35. KH Pietiläinen , T Róg , T Seppänen-Laakso (2011) Association of lipidome remodeling in the adipocyte membrane with acquired obesity in humans. PLoS Biol 9, e1000623.

36. C Stryjecki & DM Mutch (2011) Fatty acid-gene interactions, adipokines and obesity. Eur J Clin Nutr 65, 285297.

38. JM Fernández-Real , J Vendrell & W Ricart (2005) Circulating adiponectin and plasma fatty acid profile. Clin Chem 51, 603609.

39. F Pérez de Heredia , J Sánchez , T Priego (2009) Adiponectin is associated with serum and adipose tissue fatty acid composition in rats. J Endocrinol Invest 32, 659665.

41. MB Fessler , LL Rudel & JM Brown (2009) Toll-like receptor signaling links dietary fatty acids to the metabolic syndrome. Curr Opin Lipidol 20, 379385.

43. M Mei , L Zhao , Q Li (2011) Inflammatory stress exacerbates ectopic lipid deposition in C57BL/6J mice. Lipids Health Dis 10, 110 (Epublication ahead of print version).

44. MF Gregor & GS Hotamisligil (2007) Thematic review series: Adipocyte biology. adipocyte stress: the endoplasmic reticulum and metabolic disease. J Lipid Res 48, 19051914.

45. P Trayhurn , F Pérez de Heredia , B Wang (2010) Hypoxia – role in adipocyte function and dysfunction. In Novel Insight into Adipose Cell Functions, pp. 4560 [ K Clément , BM Spiegelman and Y Christen , editors]. Berlin, Heidelberg: Springer-Verlag.

46. F Pérez de Heredia , IS Wood & P Trayhurn (2010) Hypoxia stimulates lactate release and modulates monocarboxylate transporter (MCT1, MCT2, MCT4) expression in human adipocytes. Pflüg Arch – Eur J Physiol 459, 509518.

47. DJ Samuvel , KP Sundararaj , A Nareika (2009) Lactate boosts TLR4 signaling and NF-ΚB pathway-mediated gene transcription in macrophages via monocarboxylate transporters and MD-2 up-regulation. J Immunol 182, 24762484.

49. N Halberg , T Khan , ME Trujillo (2009) Hypoxia-inducible factor 1α induces fibrosis and insulin resistance in white adipose tissue. Mol Cell Biol 29, 44674483.

50. R Cancello , J Tordjman , C Poitou (2006) Increased infiltration of macrophages in omental adipose tissue is associated with marked hepatic lesions in morbid human obesity. Diabetes 55, 15541561.

51. JJ Hernández-Morante , F Milagro , JA Gabaldón (2006) Effect of DHEA-sulfate on adiponectin gene expression in adipose tissue from different fat depots in morbidly obese humans. Eur J Endocrinol 155, 593600.

52. A Villaret , J Galitzky , P Decaunes (2010) Adipose tissue endothelial cells from obese human subjects: differences among depots in angiogenic, metabolic, and inflammatory gene expression and cellular senescence. Diabetes 59, 27552763.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 324
Total number of PDF views: 808 *
Loading metrics...

Abstract views

Total abstract views: 1755 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd September 2017. This data will be updated every 24 hours.