Adipokin 3

136 Vet Clin Pathol 38/2 (2009) 136156 c 2009 American Society for Veterinary Clinical Pathology
Veterinary Clinical Pathology ISSN 0275-6382

I N V I T E D R E V I E W
Adipokines: a reviewof biological and analytical principles and an update in
dogs, cats, and horses
M. Judith Radin
1
, Leslie C. Sharkey
2
, and Bethany J. Holycross
1

1
Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA; and
2
Department of Veterinary Clinical Sciences, University of
Minnesota, St. Paul, MN, USA
Key Words
Adipokines, adiponectin, leptin, obesity,
reninangiotensin system, resistin
Correspondence
M. Judith Radin, Department of Veterinary
Biosciences, The Ohio State University, 1925
Coffey Road, Columbus, OH 43210 E-mail:
radin.1@osu.edu
DOI:10.1111/j.1939-165X.2009.00133.x
I. Introduction
II. Adipose as an Organ
III. General Biology of Adipokines
IV. Obesity, Adipokines, and Disease
V. Selected Adipokines
A. Leptin
1. Synthesis and regulation
2. Leptin receptor and signaling
3. Functions of leptin
4. Leptin and obesity
5. Measurement of leptin
6. Dogs
7. Cats
8. Horses
B. Adiponectin
1. Synthesis and regulation
2. Adiponectin receptors and signaling
3. Functions of adiponectin
4. Adiponectin and obesity
5. Measurement of adiponectin
6. Adiponectin in dogs, cats, and horses
Abstract: In addition to its role as an energy storage depot, adipose tissue is now
recognized as a complex endocrine organ. Adipose tissue releases a variety of
factors, termed adipokines, that regulate energy metabolism, cardiovascular
function, reproductive status, and immune function. Some of the better-studied
adipokines include leptin, adiponectin, and components of the renin-angiotensin
system such as angiotensinogen. The function of more recently discovered
adipokines such as resistin are under intense scrutiny. Abnormal
productionorregulationof adipokinesoccursinobeseindividualsand is implicated in
the development of a variety of associated co-morbidities including metabolic
syndrome, type 2 diabetes, atherosclerosis, heart disease, and cancer in people,
although evaluation in domestic species is just beginning. Adipokines are now
being examined as potential biomarkers for risk assessment for development of
complications related to obesity. This article summarizes the function and
regulation of some better-characterized adipokines. It also reviews the current
information on the characterization of adipokines in some domestic species in
which rates of obesity and obesityrelated disorders are increasing, such as the
dog, cat, and horse.
Introduction
Obesity and associated metabolic diseases are of increasing
prevalence and importance in companion animal
medicine.
15
Health risks reported to be associated with
obesity include diabetes mellitus and osteoarthritis in dogs
and cats. There is also evidence for obesityassociated
shortened lifespan in dogs that are fed ad libitum compared
with dogs fed an energy-restricted diet that results in a
more optimal body condition.
1,3
In horses, obesity may
predispose to laminitis, hyperlipemia, and strangulating
lipoma.
5
Adipokines, which are proteins derived from
adipose tissue that have local and systemic effects, are
important factors in the pathophysiology of obesity and its
related conditions
inpeople.Asratesofobesityincompanionanimalsclimb, the
impact of altered adipokine balance on animal health
C. Angiotensinogen and the renin-angiotensin system
(RAS)
1. Synthesis, receptors, regulation, and function
2. The RAS and obesity
D. Resistin
E. Inflammatory cytokines VI. Summary
Radin et al Adipokines in domestic animals
Vet Clin Pathol 38/2 (2009) 136156 c 2009 American Society for Veterinary Clinical Pathology 137
is expected to increase. The biological
characterization of and the measurement tools
available for the more thoroughly investigated
adipokines in dogs, cats, and horses

This review article has been peer-reviewed.

Figure1. Structure of white adipose tissue. Illustration by Tim
Vojt, Biomedical Media, The Ohio State University College of
Veterinary Medicine.
will be the focus of this review. Much of the
information regarding the basic biology of
adipokines is derived from human and rodent
data, while current information describing what
has been established in dogs, cats, and horses is
described in specific sections. A comprehensive
understanding of adipokines is facilitated by a
brief review of current concepts in adipose
biology.
Adipose as an Organ
Adipose tissue makes up a diffuse organ
comprised of adipocytes (50% of the total
cellular content), preadipocytes, multipotent
mesenchymal stem cells, endothelial cells,
pericytes, monocyte/macrophages, and nerve
cells (Figure 1). Previous models of adipocyte
biology suggested that the number of adipocytes
was fixed in childhood, and that expansion and
con-

Figure2. Adipose tissue from a rat showing white adipose tissue (WAT)
on the left and brown adipose tissue (BAT) on the right. Adipocytes
from WAToften contain a single large fat droplet. Adipocytes from
BATcontain multiple small fat droplets. H&E, 40 objective.
traction of adipose mass was due solely to modulation of the
balance of triglyceride storage and fatty acid mobilization.
Newer research demonstrates that there is a large pool of stem
cells and preadipocytes in adipose tissue in individuals of all
ages that may be recruited once existing adipocytes reach a
critical level of hypertrophy.
6

Adipose tissue hastraditionally been divided into 2 types:
white adipose tissue (WAT) consisting of cells with a single
large droplet of triglycerides, and brown adipose tissue,
consisting of cells containing multilocular lipid droplets
(Figure 2). Classical functions of WAT include insulation and
mechanical support along with storage of surplus energy,
7
while brown adipose tissue is associated with thermogenesis
as a result of the expression of distinct genes such as
uncoupling protein-1.
8
Adipocytes from different anatomic
locations may vary in their biology due to local influences on
differentiation and gene expression, and may be considered
mini-organs. The distribution of adipose tissue influences
the pathologic sequelae characterizing obesity. Preferential
deposition of fat into visceral deposits instead of
subcutaneous deposits increases the risk of insulin resistance,
atherosclerosis, and diabetes mellitus in people.
9
With
impaired deposition of lipid in adipocytes due to aging or
lipodystrophy, lipids may be deposited in nonadipocytes in
the liver, muscle, pancreas, and kidney, resulting in altered fat
and glucose metabolism and impaired organ function due to
lipotoxicity.
10
This illustrates the importance of adipose as
a specialized storage organ for excess energy. WAT is
becoming regarded as an important endocrine organ that
secretes a wide variety of substances including steroid
hormones, growth factors and cytokines, eicosanoids,
complement proteins, binding proteins, vasoactive factors,
regulators of lipid metabolism, and others.
7
Collectively, these
factors are labeled adipokines and they function as part of
a complex set of physiologic control systems that regulate
local tissue and whole organism physiology.
Adipokines in domestic animals Radin et al
General Biology of Adipokines
Adipokines are defined generally as biologically
active substances produced in adipose tissue that act
in an autocrine/paracrine or endocrine fashion.
11
Some
adipokines are produced exclusively or predominantly
by adipose tissue; however, others may be produced
in a variety of different tissues as outlined below for
individual adipokines. Production of adipokines by
adipose tissue may be influenced by sex hormones
and nutritional status.
8
While the classic adipokines
such as leptin undoubtedly have an important role in
the regulation of energy balance and metabolism, the
list of adipokines and their potential functions is
expanding rapidly. There is evidence that adipokines
may contribute to the regulation of diverse biological
processes, including inflammation and immune
function,
12,13
hemostasis and vascular biology,
14,15
hematopoiesis,
1618
and cell proliferation and
angiogenesis.
19

Obesity, Adipokines, and Disease
At a basic level, obesity is the result of imbalance
between energy intake and energy expenditure. Major
theories regarding the underlying causes for obesity
include recent changes in environmental factors such
as food availability and activity levels, genetic
influences, and developmental programming.
Normally, highly redundant and tightly regulated
physiologic systems (mostly neural and endocrine)
function to maintain body weight within a narrow
range with499% precision in most individuals over a
period of years.
20
This regulation system requires a
sensing mechanism for energy stores (ie, a
lipostat) be coordinated with eating behaviors and
energy metabolism. The thrifty gene hypothesis
predicts that this system will tend to favor
mechanisms promoting weight gain, due to the
survival value of that characteristic in environments
with unpredictableand restrictedaccessto food.
21
Thishypothesisis supported by the observation that
overfeeding produces fewer compensatory changes in
energy expenditure than underfeeding.
22
Obesity in an
individual likely is
theresultofcomplexinteractionsbetweenenvironmental
factors and genes.
A consequence of increased fat mass is
dysregulation of production and secretion of
adipokines that impact glycemic control,
inflammation, and cardiovascular function. As a result
of these diverse functions of adipose, altered
adipokine production in obesity has been implicated in the
pathophysiology of a diverse group of diseases in people and
in rodent models, including diabetes mellitus, cardiovascular
disease, and cancer. Because of the increasing significance of
adipokines in health and disease, there is a need for awareness
of their biology and measurement in veterinary medicine.
While the list of recognized adipokines continues to grow,
this review will focus on those that have been at least partially
characterized in companion animals, including leptin,
adiponectin, the reninangiotensin system (RAS), and resistin.
In particular, we will review these adipokines in dogs, cats,
and horses, species with a documented increased risk for
developing obesity and subsequent health consequences of
excess weight gain.
Selected Adipokines
Leptin
Synthesis and regulation
Leptin is the prototypic adipokine and is the best
characterized adipokine in domestic animal species.
Leptin is a 167 amino acid protein that isencoded by the
ob gene. Both the nucleotide and amino acid sequences
are highly conserved, with homologies of 8395% for
nucleotide and 7996% for amino acid sequence in
vertebrate species examined thus far.
2327
Adipocytes are
the main site of leptin synthesis and the main contributor
to serum leptin levels. However, lower levels of
expression of leptin mRNA are detectable in other tissues
such as placenta, mammary gland, gastric mucosa, and
liver.
Leptin is constitutively secreted by adipocytes; its
transcriptional regulation depends upon energy flux
within adipocytes, so circulating levels correlate closely
with body mass index.
28
As a result, the serum
concentration of leptin is predominantly defined by body
fat mass but will transiently increase following a meal
and decrease with fasting. Transcription of the ob gene is
controlled by a variety of metabolic and inflammatory
mediators. For example, binding of glucocorticoids or
peroxisome-proliferatoractivated receptor-g (PPARg) to
specific sites in the promoter region of the ob gene will
increase expression of leptin mRNA.
23
Transcription also
is increased by insulin endotoxin and proinflammatory
cytokines such as tumor necrosis factor-a (TNFa),
interleukin-1b, and interleukin-6 (IL-6).
28
Serum leptin
concentration increases during the luteal phase of the
estrus cycle, and estradiol appears to increase leptin
mRNA expression as well as protein secretion by
WAT.
2932
In
contrast,circulatingleptinlevelsareinverselycorrelatedwith
serum testosterone levels in males.
29,33,34
Studies
in rats suggest that testosterone increases leptin
clearance but does not modify leptin synthesis
and secretion.
35

Leptin receptor and signaling
Leptin is a cytokine, and its receptor (Ob-R) is
closely related to gp130, a member of the IL-6
family of receptors.
36
Multiple variable-length
isoforms of Ob-R are possible due to alternative
splicing of the cytoplasmic domain. While Ob-R
is expressed in highest concentrations in the
satiety centers of the hypothalamus, both long
and shorter splice variants are widely distributed
in many tissues throughout the body, reflecting
the involvement of leptin in the regulation of
diverse physiologic processes.
23,37,38
The long
form of the receptor, designated Ob-Rb, mediates
most of leptins physiologic actions; however,
short forms also are capable of signal
transduction.
37,3941

With the exception of the soluble Ob-Re
isoform, which acts as a binding protein for
leptin in the circulation, full length and the
shorter receptor isoforms have a cytoplasmic
domain that associates with the janus kinase
family of tyrosine kinases (JAK). Binding of
leptin to full-length Ob-Rb results in activation of
JAK and phosphorylation of signal transducers
and activators of transcription (STAT).
37,42
Because STAT activation depends on
phosphorylation of tyrosine1138 on Ob-Rb,
shorter isoforms cannot signal via STAT despite
being able to phosphorylate and activate JAK.
37,43
ObRb also signals via activation of extracellular-
signalregulated kinases (ERK1/2),
41
phosphatidylinositol-3 kinase via activation of
insulin receptor substrate 1/ 2,
39,44
and Akt
(protein kinase B).
45
Signal transduction through
ERK1/2 and Akt may also be initiated by short
isoforms without concurrent STAT activation,
thus bypassing potentially important negative
feedback mechanisms, as described below.
39,40,45

A consequence of activation of STAT
signaling is induction of expression of
suppressors of cytokine signaling (SOCS),
especially SOCS-3.
46
SOCS proteins are part of
an important negative feedback loop that inhibits
cytokine signaling by binding to phosphorylated
cytokine receptors. SOCS-3 binding to Ob-Rb
has the potential to dampen multiple leptin-
induced signaling pathways.
47
In addition, there
is potential for crosstalk to modulate signaling
initiated by other cytokines or insulin, thus modifying
their actions.
48
Increased expression and production of
SOCS-3 in brain and adipocytes occurs in rodent models
with obesity and has been proposed as a mechanism
mediating impaired response to leptin and central leptin
resistance.
46,49,50
Because shorter leptin receptor isoforms
lack the ability to activate STAT, increased SOCS-3
production is not anticipated following leptin binding to
these shorter splice variants. The physiologic
significance of the shorter isoforms and their importance
in the development of leptin resistance and obesity-
associated diseases are still largely unexplored.
Functions of leptin
The primary actions originally described for leptin are
mediated via binding to Ob-R in the brain, resulting in
suppression of appetite and increased energy expenditure
(thermogenesis).
23,51
Appetite suppression is mediated via
binding of leptin to its full length receptor (Ob-Rb) in the
hypothalamic satiety centers, with stimulation of
anorexigenic/catabolic neurons (via neurotransmitters
such as cocaine and amphetamine regulated transcript
[CART] and a-melanocyte stimulating hormone [a-
MSH]) and suppression of orexigenic/anabolic neurons
(via neurotransmitters such as neuropeptide Yand agouti-
related peptide).
50
Leptin also suppresses the release of
endocannabinoids, which are postsynaptic regulators of
presynaptic activity of orexigenic neurons. As a result,
endocannabinoid antagonists such as rimonabant are
being explored as appetite suppressors for obesity
treatment. Increased thermogenesis is mediated by
central binding of leptin to Ob-Rb, resulting in
sympathetic nerve stimulation and activation of b3-
adrenergic receptors in brown fat, thus increasing fat
oxidation.
23,28

In addition to the primary function of regulationof energy
stores, leptin has been implicated as a growth factor by virtue
of its ability to stimulate angiogenesis, suppress apoptosis,
and act as a mitogen.
52
These functions may play a role in the
increased incidence of cancer observed with increasing body
mass index and waist-to-hip ratio in humans. Leptin has been
suggested to have a role in hypothalamic development,
thereby providing a mechanistic link between altered
nutritional states during fetal and neonatal development and
long-term programming of adiposity.
53
Other important
physiologic functions of leptin include regulation of
reproductive and immune functions as well as modulation of
insulin sensitivity. Thus, leptin levels regulated by fat stores
may provide a mechanism by which reproductive readiness is
tied to nutritional status as well as an explanation for
suppression of immune function in states of malnutrition.
Leptin and obesity
Failure to produce leptin (ob/ob mouse) or failure to
produce a functional leptin receptor (db/db mouse and
the Zucker, Koletsky, and SHHF rat models) results
in massive obesity.
23,28,54
Such genetic mutations
occur rarely in humans,
23,55
and to our knowledge,
have not been documented in dogs, cats, or horses.
Obesity in
speciesotherthangeneticallyengineeredrodentsisusuall
y attributed to other factors, such as high caloric or fat
intake that is disproportionate to the level of physical
activity.
15
Obesity unrelated to specific mutations in
leptin or its receptor ischaracterizedby a syndromeof
at least partial leptin resistance and hyperleptinemia.
Hyperleptinemia is also seen with aging and may
occur secondary to weight gain during middle age,
independent of or disproportional to increases in body
fat mass, and as a consequence of aging itself.
5659
With leptin resistance, the ability of high levels of
leptin to regulate energy homeostasis is blunted,
abetting further weight gain and predisposing to the
development of metabolic abnormalities and type 2
diabetes mellitus.
5966
The blunted response to leptin
may be due in part to saturated transport systems for
leptin across the bloodbrain barrier ortoacquired
defects indownstream signaling in hypothalamic
neurons.
11
In adipose tissue, leptin gene expression
increases with age.
59
Adipocytes from aged obese rats
have increased levels of SOCS-3, which has a
feedbackinhibitoryeffectonleptinsignalingandfurther
potentiates leptin resistance.
67

Leptin resistance with obesity appears to be
selective for metabolic functions. This leaves other
functions of leptin intact, contributing to the
development of a variety of co-morbidities associated
with obesity, including cardiac, renal, and vascular
dysfunction. These are at least partially mediated
through a combination of leptin-mediated sympathetic
nervous system hyperactivity,
6871
impaired nitric
oxide generation,
72,73
and increased endothelin
production.
74,75
For example, selective leptin
resistance has been observed in agouti mice in which
the anorexic effect of leptin is blocked by
overexpression of agouti protein (an inhibitor of a-
MSH), but the ability of leptin to stimulate renal
sympathetic nerve activity remains intact.
68
Leptin has
similar sympathoexcitatory effects in diet-induced
obesity in mice.
69
Circulating leptin concentration
correlates with renal sympathetic nerve activity and
urine norepinephrine spillover in men with varying
degrees of obesity.
70
In obese humans and rodents,
increases in endothelin contribute to increased
vascular tone, and may play a role in the development
of salt sensitivity.
74,76
Generally, leptin appears to be
pro-inflammatory, prothrombotic, and pro-oxidant, therefore
opposing the effects of adiponectin, which will be addressed
in the next section.
77

Measurement of leptin
The reported half-life of leptin in the circulation is 25 minutes
for humans,
78
1.5 hours for lean mice,
79
3 hours for obese
mice,
80
and 513 minutes for rats.
35,81
Several factors may
account for this wide variability among species, including
methodological differences in the studies, protein binding,
and route or rate of clearance. Leptin binds to the soluble
leptin receptor (Ob-Re), oxidized a
2
-macroglobulin, and
several other poorly characterized serum binding proteins.
82
Leptin does not appear to bind to albumin or lipid but may
aggregate with itself due to its hydrophobicity. All of these
factors may affect distribution and clearance of leptin from
the circulation. Human serum leptin has been shown to be
stable for 2 months at 41C and for 2 years at 201C, and to
tolerate at least 5 freeze thaw cycles.
82
Our experience
suggests leptin stability is similar in rodents; however, to our
knowledge, systematic studies have not been published for
dogs, cats, or horses. Multiple variables in reference
populations and methods influence measured leptin levels, as
illustrated in Tables 1 and 2. Owing to the variation in values,
readers are encouraged to consult the original references that
are most relevant to their needs.
To date, the majority of studies have used
radioimmunoassays (RIAs) to measure leptin; however,
ELISAs are becoming more available. The Linco
Multispecies RIA (Linco Research/Millipore, St.
Charles, MO, USA) is the most frequently used
commercial kit and has been used in cats
88
and horses.
93
One commercially available enzyme immunoassay (EIA)
also has been evaluated for use in the horse.
95
Leptin has
been assessed in relatively few studies in dogs due to
lack of a validated, commercially available test kit,
although one research group has developed an in-house
ELISA.
24
While a few studies have used the Linco
Multispecies RIA in dogs with comparable results (Table
1),
100
the specificity of the kit for canine leptin is only 3%
as reported by the manufacturer. Millipore has recently
released a new ELISA kit that is specific for canine
leptin, which should aid studies in this species. Serum
and EDTA- or heparin-anticoagulated plasma samples
yield similar results for leptin measured by RIA in
humans
82
and this appears to hold true in domestic
animal species (Tables 1 and 2).
When collecting samples for leptin measurement, a
variety of preanalytical factors should be considered.
Circadian rhythm can account for a 30100% difference
between daily peak and trough in human leptin
concentration.
101
The fed state may result in serum leptin
concentrations as much as 2-fold higher than those in the
fasted state. As reviewed above, both sex and
stage of estrus cycle can influence circulating
leptin levels. Fewer studies are available that
address the effects of drug therapy. However,
corticosteroids are well documented to increase
leptin gene expression and secretion and to
potentiate the effect of insulin on leptin
production in humans and rodent models.
23,102
Circulating concentrations of leptin for dogs,
cats, and horses are summarized in Tables 1 and 2 and
are discussed in more detail below.
Dogs
Like humans and rodents, circulating leptin correlates with
body fat mass in the dog. Circulating leptin is

Table2. Circulating leptin concentrations in horses.
Age Sex Breed Body condition Other factors Lepin (ng/mL) Assay Sample Ref. no.
4 10 yr F (11) TB NR July 4.77 0.45 Multispecies Serum
RIA
Fitzgerald and
McManus
93

Mid Sept 8.27 1.02

DecJan 5.92 0.86

JanMar 2.38 0.28

8d24 yr M (14), G (15) QH BCS 38

3.37 0.38 Equine RIAw Serum Buff et al.
25

8 d-24 yr F (42)

1.85 0.21

o 2 yr M (5), G (6), F (12)

2.38 0.32

24 yr M (1), G (3), F (10)

2.64 0.55

512 yr M (4), G (3), F (10)

2.93 0.39

412 yr M (4), G (3), M (10)

3.67 0.38

623 yr F (46) LIP 535 10 kg BW Lactating
(1 wk postpartum)
9.5 0.8 Ovine RIAz Plasma Heidler et al.
94

519 yr F (11)

522 10 kg BW Nonlactating,
nonpregnant
15.0 2.6

79 yr F (5) TB BCS 3 (exercised) Fed 4.23 0.03 EIA Serum Piccione et
al.
95

Fasted (48 hr) 3.96 0.04

F (5)

BCS 3.5 (sedentary) Fed 4.24 0.03

Fasted (48 hr) 4.05 0.04

414 yr F (8) Pony BCS 6 Fed 17.20 0.41 Equine RIAw Plasma Buff et al.
96

Feed-restricted
(48 hr)
7.29 0.41

34 yrs G (6) STB BCS 4.1 0.1

1.66 0.59 (SD) Multispecies Serum
RIA
Pratt et al.
97

F (8)

BCS 4.8 0.5

2.96 2.05 (SD)

1016 yr F (5), G (2) Various BCS 79 (obese)

Median 11.0
(1.030.5)
Equine RIAw Plasma Frank et al.
4

716 yr F (5)

BSC 46 (nonobese)

Median 0.8
(0.511.0)

10 3 yr F (23) STB 514 12 kg BW

3.47 0.50 Multispecies Plasma
RIA
Kearns et al.
98

4 3 mo F (10), F (2) QH BEL, 227 11 kg BW
QH

1.90 0.34

11 2 yr F (12) STB BCS 6.7 0.2 (unfit;
unconditioned)

4.4 2.4 Multispecies Plasma
RIA
Gordon et al.
99

28 yr M, F, G (34) BCS 4.8 0.1 (fit; exercised)

1.0 0.6

Data are mean SEM unless otherwise indicated.
Linco Multispecies RIA, Linco Research, (now Millipore), St. Charles, MO, USA.
wNoncommercially available RIA as described in reference 25. zNoncommercially
available RIA as described in reference 94.
EIA-2395, DRG Instruments GmbH, Germany.
NR, Not reported; M, male; F, female; G, gelding; STB, Standardbred; QH, Quarter Horse; QH BEL, Quarterhorse Belgium cross; TB, Thoroughbred; LIP,
Lipizzaner; Number of animals shown in parentheses; BW, body weight; BCS, body condition score (scale 19); yr, years; mo, months; hr, hours.
[Correction added after online publication on 6 April 2009: The original Table 2 contained misaligned text. The correct table, above, shows the correctly
aligned text.]
increased in dogs with experimentally induced obesity as well
as in pet dogs with increased body condition scores
(BCS).
84,86,103,104
The ob gene is expressed in preadipocytes
and mature adipocytes in WAT from multiple sites in the
dog.
105
Unlike species such as human, rodent, and chicken in
which the ob gene may be expressed in other tissues,
expression of the ob gene in dogs appears to be confined to
WAT; whether this finding is dependent on experimental
methodology remains to be determined.
23,105
Weight gain
induced by the feeding of a high-fat diet results in increases in
both leptin gene expression in visceral WAT and plasma
leptin concentrations in dogs.
104
Conversely, caloric
restriction and weight loss results in decreased plasma leptin
concentrations.
106

The main factor influencing circulating leptin
concentration in dogs appears to be fat mass. However,
like other species, dogs show a transient increase in
circulating leptin following a meal.
107
This postprandial
peak occurs about 58 hours after feeding and leptin
concentration may reach 23 times fasting levels. Thus,
postprandial levels in lean dogs are comparable to levels
observed in fasted dogs with high BCS of 4 to 5/5,
86
suggesting that serum or plasma leptin concentrations
must be interpreted with knowledge of the fed/fasted
state. Interestingly, this postprandial peak appears
blunted in thin dogs with BCS of 2/5.
108

When dogs are grouped by BCS, there is no
apparent effect of age on plasma leptin, although puppies
(o1 year of age) tended to have lower plasma leptin
concentrations.
86
This was speculated to be due to low
body fat mass and a high energy requirement for growth
at a young age. In this same study, there was no apparent
effect of sex or neutering in dogs grouped by BCS
86
;
however, others have suggested an influence of sex and
estrus cycle.
109

Breed may influence leptin levels. In one study,
Shetland Sheepdogs within BCS groups tended to have
higher leptin concentrations than dogs of other breeds
including Miniature Dachshunds, Shih Tzus, and
Labrador Retrievers.
86
However the number of animals
per breed was too small to be conclusive and some
common breeds found in the United States were absent
from this study.
Glucocorticoid administration may affect circulating
leptin concentration as well as leptin secretion in
response to a meal. The effect appears to be dependent
on the type and dose of glucocorticoid used. For
example, dexamethasone increases serum leptin levels
and potentiates the leptin peak in response to a
meal,
110,111
while oral prednisolone does not appear to
affect leptin levels.
111
The effect of methylprednisolone
appears to be dose dependent, with low doses causing an
increase and high doses suppressing leptin
concentration.
87
These findings suggest that treatment
with corticosteroids or increased endogenous steroid
production may affect circulating leptin concentrations
and should be considered when evaluating leptin levels
in clinical patients.
Cats
Feline leptin is partially bound to protein in the
circulation.
88
Like other species, circulating leptin
primarily reflects body fat mass in cats,
88,89,92
and weight
loss is associated with a fall in peripheral blood leptin
levels.
112
Leptin levels are mildly increased in the fed
compared with fasted state.
88,113
The effect of dietary
composition on leptin levels is not consistent between
studies and appears to be modulated by the relative
insulin resistance and body fat mass of the cats.
114,115
Regardless of fat mass, insulin-resistant cats have higher
circulating leptin concentrations compared with insulin
sensitive cats.
113

Several studies have looked at the effect of neutering on
body weight and circulating leptin in cats. In general,
increases in leptin occur following neutering and are
correlated with the amount of body fat gained
postsurgery,
89,90,116
although this finding is not consistent in all
studies.
115
There also are conflicting results regarding the
effect of sex. There was no difference in serum leptin
concentration between neutered
maleandfemalecatswithnormal fatmass
89
orbetween intact
male and female cats.
90
In 1 study, neutered females gained
more weight and had higher leptin levels compared
withcastratedmales
90
whileinanotherstudy castrated males had
greater fat gain and a trend towards higher leptin levels
compared with neutered females.
89
In both studies, the group
that had the highest percent bodyfat had the highest average
leptin concentration. If presurgical body weight was
maintained by caloric regulation, males showed small but
significant increases in leptin subsequent to castration,
91,114
while females did not show changes in leptin following
ovariohysterectomy.
91
This may reflect the leptin lowering
effect of testosterone, as observed in other species. Although
the difference between castrated males and neutered males
was statistically significant, the actual difference was small in
comparison to the effect of weight gain and thus may be of
minor clinical significance (Table 1). No assessment of the
effects of the estrus cycle was done in any of the studies in
cats.
Horses
While fat mass appears to be the primary determinant of
serum leptin concentration in the horse,
25,93,98,117
a number of
other factors have been shown to modulate circulating levels.
Fasting results in a decline in serum leptin, which may
decrease by as much as 50% compared with the fed state after
48 hours of feed restriction.
95,96,118
Leptin shows a circadian
pattern in horses, with levels peaking at night and a nadir
reached during daylight hours.
95,96
However, this finding is
not consistent in all studies,
119
and daily fluctuations in leptin
levels result from both the feeding schedule as well as
composition of the feed. Leptin levels will rise 810 hours
subsequent to a high carbohydrate (grain) meal and follow the
rise in insulin levels.
120122
In contrast, peaks and troughs in
both insulin and leptin concentrations are blunted in horses
given frequent meals, given ad libitum hay, or on pasture.
122
Thus, husbandry practices have significant impact on
hormonal fluctuationsthat maycontributeto the development
of insulin resistance and hyperleptinemia, an increasingly
common problem in overweight horses. When horses were
matched for BCS, those animals with consistently high serum
leptin levels also were hyperglycemic and hyperinsulinemic
and had exaggerated glucoseand
insulinresponsestodexamethasone.
123
These findings are
similar to those in humans with type 2 diabetes mellitus or
metabolic syndrome.
124
However, not all overweight mares
are hyperleptinemic and 1 study found that only 35% of
mares with high BCS were hyperleptinemic and insulin
resistant.
125
This again is similar to humans in which not all
obese individuals have metabolic derangements.
124
To date,
definitive documentation of central or selective leptin
resistance has not been achieved in the horse.
The interaction of sex hormones and leptin is currently
being explored in horses. Geldings and stallions have similar
circulating leptin levels and several studies have noted mild
but significantly higher leptin levels in males compared with
females.
25,120
These data contrast with those in humans in
which leptin levels are higher in women than in men.
33,34,126
Neither administration of testosterone to mares
127
nor
ovariectomy
96
affected peripheral leptin concentration.
Several studies have looked at reproductive status and
leptin in mares. Mares with lower BCS and lower leptin
levels become seasonally anestrus while mares with higher
BCS and higher serum leptin levels continue to cycle
throughout the year.
93,117
Blood leptin levels decrease during
the first few days following parturition and remain below
prepartum levels during early lactation.
94,128,129
This decrease
in leptin concentration occurs even if BCS remains stable and
may be an adjustment to allow increased caloric intake and
avoid negative energy balance during lactation. Interestingly,
this decline in leptin does not seem to impact resumption of
postpartum ovulation.
94,130
Leptin also is present in mares
milk, with the concentration in colostrum approximately 2- to
3-fold greater than that found in blood.
128,131
It is uncertain if
this high concentration reflects active secretion/concentration
from the blood or local glandular production. The role of
colostral leptin is still uncertain; it has been speculated to aid
in gut development or thermoregulation in the foal. The
concentration of leptin in milk falls within days to below that
found in the mares blood and remains stable thereafter. The
concentration of leptin in the foals blood rises after birth and
stabilizes within a few days to levels similar to those in milk.
No work has documented whether maternal leptin contributes
to blood leptin levels in the foal.
Adiponectin
Synthesis and regulation
Adiponectin (also named apM1, Acrp30, GBP28, and
AdipoQ) has very restricted tissue expression and is
thought to be produced almost exclusively by mature
adipocytes. Adiponectin is a 244-amino acid protein and
consists of a signal sequence, a variable domain, a
collagen-like domain, and a globular C-terminal
region.
132
The C-terminal globular domain has sequence
homology to complement factor C1q and shows
structural but not sequence similarities to TNFa..
Adiponectin proteins that have undergone extensive post-
translational modification are secreted by the adipocyte
as homotrimers.In the circulation,adiponectin may form
trimers, hexamers, or high molecular weight multimers
(HMW, 46 noncovalently bonded trimers). In addition,
the globular domain may circulate independently of the
rest of the molecule. Regulation of multimer formation
and secretion as well as the biological significance of the
various multimeric forms are still under investigation.
Currently, it is thought that the HMW forms have the
most biological activity and are best correlated with
insulin sensitivity.
Adiponectin is one of the most highly expressed
genes in WAT. Secretion of adiponectin by fat cells is
stimulated by insulin, and a number of drugs and dietary
constituents modulate blood levels of adiponectin. The
best known pharmaceutical regulators of adiponectin
expression and secretion are the thiazolidinediones
(TZD), which activate PPARg and subsequently
upregulate adiponectin expression.
133
Rimonabant, a
selective cannabinoid-1 receptor (CB1) antagonist, also
stimulates adiponectin expression and increases
adiponectinemia, suggesting a role for CB-1 in the
regulation of adiponectin production.
134
Various dietary
supplements have been shown to affect circulating
adiponectin levels in rodent models. For example,
supplementation with fish oil,
135
linoleic acid,
136
and soy
protein
137
increased circulating adiponectin concentration
in rats in the absence of a change in body weight.
Females have higher total circulating adiponectin
levels compared with males.
138,139
This sexual
dimorphism is accounted for by females having a
significantly greater proportion of HMW forms
compared with males, but no difference in the mean
concentration of trimeric or hexameric forms.
139141
Testosterone mediates some of this difference by
decreasing the secretion of HMW adiponectin by ad-
ipocytes.
142

Studies on the effects of exercise have produced
somewhat conflicting results in humans.
143
In general, chronic
exercise training results in small increases in adiponectin
levels. The effect of acute exercise is more variable and
appears to depend on the intensity of exercise as well as the
fitness of the participants. For example, trained athletes
usually show an increase in circulating adiponectin while
unfit or obese individuals may show a decline in adiponectin
levels following a bout of exercise.
Adiponectin receptors and signaling
The physiologic effects of adiponectin are related to
tissue-specific receptor expression and differences in
binding affinity for the various molecular forms of
adiponectin (reviewed in Kadowaki et al
132
). Two
specific adiponectin receptors have been cloned.
AdipoR1 is primarily expressed in skeletal muscle, with
affinity for the globular and trimeric forms of
adiponectin, while AdipoR2 is highly expressed in the
liver with affinity for the hexameric and HMW forms of
adiponectin. Both receptors stimulate AMP-activated
protein kinase (AMPK) and PPARa. In the liver, this
results in increased b-oxidation of fats and decreased
gluconeogenesis. In muscle, receptor binding results in
increased b-oxidation of fats as well as increased glucose
uptake. Overall, liver and muscle effects contribute to
increased insulin sensitivity, lowering of blood glucose,
and decreased tissue triglyceride content.
Functions of adiponectin
The best characterized effects of adiponectin include
enhancement of insulin sensitivity, anti-inflammatory
properties, and inhibition of the development of
atherosclerosis.
144
Adiponectin appears to play an
important role in increasing insulin sensitivity by
stimulating phosphorylation of AMPK. Activation of
AMPK subsequently increases glucose uptake by
promoting translocation of the glucose transporter,
GLUT4, to the cell surface, increasing glycolysis by
phosphorylation of phosphofructokinase and increasing
fatty acid oxidation by inactivation of acetyl CoA
carboxylase.
A role for adiponectin in cardiovascular function has
been suggested, and treatment with adiponectin may
have a palliative effect on pathologic cardiac remodeling
after myocardial infarction.
145
These cardiovascular
effects may stem from adiponectins function as a
vasodilator.
146
Adiponectin promotes vasorelaxation
through increased vascular expression of endothelial
nitric oxide synthase and prostacylin synthase.
147
It also
is likely that stimulation of AMPK by adiponectin
increases endothelial nitric oxide generation by
endothelial nitric oxide synthase, affecting vascular tone.
Improved insulin sensitivity in endothelial cells may
increase vasorelaxation via Akt-mediated activation of
endothelial nitric oxide synthase. A recent study suggests
that adiponectin relaxes isolated aortic rings and
mesenteric arteries via opening of K
1
channels, a
mechanism that is independent of the presence of the
endothelium.
146

Adiponectin has anti-inflammatory and anti-atherogenic
properties. These functions appear to be mediated in part by
the ability of adiponectin to suppress TNF-a production by
macrophages and to both suppress myelomonocytic
progenitor cell growth and induce apoptosis.
148
Expression of
adhesion molecules by endothelial cells and subsequent
adherence of monocytes is also reduced.
149
This curtails
movement of monocytes into subendothelial areas and
inhibits the development of atherosclerotic plaques. These
same effects may also provide some protection against
carcinogenesis by inhibiting cancer cell growth and
angiogenesis associated with tumor formation.
150
Low
adiponectin levels have been observed in humans with a
variety of cancer types and have been speculated to contribute
to the increased incidence and severity of cancer in
obesity.
150,151

Adiponectin and obesity
Unlike leptin, increases in fat mass result in decreased
circulating adiponectin while weight loss results in increased
adiponectin concentrations in humans, primates, and
rodents.
152,153
In humans, circulating adiponectin levels are
negatively correlated with body mass index, fasting insulin
concentrations, and plasma triglyceride concentration but are
positively correlated with high density lipoprotein cholesterol
concentrations.
154
The decrease in adiponectin in obesity is
more severe with visceral than subcutaneous adiposity in
humans. Changes in adiponectinemia reflect not only total
adiponectin production but changes in the relative proportions
of different molecular weight forms. Overweight and obese
individuals have a relatively lower proportion of the HMW
form of adiponectin compared with other forms, and the
percentage of HMW adiponectin relative to total adiponectin
increases with weight loss.
155
The mechanisms underlying
these changes are still being explored. Increased production
of pro-inflammatory cytokines such as TNF-a and IL-6 as
well as reactive oxygen species within the enlarging fat mass
may act as autocrine or paracrine inhibitors of adiponectin
gene expression.
156,157
Insulin will downregulate AdipoR1 and
AdipoR2 expression. Therefore, hyperinsulinemia, often
associated with obesity and metabolic syndrome,
correctly aligned text.]
may contribute to a state of adiponectin resistance through
alterations in receptor availability.
132

In humans, decreased circulating adiponectin has been
linked with insulin resistance, type 2 diabetes mellitus,
essential hypertension, and development of progressive
ventricular hypertrophy and diastolic dysfunction.
132,158
Spontaneous mutations of the adiponectin gene in humans
and in engineered rodent models corroborate the association
of hypoadiponectinemia with the predilection to develop
metabolic syndrome, type 2 diabetes mellitus, and
cardiovascular disease.
132,159,160
While these syndromes are
common co-morbidities associated with obesity, adiponectin
is persistently lower in these conditions even when subjects
are matched for body mass index and adiposity. This suggests
that hypoadiponectinemia may be an independent risk factor
for the development of metabolic and cardiovascular
complications.
Measurement of adiponectin
Adiponectin is present in high concentrations (mg/mL) in
human plasma where it has a half-life of 14 hours.
140
Studies
in mice suggest that differences in half-life may depend on
the molecular form, with HMW adiponectin remaining in
circulation longer than smaller forms (9 vs. 4.5 hours,
respectively).
141
Studies in dogs and horses have used the
commercially available RIA from Linco as well as an ELISA
(Otsuka, Pharmaceuticals, Tokushima, Japan) to measure
adiponectin (Table 3). Millipore (formerly Linco, St. Charles,
MO, USA) now offers a canine-specific ELISA. These
commercial assays measure total adiponectin. Recent studies
in humans have suggested that measurement of various
molecular weight forms may provide additional risk
assessment for the development of disease such that newer,
less complicated, ELISAs are being developed to assess
individual molecular weight forms.
139,155
The clinical
importance of differentiating the various molecular weight
forms have not been addressed in dogs, cats, or horses.
Adiponectin can be measured in serum or plasma.
Samples anticoagulated with EDTA or heparin have
comparable results. One study in humans suggested that
adiponectin is stable for up to 36 hours in whole blood
before separation of plasma if kept on ice.
165
Similar
evaluations have not been done in domestic animal
species.
Adiposity appears to be the primary factor affecting
circulating adiponectin levels. Unlike leptin, adiponectin
does not have a circadian pattern in humans.
166
There is
no consensus as to whether adiponectin levels change
between the fed and fasted state or in response to glucose
tolerance testing. The changes are generally mild and
likely influenced by the metabolic state of the test
subjects and the composition of the meal.
167,168

Adiponectin in dogs, cats, and horses
Table3. Circulating adiponectin concentrations in dogs and horses.
Species Age Sex Breed Body condition Adiponectin (mg/mL) Assay Sample Ref. no.
Dog 21.6 1.2 mo SF (7) Beagle Lean 94 12 ng/mL RIA Plasma Gayet et al.
104

After 25% weight gain 52 6 ng/mL

26 yrs SF, M (5) Beagle BCS 4 to 5 33.6 4.9 Murine/rat
ELISAw
Plasma Omachi et
al.
161

Various M (6), F (4) Mixed breed 9.329.5 kg BW 1.22 (range 0.851.5) RIA Serum Brunson et
al.
162

13 yrs CM (6) SF (16) Beagle Before weight gain 37.7 2.0 Murine/rat
ELISAw
Plasma Ishioka et al.
163

After 30% weight gain 28.1 2.3

5 mo16 yr M, F (34) Various breeds BCS 3 (optimal) 33.4 2.9

Various (20) Client owned BCS 4 (overweight) 24.0 2.8

Various (17)

BCS 5 (obese) 16.8 3.0

M

33.8 4.6

F

32.9 3.5

NR M, F (4) Mix 23.1 0.6 kg BW 15.2 2.2 Murine/rat
ELISAw
Plasma Moore et al.
164

Horse 11 2 yr F (12) STB BCS 6.7 0.2 (unfit) 1.3 0.1 RIA Plasma Gordon et al.
99

28 yr M, F, G (34)

BCS 4.8 0.1 (fit) 1.8 0.05

10 3 yr F (23) STB 514 12 kg BW 2.69 0.17 RIA Plasma Kearns et al.
98

4 3 mo F (10), F (2) QH Bel, QH 227 11 kg BW 4.34 0.12

34 yrs G (6) STB BCS 4.1 0.1 4.84 0.66 RIA Plasma Pratt et al.
97

F (8)

BCS 4.8 0.5 4.49 0.59

Data are mean SEM unless otherwise indicated. Linco
Research (now Millipore), St. Charles, MO, USA. wOtsuka
Pharmaceuticals, Tokushima, Japan.
M, male; F, female; G, gelding; MC, castrated male; SF, spayed female; STB, Standardbred; QH, Quarter Horse; QH BEL, Quarter Horse Belgium cross;
number of animals indicated in parentheses; BW, body weight; BCS, body condition score (dog scale 15; horse scale 19); yr, years; mo, months; hr,
hours. [Correction added after online publication on 6 April 2009: The original Table 3 contained misaligned text. The correct table, above, shows the
In dogs, both the nucleotide and amino acid sequences of
canine adiponectin are highly homologous to those of
other species
162,163
and canine adiponectin appears to
circulate as variably sized molecular weight
complexes.
162
The adiponectin gene is expressed in a
variety of WAT depots in dogs; expression is not
observed in other tissues.
104,105,162,163
Adipocytes are the
source of adiponectin, and gene expression increases
with adipocyte differentiation.
105
Similar to primates and
rodents, adiponectin is inversely related to adiposity in
dogs (Table 3). Diet-induced obesity is accompanied by
a decrease in adiponectin gene expression in visceral
WAT
104
and a decrease in circulating adiponectin
concentration.100,104,163
The feline adiponectin gene and protein show strong
homology with human and canine adiponectin.
169
Expression was demonstrated in fat pads, and gene
expression was significantly greater in visceral compared
with subcutaneous depots. One study demonstrated that
serum adiponectin is lower in obese cats and increases
following weight loss.
112

Circulating adiponectin in horses has been shown to
be negatively correlated with fat mass, percent body fat,
BCS, and leptin levels (Table 3).
98,99
Unlike leptin,
adiponectin levels do not appear to fluctuate in a
circadian pattern,
119
or in response to feeding
119,170
or
exercise.
171
With horses, fat mass is usually estimated
from rump fat thickness and the role of visceral versus
subcutaneous fat mass in regulating leptin or adiponectin
levels has not been studied.
Angiotensinogen and the renin-argiotensin system (RAS)
Synthesis, receptors, regulation, and function
The RAS plays an important role in normal adipocyte
differentiation and metabolism. All components of the
RAS are found within fat pads and WAT is a major
source of angiotensinogen, second only to the liver.
Renin and angiotensin-converting enzyme for conversion of
angiotensinogen to angiotensin II are present within the fat
pad.
172
The physiologic actions of angiotensin II are mediated
by specific angiotensin receptors (AT1 and AT2). Local
production of angiotensin II in fat depots appears to play a
role in normal adipocyte differentiation, size, and insulin
sensitivity.
172

The RAS and obesity
Increased production of angiotensinogen with excess gain in
WATcontributes to the development of cardiovascular and
renal disease. Obesity in humans, rodent models, and dogs is
associated with activation of the RAS as evidenced by
increased levels of circulating angiotensinogen, plasma renin
activity, angiotensin converting enzyme activity, angiotensin
II, and aldosterone.
172174
Increased intraabdominal fat is
associated with a more pronounced activation of the RAS
compared with peripheral adiposity. For example, obesity
induced by feeding a high fat diet to mice results in increased
angiotensinogen expression in visceral fat but not in
subcutaneous fat or other tissues.
175
With increased WAT
mass, adipose-derived angiotensinogen spills over into the
circulation, resulting in increased plasma concentrations of
angiotensinogen, which may then be acted upon by the
kidney and other tissues to produce angiotensin II. Increases
in angiotensin II promote cardiovascular and renal
dysfunction by direct vasoconstrictor activity as well as by
increasing renal sodium retention via aldosterone release.
172
174
As evidence of dysregulation of the RAS, salt loading
failed to appropriately suppress plasma renin activity and
aldosterone in obese male humans.
176
In a rat model of obesity
due to a leptin receptor defect, a highsalt diet suppressed
aldosterone secretion, but aldosterone levels remained
abnormally high, suggesting a change (increase) in the set
point for aldosterone secretion.
74
Furthermore, weight loss in
humans resulted in decreases in circulating components of the
RAS.
177

In addition to direct vasoactive effects, increased activity
ofthe RAS contributes to local inflammation in fat tissue.
6
Angiotensin II also furthers progression of the metabolic
syndrome and insulin resistance by inhibiting the insulin-
stimulated translocation of GLUT4 subsequent to JAK/STAT
signaling and production of SOCS-3.
178

Cross-talk between components of the RAS and other
adipokines promotes development of metabolic syndrome.
For example, leptin production by adipocytes appears to be
stimulated by angiotensin II.
172
Hyperleptinemia may further
hyperactivity of the RAS by stimulating renal sympathetic
nerves and subsequent increasing renin release by the kidney.
Angiotensin II may also regulate adipocyte production of
adiponectin. Infusion of angiotensin II into rats resulted in
decreases in plasma adiponectin and in adiponectin mRNA
expression in fat pads,
179
changes that were ameliorated by
treating with an antioxidant. In humans with metabolic
syndrome, both plasma adiponectin levels and insulin
sensitivity increased subsequent to use of angiotensin-
converting enzyme activity inhibitors or AT1 receptor
blockers.
180
The mechanism by which RAS antagonism
increases adiponectin production is uncertain. Some AT1
receptor blockers appear to increase adiponectin secretion via
activationofPPARgand differentiation ofsmaller, more
insulin-sensitiveadipocytes.
181,182
This effect onPPARg
appears to be drug specific, and other inhibitors of the RAS
may work through alternate mechanisms to improve insulin-
sensitivity.
183
Some inhibitors of the RAS also may promote
redistribution of fat from visceral (metabolically
disadvantageous fat) to subcutaneous depots.
184
The
mechanism underlying this redistribution is less certain but it
appears to be related to increased expression or activation of
PPARg.
185,186

While a few studies have documented activation of the
RAS in diet-induced obesity in dogs,
173,174
the impact of
alterations of RAS on obesity-related disorders in dogs, cats,
and horses is incompletely characterized at this time. The
demonstrated significance of RAS in people and laboratory
animals suggests this system is a good candidate for
evaluation in the pathophysiology of obesity-related disorders
in domestic species, especially because many of the assays
required are functional and should have broad species
applicability.187190
Resistin
Resistin is a relatively recently described adipokine and was
originally demonstrated as a product of murine adipocytes.
191
While resistin also is expressed by human adipocytes, it
appears to be primarily produced by macrophages in this
species. Resistin expression has been demonstrated in fat and
mammary tissue from cattle,
192
and in fat and predominantly
leukocytes from pigs.
193
Expression of resistin has not yet
been documented in dogs but this may be due to technical
issues. Resistin is a cysteine-rich protein that is secreted as a
dimer. The amino acid homology between human and murine
resistin is relatively low (60%) but appears to be higher
between human, bovine, and porcine sequences.
194
The
receptor for resistin currently is unknown.
Most studies on the effects of resistin have been
performed in rodent models (recently summarized by
Lazar
191
). Resistin secretion follows a similar pattern to
that observed with leptin. Circulating levels increase with
increasing fat mass and following a meal.
Hyperresistinemia contributes to the development of
insulin resistance and metabolic derangements
compatible with type 2 diabetes mellitus. Resistin is
proinflammatory and induces upregulation of vascular
adhesion molecules and stimulation of proinflammatory
cytokine secretion by macrophages. Increased circulating
resistin in humans correlates with atherosclerosis.
Resistin is an adipokine that has not been well studied in
domestic species, but is a logical candidate for evaluation
in obesity-related disorders once analytical issues are
worked out.
Inflammatory cytokines
Fat pads are a source for a variety of inflammatory
cytokines, which also may be considered as adipokines.
Recent data suggest that both macrophages and white
adipocytes are the source of inflammatory cytokines such
as TNF-a, interferon-g, interleukins such as IL-1, IL-6,
IL-8, and IL-10, monocyte chemotactic protein-1, and
complement proteins.
195
Obesity is considered to be a
cause of chronic inflammation, in which macrophages
infiltrate the enlarging adipose mass and local and
circulating levels of proinflammatory cytokines are
increased.
196
Some authors feel that macrophages do not
initiate the inflammatory process, but rather amplify a
response to hypoxia in poorly vascularized areas of the
expanding adipose tissue mass.
197

Inflammation is associated with insulin resistance
via poorly characterized mechanisms, with insulin
resistance contributing to the metabolic derangements
that commonly accompany obesity.
198
Excessive
circulating free fatty acids that are present with
overnutrition/obesity appear to activate the innate
immune response via Toll-like receptor 4 and increased
NF-kB signaling,
199,200
although the exact mechanism for
the induction of insulin resistance is not clear. Given the
newly documented anti-inflammatory, antithrombotic,
and vasodilatory functions of insulin, impaired insulin
responsiveness has multiple pathways by which it may
modulate comorbidities observed with weight gain.
201
There is also evidence that insulin resistance may
contribute to breast cancer development, potentially via
its effect on tissue availability of insulinlike growth
factor-1.
202

Interestingly, TNF-a has effects on adipose tissue as
well: it inhibits adipocyte differentiation, thereby leading to
decreased lipid storage capacity; promotes lipid
mobilization; and impairs brown adipose tissue function. In
a nonobese individual, these effects may promote fuel
availability; however. in obesity, they exacerbate
hyperlipidemia and lipotoxicity in other organs.
203

Summary
Adipose is an important endocrine organ. It is a
developmentally dynamic tissue with the potential to
produce a broad spectrum of biologically important
modifiers. Adipokines secreted by adipose tissue are key
regulators of energy metabolism, cardiovascular health,
and immune function, and their production and function
may be influenced by nutrition and reproductive status,
with some species-specific considerations. Dysregulation
of adipokines appears to contribute to the development of
a number of complications associated with obesity,
including metabolic syndrome, type 2 diabetes,
cardiovascular disease, and cancer via changes in whole
organism physiology or at the local tissue level. These
connections have mostly been explored in humans and
rodent models; similar mechanistic studies are in their
early stages in dogs, cats, and horses. Evaluation of
individual adipokines shows promise as means to assess
pathophysiologic mechanisms and risk for development
of obesityrelated conditions in veterinary patients. An
understanding of the biology and regulation of
adipokines, and of preanalytical factors that may
influence circulating adipokine levels, will be important
in interpreting measurements of these endocrine factors.
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136 Vet Clin Pathol 38/2 (2009) 136156 c 2009 American Society for Veterinary Clinical Pathology

Veterinary Clinical Pathology ISSN 0275-6382

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