Paul Saladino· MD
the actual pathophysiology of metabolic dysfunction is fat cells that can't divide
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the actual pathophysiology of metabolic dysfunction is fat cells that can't divide
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i believe that insulin resistance begins in the adipocyte begins in the fat cell and the way that fat cells become appear to become broken is that they lose the capacity to divide so there's hypertrophy and hyperplasia and i always get too mixed up so one of them is the growth of the fat cell alluding and one of them is the actual division of the fat cell into more fat cells so fat cells that balloon and don't divide are problematic that is when fat cells become disease that's clearly associated with an insulin resistant phenotype they start to spew inflammatory meteors cytokines and free fatty acids which signal to the rest of the body that you want to become insulin resistant but that's pathology so a fat cell that cannot divide appears to be the root or one of the proximal steps of insulin resistant function
at the root of insulin resistance is not excess sugar the root of insulin resistance is broken fat cells broken fat cells that can't divide so there's hypertrophy which is the growth of the fat cell versus hyperplasia the division of the fat cell