Hormonal
Excessive extracellular matrix (ECM) remodeling and collagen accumulation in adipose tissue causes fibrosis, which restricts adipocyte expansion, triggers hypoxia and inflammation, and directly leads to insulin resistance.
For those with obesity and insulin resistance, simply losing weight may not be enough if adipose tissue fibrosis is present. Strategies that promote healthy adipose tissue expansion (like moderate, sustained weight loss rather than rapid fluctuations) and reduce inflammation may help preserve tissue elasticity. Resistance training is mentioned as potentially modulating ECM components (MMP-2, VEGF-A, TIMP-2), suggesting it may support healthier adipose tissue structure.
In obesity, accumulation of collagen causes fibrosis of adipose tissue increasing rigidity, reduces its expandability, and provokes IR [35].
Why this rating
The paper is a comprehensive review citing numerous animal and human studies, though specific clinical trial data for ECM-targeted therapies is limited.
Source
Extracellular Matrix Remodeling of Adipose Tissue in Obesity and Metabolic Diseases
Francisco Javier Ruiz‐Ojeda et al. · International Journal of Molecular Sciences · 2019
DOI 10.3390/ijms20194888
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