The review highlights the characteristics of adipose tissue as a metabolically active organ, reveals endocrinous functions of adipose tissue and the role of adipose tissue in immune system’s functioning. The role of obesity in the development of insulin resistance (IR) and diabetes mellitus type 2 and the effect of dyslipidemia on the development of metabolic syndrome (MS) and IR are given. It is shown that the main function of fatty tissue is energy storage via the maintenance of balance between lipolysis and lipogenesis processes. Inhibition of lipogenesis and enhancement of lipolysis are observed in metabolic disorders, in particular, IR. Adipose tissue’s function is regulated by adipokines excreted by it. Inflammation condition is an essential constituent and one of the reasons of IR status. Neutralization of the main inflammatory cytokines does not restore sensitivity to insulin, which is indicative of the fact that inflammation condition is not the only cause of IR. Chronic low-grade inflammation develops as a result of obesity. Pro-inflammatory cytokines affect insulin signaling via stimulation of stress kinases. Functions of signal and immune cells are dependent on phospholipid composition. Unsaturated fatty acids are the substrate for synthesis of bioactive mediators. Allocated peroxisome proliferator-activated receptors (PPARs) are considered to be the main therapeutic target. Synthetic ligands of thiazolidinidones and components of the endogenous cannabinoid system of N-acetylethanolamines, capable of interacting and binding to PPARs receptors, are investigated. N-stearoylethanolamine is of special interest; its positive effect on normalization of lipid profile of different tissues, particularly insulin-sensitive tissues, has already been shown.
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