Perspectives on human adipose tissue: from cellular mechanisms to clinical complications – published online 24/04/2026

Mikael Rydén

Adipose tissue plays a central role in the pathophysiology of obesity and its metabolic complications, yet its biological complexity has only recently begun to be fully appreciated. In this review, Mikael Rydén (https://doi.org/10.1007/s00125-026-06735-0) discusses emerging insights into human white adipose tissue as a highly dynamic metabolic organ. The article highlights how processes such as adipocyte turnover, lipid storage and mobilisation, tissue remodelling and immune cell interactions contribute to the regulation of systemic metabolism. Particular attention is given to inter-individual differences in adipose tissue function, which may help explain why people with similar levels of adiposity display markedly different metabolic risk profiles and susceptibility to weight gain and cardiometabolic disease. The review also summarises recent advances in single-cell and spatial transcriptomic technologies that are redefining adipose tissue heterogeneity and organisation. Together, these developments provide a more integrated framework for understanding how adipose tissue biology contributes to obesity, insulin resistance and cardiometabolic disease. The figures from this review are available as a downloadable slideset.