{'fraction_non_alphanumeric': 0.054679284963196635, 'fraction_numerical': 0.013669821240799159, 'mean_word_length': 5.158576051779935, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 1, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Ectopic fat: a target for cardiometabolic risk management

The incidence of cardiovascular and metabolic diseases (e.g. type 2 diabetes (T2D) and nonalcoholic fatty liver disease (NAFLD)) has shown a significant increase, growing at the same rate as obesity. The World Health Organization reported that more than 400 million people have diabetes (that’s 1 person in 11), of which 1 in 3 is overweight and 1 in 10 is obese (see WHO-Global report on diabetes, http://www.who.int/dia betes/global-report/en/). Several data indicate that the distribution of fat is very important in the determination of disease risk [1–3]. Fat accumulates in specific locations, e.g. around the heart (epicardial fat) or inside visceral area, or inside specific organs, i.e. in the liver, muscle, pancreas, and heart, also named ‘ectopic fat’ [3]. Ectopic fat is one of the major factors of the development and progression of cardiometabolic diseases [1–3]. Thus, it is not the subcutaneous fat, but rather the visceral and ectopic fat accumulation that increase the risk of T2D, NAFLD, metabolic syndrome (MetS) and cardiovascular diseases (CVD) [3]. Ectopic fat can directly contribute to the low-grade inflammatory state, mitochondrial dysfucntion, beta cell apoptosis and insulin resistance (IR) that increase the risk of cardiometabolic diseases [3,4]. This fat may be in the form of triglycerides (TG) or diacylglycerols (DAG), but other lipids, like ceramides (CER), sphyngomyelins (SPHY), lysophosphocholines, or phosphocholines, may accumulate and contribute to cellular dysfunction [5,6]. CER derive from sphingolipid metabolism, and their metabolites have a key role in cellular signaling, like apoptosis and insulin sensitivity [6]. CER act also as regulators of energy metabolism and signaling [6]. In the following discussion, we described how single organ metabolism is impaired by ectopic fat accumulation.