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Panniculus
Dr. Preethi chekuri
MD DVL
Introduction
 Occurs almost universally over the body
surface, between the skin and deep fascia
 Absent from eyelids and male genitalia
 It varies in thickness with the race, age,
sex, endocrine and nutrtional status
 In a normal person, fat constitutes 10% of
body weight
Functions
 Acts as an insulating layer
 Protective cushion
 Thermogenesis
 Store of readily available energy
 Major endocrine organ
 Provides support and has cosmetic function
(contours of face)
Embryology
 Pre  adipocyte appears in the mesenchyme at 14th
week of fetal life
 Pre  adipocyte terminally differentiate into either
brown adipocyte or white adipocyte
 Development of brown fat begins at the 20th week
of gestation, reaches maximum at birth
Brown fat
 It is multilocular and metabolically
very active with many mitochondria
 Surrounded by a greater capillary network than
white fat ( partly responsible for the brown
colour), such that heat can be rapidly tranferred
into the circulation
 Most prominent in neck and upper thorax of fetus
 Adults have supraclavicular areas of brown fat
Histology of adipocytes
 Have a diameter upto 100 microns
 Mature fat cell has a characteristic signet ring
appearance, because the oval nucleus is displaced to a
side by a single, large, intracellular, fat containing
vacuole, which is surrounded by perilipin
 Arranged in lobules, which are separated by
interlobular septa
 Each lobule consists adipocytes, stromavascular
tissue being macrophages, fibroblasts, mast cells,
pericytes, endothelial cells and pre-adipocytes
Blood, nerve and lymph supply
 BLOOD - Fat tissue has an abundant blood supply, each
lobule being supplied by a terminal arteriole running
along the septa
Then breaks up to form capillaries
 LYMPH - Also contains a rich lymphatic plexus
These lymph vessels penetrate deep fascia and drain
into regional lymph nodes
 NERVE - Innervated by noradrenergic fibres of
sympathetic nervous system and para sympathetic
fibres
Adipogenesis
 It refers to the recruitment from multipotent
stem cells in the mesenchyme and stromavascular
tissue, and proliferation of pre adipocytes
followed by their differentiation into mature fat
cells
 -Glucocorticoids -
growth hormone and
-insulin, stimulate cells to terminally
differentiate, but after a certain size, growth
occurs through hyperplasia rather than
hypertrophy
Energy homeostasis
 Catabolism and anabolism of fat depends on
-nourishment, endocrine and nervous activity
 Insulin inhibits hydrolysis and breakdown of
triglycerides, conserving the energy store
 Adipose tissue in vitro has a metabolic rate similar
to a kidney and half that of liver
Outline of lipogeneis in an adipocyte
Panniculus (adipose/fat tissue)
Fat as an organ
 Apart from the subcutaneous fat,
20% of fat tissue occurs internally,
in mediastinal and retroperitoneal
tissues, mesentry, marrow and
other individual organs including
blood vessels
 In view of the recent obesity
epidemic, increase in the upper
body and visceral fat are
associated with an increase
cardiovascular and metabolic risks
Fat as an endocrine organ
Adiponectin
 Protein with structural similarity to collagen and C1q
 Has autocrine/paracrine effects locally and endocrine
effects distally
 Promotes pre adipocytes to become mature fat cells
with increase in size
 Serum adiponectin levels are lower with weight gain
and higher with weight loss
 Also exerts anti inflammatory properties
Leptin
 Adipokine involved in energy homeostasis
 Structural homology similar to other
cytokine proteinssuch as TNF alpha and IL-6
 Exerts main effect via satiety centres
Thank you
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Panniculus (adipose/fat tissue)

  • 2. Introduction Occurs almost universally over the body surface, between the skin and deep fascia Absent from eyelids and male genitalia It varies in thickness with the race, age, sex, endocrine and nutrtional status In a normal person, fat constitutes 10% of body weight
  • 3. Functions Acts as an insulating layer Protective cushion Thermogenesis Store of readily available energy Major endocrine organ Provides support and has cosmetic function (contours of face)
  • 4. Embryology Pre adipocyte appears in the mesenchyme at 14th week of fetal life Pre adipocyte terminally differentiate into either brown adipocyte or white adipocyte Development of brown fat begins at the 20th week of gestation, reaches maximum at birth
  • 5. Brown fat It is multilocular and metabolically very active with many mitochondria Surrounded by a greater capillary network than white fat ( partly responsible for the brown colour), such that heat can be rapidly tranferred into the circulation Most prominent in neck and upper thorax of fetus Adults have supraclavicular areas of brown fat
  • 6. Histology of adipocytes Have a diameter upto 100 microns Mature fat cell has a characteristic signet ring appearance, because the oval nucleus is displaced to a side by a single, large, intracellular, fat containing vacuole, which is surrounded by perilipin
  • 7. Arranged in lobules, which are separated by interlobular septa Each lobule consists adipocytes, stromavascular tissue being macrophages, fibroblasts, mast cells, pericytes, endothelial cells and pre-adipocytes
  • 8. Blood, nerve and lymph supply BLOOD - Fat tissue has an abundant blood supply, each lobule being supplied by a terminal arteriole running along the septa Then breaks up to form capillaries LYMPH - Also contains a rich lymphatic plexus These lymph vessels penetrate deep fascia and drain into regional lymph nodes NERVE - Innervated by noradrenergic fibres of sympathetic nervous system and para sympathetic fibres
  • 9. Adipogenesis It refers to the recruitment from multipotent stem cells in the mesenchyme and stromavascular tissue, and proliferation of pre adipocytes followed by their differentiation into mature fat cells -Glucocorticoids - growth hormone and -insulin, stimulate cells to terminally differentiate, but after a certain size, growth occurs through hyperplasia rather than hypertrophy
  • 10. Energy homeostasis Catabolism and anabolism of fat depends on -nourishment, endocrine and nervous activity Insulin inhibits hydrolysis and breakdown of triglycerides, conserving the energy store Adipose tissue in vitro has a metabolic rate similar to a kidney and half that of liver
  • 11. Outline of lipogeneis in an adipocyte
  • 13. Fat as an organ Apart from the subcutaneous fat, 20% of fat tissue occurs internally, in mediastinal and retroperitoneal tissues, mesentry, marrow and other individual organs including blood vessels In view of the recent obesity epidemic, increase in the upper body and visceral fat are associated with an increase cardiovascular and metabolic risks
  • 14. Fat as an endocrine organ
  • 15. Adiponectin Protein with structural similarity to collagen and C1q Has autocrine/paracrine effects locally and endocrine effects distally Promotes pre adipocytes to become mature fat cells with increase in size Serum adiponectin levels are lower with weight gain and higher with weight loss Also exerts anti inflammatory properties
  • 16. Leptin Adipokine involved in energy homeostasis Structural homology similar to other cytokine proteinssuch as TNF alpha and IL-6 Exerts main effect via satiety centres