Our study provided an analysis and comparison of specific blood values, dietary intake, body composition, and inflammatory markers (high sensitivity-C-reactive protein (HS-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)) between adults with type 2 diabetes mellitus (T2DM) and prediabetes (PDM) to adults without diabetes. A total of 22 participants (PDM/T2DM n=12, controls n=10) in the San Luis Obispo, CA area completed the study prior to our ending recruitment due to Covid-19. Body composition data were collected through DXA scans. Dietary intake was assessed using a 3-day food record survey and nutritional analysis conducted using ESHA food processing software. In addition, participants completed an overnight fast and early morning blood draw for evaluation of blood glucose regulation, blood lipid profile and inflammatory biomarkers. Analysis included a series of randomization tests that were conducted to determine possible statistical differences between the mean of basic characteristics (age, BMI, weight, HbA1C, fasting plasma glucose, fasting insulin, triglycerides, LDL, HDL, and total cholesterol levels) of the control group and the PDM/T2DM group. Secondly, 2-way ANOVA statistical analyses were conducted to determine the interaction between sex and diabetes status on caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers. We found there was a significant difference in fasting plasma glucose (FPG) and hemoglobin A1C (HbA1C) between the control group and the PDM/T2DM group. We did not find a statistically significant difference in caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers between the PDM/T2DM and control group. Due to the lack of studies that include adults with PDM, we concluded additional future research needs to focus on blood biochemistry values, dietary intake, body composition, and inflammatory markers health-risk factors in both adults with PDM and T2DM since these values can improve diagnosis and treatment of T2DM.

The Hedgehog signaling pathway regulates many processes during embryogenesis and the homeostasis of adult organs. Recent data suggest that central metabolic processes and signaling cascades in the liver are controlled by the Hedgehog pathway and that changes in hepatic Hedgehog activity also affect peripheral tissues, such as the reproductive organs in females. Here, we show that hepatocyte-specific deletion of the Hedgehog pathway is associated with the dramatic expansion of adipose tissue in mice, the overall phenotype of which does not correspond to the classical outcome of insulin resistance-associated diabetes type 2 obesity. Rather, we show that alterations in the Hedgehog signaling pathway in the liver lead to a metabolic phenotype that is resembling metabolically healthy obesity. Mechanistically, we identified an indirect influence on the hepatic secretion of the fibroblast growth factor 21, which is regulated by a series of signaling cascades that are directly transcriptionally linked to the activity of the Hedgehog transcription factor GLI1. The results of this study impressively show that the metabolic balance of the entire organism is maintained via the activity of morphogenic signaling pathways, such as the Hedgehog cascade. Obviously, several pathways are orchestrated to facilitate liver metabolic status to peripheral organs, such as adipose tissue.

<p dir="ltr">Adipose tissue is characterized by the dominant presence of adipocytes, specialized cells adept at lipid metabolism. These adipocytes act as critical nodes, coordinating the complex processes of energy storage and mobilization according to the body's metabolic requirements. Within the adipocyte population of mammals, there are three main subtypes: white, beige, and brown adipocytes. White adipocytes are primarily dedicated to the sequestration of energy in the form of triglycerides. Conversely, beige and brown adipocytes are distinguished by their capacity for thermogenesis, the process of dissipating nutritional energy as heat. The contemporary challenge of chronic overnutrition has precipitated a global surge in obesity and cardiometabolic diseases. Addressing this issue necessitates the maintenance of white adipocyte homeostasis and the enhancement of the quantity and function of thermogenic adipocytes, which are imperative for mitigating the global obesity epidemics.</p><p dir="ltr">Mitochondrion, a multifunctional organelle, is integral to a broad spectrum of cellular processes, including anabolic and catabolic metabolism, bioenergetics, and signal transduction, all of which are essential for maintaining cellular functions and homeostasis. The efficacy of mitochondrial operations is intrinsically linked to their membrane dynamics. In this study, transmission electron microscopy and mass spectrometry were employed to investigate the proteins implicated in the cold-induced mitochondrial membrane remodeling in brown adipocytes. Through this approach, a poorly characterized protein, Family with Sequence Similarity 210 Member A (FAM210A), was identified as a mitochondrial inner membrane protein that is induced by cold stimulation. Subsequent loss-of-function experiments were conducted to elucidate the role of FAM210A in adipocytes. Mice with adipose-specific deletion of <i>Fam210a</i> (<i>Fam210a</i>^<em>AKO</em>) exhibited compromised mitochondrial cristae structure and a reduced thermogenic capacity in brown adipose tissue (BAT), resulting in an increased susceptibility to lethal hypothermia during acute cold challenge. Moreover, in mice with inducible ablation of <i>Fam210a</i> in adipocytes (<i>Fam210</i>^{<em>iAKO</em>}), mitochondrial alterations in BAT were negligible at thermoneutral conditions; however, they exhibited defective cold-induced mitochondrial cristae remodeling, culminating in a progressive loss of cristae and diminished mitochondrial density. Mechanistically, it was determined that FAM210A interacts with mitochondrial protease YME1L and modulates its activity toward OMA1 and OPA1 cleavage, thus compromising cold-induced mitochondrial remodeling in BAT.</p><p dir="ltr">Additionally, this research delved into the role of FAM210A in adipocytes in response to dietary stress by feeding mice with high-fat diet (HFD). The study found a consistent correlation between FAM210A expression and OPA1 cleavage in adipocytes under HFD challenge. Mice lacking FAM210A in all adipocytes and subjected to HFD exhibited lipoatrophy in white adipose tissue (WAT) and a downregulation of genes associated with adipogenesis and lipid metabolism. In contrast, mice with a brown adipocyte-specific ablation of <i>Fam210a </i>(<i>Fam210a</i>^<em>UKO</em>) displayed no significant change in WAT mass but had enlarged livers. Crucially, both <i>Fam210a</i>^<em>AKO</em> and <i>Fam210a</i>^<em>UKO</em> mice presented increased WAT inflammation, deteriorated glucose tolerance, and exacerbated insulin resistance. These findings underscore the pivotal role of FAM210A in brown adipose tissue (BAT) in the preservation of WAT homeostasis and the regulation of systemic glucose clearance in diet-induced obesity.</p><p dir="ltr">In summary, these studies characterize the mitochondrial dynamics in brown adipocytes in response to cold stress, identify a new cold-induced mitochondrial protein, FAM210A, and uncover its functions in adipocytes under cold and dietary stresses. These findings highlight the importance of mitochondrial remodeling in the adaptive response of adipocytes to evolving metabolic demands. This work establishes FAM210A as a key regulator of mitochondrial cristae remodeling, shedding light on the mechanisms that govern mitochondrial plasticity in adipocytes.</p>

Background and Aims: During positive energy balance, excess lipid storage in subcutaneous adipose tissue (SAT) is associated with increased lipolysis. Elevated circulating fatty acid (FA) concentrations from both SAT lipolysis and dietary fat intake may result in visceral adipose tissue (VAT) accumulation, impairment of glucose metabolism, altogether increasing obesity-associated metabolic risks. We aimed to test the hypothesis that FA composition of red blood cell total phospholipids (RBC-TPL) and SAT is associated with body fat centralisation (VAT/SAT ratio) and insulin sensitivity (SI) in black South African women with obesity. Methods: Participants’ (n = 41) body fat composition and distribution, SI, and RBC-TPL, abdominal and gluteal SAT (gSAT) FA composition (gas-liquid chromatography) were measured. Results: RBC-TPL contained higher proportions of saturated fatty acids (SFAs) than SAT (p < 0.001), which were associated with lower SI (p < 0.05). Mono-unsaturated fatty acids (MUFAs) and stearoyl-CoA desaturase-1 (SCD1)-16 were lower, while poly-unsaturated fatty acids (PUFAs), and delta-5 and delta-6 desaturase indices were higher in RBC-TPL than SAT (p < 0.001). Interestingly, FA profiles differed between SAT depots with higher SFAs and lower MUFAs, SCD1-16 and SCD1-18 indices in abdominal compared to gluteal SAT (p < 0.01). In both SAT depots, higher SFAs and lower PUFAs (n-3 and n-6) correlated with lower VAT/SAT ratio; and lower PUFAs (n-3 and n-6) and higher total MUFA correlated with higher SI. Conclusion: Our findings confirm the relationships between the FA composition of RBC-TPL and SAT and metabolic risk in black women with obesity, which are dependent on both the FA class, and the tissue type/blood compartment in which they are distributed.

No description available.

No description available.

<p>The endoplasmic reticulum (ER) is a specialized organelle that facilitates correct protein folding and maturation. Disruptions in ER homeostasis lead to ER stress and activation of a series of signal transduction cascades known as the unfolded protein response (UPR), which acts to restore ER homeostasis. In recent years, ER stress and UPR dysfunction have been linked to obesity, fatty liver and insulin resistance. Lipid-laden adipocytes, the main cellular component of white adipose tissue (WAT), play a critical role in whole body energy homeostasis as well as lipid and carbohydrate metabolism. Mature adipocytes, which are metabolically active endocrine cells, differentiate from precursor fibroblast-like preadipocytes, through a process called adipogenesis, leading to formation of cells capable of secreting numerous proteins, cytokines and hormones. ER homeostasis and UPR activation are essential to the function/differentiation of highly secretory cells, however, the role of ER stress/UPR activation in adipogenesis had previously not been examined. We hypothesized that<em> adipogenesis may rely on physiological UPR activation to accommodate the demand on the ER for increased folding and secretion of proteins.</em></p> <p>Initial experiments examining UPR activation during 3T3-L1 adipogenesis identified that expression of ER stress/UPR markers was modulated during adipocyte differentiation. Furthermore, inhibition of ER stress/UPR activation by the chemical chaperone, 4-phenyl butyric acid (4-PBA), inhibited adipogenesis and blunted high fat-diet induced weight gain in 4-PBA supplemented mice. These findings suggested that UPR activation modulates adipogenesis and adipose tissue metabolism.</p> <p>Subsequently, we sought to identify novel candidate ER stress/UPR responsive genes that may be involved in adipogenesis and WAT metabolism. The expression of a recently recognized ER stress-responsive gene, T-cell death associated gene 51 (TDAG51) was identified to be differentially regulated during adipogenesis. However, the function of TDAG51 in adipogenesis or energy regulation was not known. Studies from this thesis showed that TDAG51 protein expression is attenuated by ER stress/UPR activation in preadipocytes and declines during adipogenesis. Based on these results, and given the importance of adipogenesis in WAT function and whole body energy metabolism, it was<em> </em>hypothesized that<em> TDAG51 may be a novel regulator of adipogenesis and energy homeostasis.</em> Indeed, as reported here, knock-down or absence of TDAG51 (<em>TDAG51^-/-</em>) in pre-adipocytes increased lipogenesis and lead to earlier and more potent expression of adipogenic markers.</p> <p>Finally, we investigated whether absence of TDAG51 in mice affected adiposity and metabolic outcomes. Consistent with the <em>in vitro </em>results, we found that <em>TDAG51^-/-</em>mice fed a standard chow diet, exhibited an age-associated increase in WAT, developed fatty liver, and exhibited insulin resistance as compared to wild-type mice.</p> <p>Taken together, the findings in this thesis indicate that physiological UPR activation and the UPR-responsive gene TDAG51 play important roles in regulating adipogenesis, lipogenesis and whole-body energy metabolism. Thus, therapeutic approaches aimed at modulating ER folding capacity, UPR activation and/or TDAG51 expression may have great potential in the treatment of obesity and its co-morbidities.</p> / Doctor of Philosophy (PhD)

No description available.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. It shows an increasing prevalence in developed countries with a strong association to cardiovascular risk factors. It has become a major challenge to the healthcare system with a high morbidity and increased AF-related mortality. Recommended treatment approaches favor rhythm control strategies, which aim to restore sinus rhythm. The pathophysiologic concept of atrial fibrillation has evolved towards defining the term atrial myopathy, recognizing inflammation mediated remodeling of the left atrium (LA) as a source for and result of arrhythmogenesis. One of many features of atrial myopathy is the development of left atrial fibrosis by fibro-fatty infiltration. This corresponds to low voltage zones (LVZ), that are characterized by impaired myocardial electrical conduction during invasive electroanatomic mapping. Epicardial adipose tissue (EAT) has been revealed to be a key player in this inflammatory process that nourishes the development of left atrial fibrosis. Traditional cardiovascular risk factors favor the transdifferentiation of EAT towards a pro-inflammatory phenotype. Recently, evidence has proven the positive effect of new generation anti-diabetic drugs like sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists on EAT by inducing a favorable phenotypic shift with local anti-inflammatory effect and potential influence on atrial reverse remodeling. This thesis sought to confirm the ability to predict LVZ from cardiac magnetic resonance (CMR) derived parameters and to describe the differences of left atrial volume and left atrial epicardial adipose tissue volume in AF patients with and without LVZ. Patients with indication for primary AF ablation were prospectively enrolled. CMR imaging sequences included an LA angiography and two different techniques for left atrial epicardial adipose tissue imaging (T1 weighted and fat-water separation DIXON-based), which were compared. Left atrial volume index (LAVi) and left atrial epicardial adipose tissue volume index (LA-EATVi) from the DIXON-based technique proofed to be significant predictors of LVZ presence. No significant results could be obtained for the epicardial adipose tissue quantified from T1 weighted imaging. LA-EATVi(DIXON) was significantly higher in patients with LVZ than without, with a mean difference of 10.13 ± 5.0 ml. The same could be shown for LAVi, with a mean difference of 24.46 ± 8.13 ml. Both parameters were independent of each other. Additionally, it could be shown that higher age and female gender are associated with LVZ occurrence. CMR based quantification of LA-EATVi(DIXON) alone or in combination with other predictive variables of LVZ, like LAVi, age and female gender was able to identify patients at low or high risk of LVZ. In the studied patient population, a combined prediction model of LAVi, LA- EATVi(DIXON), age and female gender provided the highest predictive ability to determine LVZ presence with an area under the curve (AUC) in receiver operating characteristics (ROC) of 0.91. Depending on cutoff selection for the prediction model a high positive or negative predictive value can be achieved, minimizing false results. The clinical implementation of a CMR-based prediction model of LVZ presence as a feature of LA myopathy could have a tremendous impact on treatment decisions. It would allow the selection of patients for fast and easy single shot AF-ablation procedures in case of low LVZ risk, whereas complex and more time-consuming invasive procedures were to be scheduled if relevant LA myopathy is to be suspected.:1. Introduction 1 1.1. Atrial fibrillation 1 1.1.1. Risk factors 3 1.1.2. Left atrial myopathy 4 1.1.2.1. Predictive parameters of LA myopathy and atrial fibrosis 6 1.1.2.2. Imaging methods for left atrial myopathy and fibrosis 6 1.1.4. Current treatment strategies 7 1.1.4.1. Catheter ablation 9 1.2. Epicardial adipose tissue 11 1.2.1. Physiology and pathophysiology of epicardial adipose tissue 14 1.2.2. Role of epicardial adipose tissue in atrial fibrillation 15 1.2.3. Imaging techniques of epicardial adipose tissue 18 2. Objective 21 3. Methods 22 3.2. Imaging protocol 24 3.2.1. Adipose tissue imaging with DIXON approach 24 3.2.2. Adipose tissue imaging with T1 weighted imaging approach 26 3.2.3. Left atrial anatomy imaging 26 3.3. Segmentation and Quantification 27 3.4. Electroanatomic mapping and pulmonary vein isolation procedure 31 3.5. Statistical analysis 33 4. Results 34 4.2. General patient cohort characteristics 34 4.3. Patient characteristics in LVZ subgroups 36 4.4. Selected CMR parameter evaluation 39 4.4.1. Left atrial volume 39 4.4.2. Left atrial epicardial adipose tissue volume 41 4.4.2.1. DIXON based left atrial epicardial adipose tissue imaging 41 4.4.2.2. T1 weighted left atrial epicardial adipose tissue imaging 43 4.4.3. Comparison of adipose tissue imaging techniques 45 4.4.4. Reliability analysis 48 4.5. LVZ prediction models 49 4.5.1. Univariate non-CMR based LVZ prediction models 51 4.5.2. Univariate CMR based LVZ prediction models 53 4.5.3. Multivariate LVZ prediction models 57 4.5.4. Example of clinical application 62 4.5.5. Prediction model validation 64 5. Discussion 66 5.2. General aspects 66 5.3. EAT image acquisition 68 5.4. Clinical relevance 68 5.5. Future developments 70 5.6. Limitations 72 6. Summary 74 7. Zusammenfassung 76 8. References 78 9. List of figures and tables 98 10. Acknowledgement 102 11. Curriculum vitae 103 / Vorhofflimmern (AF) ist die häufigste Herzrhythmusstörung. In den Industrieländern nimmt die Prävalenz zu, wobei ein enger Zusammenhang mit kardiovaskulären Risikofaktoren besteht. Vorhofflimmern ist zu einer großen Herausforderung für das Gesundheitssystem geworden, da es eine hohe Morbidität und eine erhöhte vorhofflimmerbedingte Mortalität aufweist. Die empfohlenen Behandlungsansätze favorisieren Rhythmuskontrollstrategien, die auf die Wiederherstellung des Sinusrhythmus abzielen. Das pathophysiologische Konzept des Vorhofflimmerns hat sich dahingehend weiterentwickelt, dass der Begriff Vorhofmyopathie definiert wurde, wobei unter anderem der entzündungsbedingte Umbau (Remodeling) des linken Vorhofs (LA) als eine Ursache und Folge der Arrhythmogenese anerkannt wird. Eines der vielen Merkmale der Vorhofmyopathie ist die Entwicklung einer Fibrose im Bereich des linken Vorhofs durch fibrös-fettige Infiltration. Dies entspricht Niederspannungszonen (LVZ), die bei invasiven elektroanatomischen Kartierungen durch eine beeinträchtigte elektrische Leitung des Myokards gekennzeichnet sind. Es hat sich gezeigt, dass epikardiales Fettgewebe (EAT) eine Schlüsselrolle in diesem entzündlichen Prozess spielt, der die Entwicklung einer linksatrialen Fibrose begünstigt. Traditionelle kardiovaskuläre Risikofaktoren verursachen die Transdifferenzierung des epikardialen Fettgewebes in Richtung eines pro-inflammatorischen Phänotyps. In letzter Zeit hat sich gezeigt, dass Antidiabetika der neuen Generation, wie z. B. Natrium-Glukose-Cotransporter-2-Inhibitoren (SGLT-2) und Glucagon-like Peptide-1 (GLP-1) Rezeptor Agonisten, eine positive Wirkung auf EAT haben, indem sie eine günstige phänotypische Verschiebung mit lokaler Entzündungshemmung und potenziellem Einfluss auf ein „reverses Remodeling“ des Vorhofs bewirken. Ziel dieser Arbeit war es, die Fähigkeit der Vorhersage von LVZ anhand von Parametern aus der kardialen Magnetresonanztomographie (CMR) zu bestätigen und die Unterschiede des Volumens des linken Vorhofs und des linksatrialen epikardialen Fettgewebes bei Vorhofflimmerpatienten mit und ohne LVZ zu beschreiben. Patienten mit Indikation zur primären Vorhofflimmerablation wurden prospektiv eingeschlossen. Zu den akquirierten CMR-Bildgebungssequenzen zählte eine LA- Angiographie und zwei verschiedene Techniken zur Darstellung des linksatrialen epikardialen Fettgewebes (T1-gewichtet und Fett-Wasser-Trennung auf DIXON-Basis). Letztere wurden miteinander verglichen. Der Volumenindex des linken Vorhofs (LAVi) und der Volumenindex des linksatrialen epikardialen Fettgewebes (LA-EATVi) aus der DIXON-basierten Bildgebung erwiesen sich als signifikante Prädiktoren für das Vorhandensein von LVZ. Für das epikardiale Fettgewebe, das mit der T1-gewichteten Bildgebung quantifiziert wurde, konnten keine signifikanten Ergebnisse erzielt werden. LA-EATVi(DIXON) war bei Patienten mit LVZ signifikant höher als bei Patienten ohne LVZ, mit einer mittleren Differenz von 10.13 ± 5.0 ml. Dasselbe konnte für LAVi gezeigt werden, mit einer mittleren Differenz von 24.46 ± 8.13 ml. Beide Parameter waren unabhängig voneinander. Außerdem konnte gezeigt werden, dass höheres Alter und weibliches Geschlecht mit dem Auftreten von LVZ assoziiert sind. Die CMR-basierte Quantifizierung von LA-EATVi(DIXON) allein oder in Kombination mit anderen prädiktiven Variablen für LVZ, wie LAVi, Alter und weiblichem Geschlecht, war in der Lage, Patienten mit niedrigem oder hohem Risiko für LVZ zu identifizieren. In der untersuchten Patientenpopulation lieferte ein kombiniertes Vorhersagemodell aus LAVi, LA-EATVi(DIXON), Alter und weiblichem Geschlecht die höchste Vorhersagekraft zur Bestimmung des Vorhandenseins von LVZ mit einer Fläche unter der Kurve (AUC) in der Grenzwertoptimierungskurve (ROC) von 0.91. Je nach Auswahl des Cutoffs für das Vorhersagemodell kann ein hoher positiver oder negativer Vorhersagewert erreicht werden, wodurch falsche Ergebnisse minimiert werden. Die klinische Umsetzung eines CMR-basierten Vorhersagemodells für das Vorhandensein von LVZ als Merkmal der LA-Myopathie könnte sich enorm auf die Behandlungsentscheidungen auswirken. Es würde die Auswahl von Patienten für schnelle und einfache Single-Shot-Ablationsverfahren bei geringem LVZ-Risiko ermöglichen, während bei Verdacht auf eine relevante LA-Myopathie komplexe und zeitaufwändigere invasive Verfahren geplant werden müssten.:1. Introduction 1 1.1. Atrial fibrillation 1 1.1.1. Risk factors 3 1.1.2. Left atrial myopathy 4 1.1.2.1. Predictive parameters of LA myopathy and atrial fibrosis 6 1.1.2.2. Imaging methods for left atrial myopathy and fibrosis 6 1.1.4. Current treatment strategies 7 1.1.4.1. Catheter ablation 9 1.2. Epicardial adipose tissue 11 1.2.1. Physiology and pathophysiology of epicardial adipose tissue 14 1.2.2. Role of epicardial adipose tissue in atrial fibrillation 15 1.2.3. Imaging techniques of epicardial adipose tissue 18 2. Objective 21 3. Methods 22 3.2. Imaging protocol 24 3.2.1. Adipose tissue imaging with DIXON approach 24 3.2.2. Adipose tissue imaging with T1 weighted imaging approach 26 3.2.3. Left atrial anatomy imaging 26 3.3. Segmentation and Quantification 27 3.4. Electroanatomic mapping and pulmonary vein isolation procedure 31 3.5. Statistical analysis 33 4. Results 34 4.2. General patient cohort characteristics 34 4.3. Patient characteristics in LVZ subgroups 36 4.4. Selected CMR parameter evaluation 39 4.4.1. Left atrial volume 39 4.4.2. Left atrial epicardial adipose tissue volume 41 4.4.2.1. DIXON based left atrial epicardial adipose tissue imaging 41 4.4.2.2. T1 weighted left atrial epicardial adipose tissue imaging 43 4.4.3. Comparison of adipose tissue imaging techniques 45 4.4.4. Reliability analysis 48 4.5. LVZ prediction models 49 4.5.1. Univariate non-CMR based LVZ prediction models 51 4.5.2. Univariate CMR based LVZ prediction models 53 4.5.3. Multivariate LVZ prediction models 57 4.5.4. Example of clinical application 62 4.5.5. Prediction model validation 64 5. Discussion 66 5.2. General aspects 66 5.3. EAT image acquisition 68 5.4. Clinical relevance 68 5.5. Future developments 70 5.6. Limitations 72 6. Summary 74 7. Zusammenfassung 76 8. References 78 9. List of figures and tables 98 10. Acknowledgement 102 11. Curriculum vitae 103

Fettvävnaden är en viktig regulator för ämnesomsättningen och uppvisar en komplex cellulär arkitektur som påverkar olika fysiologiska och patologiska processer. Dess heterogena natur är relativt ostrukturerad och består huvudsakligen av bräckliga feta adipocyter och immunceller. Dessa komplikationer försvårar studier av mikroarkitekturen - som är avgörande för att förstå dess beteende - vilket nyligen har gynnats av teknik med rumslig upplösning, som möjliggör studier av genomiska profiler samtidigt som informationen från vävnaden bevaras. I detta arbete undersöks kromatindynamiken i fettvävnad med hjälp av den nyutvecklade Spatial Assay for Transposase-Accessible Chromatin med sekvensering med hög genomströmning (Spatial ATAC-seq). Med fokus på subkutan vit fettvävnad samlades prover in från en individ som led av fetma före och fem år efter en bariatrisk operation för att studera förändringar i samband med betydande viktnedgång. Studien omfattar detaljer för både experimentella protokoll och avancerade beräkningsverktyg för dataanalys, inklusive användning av en utvecklingsversion av Semla-paketet för att integrera data om rumslig tillgänglighet och kromatintillgänglighet. Analysen visade på en mångsidig cellulär arkitektur och distinkta genomiska egenskaper i vävnaden, vilket framhävde förekomsten av specifika celltyper som AdipoLEP-liknande adipocyter och infiltrerande immunceller. Denna studie visade att det är möjligt att tillämpa Spatial ATAC-seq för att undersöka de molekylära mekanismerna i fettvävnad som ligger till grund för metabol hälsa och sjukdom, särskilt i samband med fetma och viktminskning. / Adipose tissue is a critical regulator of metabolism, exhibiting a complex cellular architecture that influences various physiological and pathological processes. Its heterogeneous nature is relatively unstructured, mainly formed by fragile fatty adipocytes and immune cells. These intricacies complicate the study of its microarchitecture – crucial for understanding its behaviour – which has recently benefitted from spatially resolved technologies, that enable the study of genomic profiles while keeping the information from the tissue. This work explores the chromatin dynamics of adipose tissue using the newly developed Spatial Assay for Transposase-Accessible Chromatin with high throughput sequencing (Spatial ATAC-seq). Focusing on subcutaneous white adipose tissue, samples were collected from an individual suffering from obesity before and five years after bariatric surgery to study changes associated with significant weight loss. The study comprises details for both experimental protocols and advanced computational tools for data analysis, including the use of a development version of Semla package to integrate spatial and chromatin accessibility data. The analysis revealed a diverse cellular architecture and distinct genomic features across the tissue, highlighting the presence of specific cell types such as AdipoLEP-like adipocytes and infiltrating immune cells. This study demonstrated the feasibility of applying Spatial ATAC-seq in investigating the molecular mechanisms of adipose tissue underlying metabolic health and disease, particularly in the context of obesity and weight loss.