Figure 1: The effects of hypoxia on adipocyte gene expression and metabolism. Low O2 leads to a stabilization of HIF-1,2α and activation of NFκB. These transcription factors increase the expression of inflammatory and angiogenic adipokines and increase expression of proteins that affect glucose uptake, glycolysis and insulin sensitivity. Inhibition of PPARγ by NFκB also leads to reduced lipogenesis and free fatty acid uptake. These metabolic changes accelerate the onset of systemic insulin resistance and the development of chronic metabolic dysfunction associated with type 2 diabetes.