Alcohol and the endocrine white adipose tissue (WAT). WAT is a dynamically active endocrine organ that produces and secretes adipokines, including hormones, growth factors, and cytokines. These factors, through autocrine, paracrine, and endocrine actions, can influence the function of many tissues and coordinate numerous important biological processes such as food intake, glucose homeostasis, lipid metabolism, and pro- and anti-inflammatory functions. Acute and moderate alcohol exposure induces an increase in circulating adiponectin levels, which is associated with decreased insulin resistance. Chronic alcohol exposure induces a decrease in adiponectin, an increase in macrophage infiltration and proinflammatory cytokine secretion (e.g., tumor necrosis factor alpha (TNFα) and interleukin-6 [IL-6]) and insulin resistance. Chronic alcohol exposure also increases the risk of fatty liver (i.e., steatosis).