Despite the advances in cardiovascular disease prevention and therapeutics, the continued increase in metabolic disorders, such as diabetes and insulin resistance, associated with the obesity epidemic has driven up total mortality rates in the US for the first time in 10 years. To address this, our research is designed to understand how we can maintain an appropriate balance of cholesterol within adipose tissue to promote functional adipose tissue expansion. We have recently found that the extracellular matrix protein, procollagen C-endopeptidase enhancer protein 2 (PCPE2) modulates adipocyte SR-BI mediated HDL uptake. We are continuing these studies to identify how cholesterol homeostasis contributes to the fibro-inflammatory phenotype characterized by unhealthy adipose expansion. Our findings will help identify novel strategies for treating metabolically driven cardiovascular heart disease and related complications.