The Role of Adipokines in Inflammatory Mechanisms of Obesity

Disrupted adipokine secretion and inflammatory responses in human adipocyte hypertrophy

Adipocyte hypertrophy is a critical contributor to obesity-induced inflammation and insulin resistance. This study employed a human adipocyte hypertrophy model to investigate the adipokine release, inflammatory responses, and the intracellular singling pathways. Hypertrophic adipocytes exhibited increased lipid content and lipolysis, a decline of anti-inflammatory adipokine adiponectin release and an increase of pro-inflammatory adipokine leptin release compared to mature adipocytes. Moreover, TNFα and LPS exacerbated the decrease in adiponectin secretion by hypertrophic adipocytes while promoting the secretion of leptin, MCP-1 and IL-6, which is associated with impaired activation of p38 and JNK MAPK and persistent activation of ERK and IκBα in hypertrophic adipocytes. These altered adipokine secretions and inflammatory responses within hypertrophic adipocytes may contribute to adipocyte dysfunction in human obesity.

MRI Measures of Fat Distribution and Risk of Cancer

BACKGROUND

Excess adiposity has been associated with an increased risk of several types of cancer. The relationship between fat tissue distribution in the body and these outcomes is less well known. Using data from the UK Biobank imaging substudy, we evaluated the prospective relationship between MRI-derived measurements of adipose tissue distribution and the risk of the major site-specific cancers associated with obesity.

METHODS

Between 2014 and 2023, MRI measurements on adipose tissue distribution and volume were obtained from 49,044 (52.2% women) cancer-free UK Biobank participants. Quantitative MRI data included volumes of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (ASAT), total abdominal fat/height squared (TAT/h2), and muscle fat infiltration (MFI). Cox proportional hazard models adjusted for cancer-specific risk factors were used to generate HRs and 95% confidence intervals.

RESULTS

Incident cancer cases of the breast (N = 179), endometrium (n = 30), colorectum (n = 145), and kidney (n = 50) were ascertained over a median follow-up of 4.5 years. In women, VAT, TAT/h2, and MFI were positively associated with a risk of postmenopausal breast cancer, and ASAT was associated with an increased risk of endometrial cancer. In men, VAT and TAT/h2 were positively associated with a risk of colorectal cancer, whereas ASAT was associated with an increased risk of kidney cancer.

CONCLUSIONS

The present study showed that increasing volumes of VAT, ASAT, and MFI were associated with cancers at specific organ sites, indicating a potential role for adipose tissue distribution in influencing cancer risk.

IMPACT

Both visceral and subcutaneous fat may have an impact on the risk of certain cancers.

Weight gain secondary to the use of oral Janus kinase inhibitors: A systematic review and meta-analysis

Oral Janus kinase inhibitors (JAKi) are increasingly used in dermatology, rheumatology, gastroenterology, and hematology. While effective, they can cause adverse effects such as acne, nausea, cytopenia, dyslipidemia, and Herpes zoster. Recent reports have linked JAKi usage to weight changes, particularly weight gain, which can significantly impact patients' quality of life. This study aimed to describe the incidence and characteristics of weight changes associated with the use of JAKi. Ovid MEDLINE, Embase, Web of Science, and Clinicaltrials.gov were searched up to April 2024. From 1080 initial articles, 90 studies covering 16,000 patients were selected. Our analysis found a notable incidence of weight gain with JAKi usage. Overall, 5.9% (947/16,000) of patients reported weight again. In randomized control trials, weight gain was observed in 7% (95% CI: 0.04; 0.09) of patients, while weight loss was observed in 1% (95% CI: 0.00; 0.03). Patients with dermatologic indications had lower weight gain rates (4%, 95% CI: 0.01; 0.06) than those with nondermatological indications (7%, 95% CI: 0.04; 0.10). Overall, JAKi therapy is associated with weight changes, particularly weight gain, underscoring the importance of appropriate counseling and weight monitoring. Further long-term studies are needed to better understand the mechanisms and management of JAKi-related weight changes.

Unraveling the Mystery of Insulin Resistance: From Principle Mechanistic Insights and Consequences to Therapeutic Interventions

Insulin resistance (IR) is a significant factor in the development and progression of metabolic-related diseases like dyslipidemia, T2DM, hypertension, nonalcoholic fatty liver disease, cardiovascular and cerebrovascular disorders, and cancer. The pathogenesis of IR depends on multiple factors, including age, genetic predisposition, obesity, oxidative stress, among others. Abnormalities in the insulin-signaling cascade lead to IR in the host, including insulin receptor abnormalities, internal environment disturbances, and metabolic alterations in the muscle, liver, and cellular organelles. The complex and multifaceted characteristics of insulin signaling and insulin resistance envisage their thorough and comprehensive understanding at the cellular and molecular level. Therapeutic strategies for IR include exercise, dietary interventions, and pharmacotherapy. However, there are still gaps to be addressed, and more precise biomarkers for associated chronic diseases and lifestyle interventions are needed. Understanding these pathways is essential for developing effective treatments for IR, reducing healthcare costs, and improving quality of patient life.

The dual role of gut microbiota in pancreatic cancer: new insights into onset and treatment

Pancreatic cancer ranks among the most lethal digestive malignancies, exhibiting a steadily increasing incidence and mortality worldwide. Despite significant advances in cancer research, the 5-year survival rate remains below 10%, predominantly due to delayed diagnosis and limited therapeutic options. Concurrently, the gut microbiota-an integral component of host physiology-has emerged as a crucial player in the pathogenesis of pancreatic cancer. Mounting evidence indicates that alterations in gut microbial composition and function may influence tumor initiation, progression, and response to therapy. This review provides an in-depth examination of the intricate interplay between the gut microbiome and pancreatic cancer, highlighting potential diagnostic biomarkers and exploring microbiome-targeted therapeutic strategies to improve patient outcomes.

Obesity Class and Severity of Metabolic Emergencies: A Single-Center Retrospective Five-Year Study

Background/Objectives: This study aims to investigate the impact of obesity severity on the prevalence and outcomes of acute metabolic emergencies in the emergency department (ED) setting, with a specific focus on obesity class stratification and associated metabolic complications. Methods: This retrospective, single-center study analyzed data from 433 patients admitted to the ED of the Timisoara Municipal Emergency Hospital between January 2019 and March 2024. Patients were classified according to WHO obesity grades (Class I: BMI 30.0-34.9 kg/m2, Class II: 35.0-39.9 kg/m2, Class III: ≥ 40.0 kg/m2). The prevalence and severity of metabolic emergencies, including hyperglycemic crises, acute kidney injury (AKI), and severe electrolyte imbalances, were compared across obesity classes. Results: Obese patients (37.2%) exhibited a significantly higher prevalence of metabolic emergencies than non-obese individuals (p < 0.001). Hyperglycemia was present in 27.9% of obese patients vs. 11.0% of non-obese patients (p < 0.001). AKI incidence nearly doubled in obese patients (12.4% vs. 5.5%, p = 0.01). Logistic regression identified Class III obesity as an independent risk factor for metabolic emergencies (adjusted OR = 3.2, 95% CI: 2.1-4.9, p < 0.001). Conclusions: The severity of metabolic emergencies increases with increasing obesity class, emphasizing the need for obesity-specific risk stratification in ED settings. Routine monitoring of metabolic markers and early intervention strategies should be prioritized for high-risk obese patients.

Potential Therapeutic Exploitation of G Protein-Coupled Receptor 120 (GPR120/FFAR4) Signaling in Obesity-Related Metabolic Disorders

The increasing prevalence of overweight and obesity not only in adults but also among children and adolescents has become one of the most alarming health problems worldwide. Metabolic disorders accompanying fat accumulation during pathological weight gain induce chronic low-grade inflammation, which, in a vicious cycle, increases the immune response through pro-inflammatory changes in the cytokine (adipokine) profile. Obesity decreases life expectancy, largely because obese individuals are at an increased risk of many medical complications, often referred to as metabolic syndrome, which refers to the co-occurrence of insulin resistance (IR), impaired glucose tolerance, type 2 diabetes (T2D), atherogenic dyslipidemia, hypertension, and premature ischemic heart disease. Metabotropic G protein-coupled receptors (GPCRs) constitute the most numerous and diverse group of cell surface transmembrane receptors in eukaryotes. Among the GPCRs, researchers are focusing on the connection of G protein-coupled receptor 120 (GPR120), also known as free fatty acid receptor 4 (FFAR4), with signaling pathways regulating the inflammatory response and insulin sensitivity. This review presents the current state of knowledge concerning the involvement of GPR120 in anti-inflammatory and metabolic signaling. Since both inflammation in adipose tissue and insulin resistance are key problems in obesity, there is a rationale for the development of novel, GPR120-based therapies for overweight and obese individuals. The main problems associated with introducing this type of treatment into clinical practice are also discussed.

Frozen Shoulder as a Metabolic and Immune Disorder: Potential Roles of Leptin Resistance, JAK-STAT Dysregulation, and Fibrosis

Frozen shoulder (FS) is a complex and multifactorial condition characterized by persistent inflammation, fibrosis, and metabolic dysregulation. Despite extensive research, the underlying drivers of FS remain poorly understood. Recent findings indicate the coexistence of pro-inflammatory and fibrosis-resolving macrophages within affected tissues, suggesting a dysregulated immune response influenced by metabolic and neuroendocrine factors. This review proposes that leptin resistance, a hallmark of metabolic syndrome and chronic inflammation, may play a central role in FS pathogenesis by impairing macrophage polarization, perpetuating inflammation, and disrupting fibrosis resolution. The JAK-STAT signaling pathway, critically modulated by leptin resistance, may further contribute to immune dysregulation by sustaining inflammatory macrophage activation and interfering with tissue remodeling. Additionally, FS shares pathogenic features with fibrotic diseases driven by TGF-β signaling, mitochondrial dysfunction, and circadian disruption, further linking systemic metabolic dysfunction to localized fibrotic pathology. Beyond immune and metabolic regulation, alterations in gut microbiota, bacterial translocation, and chronic psychosocial stress may further exacerbate systemic inflammation and neuroendocrine imbalances, intensifying JAK-STAT dysregulation and leptin resistance. By examining the intricate interplay between metabolism, immune function, and fibrotic remodeling, this review highlights targeting leptin sensitivity, JAK-STAT modulation, and mitochondrial restoration as novel therapeutic strategies for FS treatment. Future research should explore these interconnections to develop integrative interventions that address both the metabolic and immune dysregulation underlying FS, ultimately improving clinical outcomes.

Mechanism of PI3K/Akt‑mediated mitochondrial pathway in obesity‑induced apoptosis (Review)

Obesity is a pervasive global health challenge that substantially reduces the quality of life of millions of individuals and impedes social and economic advancement. Obesity is an independent risk factor that contributes to a range of chronic non-communicable metabolic diseases, significantly affecting energy metabolism, mental health, cancer susceptibility, sleep quality, and other physiological processes. The PI3K/AKT signaling pathway, a significant glucose, lipid, and protein metabolism regulator, is integral to cellular growth, survival, and apoptosis. Apoptosis is a highly regulated form of programmed cell death that is critical for immune cell maturation and tissue repair. The present review examines the association between obesity, the PI3K/AKT pathway, and mitochondrial apoptosis to elucidate the potential mechanisms by which obesity may activate apoptotic pathways. These findings provide a theoretical foundation for mitigating obesity-related complications by targeting these critical pathways.

Olea europaea L. cv. Nepal Leaf Extract Alleviates Dyslipidemia and Inflammation Related to Obesity in Rabbits: A Network Pharmacology Approach Revealing Effective Antihyperlipidemic Bioactive Compounds

The current study investigated the effects of Olea europaea L. cv. Nepal (OEN) leaf extract on obesity-related disorders in rabbits. OEN extract, in dose 100 mg/kg body weight, significantly reduced cholesterol (TC), triglycerides (TAG), and inflammatory markers (MCP-1, VCAM-1, IL-6, IL-1β, TNFα, NF-κB) in both preventative and treatment groups. In addition, heart tissue displayed near-normal collagen fiber distribution. LC-HRESIMS analysis tentatively identified 20 metabolites (1-20) in OEN, including lignans, secoiridoids, and triterpenoids. Network pharmacology analysis suggested 8-hydroxy-p-menth-1-en-7-oic-acid (13), 6,7-dihydroxy-2H-1-benzopyran-2-one 6-O-d-glucopyranoside (5), and 3-hydroxy-12-oleanen-28-oic-acid (20) as key antihyperlipidemic compounds, potentially targeting pathways involved in hyperlipidemia regulation. Furthermore, in silico studies revealed that lignans (compounds 1, 2, and 16) from OEN may bind and inhibit HMG-CoA reductase, a crucial enzyme in cholesterol metabolism. These results indicate the potential of using OEN leaf extract as a therapeutic strategy for managing hyperlipidemia and inflammation associated with obesity. More investigation is necessary to confirm and validate these results and explore the extract's full therapeutic potential.

Advances in Metabolic Bariatric Surgeries and Endoscopic Therapies: A Comprehensive Narrative Review of Diabetes Remission Outcomes

Background and Objectives: Type 2 diabetes (T2D), closely associated with obesity, contributes to increased morbidity and mortality due to complications such as cardiometabolic disease. This review aims to evaluate the effectiveness of metabolic and bariatric surgeries (MBS) and endoscopic bariatric therapies (EBTs) in achieving diabetes remission and to examine key predictors influencing remission outcomes. Materials and Methods: This review synthesizes data from studies on MBS and EBT outcomes, focusing on predictors for diabetes remission such as preoperative insulin use, diabetes duration, HbA1c, and C-peptide levels. Additionally, predictive scoring systems, including the Individualized Metabolic Surgery (IMS), DiaRem, Advanced-DiaRem, ABCD, and Robert et al. scores, were analyzed for their utility in forecasting remission likelihood. Results: Key predictors of T2D remission include shorter diabetes duration, lower HbA1c, and higher C-peptide levels, while prolonged insulin use, and higher insulin doses are associated with lower remission rates. Scoring models like IMS and DiaRem demonstrate that lower scores correlate with a higher likelihood of remission, especially for procedures such as Roux-En-Y gastric bypass (RYGB). RYGB generally shows higher remission rates compared to sleeve gastrectomy (SG), particularly among patients with mild disease severity, while EBTs like ESG and IGBs contribute 5-20% total weight loss (TWL) and moderate glycemic control improvements. Conclusions: Both MBS and EBTs are effective for T2D management, with predictive scoring models aiding in individualized patient selection to optimize remission outcomes. Further research to validate these predictive tools across diverse populations could enhance treatment planning for both surgical and endoscopic interventions.

Evaluating Anti-Diabetic Effect of Courmarin Derivative Aesculetin in Rats with Diet-Induced Obesity

Obesity, modifiable and an avertable medical condition, has become a global threat due to rapid modernization and industrialization. Swift growth in modernization not only eases the day-to-day life, it also mandates sedentary lifestyle, which leads to various noncommunicable diseases. At present one in eight people in global population are obese, and these booming obese individuals are prone to various other micro- and macrovascular diseases such hyperglycemia, myocardial infraction, hypertension, stroke, and so forth. Ample research had unveiled an intricate association perceived between obesity and Type 2 diabetes mellitus pathogenesis. Although the intake of anti-obesity drugs along with anti-diabetic drugs had effectively regulated the hyperglycemic conditions in diabetic patients, it causes various side effects on long-term usage. Coumarins are phytochemicals that have demonstrated pharmacological properties including anti-inflammatory, antioxidant, anti-tumor, and so forth. In this analysis, we assessed anti-obesity and anti-diabetic potency of aesculetin, a courmarin derivative. The rats were induced obesity with high-fat diet and subjected to streptozotocin infusion to induce hyperglycemia. Obese diabetic induced rats were treated with aesculetin and assessed for its anti-diabetic effect. BMI were assessed in the rats to analyze the anti-obesity effect of aesculetin. Diabetic profile test and lipid profile test were performed to evaluate the anti-diabetic effect of aesculetin. Ameliorative effect of aesculetin in obese rats during hyperglycemic conditions was assessed with renal profile test, hepatic function biomarkers, and by histopathological analysis of cardiac tissue. The anti-inflammatory and antioxidant property were also assessed to determine the mechanism of action of aesculetin. To confirm the anti-obesity potency of aesculetin, adipokines levels were estimated. Aesculetin eminently decreased the BMI, HbA1c, cholesterol levels, and intensified secretion of insulin in obese diabetic rats. It also regulated the renal, hepatic functional markers and prevented cardiac tissue injury in obese diabetic rats. It regulated the adipokines, increased antioxidants, and decreased level of proinflammatory cytokines, thereby prevented obesity-induced hyperglycemic effects in rats. To conclude, our findings had confirmed the supplementary intake of aesculetin prevents obesity-induced hyperglycemic disorder in rats.

Obesity as a Risk Factor for Hyperglycemia, Electrolyte Disturbances, and Acute Kidney Injury in the Emergency Department

Background/Objectives: Obesity is a global health challenge linked to a higher risk of metabolic and cardiovascular complications. This study investigates the role of cardiovascular markers in predicting metabolic crises in obese patients, focusing on the prevalence and clinical implications of these markers. Methods: This retrospective cohort study included 433 patients presenting with metabolic crises at the Emergency Department of Timișoara Municipal Emergency Hospital between 2019 and 2024. Patients were classified into obese (n = 161) and non-obese (n = 272) groups, with obesity further stratified into four grades based on body mass index (BMI). Cardiovascular markers, including NT-proBNP, troponin I, CRP, CK-MB, and D-dimer, alongside metabolic parameters, were analyzed. Results: Metabolic crises were significantly more prevalent in obese patients in all metabolic emergencies: hyperglycemia (27.9% vs. 11.0%, p < 0.001), electrolyte imbalance (23.6% vs. 9.2%, p < 0.001), and acute kidney injury (AKI) (12.4% vs. 5.5%, p = 0.01). NT-proBNP levels independently predicted AKI in obese patients (adjusted OR: 1.14 per 1000 pg/mL, 95% CI: 1.10-1.19, p < 0.001), with excellent discriminatory power (AUC: 0.88). Troponin I and D-dimer were higher in hyperglycemia and electrolyte imbalance, respectively, emphasizing the role of cardiac stress and pro-thrombotic states. Inflammatory markers such as CRP were significantly associated with metabolic disturbances, supporting the contribution of systemic inflammation. Comorbidities, particularly heart failure and atrial fibrillation, further increased the risk of metabolic crises. Conclusions: Cardiovascular markers suggest potential utility for early risk stratification of metabolic crises in obese patients. However, further studies are needed to validate their clinical applicability and to establish standardized approaches for integrating these biomarkers into routine practice, especially in patients with advanced obesity grades.

Improvement of measured and perceived disability in overweight patients with Multiple Sclerosis trough different patterns of Mediterranean hypocaloric diet

OBJECTIVES

overweight and other cardiovascular risk factors are known contributors to disability accrual in Multiple Sclerosis (MS). We aimed to explore the impact of three hypocaloric dietetic patterns, based on the Mediterranean diet, on cardiovascular risk and clinical status in overweight persons with MS (pwMS).

MATERIAL AND METHODS

overweight pwMS (body mass index-BMI ≥25 kg/m2) were prospectively enrolled, randomly allocated to three hypocaloric dietetic plans differing in macronutrients composition (carbohydrates/proteins/lipids: diet A 65 %/15 %/20 %; diet B 35 %/25 %/40 %; diet C 50 %/20 %/30 %) and followed-up for 1 year (6 months of dietetic intervention + 6 months of observation). The Multiple Sclerosis Performance Test, a self-administered, iPad®-based system for quantifying cognition, upper and lower extremity motor function, and vision was performed at baseline, 6 and 12 months. Questionnaires for the evaluation of sleep quality, fatigue, anxiety, depression, stigma, social participation and satisfaction were administered. Information about cardiovascular risk parameters (BMI, waist circumference-WC, umbilical circumference-UC, hip circumference-HP, blood pressure, HDL and LDL cholesterol, triglycerides, glycemia) were collected. Adherence to the dietetic plan was quantified as days of complete to insufficient adherence across the treatment period. Between-group comparisons were performed with Chi-square and ANOVA; longitudinal analyses with one-way ANOVA for repeated measures and mixed-design ANOVA.

RESULTS

fifty-three patients completed the study (diet A n = 19, diet B n = 18, diet C n = 16). The three groups were well matched for sex, age, disease duration and EDSS. Along the 6 months of dietetic intervention, no difference in adherence was detected across the three dietetic plans (p = 0.84). Overall, patients showed a significant weight loss over time (p < 0.001) with no difference across diets (p = 0.34). BMI, WC, UC, HC and cholesterol improved over time (p ranging from 0.06 to 0.001), with no differences across diets (p ranging from 0.16 to 0.58). Among all tested clinical variables, fatigue, anxiety, information processing speed and manual dexterity improved significantly (p = 0.005, p = 0.012, p = 0.013, p = 0.005), with no differences across diets (p = 0.84, p = 0.89, p = 0.53, p = 0.72).

CONCLUSION

dietetic interventions in overweight pwMS, irrespective of their specific macronutrients composition, are able to improve the cardiovascular profile, the perception of subjective symptoms as well as objective disability scores.

Obesity-related indices are associated with self-reported infertility in women: findings from the National Health and Nutrition Examination Survey

OBJECTIVE

Obesity can contribute to infertility, but the exact relationship between infertility risk and obesity-related measurements like waist-to-height ratio (WHtR), body roundness index (BRI), conicity index (CoI), and A body shape index (ABSI) in women is uncertain. We investigated the association between these indices and female infertility.

METHODS

In this cross-sectional study, we used National Health and Nutrition Examination Survey data (2013-2018). We used weighted multivariable logistic regression analysis, receiver operating characteristic (ROC) curves, and subgroup analysis, as well as propensity score matching.

RESULTS

Among 3373 participants, 344 (10.2%) reported infertility. A significant link between higher infertility risk and increased WHtR, BRI, CoI, ABSI, and body mass index (BMI) was found. Multivariable logistic regression analysis showed WHtR (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.14-1.42), BRI (OR = 1.09, 95% CI: 1.05-1.14), CoI (OR = 1.36, 95% CI: 1.18-1.56), ABSI (OR = 1.22, 95% CI: 1.12-1.33), and BMI (OR = 1.03, 95% CI: 1.02-1.05) were significantly associated with female infertility. CoI had the best diagnostic performance (area under the ROC curve 0.628, 95% CI: 0.597-0.658).

CONCLUSIONS

Obesity-related indices were positively linked to infertility risk among women in the United States. These indices serve as valuable tools for assessing female infertility risk.

Unraveling the role of muscle mass and strength in predicting type 2 diabetes risk: a systematic review

INTRODUCTION

Skeletal muscle is the largest insulin-sensitive tissue in the human body, alteration in muscle mass and strength substantially impact glucose metabolism. This systematic review aims to investigate further the relationship between muscle mass and strength towards type 2 diabetes mellitus (T2DM) incidence.

METHODS

This systematic review included cohort studies that examinedthe relationship between muscle mass and/or muscle strength on T2DM incidence. A comprehensive search was conducted across PubMed, EBSCO, ProQuest, and Google scholar employing specific Medical Subject Headings (MeSH) and relevant keywords related to or synonymous with "muscle mass", "muscle strength", and "Type 2 Diabetes Mellitus incidence".

RESULTS

Twenty-five cohort studies were included, 11 studies on muscle mass and 16 studies on muscle strength. Participants included were 278,475 for muscle mass and 400,181 for muscle strength. Skeletal muscle mass normalized to body weight (SMM/BW), appendicular skeletal musce mass normalized to body weight (ASM/BW), and handgrip strength normalized to body mass index (HGS/BMI) consistently demonstrate significant inverse association with T2DM even after sex and/or BMI stratification. Handgrip strength normalized to body weight (HGS/BW) demonstrates a strong inverse association with T2DM incidence, however, adiposity should be considered.

CONCLUSION

Muscle mass and strength demonstrate strong association with T2DM incidence. Adiposity, a key T2DM risk factor, should also be assessed through a simple BMI or a sophisticated technique with BIA or CT-scan. The combination of muscle variables and adiposity could further enhance T2DM risk assessment. However, T2DM risks are multifactorial, with various contributing factors, further large-scale studies are needed to validate these findings.

Body Mass Index is Not an Appropriate Proxy for the Condition of Peri-Incisional Adiposity in Primary Total Joint Arthroplasty Patients

BACKGROUND

The American Academy of Orthopaedic Surgeons defined the acceptable threshold for elective safe surgery as a body mass index (BMI) under 40 due to the increased risk of complications. A consequence of this recommendation has been a hard cutoff based on BMI, which restricts access to care for an increasingly large and diverse population. There is an improved understanding that excess adipose tissue confers additional risk for postoperative complications, including infection, through mechanical and physiologic mechanisms. But, it is unclear if BMI is an accurate indicator of adiposity in total joint arthroplasty (TJA) patients and, thus, whether BMI is capturing clinically relevant information in obese patients. Our objective was to determine the relationship between peri-incisional adiposity (PIA) and BMI in a consecutive series of diverse primary TJA patients.

METHODS

A consecutive series of patients indicated for primary TJA were preoperatively evaluated. For each patient, the following variables were collected: BMI and measures of PIA on radiographs and ultrasounds.

RESULTS

In THA patients (N = 99), Pearson's correlation coefficient (r) = 0.436, which indicates a moderate correlation between BMI and adiposity. In total knee arthroplasty patients (N = 271), r = 0.395 for femoral PIA (FPIA) and r = 0.249 for tibial PIA, which indicates a weak correlation between BMI and adiposity measured on radiography. In total knee arthroplasty patients, r = 0.560 for femoral PIA and r = 0.544 for tibial PIA, which indicates a moderate correlation between BMI and adiposity measured on ultrasound.

CONCLUSIONS

Quantification of obesity has become a common practice in the preoperative evaluation of primary TJA patients. The intent is to determine the magnitude of adipose tissue, which is one of the main drivers of postoperative complications in obesity. The BMI is ubiquitously used as a proxy for obesity due to its simplicity of attainment and calculation. We report that BMI has a weak-to-moderate association with PIA in this population. These findings indicate that BMI may not accurately represent the condition of peri-incisional adipose tissue and, thus, is not capturing the relevant obesity data for preoperative risk stratification in primary TJA patients.

LEVEL OF EVIDENCE

III.

Analysis of the relationship between resistin with prognosis, cell migration, and p38 and ERK1/2 activation in breast cancer

Obesity increases the risk and mortality of breast cancer through dysregulated secretion of proinflammatory cytokines and tumor adipokines that induce an inflammatory breast microenvironment. Resistin is an adipokine secreted by adipocytes, immune cells, and predominantly macrophages, which contributes to cancer progression, but its molecular mechanism in cancer is not completely described. In this study, we analyzed the relationship of resistin on breast cancer prognosis and tumor progression and the effect in vitro of resistin on p38 and ERK1/2 activation in breast cancer cell lines. By bioinformatic analysis, we found that resistin is overexpressed in the basal subtype triple-negative breast cancer and is related to poor prognosis. In addition, we demonstrated a positive correlation between RETN and MAPK3 expression in basal triple-negative breast cancer. Importantly, we found amplifications of the RETN gene in at least 20 % of metastatic samples from patients with breast cancer. Most samples with RETN amplifications metastasized to bone and showed high expression of IL-8 (CXCL8) and IL-6 (IL6). Finally, resistin could be considered a prognostic marker for basal triple-negative breast cancer, and we also proposed the possibility that resistin-induced cell migration involves the activation of MAPK in breast cancer cells.

Sustainable utilization of bovine adipose tissue derivatives as robust antimicrobial agents against Methicillin-resistant Staphylococcus aureus

BACKGROUND

The excessive use of antibiotics is a major contributor to the global issue of antimicrobial resistance (AMR), a significant threat to human and animal health. Hence, assessing new strategies for managing Multi-Drug Resistant (MDR) microorganisms is vital. In this study, the use of mechanically isolated mature adipose cells (MIMACs) and their lysate (Adipolysate) as a new sustainable antimicrobial agent was assessed against Methicillin-resistant Staphylococcus aureus (MRSA).

CONCLUSIONS

The minimum volume of MIMACs achieved complete bacterial inhibition (Minimum Lethal volume) was 75 µl and 100 µl for bacterial concentration of 1010 and 1012 cfu/ml, respectively. Direct bacterial membrane attachment and intracellular capture was visualized under light and electron microscopy. Adipolysate was characterized via GC-MS, the fatty acid profile demonstrated several components with known antimicrobial properties. The tested Adipolysate revealed inhibition zone of diameter 25.33 ± 0.88 mm against the tested S. aureus strain, compared with the inhibition zone of Vancomycin (24.0 ± 0.00 mm) and Erythromycin (30.0 ± 0.00). The study revealed the potential effects of MIMACs and Adipolysate as sustainable, natural, and robust antimicrobial agents. However, these preliminary results will be further investigated to understand the mechanism of action and explore possible applications in various fields.

Hallmarks of Appetite: A Comprehensive Review of Hunger, Appetite, Satiation, and Satiety

PURPOSE OF REVIEW

The present review describes the available literature on the physiologic mechanisms that modulate hunger, appetite, satiation, and satiety with a particular focus on well-established and emerging factors involved in the classic satiety cascade model.

RECENT FINDING

Obesity is a significant risk factor for numerous chronic conditions like cancer, cardiovascular diseases, and diabetes. As excess energy intake is considered by some to be the primary driver of weight gain, tremendous collective effort should be directed toward reducing excessive feeding at the individual and population levels. From this perspective, detailed understanding of physiologic mechanisms that control appetite, and in turn, the design of effective interventions to manage appetite, may represent key strategies in controlling the obesity epidemic. With the obesity's prevalence on the rise worldwide, research on hunger, appetite, satiation and satiety is more relevant than ever. This research aims to provide practical insights for medical practitioners, nutrition professionals, and the broader scientific community in the fight against this global health challenge.

Metabolic Dysfunction-Associated Steatotic Liver Disease: Pathogenetic Links to Cardiovascular Risk

Metabolic dysfunction-associated steatotic liver disease (MASLD) is correlated with an increased cardiovascular risk, independent of other traditional risk factors. The mechanisms underlying this pathogenic link are complex yet remain incompletely elucidated. Among these, the most significant are visceral adiposity, low-grade inflammation and oxidative stress, endothelial dysfunction, prothrombotic status, insulin resistance, dyslipidemia and postprandial hyperlipemia, gut dysbiosis, and genetic mutations. Cardiovascular diseases are the leading cause of death in patients with MASLD. These patients have an increased incidence of coronary artery disease, carotid artery disease, structural and functional cardiac abnormalities, and valvulopathies, as well as arrhythmias and cardiac conduction disorders. In this review, we present the latest data on the association between MASLD and cardiovascular risk, focusing on the pathogenic mechanisms that explain the correlation between these two pathologies. Given the high rates of cardiovascular morbidity and mortality among patients with MASLD, we consider it imperative to raise awareness of the risks associated with this condition within the general population. Further research is essential to clarify the mechanisms underlying the increased cardiovascular risk linked to MASLD. This understanding may facilitate the identification of new diagnostic and prognostic biomarkers for these patients, as well as novel therapeutic targets.

Obesity and recurrent spontaneous abortion: the crucial role of weight management in pregnancy

Recurrent spontaneous abortion (RSA), characterized by the loss of two or more pregnancies, impacts approximately 1-2% of couples and poses a significant challenge for individuals of childbearing age. The precise mechanisms underlying RSA remain incompletely understood. Concurrently, the global prevalence of obesity is on the rise, with obesity being closely associated with female reproductive disorders and infertility. This study initially examines the pathways through which obesity contributes to RSA, encompassing factors such as embryonic euploid miscarriage, endometrial development, immune function, among others. Furthermore, adipokines and the fat mass and obesity-related (FTO) are identified as potential contributors to RSA. The study also explores the enhancement of pregnancy outcomes through various weight management strategies, with a particular focus on the roles of dietary interventions, physical activity, and weight control during pregnancy. Obesity is closely related to RSA in multiple aspects. Additional clinical prospective and experimental studies are required to explore its precise pathogenesis. Through this review, we aim to provide strategies for improvement and treatment approaches for RSA related to obesity. Through this review, we suggest potential clinical management strategies and research avenues aimed at offering enhancements and therapeutic insights for miscarriages linked to obesity and its associated risk factors.

Exploring How Adipose Tissue, Obesity, and Gender Influence the Immune Response to Vaccines: A Comprehensive Narrative Review

Vaccines represent an essential tool for the prevention of infectious diseases. Upon administration, a complex interaction occurs between the vaccine formulation and the recipient's immune system, ultimately resulting in protection against disease. Significant variability exists in individual and population responses to vaccination, and these differences remain the focus of the ongoing research. Notably, well-documented factors, such as age, gender, and genetic predisposition, influence immune responses. In contrast, the effects of overweight and obesity have not been as thoroughly investigated. The evidence indicates that a high body mass index (BMI) constitutes a significant risk factor for infections in general, with adipose tissue playing a crucial role in modulating the immune response. Furthermore, suboptimal levels of vaccine seroconversion have been observed among individuals with obesity. This review provides a plausible examination of the immunity and protection conferred by various vaccines in individuals with an overweight status, offering a comprehensive analysis of the mechanisms to enhance vaccination efficiency.

Kidney and gallbladder stones and the risk of prostate cancer: Results from the EPICAP study

BACKGROUND

Prostate cancer remains the most frequent cancer among men, representing a significant health burden. Despite its high morbidity and mortality rates, the etiology of prostate cancer remains relatively unknown, with only non-modifiable established risk factors. Chronic inflammation has emerged as a potential factor in prostate carcinogenesis. We investigated the role of kidney and gallbladder stones and the risk of prostate cancer.

METHODS

We used data from EPICAP, a population-based case-control study. A total of 819 diagnosed prostate cancer cases and 879 controls were face-to-face interviewed using a standardized questionnaire that collected information on personal medical history, including history of kidney and gallbladder stones. Odds Ratios (OR) and their 95% confidence interval (CI) were estimated using multivariate unconditional logistic regression.

RESULTS

Our study revealed intriguing patterns regarding kidney and gallbladder stones in relation to prostate cancer risk. The analysis indicated significant potential associations between kidney stones and the risk of prostate cancer (OR: 1.46 95% CI: 1.13-1.90), particularly in men with a history of kidney infection. Additionally, our data suggested a possible relationship between gallbladder stones and prostate cancer when considering triglyceride (OR: 2.27, 95% CI: 0.99-5.28), although further research is needed for a conclusive understanding.

CONCLUSIONS

Our results suggest an association between calculi and the risk of prostate cancer. Findings from this study underscore the need for a more comprehensive investigation to understand the role of chronic inflammation or metabolism and delineate the mechanisms underlying these potential associations in order to guide the development of targeted preventive strategies for aggressive prostate cancer.

The Influence of Body Composition, Lifestyle, and Dietary Components on Adiponectin and Resistin Levels and AR Index in Obese Individuals

Adipose tissue of obese people secretes a number of adipokines, including adiponectin and resistin, which have an antagonistic effect on the human metabolism, influencing the pathogenesis of many diseases based on low-grade inflammation. Body composition analysis using bioelectrical impedance analysis (BIA) was performed in 84 adults with obesity, i.e., body mass index (BMI) greater than or equal to 30 kg/m2. Serum was collected to analyze the concentration of adiponectin (ApN) and resistin. The subjects additionally completed a food frequency questionnaire FFQ-6 and a three-day food diary. Adiponectin-resistin index (AR index) was calculated. The results show a positive correlation between resistin levels and BMI and subcutaneous fat content. AR index value was also positively associated with the amount of adipose tissue and body mass. Adiponectin level in the serum of the studied individuals decreased with the content of lean tissue. Adiponectin level also decreased with the amount of carbohydrates, amount of starch, and glycemic load of the diet. Resistin decreased in patients who frequently consumed white pasta and red meat, while AR index was positively associated with the amount of white rice and saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) consumed but negatively associated with the frequent consumption of carbohydrates, including starch. Physical activity was negatively correlated with adiponectin levels and AR index. We concluded that body composition significantly influenced serum resistin and adiponectin concentrations the AR index. Dietary components also had a significant effect.

The Interplay Between Adipokines and Body Composition in Obesity and Metabolic Diseases

The worldwide health system faces challenges from obesity and related metabolic disorders because they exhibit both rising rates of occurrence and intricate pathophysiological mechanisms. This work examines how adipokines interact with body composition during obesity to control important metabolic functions. Bioactive molecules produced by adipose tissue function as adipokines which regulate essential biological pathways that control inflammation response and insulin sensitivity alongside energy balance management and immune system operation. The disruption of adipokine secretion and function leads directly to metabolic disorders which include insulin resistance and persistent inflammation characteristic of obesity-related conditions. This article investigates the therapeutic possibilities of adipokine pathway manipulation through new pharmacological approaches and lifestyle changes alongside personalized medicine developments. Researchers analyze adipokines as important biomarkers for patient disease classification and their application in creating individualized treatment plans. The review highlights existing research deficiencies and obstacles that stand in the way of applying adipokine discoveries to clinical settings. This article integrates existing research to show how adipokine regulation helps prevent obesity-related metabolic issues and suggests directions for future studies to enhance treatment results.

Adiponectin as a biomarker in liver cirrhosis-A systematic review and meta-analysis

INTRODUCTION

Adiponectin, a key adipokine, shows promise as a non-invasive biomarker for liver cirrhosis by reflecting inflammation and metabolic changes, but conflicting findings highlight the need for a systematic review and meta-analysis to clarify its role. Our study aimed to evaluate adiponectin levels across various stages of liver cirrhosis, compare them with other chronic liver diseases (CLD) and hepatocellular carcinoma (HCC), and assess its potential as a diagnostic and prognostic biomarker.

METHODS

Our systematic search was conducted on September 2023 using PubMed, EMBASE and Scopus, searching for observational studies evaluating serum and plasma adiponectin levels in liver cirrhosis. Inclusion and exclusion criteria were applied, and study quality was assessed using the Newcastle-Ottawa Scale. To evaluate the overall effect size, we utilized a random-effects model along with a mean difference (MD) analysis. The principal summary outcome was the MD in adiponectin levels.

RESULTS

We included 16 articles involving 2617 subjects in our qualitative and quantitative synthesis. We found significantly higher adiponectin levels in liver cirrhosis patients (8.181 [95% CI 3.676, 12.686]), especially in Child-Pugh B individuals (13.294 [95% CI 4.955, 21.634]), compared to controls. Child-Pugh A patients did not show significant differences compared to controls. In addition, adiponectin levels were significantly elevated in primary biliary cholangitis (PBC) patients compared to controls (8.669 [95% CI .291, 17.047]), as well as in liver cirrhosis compared to other CLD patients (4.805 [95% CI 1.247, 8.363]), including non-alcoholic fatty liver disease (NAFLD) (8.532 [95% CI 3.422, 13.641]), but not viral hepatitis. No significant MD was observed between liver cirrhosis and HCC patients.

CONCLUSION

Adiponectin levels are significantly elevated in liver cirrhosis, especially in advanced stages, potentially serving as a biomarker for advanced cirrhosis. Adiponectin also differentiates cirrhosis from other CLD, including NAFLD. However, its role in distinguishing cirrhosis from viral hepatitis and HCC is limited.

The interplay of factors in metabolic syndrome: understanding its roots and complexity

Metabolic syndrome (MetS) is an indicator and diverse endocrine syndrome that combines different metabolic defects with clinical, physiological, biochemical, and metabolic factors. Obesity, visceral adiposity and abdominal obesity, dyslipidemia, insulin resistance (IR), elevated blood pressure, endothelial dysfunction, and acute or chronic inflammation are the risk factors associated with MetS. Abdominal obesity, a hallmark of MetS, highlights dysfunctional fat tissue and increased risk for cardiovascular disease and diabetes. Insulin, a vital peptide hormone, regulates glucose metabolism throughout the body. When cells become resistant to insulin's effects, it disrupts various molecular pathways, leading to IR. This condition is linked to a range of disorders, including obesity, diabetes, fatty liver disease, cardiovascular disease, and polycystic ovary syndrome. Atherogenic dyslipidemia is characterized by three key factors: high levels of small, low-dense lipoprotein (LDL) particles and triglycerides, alongside low levels of high-density lipoprotein (HDL), the "good" cholesterol. Such a combination is a major player in MetS, where IR is a driving force. Atherogenic dyslipidemia contributes significantly to the development of atherosclerosis, which can lead to cardiovascular disease. On top of that, genetic alteration and lifestyle factors such as diet and exercise influence the complexity and progression of MetS. To enhance our understanding and consciousness, it is essential to understand the fundamental pathogenesis of MetS. This review highlights current advancements in MetS research including the involvement of gut microbiome, epigenetic regulation, and metabolomic profiling for early detection of Mets. In addition, this review emphasized the epidemiology and fundamental pathogenesis of MetS, various risk factors, and their preventive measures. The goal of this effort is to deepen understanding of MetS and encourage further research to develop effective strategies for preventing and managing complex metabolic diseases.

Evaluation of Selected Pro- and Anti-Inflammatory Adipokines in Colostrum from Mothers with Gestational Diabetes Mellitus

Adipokines related to gestational diabetes mellitus (GDM) are an emerging area of interest. The aim of this study was to evaluate the associations between GDM and adipokine levels in human milk. This was an observational cohort study targeting mothers with gestational diabetes, which evaluated the association of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment), with colostral adipokines involved in pro- and anti-inflammatory processes. Colostrum was collected from hyperglycemic (N = 34) and normoglycemic (N = 26) mothers, and adipokine levels were determined by immunoenzymatic assay. Among anti-inflammatory adipokines, only for irisin and vaspin, but not for obestatin and adropin, were significantly different levels noted between the GDM-G1, GDM-G2 and non-GDM cohorts. Colostrum of the GDM-G2 subgroup contained more vaspin (4.77 ng/mL) than that of normoglycemic mothers (3.12 ng/mL) and more irisin (26.95 μg/mL) than in the GDM-G1 subgroup (17.59 μg/mL). The levels of pro-inflammatory adipokines, namely, dermcidin, chemerin and visfatin, were at similar levels irrespective of maternal glycemia. Moreover, irisin showed a negative correlation with dermcidin in GDM-G2 and non-GDM cohorts. Associations were observed between colostral irisin and maternal preconception BMI, dermcidin and gestational age, and vaspin and maternal age. This study provides evidence that the way of restoring glucose homeostasis in pregnant women has an impact on the anti-inflammatory adipokines irisin and vaspin, but not on obestatin and adropin. GDM, regardless of severity, did not influence the colostral pro-inflammatory adipokines visfatin, chemerin and dermcidin.

The Interplay of Systemic Inflammation and Oxidative Stress in Connecting Perirenal Adipose Tissue to Hyperuricemia in Type 2 Diabetes Mellitus: A Mediation Analysis

Background

Emerging evidence suggests that increased perirenal adipose tissue (PAT) may trigger systemic inflammation and oxidative stress, potentially contributing to hyperuricemia (HUA). This study aimed to explore the link between PAT and HUA risk, and the potential mediating role of inflammation and oxidative stress.

Methods

This study recruited 903 participants with T2DM. Monocyte to high-density lipoprotein cholesterol ratio (MHR) was computed to assess systemic inflammation and oxidative stress. Perirenal fat thickness (PrFT) was measured by unenhanced abdominal CT, indicating PAT mass. Weighted binomial logistic regression analysis and restricted cubic splines (RCS) analyses were employed to analyze the association correlation of HUA risk with PrFT and MHR. Meanwhile, adjusted mediation analysis based on bootstrapping calculations was performed to evaluate the direct impact of PrFT on HUA risk and the indirect effect mediated by MHR.

Results

Participants in the HUA group exhibited markedly higher levels of PrFT and MHR than the non-HUA group (P < 0.001). Serum uric acid presented a positive correlation with PrFT (β=0.368, P<0.001) and MHR (β=0.188, P<0.001) following adjustments for confounding factors. PrFT and MHR demonstrated an independent association with HUA risk after full adjustment for confounding factors in Model 3, with the ORs (95% CI) at 1.24 (95% CI:1.19-1.30, P<0.001) and 1.32 (95% CI:1.14-1.53, P<0.001), respectively. RCS analysis confirmed a non-linear association between PrFT, MHR, and HUA risk (P for nonlinear and overall< 0.001). Furthermore, MHR accounted for a mediated proportion of 11.29% in this association (P<0.001).

Conclusion

Increased PAT was an independent factor in HUA risk, with systemic inflammation and oxidative stress mediating this relationship.

Dietary Modulation of the Immune System

Recent insights into the influence of nutrition on immune system components have driven the development of dietary strategies targeting the prevention and management of major metabolic-inflammatory diseases. This review summarizes the bidirectional relationship between nutrition and immunocompetence, beginning with an overview of immune system components and their functions. It examines the effects of nutritional status, dietary patterns, and food bioactives on systemic inflammation, immune cell populations, and lymphoid tissues, as well as their associations with infectious and chronic disease pathogenesis. The mechanisms by which key nutrients influence immune constituents are delineated, focusing on vitamins A, D, E, C, and B, as well as minerals including zinc, iron, and selenium. Also highlighted are the immunomodulatory effects of polyunsaturated fatty acids as well as bioactive phenolic compounds and probiotics, given their expanding relevance. Each section addresses the implications of nutritional and nutraceutical interventions involving these nutrients within the broader context of major infectious, metabolic, and inflammatory diseases. This review further underscores that, while targeted nutrient supplementation can effectively restore immune function to optimal levels, caution is necessary in certain cases, as it may increase morbidity in specific diseases. In other instances, dietary counseling should be integrated to ensure that therapeutic goals are achieved safely and effectively.

Anticoagulation approach in morbid obesity: a comprehensive review on venous thromboembolism management

Obesity is a recognized risk factor for venous thromboembolism (VTE), associated with distinct challenges in managing anticoagulation therapy. There is still limited evidence regarding the impact of extreme body weight on the pharmacokinetics, pharmacodynamics, efficacy, and safety of various anticoagulant medications. To our knowledge, this is the first comprehensive review to address both prophylactic and therapeutic anticoagulant dosages specifically for managing VTE in patients with a body mass index (BMI) ≥40 kg/m2 or weight ≥120 kg. Our aim was to synthesize the findings of relevant studies alongside the latest recommendations on anticoagulation in this unique population. We gathered and analyzed data on all classes of anticoagulants available for VTE management, including vitamin K antagonists (VKAs), unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), fondaparinux, and direct oral anticoagulants (DOACs), offering insights into their efficacy and safety profiles. Additionally, we explored special subpopulations of morbidly obese patients, such as those with cancer, renal dysfunction, or those undergoing bariatric surgery, recognizing the nuanced therapeutic challenges they present. The current evidence for anticoagulant therapy in morbidly obese patients with VTE is evidently insufficient, underscoring the need for a tailored approach and meticulous monitoring to achieve an optimal therapeutic balance.

Racial-Ethnic Disparities of Obesity Require Community Context-Specific Biomedical Research for Native Hawaiians and Other Pacific Islanders

Compared to the general population of Hawai'i, Native Hawaiians and Other Pacific Islanders (NHPI) shoulder a disproportionately high risk for obesity-related cardiometabolic disorders, such as type 2 diabetes and cardiovascular disease. The gut microbiome is an area of rapid research interest for its role in regulating adjacent metabolic pathways, offering novel opportunities to better understand the etiology of these health disparities. Obesity and the gut microbiome are influenced by regional, racial-ethnic, and community-specific factors, limiting the generalizability of current literature for understudied populations. Additionally, anthropometric and directly measured obesity indices are variably predictive of adiposity and metabolic health risk in this diverse population. Thus, further NHPI-inclusive research is required to adequately characterize community-specific factors in the context of obesity-related disease etiology. Culturally responsible research ethics and scientific communication are crucial to conducting such research, especially among indigenous and understudied populations. In this review, we explore these limitations in current literature, emphasizing the urgent need for NHPI-inclusive research to assess community-specific factors accurately. Such accuracy in Indigenous health research may ensure that findings relevant to individual or public health recommendations and/or policies are meaningful to the communities such research aims to serve.

Immune Repertoires in Various Dermatologic and Autoimmune Diseases

The immune repertoire (IR) is a term that defines the combined unique genetic rearrangements of antigen receptors expressed by B and T lymphocytes. The IR determines the ability of the immune system to identify and respond to foreign antigens while preserving tolerance to host antigens. When immune tolerance is disrupted, development of autoimmune diseases can occur due to the attack of self-antigens. Recent technical advances in immune profiling allowed identification of common patterns and shared antigen-binding sequences unique to diverse array of diseases. However, there is no current literature to date evaluates IR findings in autoimmune and skin inflammatory conditions. In this review, we provide an overview of the past and current research findings of IR in various autoimmune and dermatologic conditions. Enriching our understanding of IRs in these conditions is critical for understanding the pathophysiology behind autoimmune skin disease onset and progression. Furthermore, understanding B-cell and T-cell IR will help devise therapeutic treatments in the hopes of restoring immune tolerance and preventing disease onset and progression.

Metabolic Syndrome, Kidney-Related Adiposity, and Kidney Microcirculation: Unraveling the Damage

Metabolic syndrome (MetS) is a cluster of interrelated risk factors, including insulin resistance, hypertension, dyslipidemia, and visceral adiposity, all of which contribute to kidney microvascular injury and the progression of chronic kidney disease (CKD). However, the specific impact of each component of MetS on kidney microcirculation remains unclear. Given the increasing prevalence of obesity, understanding how visceral fat-particularly fat surrounding the kidneys-affects kidney microcirculation is critical. This review examines the consequences of visceral obesity and other components of MetS on renal microcirculation. These kidney-related fat deposits can contribute to the mechanical compression of renal vasculature, promote inflammation and oxidative stress, and induce endothelial dysfunction, all of which accelerate kidney damage. Each factor of MetS initiates a series of hemodynamic and metabolic disturbances that impair kidney microcirculation, leading to vascular remodeling and microvascular rarefaction. The review concludes by discussing therapeutic strategies targeting the individual components of MetS, which have shown promise in alleviating inflammation and oxidative stress. Integrated approaches that address both of the components of MetS and kidney-related adiposity may improve renal outcomes and slow the progression of CKD.

Adipokines and Cardiometabolic Heart Failure with Preserved Ejection Fraction: A State-of-the-Art Review

BACKGROUND

Cardiometabolic heart failure with preserved ejection fraction (HFpEF) is largely driven by obesity-related factors, including adipokines and bioactive peptides primarily secreted by the adipose tissue, such as leptin, adiponectin, and resistin. These molecules link metabolic dysregulation to cardiovascular dysfunction, influencing HFpEF progression and patient outcomes Methods: A comprehensive literature search was conducted in PubMed up to 20 November 2024, using keywords and MeSH terms, such as "HFpEF", "adipokines", "leptin", "adiponectin", and "resistin", yielding 723 results. Boolean operators refined the search, and reference lists of key studies were reviewed. After screening for duplicates and irrelevant studies, 103 articles were included, providing data on adipokines' roles in HFpEF pathophysiology, biomarkers, and therapeutic implications.

RESULTS

Both preclinical and clinical studies have demonstrated that adipokines play a role in modulating cardiovascular function, thereby contributing to the development of cardiometabolic HFpEF. Leptin promotes myocardial hypertrophy, fibrosis, endothelial dysfunction, and inflammation, though contradictory evidence suggests potential cardioprotective roles in subgroups like obese African American women. Adiponectin generally offers protective effects but presents a paradox, where elevated levels may correlate with worse outcomes, which may reflect either a compensatory response to cardiac dysfunction or a maladaptive state characterized by adiponectin resistance. Resistin is associated with increased cardiovascular risk through pro-inflammatory and pro-fibrotic effects, though its role in HFpEF requires further clarification. Other adipokines, like retinol-binding protein 4 and omentin-1, have emerged as potential contributors. Despite growing insights, clinical translation remains limited, underscoring a significant gap between experimental evidence and therapeutic application.

CONCLUSIONS

Future research should focus on targeted interventions that modulate adipokine pathways to potentially improve HFpEF outcomes. Innovative treatment strategies addressing underlying metabolic disturbances and adipokine dysregulation are essential for advancing the management of this challenging condition.

Leptin levels are associated with coronary artery calcification in patients with advanced prostate cancer

BACKGROUND

Convergent data suggest that advanced prostate cancer and coronary heart disease (CHD) share biological vulnerabilities that may be linked to adiposity. Here we explore whether leptin, as a marker and mediator of adiposity, could link prostate cancer to CHD.

METHODS

Patients with metastatic castration-resistant prostate cancer (mCRPC) enrolled in a phase II trial (NCT02703623) studying androgen deprivation therapy, abiraterone, prednisone, and apalutamide were eligible if they had plasma and a chest CT scan available. Coronary artery calcium (CAC) scores and adipokine levels were measured upon enrollment.

RESULTS

Of 164 patients, 87% were white. The mean age was 65.6 ± 7.5 years, 88% were either overweight or obese, 59% had hypertension, 48% had hyperlipidemia (HLD), 20% had type 2 diabetes mellitus, and 41% were former or current smokers. Coronary calcifications were found in 115 patients (70%). Among 47 patients with non-contrast chest CT scans, the median total CAC score was 133 AU (IQR 22.6-704.6). Four patients (9%) had a score of 0 AU (low risk) and 24 (51%) scores ≥100 AU, associated with high risk for major adverse cardiovascular events. Leptin levels correlated positively with the right coronary artery (RCA) CAC score [Pearson correlation coefficient (ρ) = 0.3715 (P = .0142)]. In a multivariate logistic regression analysis, older age, HLD, and higher leptin levels were independently associated with RCA calcification and a higher number of calcified coronary arteries.

CONCLUSION

Among men with mCRPC, there was a high burden of CHD, and higher leptin levels were associated with coronary atherosclerosis independently of traditional cardiac risk factors.

The Trend of Changes in Adiponectin, Resistin, and Adiponectin-Resistin Index Values in Type 2 Diabetic Patients with the Development of Metabolic Syndrome

Background and Objectives: This study aimed to investigate the novel adiponectin-resistin (AR) index as a predictor of the development of metabolic syndrome (MetS) in individuals with type 2 diabetes mellitus (T2DM). MetS is common in T2DM and increases cardiovascular risk. Adiponectin and resistin, adipokines with opposing effects on insulin sensitivity and inflammation, make the AR index a potential marker for metabolic risk. Materials and Methods: This prospective observational study included 80 T2DM participants (ages 30-60) from Sarajevo, Bosnia and Herzegovina, over 24 months. The participants were divided into two groups: T2DM with MetS (n = 48) and T2DM without MetS (n = 32). Anthropometric data, biochemical analyses, and serum levels of adiponectin and resistin were measured at baseline and every six months. The AR index was calculated using the formula AR = 1 + log10(R) - 1 + log10(A), where R and A represent resistin and adiponectin concentrations. Logistic regression identified predictors of MetS. Results: T2DM patients who developed MetS showed a significant decline in adiponectin levels (40.19 to 32.49 ng/mL, p = 0.02) and a rise in resistin levels (284.50 to 315.21 pg/mL, p = 0.001). The AR index increased from 2.85 to 2.98 (p = 0.001). The AR index and resistin were independent predictors of MetS after 18 months, with the AR index showing a stronger predictive value (p = 0.007; EXP(B) = 1.265). Conclusions: The AR index is a practical marker for predicting MetS development in T2DM participants, improving metabolic risk stratification. Incorporating it into clinical assessments may enhance early detection and treatment strategies.

Research progress on the potential correlation between polycystic ovary syndrome and periodontal disease

Over the past few years, the correlation between periodontal disease (PD) and polycystic ovary syndrome (PCOS) has attracted widespread attention owing to the increased incidence of these diseases. Several studies have suggested a possible link between the two. In this narrative review, we examined the epidemiology, common risk factors, and pathological mechanisms of PCOS and PD to investigate the potential association between these diseases. Evidence from the literature indicates that PCOS and PD can interact with each other. Common risk factors, such as microbial homeostasis imbalance owing to dysbiosis, along with multiple hormone and inflammatory mediators, as well as inflammatory responses owing to oxidative stress and oxidative responses owing to ferroptosis, are all associated with the pathogenesis of both diseases. Further studies are needed to clarify the specific mechanisms of interaction between PCOS and PD, which could clarify future directions in disease management and combined multidisciplinary treatment.

Asprosin-mediated regulation of ovarian functions in mice: An age-dependent study

Asprosin is a recently discovered adipokine reported to be involved in the modulation of mammalian gonadal functions. Preliminary investigations suggest its role in regulation of ovarian functions in rodents as well as bovids. In addition, increased levels of the adipokine during human ovarian pathophysiologies implicate it in disease progression and severity. The present study evidenced high expression of asprosin in ovaries of juvenile, pubertal and adult mice while expression was significantly low in ageing ovaries. Further, asprosin stimulated expression of markers for ovarian folliculogenesis (Scf, c-Kit, Gdf9, Bmp6, Fshr, Lhr) and steroidogenesis (3β-Hsd) in adult mice. In addition to exploring concentration-dependent effect of asprosin, the study implicates asprosin as an age-dependent modulator of ovarian functions as treatment of ovaries with asprosin led to upregulation of Fshr, c-Kit, Bmp6, and Gdf9 in both adult and juvenile ovaries, Lhr only in adults while that of Scf only in juvenile ovaries. The current study is first to report an age-dependent expression and role of asprosin in murine ovaries.

Reconsidering Semaglutide Use for Chronic Obesity in Patients of Asian Descent: A Critical Review

Semaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist. It is the first approved drug for chronic weight management in adults who are overweight or obese since 2014. Its increasing popularity has garnered significant media attention and led to a drug shortage, resulting in limited access for its intended use - patients with type 2 diabetes. Numerous studies have demonstrated its effectiveness in promoting weight loss. This review seeks to explain the use of semaglutide, a GLP-1 receptor agonist, to treat metabolic syndrome in the Asian American population. It raises concerns about the existing diagnostic and treatment approaches and stresses the necessity of integrating visceral fat and other ethnicity-specific risk predictors for the diagnosis of metabolic syndrome. The objective of this review is to examine the eligibility criteria for the prescription of semaglutide critically and determine whether Asians are being unfairly excluded and denied access to this medication due to ineffective prescription guidelines.

Effect of Vitamin D Supplementation on Inflammatory Markers in Obese Patients with Acute and Chronic Orthopedic Conditions

Numerous studies have shown that vitamin D may play an important role in modulating the inflammatory process. This study aimed to evaluate the effect of vitamin D supplementation on inflammatory markers in patients with orthopedic disorders and obesity. Thirty-three obese subjects were included in the study and were divided into two groups based on their medical condition: acute orthopedic diseases and chronic orthopedic diseases. Inclusion criteria for the research included age 18-75 years, BMI > 30 kg/m2, vitamin D deficiency, and no previous vitamin D supplementation. Samples were collected before and after 3 months of 4000 IU/day vitamin D supplementation. The study used enzyme-linked immunosorbent assay (ELISA) and measured serum levels of markers such as chitinase-3-like protein 1 (YKL-40), interleukin 6 (IL-6), interleukin 17 (IL-17), tumor necrosis factor (TNF-α), and adiponectin. After 3 months of vitamin D supplementation, a statistically significant increase in vitamin D and IL-17 levels was observed in the group with acute orthopedic diseases. Similarly, after supplementation, a statistically significant increase in vitamin D, IL-6 and TNF-α levels was observed in the group with chronic orthopedic diseases. Moreover, after vitamin D supplementation, statistically significantly higher adiponectin levels were observed in the chronic orthopedic group than in the acute orthopedic group. Despite high-dose vitamin D supplementation, inflammatory markers increased in acute and chronic orthopedic conditions. Based on our study, vitamin D does not reduce inflammation in patients with orthopedic conditions and obesity.

Associations of sedentary behavior and screen time with biomarkers of inflammation and insulin resistance

Sedentary behavior (SB) has been linked to risk factors of cardiometabolic disease, with inconsistent findings reported in the literature. We aimed to assess the associations of SB with multiple biomarkers of inflammation and insulin resistance in adults. Domain-specific SB, sitting time and moderate-to-vigorous physical activity (MVPA) were measured in 78 adults (mean ± SD 52.0 ± 10.8 y). Body fat percentage (BF%) was assessed using multi-frequency bioelectrical impedance. A blood draw assessed glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, and adiponectin. Adiponectin-leptin ratio (ALR), homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) were calculated. Multivariable linear regression analyses, controlling for age, sex, MVPA, and BF%, were used to assess associations. After adjustment for age, sex and MVPA, total SB (7.5 ± 2.5 h/day) was positively associated with leptin, insulin, HOMA-IR, HOMA-β (Standardized Beta (β) range 0.21-0.32) and negatively associated with ALR (β = -0.24, p < 0.05 for all). Similarly, total sitting time (7.2 ± 2.9 h/day) was associated with TNF-α (β = 0.22) and ALR (β = -0.26). These associations were attenuated to non-significance after adjustment for BF%. Leisure screen time was detrimentally associated with IL-6 (β = 0.24), leptin (β = 0.21), insulin (β = 0.37), HOMA-IR (β = 0.37), and HOMA-β (β = 0.34), independent of age, sex and MVPA (p < 0.05 for all). Only the associations with insulin (β = 0.26), HOMA-IR (β = 0.26), and HOMA-β (β = 0.23) remained significant after further controlling BF% (p < 0.05). Self-reported SB is associated with biomarkers of inflammation and insulin resistance, independent of MVPA, and in some cases BF%.

Versican maintains the homeostasis of adipose tissues and regulates energy metabolism

Versican is a large chondroitin sulfate proteoglycan in the extracellular matrix. It plays a pivotal role in the formation of the provisional matrix. S100a4, previously known as fibroblast-specific protein, functions as a calcium channel-binding protein. To investigate the role of versican expressed in fibroblasts, we generated conditional knockout mice in which versican expression is deleted in cells expressing S100a4. We found that S100a4 is expressed in adipose tissues, and these mice exhibit obesity under a normal diet, which becomes apparent as early as five months. The white adipose tissues of these mice exhibited decreased expression levels of S100a4 and versican and hypertrophy of adipocytes. qRT-PCR showed a reduced level of UCP1 in their white adipose tissues, indicating that the basic energy metabolism is diminished. These results suggest that versican in adipose tissues maintains the homeostasis of adipose tissues and regulates energy metabolism.

Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), poses a significant global health challenge due to its increasing prevalence and strong association with cardiovascular disease (CVD). This comprehensive review summarizes the current knowledge on the MASLD-CVD relationship, compares analysis of how different terminologies for fatty liver disease affect cardiovascular (CV) risk assessment using different diagnostic criteria, explores the pathophysiological mechanisms connecting MASLD to CVD, the influence of MASLD on traditional CV risk factors, the role of noninvasive imaging techniques and biomarkers in the assessment of CV risk in patients with MASLD, and the implications for clinical management and prevention strategies. By incorporating current research and clinical guidelines, this review provides a comprehensive overview of the complex interplay between MASLD and cardiovascular health.

Adipokines in the Crosstalk between Adipose Tissues and Other Organs: Implications in Cardiometabolic Diseases

Adipose tissue was previously regarded as a dormant organ for lipid storage until the identification of adiponectin and leptin in the early 1990s. This revelation unveiled the dynamic endocrine function of adipose tissue, which has expanded further. Adipose tissue has emerged in recent decades as a multifunctional organ that plays a significant role in energy metabolism and homeostasis. Currently, it is evident that adipose tissue primarily performs its function by secreting a diverse array of signaling molecules known as adipokines. Apart from their pivotal function in energy expenditure and metabolism regulation, these adipokines exert significant influence over a multitude of biological processes, including but not limited to inflammation, thermoregulation, immune response, vascular function, and insulin sensitivity. Adipokines are pivotal in regulating numerous biological processes within adipose tissue and facilitating communication between adipose tissue and various organs, including the brain, gut, pancreas, endothelial cells, liver, muscle, and more. Dysregulated adipokines have been implicated in several metabolic diseases, like obesity and diabetes, as well as cardiovascular diseases. In this article, we attempted to describe the significance of adipokines in developing metabolic and cardiovascular diseases and highlight their role in the crosstalk between adipose tissues and other tissues and organs.

Hypoxia in Human Obesity: New Insights from Inflammation towards Insulin Resistance-A Narrative Review

Insulin resistance (IR), marked by reduced cellular responsiveness to insulin, and obesity, defined by the excessive accumulation of adipose tissue, are two intertwined conditions that significantly contribute to the global burden of cardiometabolic diseases. Adipose tissue, beyond merely storing triglycerides, acts as an active producer of biomolecules. In obesity, as adipose tissue undergoes hypertrophy, it becomes dysfunctional, altering the release of adipocyte-derived factors, known as adipokines. This dysfunction promotes low-grade chronic inflammation, exacerbates IR, and creates a hyperglycemic, proatherogenic, and prothrombotic environment. However, the fundamental cause of these phenomena remains unclear. This narrative review points to hypoxia as a critical trigger for the molecular changes associated with fat accumulation, particularly within visceral adipose tissue (VAT). The activation of hypoxia-inducible factor-1 (HIF-1), a transcription factor that regulates homeostatic responses to low oxygen levels, initiates a series of molecular events in VAT, leading to the aberrant release of adipokines, many of which are still unexplored, and potentially affecting peripheral insulin sensitivity. Recent discoveries have highlighted the role of hypoxia and miRNA-128 in regulating the insulin receptor in visceral adipocytes, contributing to their dysfunctional behavior, including impaired glucose uptake. Understanding the complex interplay between adipose tissue hypoxia, dysfunction, inflammation, and IR in obesity is essential for developing innovative, targeted therapeutic strategies.

Prospects and challenges of tissue-derived extracellular vesicles

Extracellular vesicles (EVs) are considered a vital component of cell-to-cell communication and represent a new frontier in diagnostics and a means to identify pathways for therapeutic intervention. Recently, studies have revealed the importance of tissue-derived EVs (Ti-EVs), which are EVs present in the interstitial spaces between cells, as they better represent the underlying physiology of complex, multicellular tissue microenvironments in biology and disease. EVs are native, lipid bilayer membraned nano-sized particles produced by all cells that are packaged with varied functional biomolecules including proteins, lipids, and nucleic acids. They are implicated in short- and long-range cellular communication and may elicit functional responses in recipient cells. To date, studies have often utilized cultured cells or biological fluids as a source for EVs that do not capture local molecular signatures of the tissue microenvironment. Recent work utilizing Ti-EVs has elucidated novel biomarkers for disease and provided insights into disease mechanisms that may lead to the development of novel therapeutic agents. Still, there are considerable challenges facing current studies. This review explores the vast potential and unique challenges for Ti-EV research and provides considerations for future studies that seek to advance this exciting field.

Peripheral to brain and hippocampus crosstalk induced by exercise mediates cognitive and structural hippocampal adaptations

Endurance exercise leads to robust increases in memory and learning. Several exercise adaptations occur to mediate these improvements, including in both the hippocampus and in peripheral organs. Organ crosstalk has been becoming increasingly more present in exercise biology, and studies have shown that peripheral organs can communicate to the hippocampus and mediate hippocampal changes. Both learning and memory as well as other hippocampal functional-related changes such as neurogenesis, cell proliferation, dendrite morphology and synaptic plasticity are controlled by these exercise responsive peripheral proteins. These peripheral factors, also called exerkines, are produced by several organs including skeletal muscle, liver, adipose tissue, kidneys, adrenal glands and circulatory cells. Previous reviews have explored some of these exerkines including muscle-derived irisin and cathepsin B (CTSB), but a full picture of peripheral to hippocampus crosstalk with novel exerkines such as selenoprotein 1 (SEPP1) and platelet factor 4 (PF4), or old overlooked ones such as lactate and insulin-like growth factor 1 (IGF-1) is still missing. We provide 29 different studies of 14 different exerkines that crosstalk with the hippocampus. Thus, the purpose of this review is to explore peripheral exerkines that have shown to exert hippocampal function following exercise, demonstrating their particular effects and molecular mechanisms in which they could be inducing adaptations.

The Impact of the Endocrine and Immunological Function of Adipose Tissue on Reproduction in Women with Obesity

Obesity, which leads to metabolic dysregulation and body function impairment, emerges as one of the pressing health challenges worldwide. Excessive body fat deposits comprise a dynamic and biologically active organ possessing its own endocrine function. One of the mechanisms underlying the pathophysiology of obesity is low-grade systemic inflammation mediated by pro-inflammatory factors such as free fatty acids, lipopolysaccharides, adipokines (including leptin, resistin and visfatin) and cytokines (TNF-α, IL-1β, Il-6), which are secreted by adipose tissue. Together with obesity-induced insulin resistance and hyperandrogenism, the exacerbated immune response has a negative impact on the hypothalamic-pituitary-gonadal axis at all levels and directly affects reproduction. In women, it results in disrupted ovarian function, irregular menstrual cycles and anovulation, contributing to infertility. This review focuses on the abnormal intracellular communication, altered gene expression and signaling pathways activated in obesity, underscoring its multifactorial character and consequences at a molecular level. Extensive presentation of the complex interplay between adipokines, cytokines, immune cells and neurons may serve as a foundation for future studies in search of potential sites for more targeted treatment of reproductive disorders related to obesity.