Obesity and Its Comorbidities: Current Treatment Options, Emerging Biological Mechanisms, Future Perspectives and Challenges.

IF 3 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Lihua Wang, Qian Wang, Yumo Xiong, Wei Shi, Xiao Qi
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Abstract

Obesity is a chronic, multifactorial disease and a major global public health challenge. Defined by excessive fat accumulation, obesity significantly increases the risk of numerous diseases, including type 2 diabetes mellitus (T2DM), cardiovascular disease, heart failure, and metabolic dysfunction-associated steatotic liver disease, contributing to rising morbidity and mortality rates worldwide. Although several pharmacological treatments have demonstrated notable efficacy in weight management, concerns regarding drug safety remain a significant challenge. Metabolic bariatric surgery (MBS) has emerged as the most effective intervention for achieving long-term and sustained weight loss; however, it is typically reserved for advanced stages of the disease. Moreover, the role of MBS in managing obesity-related comorbidities remains a topic of ongoing debate. In this review, we provide a comprehensive analysis of the epidemiology of obesity and its associated comorbidities, along with the latest insights into the mechanisms underlying obesity-induced chronic complications. Growing evidence highlights the crucial role of imbalances between white and brown adipose tissues, alterations in gut microbiota, genetic and epigenetic modifications, and immune system dysregulation in driving obesity and its related conditions. These emerging insights have unveiled numerous potential therapeutic targets with promising weight-reducing effects. Furthermore, advancements in our understanding of signal transduction pathways may pave the way for future multimodal therapeutic strategies in obesity management, ushering in a new era of precision medicine.

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Abstract Image

肥胖及其合并症:目前的治疗方案,新出现的生物学机制,未来的前景和挑战。
肥胖是一种慢性多因素疾病,也是一项重大的全球公共卫生挑战。肥胖的定义是过度脂肪积累,它显著增加了许多疾病的风险,包括2型糖尿病(T2DM)、心血管疾病、心力衰竭和代谢功能障碍相关的脂肪变性肝病,导致全球发病率和死亡率上升。尽管一些药物治疗在体重管理方面已经显示出显著的疗效,但对药物安全性的担忧仍然是一个重大挑战。代谢减肥手术(MBS)已成为实现长期和持续减肥的最有效的干预措施;然而,它通常用于疾病的晚期。此外,MBS在管理肥胖相关合并症中的作用仍然是一个持续争论的话题。在这篇综述中,我们对肥胖及其相关合并症的流行病学进行了全面分析,并对肥胖引起的慢性并发症的机制进行了最新研究。越来越多的证据强调了白色和棕色脂肪组织之间的不平衡、肠道微生物群的改变、遗传和表观遗传修饰以及免疫系统失调在导致肥胖及其相关疾病中的关键作用。这些新兴的见解揭示了许多有希望的减肥效果的潜在治疗靶点。此外,我们对信号转导途径的理解的进步可能为未来肥胖管理的多模式治疗策略铺平道路,迎来精准医学的新时代。
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来源期刊
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
5.90
自引率
6.10%
发文量
431
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.
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