Current Obesity Reports最新文献

Purpose of review: This review aims to discuss emerging therapeutic strategies for managing Metabolic Syndrome (MetS) by focusing on modulating the gut microbiota using prebiotics, probiotics, and postbiotics, emphasizing their mechanistic roles in restoring metabolic balance and improving host metabolic health.

Recent findings: The biotics exert various pharmacological effects in restoring gut health and managing MetS by modulating multiple gut-system axes, including the gut-brain axis, gut-liver axis, gut-immune axis, and gut-endocrine axis. Through these mechanisms, they influence satiety regulation, insulin sensitivity, bile acid metabolism, systemic inflammation, and overall energy homeostasis, thereby contributing in the management of MetS. This review categorizes therapeutic biotics into three distinct classes: Prebiotics, which serve as substrates to stimulate beneficial bacteria; Probiotics, which supplement the gut with live beneficial microorganisms; and Postbiotics, which are bioactive microbial byproducts that directly modulate host metabolism. Conventional therapies for MetS address individual conditions rather than the syndrome comprehensively, which can promote adverse drug reactions. Whereas, biotic interventions target gut microbiota, a central regulator of energy balance, metabolic signalling and systemic inflammation. By restoring microbial composition and function, these biotics can simultaneously improve insulin sensitivity, reduce inflammation, regulate appetite, and modulate lipid and bile acid metabolism. This multi-dimensional modulation offers biotics as a promising adjunct or complementary strategy, capable of addressing the underlying dysregulation in MetS and offering a more integrative and mechanistic approach to its prevention and management.

Purpose of review: This review aims to summarize current knowledge of the alterations and pathophysiological roles of adipose tissue (AT)-derived extracellular vesicles (AT-EVs) and adipocyte-derived EVs (Ad-EVs) in the context of obesity, while providing mechanistic insights into their potential functions within the tumor microenvironment.

Recent findings: Emerging evidence indicates that obese AT-EVs and Ad-EVs contribute to insulin resistance, diabetes, metabolic dysfunction-associated steatotic liver disease, cardiovascular disorders, and cancer by delivering pathological cargo or altering recipient cell signaling. Conversely, both lean and obese AT-EVs and Ad-EVs have demonstrated therapeutic potential in specific settings, such as restoring insulin sensitivity, enhancing β-cell function, improving wound healing, and mitigating ischemia/reperfusion injury. One of the most prominent features of obesity is AT remodeling, which markedly increases the release of EVs and alters their cargo composition. These EVs can play context-dependent roles in pathophysiological processes, underscoring the complexity of AT-EV and Ad-EV biology and highlighting the need for further mechanistic investigations, particularly in cancer, where evidence remains limited. Advancing our understanding of the molecular pathways underlying their biogenesis, cargo sorting, and intercellular communication will not only deepen our knowledge of obesity-related pathophysiology but also facilitate the development of novel biomarkers and EV-based therapeutic strategies.

Purpose of review: This review aims to provide a comprehensive synthesis of current clinical evidence on the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonists on body mass index (BMI), body composition, and glucose metabolism in patients with obesity and type 2 diabetes mellitus (T2DM), a condition often referred to as "diabesity."

Recent findings: The coexistence of obesity and T2DM represents a major clinical and public health challenge due to their synergistic effects on metabolic dysfunction and the increased risk of cardiovascular and renal complications. Traditional approaches focused solely on glycemic control have proven insufficient to address the intertwined pathophysiology of excess adiposity and impaired glucose metabolism. Recently, novel pharmacological agents, including SGLT2 inhibitors, GLP-1 RAs, and dual GIP/GLP-1 receptor agonists, have demonstrated dual benefits in improving glycemic control and reducing body weight. These drugs act through distinct but complementary mechanisms-such as promoting glycosuria, enhancing satiety, delaying gastric emptying, and modulating energy homeostasis-resulting in significant reductions in BMI and visceral fat. Among these agents, tirzepatide has shown superior efficacy in improving metabolic parameters and body composition compared with single receptor agonists. Understanding the multifaceted metabolic benefits of these pharmacotherapies is essential for optimizing individualized therapeutic strategies for patients with diabesity. Integrating these agents into comprehensive diabetes care allows clinicians to more effectively target the complex pathophysiology of diabesity, ultimately improving long-term metabolic and clinical outcomes in this growing patient population.

Purpose of review: We aimed to summarise recent evidence on age- and sex-specific reference curves for metabolic syndrome (MetS) indicators in paediatric populations.

Recent findings: There is a lack of consensus regarding diagnostic thresholds for MetS in children and adolescents, leading to challenges in its early identification and intervention. A systematic search was performed in PubMed/Medline, Web of Science and Scopus, covering the period between January 2018 and February 2025. Three researchers evaluated 8,529 studies according to the inclusion criteria. Finally, 46 articles that reported reference values for at least one metabolic indicator: waist circumference, fasting glucose, glycated haemoglobin, homeostatic model assessment for insulin resistance, high-density lipoprotein cholesterol, triglycerides, systolic or diastolic blood pressure, in children aged 0 to 18 years were included in the review and data synthesis. The age-specific trends in each MetS indicator were assessed by calculating the median reference curves along with the lower and upper percentile bounds. Overall, there has been a substantial heterogeneity in the reported reference values for waist circumference and glucose metabolism biomarkers. Comparatively smaller variations were observed for blood pressure and lipid parameters. Limited data were available for young age groups (0-4 years) and there have been substantial differences in study methodologies including study design, assays and statistical approaches used to derive reference curves. This systematic review highlighted the substantial inconsistencies in the reported reference curves for MetS indicators in children and adolescents. There is a pressing need for deriving harmonized reference curves for paediatric MetS from diverse populations.

Purpose of review: Obesity in childhood remains a critical public health issue, with emerging evidence highlighting developmental origins rooted in parental behaviours before conception. While diet and weight status of birthing parents are well-established predictors of offspring health, the role of preconception physical activity (PA) remains understudied. This scoping review synthesizes current evidence between preconception PA and its association with adverse birth outcomes, and downstream infant and child obesity outcomes, contextualizing findings within the broader parental lifestyle influence. A systematic literature search across ten databases identified 41 relevant studies, predominantly cohort designs, analyzing PA effects on birth weight, gestational diabetes mellitus (GDM), excessive gestational weight gain (eGWG), and offspring adiposity.

Recent findings: Findings revealed no consistent association between preconception PA and birth weight or preterm birth risk. However, studies suggest that preconception PA may lower the likelihood of GDM and eGWG, both of which are linked to increased obesity risk in offspring. A significant methodological limitation across studies was the widespread temporal discontinuity, with PA predominantly assessed through retrospective recall rather than objective measures. Additionally, inconsistencies in study design, PA intensity definitions, and confounding lifestyle factors limit definitive conclusions.  While obesity in birthing parents and suboptimal feeding practices dominate current etiological models, the potential preventive role of preconception PA warrants further investigation. Future research should implement intervention designs incorporating objective PA measures (e.g., accelerometry, wearable sensors) within life-course frameworks. Methodologically rigorous studies are critical for disentangling PA-specific effects from confounding lifestyle factors to inform evidence-based guidelines for preconception care.