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Chronic Inflammation in Obesity and the Metabolic Syndrome
Open accessAbstract
The increasing incidence of obesity and the metabolic syndrome is disturbing. The activation of inflammatory pathways, used normally as host defence, reminds the seriousness of this condition. There is probably more than one cause for activation of inflammation. Apparently, metabolic overload evokes stress reactions, such as oxidative, inflammatory, organelle and cell hypertrophy, generating vicious cycles. Adipocyte hypertrophy, through physical reasons, facilitates cell rupture, what will evoke an inflammatory reaction. Inability of adipose tissue development to engulf incoming fat leads to deposition in other organs, mainly in the liver, with consequences on insulin resistance. The oxidative stress which accompanies feeding, particularly when there is excessive ingestion of fat and/or other macronutrients without concomitant ingestion of antioxidant-rich foods/beverages, may contribute to inflammation attributed to obesity. Moreover, data on the interaction of microbiota with food and obesity brought new hypothesis for the obesity/fat diet relationship with inflammation. Beyond these, other phenomena, for instance psychological and/or circadian rhythm disturbances, may likewise contribute to oxidative/inflammatory status. The difficulty in the management of obesity/metabolic syndrome is linked to their multifactorial nature where environmental, genetic and psychosocial factors interact through complex networks.
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“Continuous low-level translocation of LPS into circulation can induce chronic low-level inflammatory states associated with development of obesity and other metabolic syndromes [92].”
From The athletic gut microbiota (2020) · cites this paper as [92]
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“As systemic inflammatory markers 123 and metabolites such as those derived from the gut microbiota have been associated with obesity and food addiction, future mechanistic studies that integrate these mediators are also of value.”
From History of early life adversity is associated with increased food addiction and sex-specific alterations in reward network connectivity in obesity (2019) · cites this paper as [123]
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Obesidade: inflamação e compostos bioativos
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Iyengar, N. M., Zhou, X. K., Mendieta, H., Giri, D. D., El-Hely, O., Winston, L. A., Falcone, D. J., Wang, H., Meng, L., Landa, J., et al. (2021) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-20-0507 · Cited by 19
Tian, Y., Gao, L., Guo, Y., & Xu, Y. (2017) · Journal of Food Biochemistry · doi:10.1111/jfbc.12407 · Cited by 19
Adipose Tissue and Inflammation
Awad, A. B., & Bradford, P. G. (2009) · CRC Press eBooks · doi:10.1201/9781420091311 · Cited by 20
Lv, C., Liu, X., Chen, S., Yi, Y., Wen, X., Li, T., & Qin, S. (2024) · Antioxidants · doi:10.3390/antiox13030293 · Cited by 21
“Glycolipid metabolism disorder is characterized by dysregulation in glucose and lipid metabolism, accompanied by insulin resistance, oxidative stress, inflammatory response, and an imbalance in intestinal flora as the core pathological mechanisms [1–3].”
BackgroundTime Restricted Eating: A Valuable Alternative to Calorie Restriction for Addressing Obesity?
Parrotta, M. E., Colangeli, L., Scipione, V., Vitale, C., Sbraccia, P., & Guglielmi, V. (2025) · Current Obesity Reports · doi:10.1007/s13679-025-00609-z · Cited by 19
Multidrug-Resistant Infections and Metabolic Syndrome: An Overlooked Bidirectional Relationship
Acierno, C., Nevola, R., Barletta, F., Rinaldi, L., Sasso, F. C., Adinolfi, L. E., & Caturano, A. (2025) · Biomedicines · doi:10.3390/biomedicines13061343 · Cited by 20
“A hallmark feature of metabolic syndrome (MetS) is the presence of low-grade, systemic inflammation that develops insidiously and persists chronically [35,42].”
Scazzocchio, B., Varı́, R., Silenzi, A., Giammarioli, S., Masotti, A., Baldassarre, A., Santangelo, C., D’Archivio, M., Giovannini, C., Cornò, M. D., et al. (2019) · European Journal of Nutrition · doi:10.1007/s00394-019-02003-7 · Cited by 19
“Excess macronutrient intake and/or lipid overload associated with adiposity are thought to contribute to inflammation and aberrant signaling in visceral AT [42].”
BackgroundInflammatory Markers and Atherogenic Coefficient: Early Markers of Metabolic Syndrome
Mahdavi‐Roshan, M., Shoaibinobarian, N., Noormohammadi, M., Mousavi, A. F., Rakhsh, A. S., Salari, A., & Ghorbani, Z. (2022) · Intern J Endocrinol Metab · doi:10.5812/ijem-127445 · Cited by 18
“Therefore, these inexpensive and available laboratory measures that could also be used in clinical settings would be most helpful in the early detection of atherosclerosis development and primary prevention of CVDs among MetSyn subjects.”
BackgroundResultInfluentialImmune response to arbovirus infection in obesity
Hameed, M., Geerling, E., Pinto, A. K., Miraj, I., & Weger‐Lucarelli, J. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.968582 · Cited by 19
Stress-induced brain responses are associated with BMI in women
Kühnel, A., Hagenberg, J., Arloth, J., Ködel, M., Czisch, M., Sämann, P. G., BeCOME working group, Brückl, T. M., Spoormaker, V. I., Erhardt, A., et al. (2023) · Communications Biology · doi:10.1038/s42003-023-05396-8 · Cited by 21
Temporal associations of BMI and glucose parameters with depressive symptoms among US adults
Meshkat, S., Liu, Y., Jung, H. J., Tassone, V. K., Pang, H. Y. M., Janssen‐Aguilar, R., Lou, W. Y. W., & Bhat, V. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2023.115709 · Cited by 18
NADPH Oxidase 3: Beyond the Inner Ear
Herb, M. (2024) · Antioxidants · doi:10.3390/antiox13020219 · Cited by 19
Wu, S., Teng, Y., Lan, Y., Wang, M., Zhang, T., Wang, D., & Qi, F. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02223-9 · Cited by 20
“Obesity, once believed to be just a metabolic abnormality, has been shown to demonstrate mutual causality with non-specific immune responses [2–7].”
BackgroundPerinatal outcome in normal pregnant women with incidental thrombocytopenia at delivery
Lin, Y.-H., Lo, L., Hsieh, C.-C., et al. (2013) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2013.01.025 · Cited by 18
Tuomisto, K., Jousilahti, P., Havulinna, A. S., et al. (2019) · Metabolism Open · doi:10.1016/j.metop.2019.100016 · Cited by 18
Żelechowska, P., Brzezińska‐Błaszczyk, E., Kusowska, A., & Kozłowska, E. (2020) · Obesity Reviews · doi:10.1111/obr.13055 · Cited by 18
“where they act in an endocrine manner to promote chronic systemic inflammation.(160) Thus, it can be stated that underweight or overweight and obesity notably affect the immune system functioning”
BackgroundPark, M., Park, E., Kim, S.-H., & Lee, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22094444 · Cited by 18
Lordan, R., Τσούπρας, Α., & Zabetakis, I. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813792-5.00002-1 · Cited by 20
Du, Y., Dai, Q., Zhang, H., et al. (2019) · Journal of Immunology Research · doi:10.1155/2019/7026067 · Cited by 18
“Inhibiting the expression or function of NF-κB is crucial for maintaining DCs in an immature state [35–37], with the decreased expression of various cytokines, such as IL-1β, IL-6, and TNF-α [38, 39], which further amplify the inflammatory responses [40].”
BackgroundGut microbiome links obesity to type 2 diabetes: insights from Mendelian randomization
Fu, L., Baranova, A. V., Cao, H., & Zhang, F. (2025) · BMC Microbiology · doi:10.1186/s12866-025-03968-8 · Cited by 20
“The chronic systemic inflammatory state induced by obesity may be a major factor affecting GM [87].”
Understanding Cystic Fibrosis Comorbidities and Their Impact on Nutritional Management
Patel, D. R., Shan, A., Mathews, S. K., & Sathe, M. (2022) · Nutrients · doi:10.3390/nu14051028 · Cited by 17
“Additionally, research shows that excessive fat ingestion, particularly without concomitant antioxidant ingestion, may contribute to inflammation linked with obesity [17].”
BackgroundZhang, R., Sun, X., Huang, Z., Pan, Y., Westbrook, A., Li, S.-X., Bazzano, L., Chen, W., He, J., Kelly, T., et al. (2022) · Obesity · doi:10.1002/oby.23386 · Cited by 15
“Second, obesity is characterized by chronic inflammation (36), and LPEs could regulate body weight through inhibiting the production of proinflammatory cytokines and promoting the secretion of antiinflammation cytokine interleukin (IL)10 (37,38).”
BackgroundLi, J., Gower, B. A., McLain, A., & Yarar‐Fisher, C. (2022) · Physiological Reports · doi:10.14814/phy2.15501 · Cited by 17
“Research showed that chronic inflammation associated with obesity impairs insulin signaling pathways and lipid metabolism (Monteiro & Azevedo, 2010).”
BackgroundBMI modifies HDL-C effects on coronary artery bypass grafting outcomes
Rezaee, M., Fallahzadeh, A., Sheikhy, A., Jameie, M., Behnoush, A. H., Pashang, M., Tajdini, M., Tavolinejad, H., Masoudkabir, F., Mansourian, S., et al. (2022) · Lipids in Health and Disease · doi:10.1186/s12944-022-01739-2 · Cited by 18
“As a result, these processes contribute to the activation of systemic inflammatory pathways [38].”
BackgroundLamichhane, G., Pandeya, P. R., Lamichhane, R., et al. (2023) · Current Research in Biotechnology · doi:10.1016/j.crbiot.2023.100138 · Cited by 17
Chen, Q., Luo, Y., Shen, Y., Li, X., Yang, H., Li, J., Wang, J., & Xiao, Y. (2023) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2023.109527 · Cited by 17
Biomarkers of food intake and their relevance to metabolic syndrome
Cifuentes, M., Vahid, F., Devaux, Y., & Bohn, T. (2024) · Food & Function · doi:10.1039/d4fo00721b · Cited by 18
Diet-induced obesity reprograms the inflammatory response of the murine lung to inhaled endotoxin
Tilton, S. C., Waters, K. M., Karin, N. J., Webb‐Robertson, B., Zangar, R. C., Lee, K. M., Bigelow, D. J., Pounds, J. G., & CORLEY, R. A. (2013) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2012.12.020 · Cited by 17
“…Author M anuscript N IH -PA Author M anuscript initiation of pulmonary pathologies and suggests convergent pathways of LPS exposure and obesity (Furukawa et al., 2004; Arkan et al., 2005; Xue et al., 2005; Hotamisligil, 2006; Houstis et al., 2006; Zhang et al., 2008; Monteiro and Azevedo, 2010).”
BackgroundA multiscale modeling framework for studying the mechanobiology of sarcopenic obesity
Shoham, N., Levy, A., Shabshin, N., Benayahu, D., & Gefen, A. (2016) · Biomechanics and Modeling in Mechanobiology · doi:10.1007/s10237-016-0816-z · Cited by 19
“…even in tissues with healthy fat contents, as part of the normal turnover process in fat; however, in subjects with excessive fat mass, there is often chronic inflammation in fat tissues, whichmay indeed relate to frequent cell deformation damage (Monteiro and Azevedo 2010; Gefen and Weihs 2016).”
BackgroundKemse, N. G., Sundrani, D. P., Kale, A. A., & Joshi, S. (2017) · Archives of Medical Research · doi:10.1016/j.arcmed.2017.10.006 · Cited by 18
Effect of Low-Fat Diet in Obese Mice Lacking Toll-like Receptors
Rau, C., Wu, S., Lu, T., Wu, Y.-C., Wu, C., Chien, P., Kuo, P., Lin, C.-W., Tsai, C.-W., & Hsieh, C. (2018) · Nutrients · doi:10.3390/nu10101464 · Cited by 17
“Uptake of a high-fat diet leads to the synthesis and release of adipokines and proinflammatory cytokines in the adipose tissue [1].”
BackgroundMoreira, B. P., Monteiro, M. P., Sousa, M., Oliveira, P. F., & Alves, M. G. (2018) · Biochemical Journal · doi:10.1042/bcj20180631 · Cited by 18
Kim, H., Kwon, H., Jeong, S., Hwang, S. E., & Park, J. (2019) · Scientific Reports · doi:10.1038/s41598-019-42398-1 · Cited by 17
Metadata
- Authors
- Monteiro, R., & Azevedo, I.
- Affiliations
- Universidade do Porto (PT)
- Corresponding author
- Monteiro, Rosário
- Venue
- Mediators of Inflammation
- Publisher
- Wiley
- Published
- 2010
- Volume
- 2010
- Pages
- 1-10
- ISSN
- 0962-9351 (ISSN-L)
- 1466-1861
- PMC
- PMC2913796
- OpenAlex
- W1997248937
- Cited by
- 1,186
- References
- 124
- Citations by year
- 2026: 40 · 2025: 93 · 2024: 104 · 2023: 99 · 2022: 126 · 2021: 102 · 2020: 120 · 2019: 113 · 2018: 95 · 2017: 68 · 2016: 47 · 2015: 33 · 2014: 29 · 2013: 45 · 2012: 34
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Mediators of Inflammation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
- Keywords
- obesity, metabolic syndrome, chronic inflammation, adipocyte hypertrophy, oxidative stress, insulin resistance, hepatic lipid accumulation, gut microbiota, dietary fat, circadian rhythm, psychological factors, adipose tissue
- MeSH terms
- Animals, Energy Metabolism, Humans, Inflammation, Obesity, Adipocytes, Metabolic Syndrome
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