Kang Zezheng, Jin Zishan, Wu Lei, Sun Aru, Dong Lishuo, Li Jiarui, Li Qingwei, Tong Xiaolin
Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China.
Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Jul 14;18:2343-2360. doi: 10.2147/DMSO.S524000. eCollection 2025.
Type 2 diabetes mellitus (T2DM) has a high prevalence worldwide; its cardiac, renal, and visual complications greatly affect patients' quality of life. This, together with the large patient base, makes clinical health management of T2DM a problem. Existing studies have shown that obesity and the onset of T2DM are highly correlated, which can start from the earliest lipid metabolism problems and ultimately develop into T2DM. Moreover, adipose tissue can also seriously affect patient treatment by affecting insulin secretion, promoting pancreatic β-cell proliferation, and increasing insulin resistance. Our study describes the association between obesity and T2DM, summarizes the role played by the adipose tissue in T2DM, and focuses on fatty acid esters of hydroxy fatty acids (FAHFA), whose role in improving insulin secretion and increasing insulin sensitivity shows greater potential in T2DM. In addition, we summarize the existing more mature clinical treatment strategies, such as life interventions, drugs, and surgery, which can help control blood glucose levels and reduce adipose-related insulin resistance by reducing the adipose tissue. Among these treatments, Chinese medicine is another factor worth exploring. However, due to the influence of geography, culture, and other factors, this method has only achieved some success in China and part of the East Asia region and has been applied clinically. Although there is no evidence of clinical benefit for obesity or adipose tissue, its clinical benefit for T2DM has been demonstrated; therefore, there is still a need to develop it, as well as considerable potential for development.
2型糖尿病（T2DM）在全球范围内具有很高的患病率；其心脏、肾脏和视觉并发症极大地影响了患者的生活质量。这与庞大的患者群体一起，使得T2DM的临床健康管理成为一个问题。现有研究表明，肥胖与T2DM的发病高度相关，其可始于最早的脂质代谢问题并最终发展为T2DM。此外，脂肪组织还可通过影响胰岛素分泌、促进胰腺β细胞增殖以及增加胰岛素抵抗来严重影响患者的治疗。我们的研究描述了肥胖与T2DM之间的关联，总结了脂肪组织在T2DM中所起的作用，并重点关注羟基脂肪酸的脂肪酸酯（FAHFA），其在改善胰岛素分泌和增加胰岛素敏感性方面的作用在T2DM中显示出更大的潜力。此外，我们总结了现有的更成熟的临床治疗策略，如生活方式干预、药物和手术，这些策略可通过减少脂肪组织来帮助控制血糖水平并降低与脂肪相关的胰岛素抵抗。在这些治疗方法中，中医药是另一个值得探索的因素。然而，由于地理、文化等因素的影响，这种方法仅在中国和部分东亚地区取得了一些成效并已应用于临床。虽然尚无证据表明其对肥胖或脂肪组织有临床益处，但其对T2DM的临床益处已得到证实；因此，仍有必要对其进行开发，且具有相当大的发展潜力。
