Obesity, and other metabolic diseases including non-alcoholic fatty liver disease (NAFLD), metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM) and its related complications like chronic kidney disease (CKD), and hepatocellular carcinoma (HCC) have led to alarming health and social burdens globally and in China as well. Although strong links exist among those multifactorial metabolic disorders, there are limited researches on better understanding of their pathogenesis and the provision of effective interventional measures in practice. In this special issue, we have five researches including three research articles providing new insights into potential mechanisms in the development and possible prevention and treatment therapies of NAFLD, HCC, and CKD, as well as two review articles summarizing multi-omics profiling and future strategies for precision medicine in T2DM, NAFLD, and MetS, and the rapid advances in the field of metabolic surgery in China.
Due to its high prevalence and complex damages from simple steatosis to HCC, NAFLD has received extensive attention. Although dysregulation of mitochondrial functions is reported to aid in the development of NAFLD, there were few studies focusing on uncovering the association of insulin-like growth factor 2 (IGF2) with mitochondrial functions in the liver. In this issue, Gui et al. (2021) demonstrated that IGF2 modulated the expression of SIRT1 and the downstream gene PGC1α, and thus regulated mitochondrial functions, which might aid in the development of NAFLD. This study provided evidence in making IGF2 a potential target for treatment of NAFLD. Additionally, NAFLD and environment risk factors have been proved to exert adverse effects on the development of HCC. As a common environmental and foodborne pollutant in smoke and fire-grilled foods, benzo(a)pyrene (B[a]P) might facilitate the transition of NAFLD to HCC. However, the role of B[a]P in HCC progression and its related molecular and toxicological mechanisms remained unclear. Ge et al. (2021) found that among various miRNAs, miR-650 could be the most important inducer in B[a]P-exposed liver cancer. These findings might facilitate the prevention strategy making in public health.
Precision medicine was first put forward in 2008, indicating personalized medical treatments to enhance treatment effectiveness and tolerability. To better understand the association of dyslipidemia with obesity and the development of IgA nephropathy (IgAN) and find possible predictive markers for guiding the interventional measures of traditional Chinese medicine and combined treatment, Deng et al. (2021) uncovered the positive association of different dyslipidemia patterns with high body mass index among IgAN patients of different obesity patterns. Furthermore, they found that elevated levels of triacylglycerols species containing linolenic acid mainly promoted IgAN progression and the association of circulating lipids with treatment outcomes in IgAN (Deng et al., 2021). These findings provided new insight in achieving precision medicine for IgAN patients. Compared to the limited power of single-omics data, multi-omics data, including genetic, epigenomic, transcriptomic, proteomic, and metabolic information, may provide a more comprehensive analysis for precision medicine. In this issue, Hu and Jia (2021) provided a summary of the latest multi-omics studies of T2DM, NAFLD, and MetS, highlighting the potential biomarkers and strategies for precision medicine in the future.
Finally, metabolic surgery exists as a new type of treatment in obesity these years. Since 2016, it has been included in an international joint statement as a recommended treatment for T2DM. It changes the volume and order of the gastrointestinal tract to reduce weight and improve obesity-related complications. In China, there were over 5000 patients receiving metabolic surgery per year with the development of this technology in clinical practice. Tu et al. (2021) presented a narrative review on the efficacy and safety of this new treatment, as well as the latest progress of studies on mechanisms and surgical procedures from China. For now, the advantages of metabolic surgery in weight loss and improvement of hyperglycemia and related complications are clear. Some studies also showed that, compared with drug treatment, metabolic surgery presents better economic benefits and reduction of hospitalization. However, the long-term effectiveness and safety still needs to be explored. Thus, it is essential to develop metabolic surgery registration systems in China.
References
- Deng Y., Wu Q., Chen W., et al. (2021). Lipidomics reveals association of circulating lipids with body mass index and outcomes in IgA nephropathy patients. J. Mol. Cell Biol. 13, 565–575. [DOI] [PMC free article] [PubMed] [Google Scholar]
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