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Obesity-Related Metabolic and Cardiovascular Disorders
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Obesity-Related Metabolic and Cardiovascular Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 3380

Special Issue Editors

Prof. Dr. Lucia Frittitta

E-Mail Website
Guest Editor
1. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
2. Diabetes and Obesity Center, Garibaldi Hospital, Catania, Italy
Interests: insulin; adipose tissue; insulin resistance; type 2 diabetes mellitus; metabolism; bariatric surgery
Dr. Federica Vinciguerra

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
Interests: insulin; adipose tissue; insulin resistance; type 2 diabetes mellitus; metabolism; bariatric surgery

Special Issue Information

Dear Colleagues,

Obesity has emerged as a global pandemic and serves as a primary driver of metabolic and cardiovascular complications. The complex interplay among obesity-related disorders—including insulin resistance, type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease—represents one of the most pressing challenges in contemporary medicine. These interconnected conditions share common pathophysiological pathways and amplify each other’s effects, creating a multifaceted clinical landscape that necessitates innovative, integrative approaches.

This Special Issue will focus specifically on obesity-related metabolic and cardiovascular disorders, exploring the mechanistic links that connect adipose tissue dysfunction with systemic metabolic disruption and cardiovascular pathology. We invite contributions that will advance our understanding of how obesity initiates and perpetuates these cascading health complications, while also presenting evidence-based solutions for its prevention and management.

This Special Issue will bring together multidisciplinary perspectives to address several critical areas:

  • Adipose tissue dysfunction and its role in metabolic inflammation;
  • Endothelial dysfunction and vascular complications in obesity;
  • Health disparities and social determinants in obesity-related disorders;
  • Epidemiological trends and health disparities in obesity-related disorders across diverse populations and geographic regions;
  • Novel diagnostic approaches and biomarkers for early detection and more precise risk stratification;
  • Integrated prevention strategies spanning lifestyle interventions, pharmacological approaches, and policy measures;
  • Emerging therapeutic targets and personalized medicine approaches and their roles in modifying disease trajectories;
  • Special considerations for vulnerable populations, including children, the elderly, and underserved communities.

By showcasing contributions from leading researchers and clinicians in endocrinology, cardiology, metabolism, public health, and related fields, this Special Issue will facilitate the cross-disciplinary collaboration that is essential in addressing the spectrum of obesity-related health challenges. The insights gleaned will inform the development of innovative approaches to the prevention, diagnosis, and management of obesity-related cardiometabolic dysfunction, ultimately improving global health and patient outcomes.

Prof. Dr. Lucia Frittitta
Dr. Federica Vinciguerra
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • obesity
  • type 2 diabetes mellitus
  • insulin resistance
  • metabolic syndrome
  • cardiovascular disease
  • lipid disorder
  • adipose tissue dysfunction
  • visceral adiposity
  • cardiometabolic risk
  • endothelial dysfunction
  • health disparities
  • gut microbiota
  • bariatric surgery
  • precision medicine

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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13 pages, 253 KB  
Article
Study of the Relationship Between the Number of Metabolic Syndrome Components and Subclinical Cardiac Dysfunction: A Retrospective Analysis
by Monika Starzak, Grzegorz K. Jakubiak, Natalia Pawlas, Grzegorz Cieślar and Agata Stanek
J. Clin. Med. 2026, 15(8), 2920; https://doi.org/10.3390/jcm15082920 - 11 Apr 2026
Viewed by 495
Abstract
Background: Metabolic syndrome (MetS) comprises coexisting risk factors enhancing the likelihood of developing cardiovascular disease (CVD). The aim of this study was to investigate the correlation between the number of MetS components and subclinical cardiac dysfunction, assessed via transthoracic echocardiography (TTE), in individuals [...] Read more.
Background: Metabolic syndrome (MetS) comprises coexisting risk factors enhancing the likelihood of developing cardiovascular disease (CVD). The aim of this study was to investigate the correlation between the number of MetS components and subclinical cardiac dysfunction, assessed via transthoracic echocardiography (TTE), in individuals without overt CVD. Methods: A retrospective analysis was performed using data from 100 patients (63% female; mean age 58.8 ± 16.81 years) hospitalized in the Department of Internal Medicine, Angiology and Physical Medicine at the Medical University of Silesia in Katowice, Poland, between June 2022 and February 2024. The inclusion criteria were the absence of diagnosed atherosclerotic CVD and no evidence of acute illness or exacerbation of chronic diseases. Each participant was evaluated for MetS components and underwent TTE. Results: Univariate analysis revealed significant correlations between the number of MetS components and selected TTE parameters, including left ventricular mass (LVM) (R = 0.406; p < 0.001), left ventricular mass index (LVMI) (R = 0.248; p = 0.013), left ventricular ejection fraction (LV EF) (R = −0.261; p = 0.009), left atrial volume (LAV) (R = 0.312; p < 0.001), and left atrial volume index (LAVI) (R = 0.273; p = 0.007). These correlations did not remain significant after adjusting for age, sex, and body mass index (BMI). Among patients not meeting the full diagnostic criteria for MetS, LAV and LAVI values remained significantly correlated with the number of MetS components, independent of confounding variables. Conclusions: The selected echocardiographic parameters were significantly correlated with the number of MetS components; however, most associations were explained by age, sex, and BMI. Full article
(This article belongs to the Special Issue Obesity-Related Metabolic and Cardiovascular Disorders)
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10 pages, 492 KB  
Article
Undiagnosed Diabetes in Metabolically Unhealthy Normal Weight Adults: A Cross-Sectional Analysis of National Health and Nutrition Examination Survey Cycle 2017–2020 in the United States
by Sándor Pál and Annamária Sepsey
J. Clin. Med. 2026, 15(4), 1385; https://doi.org/10.3390/jcm15041385 - 10 Feb 2026
Viewed by 562
Abstract
Background/Objectives: Although body mass index (BMI) is a conventional screening tool for type 2 diabetes mellitus (T2D), its reliability as a sole indicator of metabolic health is controversial, and the metabolic profile of a subset of individuals with normal BMI is indicative [...] Read more.
Background/Objectives: Although body mass index (BMI) is a conventional screening tool for type 2 diabetes mellitus (T2D), its reliability as a sole indicator of metabolic health is controversial, and the metabolic profile of a subset of individuals with normal BMI is indicative of obesity-related complications. This study aimed to estimate the prevalence and predictors of undiagnosed diabetes among Metabolically Unhealthy Normal Weight (MUNW) adults. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2017–March 2020 were analyzed. Normal weight adults (BMI 18.5–24.9 kg/m2) were categorized into Metabolically Healthy (MHNW) and Unhealthy (MUNW) phenotypes based on the presence of ≥2 metabolic risk factors, including elevated blood pressure, triglycerides, waist circumference, or low HDL cholesterol. The primary outcome was undiagnosed diabetes, defined as HbA1c ≥ 6.5% or Fasting Plasma Glucose ≥ 126 mg/dL. Results: The study population represented approximately 60 million US adults. The prevalence of undiagnosed diabetes was nearly four times higher in the MUNW group (4.84%) compared to the MHNW group (1.28%). In multivariable logistic regression analysis, age and race emerged as significant predictors. Notably, Asian adults exhibited a significantly higher risk of undiagnosed diabetes (OR 6.10; 95% CI: 1.32–28.2) compared to White adults, independent of metabolic phenotype. Conclusions: Reliance solely on BMI may overlook undiagnosed diabetes in normal-weight adults, particularly those with metabolic clustering or of Asian descent. These findings underscore the importance of multidimensional risk assessment integration into preventive care, optimizing clinical management. Full article
(This article belongs to the Special Issue Obesity-Related Metabolic and Cardiovascular Disorders)
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17 pages, 288 KB  
Article
Sociodemographic and Health Determinants of Adipose Tissue Distribution in a Local Community from Eastern Poland: A Cross-Sectional Study
by Maciej Polak, Grzegorz Józef Nowicki, Magdalena Kozela, Maciej Matyja and Barbara Ślusarska
J. Clin. Med. 2025, 14(18), 6642; https://doi.org/10.3390/jcm14186642 - 20 Sep 2025
Viewed by 840
Abstract
Objectives: The aim of this study was to assess the distribution of abdominal volume index (AVI) conicity index (C-Index) and weight adjusted waist index (WWI) attributes by sociodemographic and health characteristics in apparently healthy individuals (residents of the Janów Lubelski district in the [...] Read more.
Objectives: The aim of this study was to assess the distribution of abdominal volume index (AVI) conicity index (C-Index) and weight adjusted waist index (WWI) attributes by sociodemographic and health characteristics in apparently healthy individuals (residents of the Janów Lubelski district in the eastern Poland). Additionally, the study examined whether sociodemographic and health characteristics differentiate the distribution of adipose tissue indicators in individuals with a normal body weight, defined as a BMI of less than 25 kg/m2. Methods: A total of 3752 apparently healthy respondents participated in the cross-sectional study. In order to determine the participants’ adipose tissue distribution, professionally trained nurses measured their anthropometric indices and interviewed them to assess the sociodemographic and health variables. Results: The study group’s mean values for anthropometric indices related to central adipose tissue distribution were as follows: C-Index 1.26 ± 0.088, AVI 18.28 ± 4.96 and WWI 10.63 ± 0.73. The three indices examined in multivariable analyses showed a significant relationship with age, gender, place of residence, education, living alone, smoking status, alcohol consumption and comorbidities (diabetes, hypertension and hypercholesterolemia). Conclusions: The study findings demonstrate a significant relationship between the level of specific anthropometric indices related to central adipose tissue distribution and sociodemographic and health-related variables. The employment of certain anthropometric indices related to central adipose tissue distribution, which are derived from waist circumference, can be beneficial in primary healthcare by potentially facilitating early prevention of cardiometabolic diseases. Full article
(This article belongs to the Special Issue Obesity-Related Metabolic and Cardiovascular Disorders)

Review

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28 pages, 1509 KB  
Review
Gaps in Current Cardiometabolic Risk Assessment: A Review Supporting the Development of the C.O.R.E. Indicator Model
by Calogero Geraci, Giulio Geraci, Agostino Buonauro, Valentina Morello, Francesca La Rocca and Roberta Esposito
J. Clin. Med. 2026, 15(2), 617; https://doi.org/10.3390/jcm15020617 - 12 Jan 2026
Cited by 1 | Viewed by 994
Abstract
Obesity is a multidimensional condition characterized by autonomic imbalance, metabolic inflexibility, impaired physical resilience, and ectopic adiposity, pathophysiological alterations that arise long before overt cardiometabolic disease becomes clinically detectable. Despite this, current cardiometabolic risk scores continue to rely predominantly on biochemical and anthropometric [...] Read more.
Obesity is a multidimensional condition characterized by autonomic imbalance, metabolic inflexibility, impaired physical resilience, and ectopic adiposity, pathophysiological alterations that arise long before overt cardiometabolic disease becomes clinically detectable. Despite this, current cardiometabolic risk scores continue to rely predominantly on biochemical and anthropometric variables, such as BMI, waist circumference, glucose, and lipid levels. While these markers are practical, inexpensive, and validated across large population cohorts, growing evidence shows that they offer limited incremental predictive value and fail to capture early functional and structural abnormalities. The recent literature highlights the prognostic importance of autonomic dysfunction, reduced metabolic flexibility, diminished cardiorespiratory fitness, impaired muscular strength, and ectopic fat depots including visceral and epicardial adiposity, independently of the traditional anthropometric indices. The domains remain absent from traditional algorithms such as the Metabolic Syndrome criteria, the Framingham Risk Score, and SCORE2. As a result, cardiometabolic risk is frequently underestimated in key subgroups, including young adults with obesity, individuals with high visceral adiposity but normal BMI, those with subclinical myocardial dysfunction, and metabolically unhealthy normal-weight phenotypes. This narrative review synthesizes current evidence on obesity-related cardiometabolic impairment, highlights major gaps in established risk scores, and supports the conceptual development of the C.O.R.E. (Cardio-Obesity Risk Evaluation) Indicator Model—a hypothesis-generating, non-validated multidomain framework integrating autonomic, metabolic, functional, and structural markers to enable earlier risk phenotyping in future studies. Full article
(This article belongs to the Special Issue Obesity-Related Metabolic and Cardiovascular Disorders)
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