Metabolic syndrome: molecular mechanisms and therapeutic interventions

Abstract Metabolic syndrome (MetS, MS) is a group of metabolic disorders characterized by central obesity, insulin resistance, dyslipidemia, and imbalance of glucose homeostasis. Studies have revealed that the molecular mechanism of MetS may be related to adipose dysfunction, insulin resistance, chronic inflammation, oxidative stress, the gut microbiota and epigenetic modifications. At present, the clinical treatment of MetS is limited to lifestyle changes and targeted drugs for a single risk factor, which makes it difficult to achieve the desired effects. Recent studies have shown that the gut microbiota and its metabolites play important roles in various metabolic activities. Polyphenols are the most prevalent chemical components in traditional Chinese medicines (TCMs). TCMs have long been used in the treatment of MetS. TCM polyphenols exhibit significant efficacy in the treatment of MetS by regulating the homeostasis of the gut microbiota, affecting the secretion of its metabolites, and regulating related upstream and downstream pathways such as the AMPK, PPAR, MAPK, PI3K/Akt and NF-κB pathways. This study investigated the molecular mechanisms of MetS and gut microbiota homeostasis in relation to the therapeutic efficacy of TCM polyphenols against MetS. This study further compared TCM polyphenols with existing treatments, thus providing a novel theoretical basis and strategy for MetS treatment and prevention using TCM polyphenols.