Extracellular vesicles and the lipid messengers: The adipose tissue connection to cancer and metabolic disease

Adipose tissue is essential for maintaining metabolic balance by serving as a major lipid depot for energy storage and release, while also secreting adipokines and extracellular vesicles that regulate inflammation and insulin sensitivity. The lipidic content of adipose tissue not only supports energy homeostasis but also contributes to its inflammatory profile, with altered lipid composition being a key factor in the pathogenesis of metabolic diseases such as obesity, type 2 diabetes, and cardiovascular disorders. Moreover, adipose tissue-derived extracellular vesicles, enriched in lipids, have emerged as significant mediators of intercellular communication, influencing local and systemic processes, including tumor progression. Adipose tissue-derived extracellular vesicles (EVs) have emerged as pivotal mediators of intercellular communication, with increasing evidences describing their role in microenvironment communication. In this review, we explore the diverse lipid species identified within EVs and examine lipidomics as a powerful and emerging technique to decode their functional roles. By analyzing the lipid cargo of these vesicles, we highlight their potential influence on cancer progression and cardiovascular disease. Furthermore, we discuss the broader implications of EV-derived lipids in metabolic regulation and disease pathophysiology. Understanding the complex interplay between EV lipid composition and pathological processes could open new avenues for biomarker discovery and therapeutic interventions in oncology and cardiovascular medicine.