Current Knowledge of Obesity-Related Vascular Injury

Obesity has emerged as a serious public health concern, exerting direct and indirect detrimental effects on vascular injury. This review systematically integrates current knowledge regarding the pathological effects, underlying mechanisms, and recent advances in understanding obesity-induced vascular injury. Obesity triggers pathological changes such as adipose tissue abnormalities, systemic metabolic disorders, and chronic inflammation. These alterations subsequently promote vascular wall pathology through multiple interconnected mechanisms, including adipokine imbalance disrupting endothelial homeostasis and vascular smooth muscle cell phenotypic switching, chronic inflammatory responses triggering vascular remodeling, insulin resistance impairing vascular reactivity, and enhanced oxidative stress accelerating vascular senescence. Notably, obesity establishes a complex interorgan crosstalk network involving adipose tissue, vascular systems, immune components, hepatic function, and lymphatic circulation, which collectively exacerbate vascular damage through paracrine and endocrine pathways. Although some progress has been made in this field, several knowledge gaps and research limitations remain to be addressed. This comprehensive review not only synthesizes existing findings on obesity-related vascular injury but also proposes future research directions based on current limitations, thereby providing a theoretical framework for developing novel preventive and therapeutic strategies against obesity-associated vascular pathologies.