Elabela in Lipid-Related Cardiometabolic Dysfunction: A Critical Narrative Review.

Area of Science:

• Endocrinology
• Metabolic Regulation
• Molecular Biology

Background:

• Elabela (ELA) is an endogenous peptide and ligand for the apelin receptor (APLNR), part of the apelinergic signaling system.
• While ELA's roles in development and cardiovascular health are known, its function in metabolic regulation is unclear.
• ELA activates key metabolic homeostasis pathways, but direct regulation of adipocyte lipid metabolism is not established.

Purpose of the Study:

• To review and categorize existing evidence on Elabela's role in metabolic regulation.
• To evaluate ELA's potential as a direct or indirect modulator of adipocyte lipid metabolism.
• To assess ELA as a potential biomarker for cardiometabolic stress.

Main Methods:

• Narrative review of scientific literature.
• Categorization of evidence at receptor, organ, immunometabolic, and intra-adipocyte levels.
• Consideration of the adipose tissue microenvironment.

Main Results:

• Evidence suggests ELA may indirectly influence lipid metabolism via anti-inflammatory, antioxidant, and tissue-protective mechanisms.
• Macrophage lipid metabolism is identified as a key immunometabolic interface for ELA.
• Human studies are limited by heterogeneity and lack of standardization.

Conclusions:

• Elabela is a candidate indirect modulator of metabolic homeostasis.
• ELA may serve as a biomarker for cardiometabolic stress or adaptation.
• Current data do not support ELA as a direct regulator of adipocyte lipid metabolism.