Endotoxins and Metabolic Endotoxemia in Obesity and Associated Noncommunicable Diseases: A Focus on Sex Differences.

Gut dysbiosis is a hallmark of obesity and contributes to metabolic endotoxemia through impaired intestinal barrier function.

• Microbial imbalance and impaired intestinal mucosa allow bacterial endotoxins, specifically lipopolysaccharides (LPS), to translocate from the gut into the bloodstream.
• Circulating LPS sustain a prolonged, sterile, low-grade inflammation that raises the risk of several noncommunicable diseases.
• Diet has been reported to regulate both inflammation and disease risk by affecting gut microbiota composition and gut barrier function.

The risk and incidence of obesity and several obesity-associated disorders are sex-specific.

• Increasing evidence indicates sex differences in the risk and incidence of obesity and associated disorders.
• The underlying mechanisms of sex differences in obesity-related disease risk are described as 'only just emerging.'
• Most of the factors influencing metabolic endotoxemia exhibit sexual dimorphism.

Metabolic endotoxemia has been proposed as a possible mechanism to explain the link between inflammation, obesity, and obesity-associated disorders.

• The review focuses on human studies investigating the role of metabolic endotoxemia in obesity and associated diseases.
• Circulating endotoxins are discussed as having clinical relevance in metabolic derangements.
• Endotoxins are identified as potential sex-related and modifiable risk factors to consider in future prevention strategies.

Circulating endotoxins are discussed as potential sex-related and modifiable risk factors relevant to metabolic derangements.

• The review highlights the potential role of circulating endotoxins in prevention strategies.
• Sex differences in metabolic endotoxemia are emphasized as a focus area for future research.
• The authors discuss the clinical relevance of circulating endotoxins specifically in the context of metabolic derangements associated with obesity.

Most factors influencing metabolic endotoxemia exhibit sexual dimorphism.

• Sexual dimorphism is noted across most of the factors that influence metabolic endotoxemia.
• This sexual dimorphism is identified as a notable and recurring theme across the reviewed literature.
• The review specifically aims to summarize human studies highlighting sex differences in metabolic endotoxemia and associated diseases.