Role of adipocytes and their derived extracellular vesicles in the progression, diagnosis and treatment of liver diseases (Review)

The growing burden of liver diseases underscores the urgent need to elucidate the adipose‑liver axis. Although adipocyte dysfunction, dysregulated adipokine secretion and adipocyte‑derived extracellular vesicles (Ad‑EVs) have been implicated in hepatic steatosis, inflammation and fibrogenesis, their precise pathogenic roles and translational potential remain incompletely defined. The present review uniquely centers on adipocytes as a specific cellular source, systematically examining their biological functions and those of Ad‑EVs, delineating their differential roles across the stages of liver disease, and evaluating adipocyte‑targeted therapeutic strategies together with their clinical prospects. However, the clinical translation of adipocyte‑targeted interventions and Ad‑EV‑based applications is constrained by several limitations: Current mechanistic evidence derives largely from preclinical models and awaits validation in human adipose tissue and liver biopsy specimens; moreover, methods for the isolation and characterization of Ad‑EVs have yet to be standardized. The present review aimed to identify the translational connections and unresolved challenges within the adipose‑liver axis, thereby informing basic research and the clinical diagnosis and treatment of liver diseases.