Molecular Mechanisms Linking Obesity and Type 2 Diabetes: Pathogenesis, Biomarkers, and Therapeutic Potential

Obesity and diabetes are major global health burdens, with their prevalence projected to continue rising. The comorbidity of obesity and diabetes increases the risk of serious complications and mortality, highlighting the need for early prevention and intervention. However, the precise mechanisms underlying their relationship remain unclear. A review of ten articles selected from PubMed and published from 2016 to 2026 was conducted to study the pathogenesis of type 2 diabetes (T2D) in the context of obesity and to identify biomarkers with potential for novel treatment strategies. Circulating myeloperoxidase (MPO), piezo-type mechanosensitive ion channel component 1 (PIEZO1), branched-chain amino acids, particularly BCKDH phosphatase, and lectins, such as Gal-4, may serve as inflammatory markers in comorbid obesity and T2D. α-2-Macroglobulin (α2-MG) may be a possible predictive marker in the comorbidity. Angiopoietin-like protein 6 (ANGPTL6) levels may be involved in the T2D pathway. Macrophage and THP-1 exosomes have been shown to be involved in the regulation of inflammation and reduce the expression of proinflammatory genes in mouse models. A thorough understanding of the pathways linking diabetes and obesity is essential for effective prevention, diagnosis, and treatment in T2D patients with obesity. Further research into these biomarkers may contribute to improved patient outcomes and more effective therapeutics.