{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:10:42Z","timestamp":1790125842040,"version":"4.0.1"},"reference-count":170,"publisher":"Portland Press Ltd.","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:p>Obesity is a multifactorial health condition influenced by genetic predisposition and environmental factors, identified as a condition of persistent, mild systemic inflammation marked by an abnormal buildup of fat tissue, becoming clinical when accompanied by functional impairment of organs. This review explores the role of hyperinsulinemia and hypertriglyceridemia in driving the transition from a preclinical to a clinical state of obesity. Insulin resistance leads to compensatory hyperinsulinemia, impairing glucose homeostasis in skeletal muscle, liver, and adipose tissue. Concurrently, excessive dietary fat intake contributes to elevated triglyceride levels, which promote systemic inflammation and facilitate the onset of endocrine and cardio vascular disorders. Early risk factors, such as childhood obesity, as well as other contributors, including chronic psychological stress, alterations in gut microbiota, sleep disturbances, and vitamin D deficiency, are discussed in the context of their role in disease progression. Critically, the concept of a \u2018borderline\u2019 stage is introduced\u2013a transitional phase characterized by elevated triglycerides, insulin resistance, and low-grade chronic inflammation\u2013representing a critical point in the progression toward clinical obesity. Identifying this intermediary stage, even present in other pathologies, offers a valuable window for early interven tion, potentially preventing the establishment of chronic degenerative diseases associated with advanced obesity. Current strategies aimed at controlling hyperinsulinemia and hypertriglyceridemia, including dietary interventions, physical activity, and pharmacological approaches such as GLP-1 receptor agonists and SGLT2 inhibitors, should be considered.<\/jats:p>","DOI":"10.1042\/cs20256728","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:42:46Z","timestamp":1767771766000},"page":"1-26","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The transition from preclinical to clinical obesity: the importance of a borderline stage"],"prefix":"10.1042","volume":"140","author":[{"given":"Jesus E.","family":"Maldonado-Arvizu","sequence":"first","affiliation":[{"name":"1Departamento de Bioqu\u00edmica, Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, Baja California, M\u00e9xico"},{"name":"2Laboratorio Multidisciplinario de Estudios Metab\u00f3licos y C\u00e1ncer, Facultad de Medicina Mexicali, Mexicali, Baja California, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3514-9879","authenticated-orcid":false,"given":"Paula Vanessa","family":"Rios-Verdugo","sequence":"additional","affiliation":[{"name":"1Departamento de Bioqu\u00edmica, Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, Baja California, M\u00e9xico"},{"name":"2Laboratorio Multidisciplinario de Estudios Metab\u00f3licos y C\u00e1ncer, Facultad de Medicina Mexicali, Mexicali, Baja California, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-2268","authenticated-orcid":false,"given":"Jos\u00e9 Fernando","family":"D\u00edaz-Villanueva","sequence":"additional","affiliation":[{"name":"1Departamento de Bioqu\u00edmica, Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, Baja California, M\u00e9xico"},{"name":"2Laboratorio Multidisciplinario de Estudios Metab\u00f3licos y C\u00e1ncer, Facultad de Medicina Mexicali, Mexicali, Baja California, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-0708","authenticated-orcid":false,"given":"Brenda","family":"Chimal-Vega","sequence":"additional","affiliation":[{"name":"1Departamento de Bioqu\u00edmica, Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, Baja California, M\u00e9xico"},{"name":"2Laboratorio Multidisciplinario de Estudios Metab\u00f3licos y C\u00e1ncer, Facultad de Medicina Mexicali, Mexicali, Baja California, M\u00e9xico"},{"name":"3Centro de Investigaci\u00f3n e Innovaci\u00f3n en Salud (CIIS), Universidad Aut\u00f3noma de Baja California, Mexicali, 21000, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8169-3715","authenticated-orcid":false,"given":"Jos\u00e9 L.","family":"Vique-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"3Centro de Investigaci\u00f3n e Innovaci\u00f3n en Salud (CIIS), Universidad Aut\u00f3noma de Baja California, Mexicali, 21000, M\u00e9xico"},{"name":"4Centro de Ciencias de la Salud Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, 21000, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9421-3730","authenticated-orcid":false,"given":"Victor","family":"Garc\u00eda-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"1Departamento de Bioqu\u00edmica, Facultad de Medicina Mexicali, Universidad Aut\u00f3noma de Baja California, Mexicali, Baja California, M\u00e9xico"},{"name":"2Laboratorio Multidisciplinario de Estudios Metab\u00f3licos y C\u00e1ncer, Facultad de Medicina Mexicali, Mexicali, Baja California, M\u00e9xico"},{"name":"3Centro de Investigaci\u00f3n e Innovaci\u00f3n en Salud (CIIS), Universidad Aut\u00f3noma de Baja California, Mexicali, 21000, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"2026011406063212200_CS-2025-6728C1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.22201\/ceiich.24485705e.2022.26.80973","article-title":"La obesidad: aspectos fisiopatol\u00f3gicos y cl\u00ednicos","volume":"10","author":"Kaufer-Horwitz","year":"2021","journal-title":"Id"},{"key":"2026011406063212200_CS-2025-6728C2","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults","volume":"403","author":"Phelps","year":"2024","journal-title":"The Lancet"},{"key":"2026011406063212200_CS-2025-6728C3","unstructured":"World Health Organization. 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