{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:07:17Z","timestamp":1789402037404,"version":"build-2803163510"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Despite extensive research on radiation effects on various tissues, the impact on adipose tissue remains largely unexplored. This represents a critical knowledge gap given adipose tissue\u2019s role as an active endocrine organ and the extensive use of ionizing radiation in medical procedures. This review synthesizes the current evidence regarding the effects of ionizing radiation on adipose tissue pathophysiology, examining molecular mechanisms and clinical implications for metabolic health. We comprehensively reviewed studies investigating radiation effects on adipocytes and adipose-derived stem cells (ADSCs), analyzing different radiation energies, dose rates, and exposure timeframes. Converging evidence demonstrates that different dose protocols with ionizing radiation induce heterogeneous effects on adipose tissue cell number and size, pro-inflammatory secretome, and ADSCs functionality. Clinical studies in childhood cancer survivors reveal strong associations between abdominal radiation exposure and subsequent metabolic dysregulation, including insulin resistance and diabetes. Mechanistic studies suggest radiation-induced oxidative stress, impaired adipogenesis, and altered adipokine secretion as key pathways. Overall, ionizing radiation disrupts adipose tissue function through multiple molecular pathways, potentially predisposing individuals to long-term endocrine and metabolic dysfunctions. Elucidating the underlying mechanisms will contribute to optimize radiation therapy protocols and guide the development of targeted strategies to preserve metabolic health.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1953578","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:48:39Z","timestamp":1789400919000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adipose tissue: an overlooked target of medical ionizing radiation and its metabolic consequences"],"prefix":"10.3389","volume":"14","author":[{"given":"Maria Jos\u00e9","family":"Pereira","sequence":"first","affiliation":[{"name":"Instituto Portugu\u00eas Oncologia de Coimbra Francisco Gentil, E.P.E.","place":["Coimbra, Portugal"]},{"name":"ESTESC - Coimbra Health School, Polytechnic University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Faculty of Sciences and Technology, University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Rosendo-Silva","sequence":"additional","affiliation":[{"name":"ESTESC - Coimbra Health School, Polytechnic University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR) and Institute of Physiology, University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas A.","family":"Marques","sequence":"additional","affiliation":[{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Clinical Academic Center of Coimbra (CACC), Coimbra","place":["Coimbra, Portugal"]},{"name":"Faculty of Medicine, Institute of Biophysics, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Santos","sequence":"additional","affiliation":[{"name":"ESTESC - Coimbra Health School, Polytechnic University of Coimbra","place":["Coimbra, Portugal"]},{"name":"ESTESC - Coimbra Health School, Health and Technology Research Center (H&TRC), Polytechnic University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Matafome","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR) and Institute of Physiology, University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra","place":["Coimbra, Portugal"]},{"name":"ESTESC - Coimbra Health School, Health and Technology Research Center (H&TRC), Polytechnic University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Margarida","family":"Abrantes","sequence":"additional","affiliation":[{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra","place":["Coimbra, Portugal"]},{"name":"Clinical Academic Center of Coimbra (CACC), Coimbra","place":["Coimbra, Portugal"]},{"name":"Faculty of Medicine, Institute of Biophysics, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"ref1","first-page":"747","volume-title":"T\u00e9cnicas de diagn\u00f3stico com raios X - Aspetos F\u00edsicos e Biof\u00edsicos","author":"de 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