{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:59:18Z","timestamp":1790863158678,"version":"4.1.0"},"reference-count":213,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2023YFS007"],"award-info":[{"award-number":["2023YFS007"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2023YFS007"],"award-info":[{"award-number":["2023YFS007"]}],"id":[{"id":"https:\/\/ror.org\/04323m874","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Extracellular vesicles (EVs) have emerged as key mediators of intercellular communication, shuttling bioactive proteins, lipids, and nucleic acids between organs to maintain metabolic homeostasis. In this review, we provide an overview of recent advances in EV-mediated local and systemic communication across four interconnected metabolic diseases: diabetes, obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), and sarcopenia, with a focus on the mechanistic roles of EVs in disease onset, adaptation, and progression. We highlight how EVs from the pancreas, adipose tissue, liver, and skeletal muscle propagate metabolic dysfunction across organs, and identify some shared cargo signatures, including miR-27a, miR-155, miR-146a-5p, miR-690, CXCL10, RBP4, ceramides, adipokine composition, and mitochondrial components, which may represent common pathogenic mechanisms. Current EV-based therapeutic strategies are discussed, and future efforts should prioritize the standardization of EV isolation and characterization to improve reproducibility, thereby facilitating clinical translation.<\/jats:p>","DOI":"10.3390\/ijms27188287","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:18:26Z","timestamp":1790860706000},"page":"8287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracellular Vesicle-Mediated Local and Systemic Communication in Metabolic Diseases"],"prefix":"10.3390","volume":"27","author":[{"given":"Rong-Ping","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9388-2887","authenticated-orcid":false,"given":"Li-Ping","family":"Gou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Fang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Min","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack Isaac","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, 43180 M\u00f6lndal, Sweden"},{"name":"Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-Ning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Hui","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Department of Biotherapy, Center for Diabetes and Metabolism Research, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5395-3660","authenticated-orcid":false,"given":"Nan-Wei","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, West China Hospital, Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1111\/dom.70398","article-title":"Spatiotemporal burden, risk factors, and genetic causality of non-alcoholic fatty liver disease and type 2 diabetes mellitus comorbidity in Europe: A multi-database analysis","volume":"28","author":"Hu","year":"2026","journal-title":"Diabetes Obes. 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