Review Article Volume 20 Issue 1 - 2025

Homeostatic Adjustments in Obesity: Narrative Review

Rosini Sergio1, Rosini Stefano2, Molfetta Francesco3, Florian Andrea4 and Luigi Molfetta4*

1Biomaterial Research Center, Livorno, Italy
2Smile-Restyle, Livorno, Italy
3DINOGMI Department, School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy
4DISC Department, School of Medical and Pharmaceutical Sciences, University of Genoa, Research Center of Osteoporosis and Osteoarticular Pathologies, Genoa, Italy

*Corresponding Author: Luigi Molfetta, Professor, DISC Department, School of Medical and Pharmaceutical Sciences, University of Genoa, Research Center of Osteoporosis and Osteoarticular Pathologies, Genoa, Italy.
Received: August 11, 2025; Published: September 02, 2025



Numerous regulatory mechanisms are activated by the human body to restore altered metabolic conditions to normal, i.e. to re-establish disrupted homeostasis. This occurs when there is a deficiency of a crucial metabolic factor such as Vitamin D (Vit D) or in the presence of a more complex pathophysiological condition, such as obesity. The organism adopts compensatory measures to correct these metabolic disturbances, which may in turn induce temporary functional imbalances in other organs, with outcomes that are not always fully understood. Obesity induces an imbalance not only due to elevated leptin levels but also by promoting the adipogenic differentiation of mesenchymal stem cells and enhancing parathyroid hormone (PTH) secretion. This leads to increased osteoclastic activity, secondary hyperparathyroidism, enhanced bone resorption and interference with renal function. Consequently, in the broader context of homeostatic regulation, much remains unknown regarding the intricate mechanisms by which the body maintains physiological equilibrium and how these are affected by disease states or pharmacological therapies.

 Keywords: Homeostasis; Deficiencies; Obesity; Hypovitaminosis; Metabolic Complications

  1. Goltzman D., et al. “Physiology of the calcium-parathyroid hormone vitamin D axis”. Frontiers of Hormone Research 50 (2018): 1-13.
  2. Gembillo G., et al. “Vitamin D and glomerulonephritis”. Medicina (Kaunas)2 (2021): 186.
  3. Aysha Habib Khan., et al. “Are serum leptin levels predicted by lipoproteins, vitamin D and body composition?” World Journal of Diabetes 4 (2019): 260-268.
  4. Ren Y., et al. “Adipokines, hepatokines and myokines: focus on their role and molecular mechanisms in adipose tissue inflammation”. Frontiers in Endocrinology (Lausanne) 13 (2022): 873699.
  5. Monteiro L., et al. “Leptin in the regulation of the immunometabolism of adipose tissue-macrophages”. Journal of Leukocyte Biology 3 (2019): 703-716.
  6. Martiniakova M., et al. “Links among obesity, type 2 diabetes mellitus, and osteoporosis: bone as a target”. International Journal of Molecular Science 9 (2024): 4827.
  7. Forte YS., et al. “Cellular and molecular mechanisms associating obesity to bone loss”. Cells 4 (2023): 521.
  8. Obradovic M., et al. “Leptin and obesity: role and clinical implication”. Frontiers in Endocrinology (Lausanne) 12 (2021): 585887.
  9. Kuronuma K., et al. “Matrix Gla protein maintains normal and malignant hematopoietic progenitor cells by interacting with bone morphogenetic protein-4”. Heliyon4 (2020): e03743.
  10. Zhang L., et al. “Two-step regulation by matrix Gla protein in brown adipose cell differentiation”. Molecular Metabolism 80 (2024): 101870.
  11. Oury F and Karsenty G. “Towards a serotonin-dependent leptin roadmap in the brain”. Trends in Endocrinology and Metabolism 9 (2011): 382-387.
  12. Marazziti D., et al. “The complex interactions among serotonin, insulin, leptin, and glycolipid metabolic parameters in human obesity”. CNS Spectrums 1 (2022): 99-108.
  13. Silva BC., et al. “Catabolic and anabolic actions of parathyroid hormone on the skeleton”. Journal of Endocrinological Investigation 10 (2011): 801-810.
  14. Chen T., et al. “Parathyroid hormone and its related peptides in bone metabolism”. Biochemical Pharmacology 192 (2021): 114669.
  15. Mizokami A., et al. “Osteocalcin and its endocrine functions”. Biochemical Pharmacology 132 (2017): 1-8.
  16. Bilotta FL., et al. “Insulin and osteocalcin: further evidence for a mutual cross-talk”. Endocrine3 (2018): 622-632.
  17. Channuwong P., et al. “Hyperglycemia from diabetes potentiates uncarboxylated osteocalcin-stimulated insulin secretion in rat INS-1 pancreatic β-cells”. Nutrients15 (2024): 2384.

Luigi Molfetta., et al. “Homeostatic Adjustments in Obesity: Narrative Review”. EC Nutrition  20.1 (2025): 01-05.