Obesity and carbohydrate metabolism disorders as factors modifying the toxic effect of xenobiotics

The influence of chemical factors of production and the environment on humans is increasingly realized against the background of an existing pathological condition: the prevalence of obesity, metabolic syndrome, insulin resistance and other disorders of carbohydrate metabolism is growing in the population, and in a number of occupational groups their share already reaches and even exceeds a third of workers.The study aims to summarize experimental and epidemiological data on obesity, metabolic syndrome, insulin resistance, and other disorders of carbohydrate metabolism as factors modifying the toxic effects of xenobiotics in conditions of occupational and man-made exposure.The search for original in vivo and human studies was conducted in Russian and international databases, taking into account the recommendations of PRISMA; the analysis included 27 sources from 1987–2024, where metabolic disorders were initiated or diagnosed before assessing the effects of chemical agents of various nature.The results show that the metabolic dysregulations under consideration in most cases enhance the toxic effects of xenobiotics, altering their toxicokinetics and toxicodynamics and increasing the severity of hepatotoxicity, nephrotoxicity, and cardiotoxicity, oxidative stress, and inflammation. Data from epidemiological studies in the working cohort and in the general population, although extremely limited in the number of studies, generally confirm that obesity, metabolic syndrome, insulin resistance and other disorders of carbohydrate metabolism act not only as a background, but also as independent determinants of sensitivity to chemical stress. Given the high prevalence of these conditions among the working-age population, it is necessary to consider the possibility of taking them into account when assessing health risks and developing preventive measures.Ethics. The study did not require the conclusion of a bioethical commission.Funding. The study had no funding.Conflict of interest. The author declares no conflict of interest.Received: 23.12.2025 / Accepted: 11.02.2026 / Published: 27.03.2026