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Also, TGR5 seems to have an important role in the maintenance of intestinal barrier integrity, since murine models TGR5 deficient developed an increased intestinal permeability, made of an altered molecular architecture of epithelial thigh junctions with an increased expression and an abnormal distribution of zonulin-1 [25]

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The causes can be broadly categorised into exogenous (external) and endogenous (internal) factors, with the latter being of greater clinical significance

(12) The growing number of orthopedic patients with obesity thus underscores an urgent need for interventions that target both weight reduction and metabolic optimization, offering the potential to improve overall surgical safety and long-term musculoskeletal health