Effect of Obesity on Liver Cytochrome P450 in Human Models: A Narrative Review

This review investigates the intricate relationship between obesity and the cytochrome P450 (CYP) system, insight on the multiple impact of excessive adiposity on drug metabolism.Beginning with a global perspective on obesity's rise and its alarming health implications, the review finds into the complex of CYP enzymes, emphasizing their crucial role in metabolizing drugs and xenobiotics.Focusing on pharmacokinetic changes in obesity, the review shows alterations in drug absorption, distribution, metabolism, and elimination, underscoring the challenges in predicting drug clearance in obese individuals.Pharmacodynamic variations, encompassing changes in drug efficacy and toxicity, are explored with a specific focus on the intravenous anesthetic propofol.This review highlights the delicate balance in drug toxicity in obesity, where increased metabolism may lead to higher rates of transformation into harmful metabolites.An in-depth examination of specific CYP enzymes, including CYP1A2, CYP2B, CYP3A4, CYP2E1, CYP2D6, and CYP2C19, reveals alterations in their activity within the context of obesity.It concludes by advocating for a personalized approach to drug therapy in obese patients, emphasizing vigilant monitoring and further research to understand the complex interplay between obesity and the liver's CYP system, crucial for enhancing drug safety and efficacy in this expanding patient demographic.