Brain-gut interaction for holistic regulation: Transcutaneous auricular vagus nerve stimulation in modulating glucose and lipid metabolic disorders

Dysregulation of glucose and lipid metabolism is a systemic disorder involving intricate interactions between the central nervous system, which governs stress and emotional regulation, and peripheral organs such as the gastrointestinal tract, liver, and pancreas. As a key component of the autonomic nervous system, the vagus nerve plays a pivotal role in regulating metabolic homeostasis through its widespread distribution and bidirectional communication along the gut-brain axis. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising non-pharmacological therapy for metabolic disorders, modulating autonomic function via brain-gut coordination to reduce food intake and enhance energy expenditure, thereby alleviating obesity, type 2 diabetes, and related conditions. However, the dynamic mechanisms by which taVNS maintains homeostatic balance through the gut-brain axis, as well as its novel targets, mediators, and pathways, remain elusive. Based on the concept of "brain-gut interaction for holistic regulation", this review explores the potential mechanisms of taVNS in ameliorating glucose and lipid metabolic disorders, offering new perspectives and strategies for clinical intervention.