Abstract Central obesity is characterized primarily by visceral fat accumulation, which increases the risk of metabolic complications and premature death. This study reviewed literature on central obesity published in databases such as PubMed and China National Knowledge Infrastructure from 2004 to 2024, reviewing advancements in its pathogenesis, diagnosis, and prevention/treatment. Regarding pathogenesis, abnormalities in epigenetic regulation, gut microbiota imbalance, dysfunction of the hypothalamic-pituitary-adrenal axis and the gut-brain axis contribute to abnormal visceral fat accumulation, leading to central obesity. In terms of diagnosis, the optimized application of the International Diabetes Federation's waist circumference criteria, along with Chinese indicators such as waist-to-hip ratio and waist-to-height ratio, enhances early identification and diagnostic accuracy. For prevention and treatment, lifestyle interventions including energy-restricted diets, intermittent fasting, and optimized exercise regimens combined with multidimensional strategies involving pharmacotherapy and bariatric surgery, can effectively improve central obesity. With advances in precision medicine and translational medicine, the management of central obesity is shifting from empirical medicine to precision medicine and from single-treatment approaches to comprehensive interventions, providing evidence-based foundations for refining strategies aimed at central obesity prevention and control.

Objective To investigate the effect of gastrointestinal lipase inhibitor combined with biguanides on serum estrogens in the treatment of polycystic ovary syndrome with infertility in patients.Methods 72 cases with polycystic ovary syndrome with infertility from Huangyan Hospital Affiliated to Wenzhou Medical University were selected and randomly divided into 2 groups, 36 cases of each group.The control group received conventional therapy, and the treatment group received more with orlistat, serological indicators, clinical symptoms, signs, pregnancy rate and ovulation rate were compared after the treatment.Results Compared with control group, levels of blood glucose and blood lipid index decreased in treatment group after treatment (P<0.05), the levels of luteinizing hormone (LH), follicles estrogen (FSH), estradiol (E2) and testosterone (T) decrease(P<0.05), levels of visfatin (VF) and leptin (LEP) decreased(P<0.05), adiponectin (APN) increased(P<0.05), and levels of BMI, WHR, hirsutism score and ovarian volume decreased (P<0.05).Compared with the control group(69.44%, 55.56%), the ovulation rate and pregnancy rate in the treatment (91.67%, 80.56%) were higher(P<0.05).Conclusion Gastrointestinal lipase inhibitor combined with biguanides could improve the pregnancy rate and ovulation rate in patients with polycystic ovary syndrome with infertility, reduce the levels of estrogens.