Zhou ZP. Letter to the Editor: Dynamic SERCA regulation and early metabolic dysfunction in young adults with high waist-to-height ratio. World J Diabetes 2026; 17(9): 123444 [DOI: 10.4239/wjd.123444]
Corresponding Author of This Article
Zhi-Peng Zhou, Department of Integrated Traditional Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Qiuyang Road, Fuzhou 350122, Fujian Province, China. zhouzhipengl@163.com
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Biochemistry & Molecular Biology
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letter
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Zhou ZP. Letter to the Editor: Dynamic SERCA regulation and early metabolic dysfunction in young adults with high waist-to-height ratio. World J Diabetes 2026; 17(9): 123444 [DOI: 10.4239/wjd.123444]
World J Diabetes. Sep 15, 2026; 17(9): 123444 Published online Sep 15, 2026. doi: 10.4239/wjd.123444
Letter to the Editor: Dynamic SERCA regulation and early metabolic dysfunction in young adults with high waist-to-height ratio
Zhi-Peng Zhou
Zhi-Peng Zhou, Department of Integrated Traditional Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China
Author contributions: Zhou ZP conceptualized the commentary, performed the literature review, and wrote the manuscript and he have read and approved the final version of the manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Conflict-of-interest statement: The authors have no potential conflicts of interest to disclose.
Corresponding author: Zhi-Peng Zhou, Department of Integrated Traditional Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Qiuyang Road, Fuzhou 350122, Fujian Province, China. zhouzhipengl@163.com
Received: May 19, 2026 Revised: July 1, 2026 Accepted: July 14, 2026 Published online: September 15, 2026 Processing time: 104 Days and 9.1 Hours
Abstract
The recent study published in World Journal of Diabetes by Casillas et al provides compelling evidence that a high waist-to-height ratio (WtHR) cutoff of 0.5 in 39 young adults is associated with insulin resistance and endoplasmic reticulum (ER) stress in platelets. This association is characterized by elevated SERCA expression and increased protein kinase PERK and JNK phosphorylation. The work highlights the value of WtHR as an early marker of metabolic dysfunction. It also establishes platelets as a minimally invasive model for studying systemic ER stress. However, 2 critical aspects warrant further discussion. The first is the dynamic nature of SERCA regulation during disease progression, particularly given the small sample size. The second is the clinical significance of metabolic dysfunction in young adults with elevated WtHR, regardless of their body mass index classification. These findings provide novel perspectives for translational research regarding early metabolic risk stratification.
Core Tip: This commentary extends the findings of Casillas et al. It discusses the biphasic regulation of SERCA as a key determinant of disease progression. It emphasizes the unrecognized metabolic risk in young adults with elevated waist-to-height ratio. It also highlights the cross-disease implications of endoplasmic reticulum stress and JNK activation. These perspectives provide important insights for early risk stratification and mechanism-based interventions.
