101
|
Kang D, Zhang Y, Wu G, Song C, Peng X, Long Y, Yu G, Tang H, Gui Y, Wang Q, Yuan T, Wu R. The Effect of Accelerated Continuous Theta Burst Stimulation on Weight Loss in Overweight Individuals With Schizophrenia: A Double-Blind, Randomized, Sham-Controlled Clinical Trial. Schizophr Bull 2024; 50:589-599. [PMID: 37921353 PMCID: PMC11059792 DOI: 10.1093/schbul/sbad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND AND HYPOTHESIS Obesity is a common comorbidity in individuals with schizophrenia and is associated with poor clinical outcomes. At present, there are limited effective approaches for addressing this issue. We conducted a double-blind, randomized, sham-controlled clinical trial to investigate the efficacy of noninvasive magnetic stimulation techniques in reducing obesity in individuals with schizophrenia. STUDY DESIGN Forty overweight individuals with schizophrenia were recruited and randomly assigned to receive either the active or sham intervention. The active group received 50 accelerated continuous theta burst stimulation (cTBS) sessions over the left primary motor area (M1), while the sham group received sham stimulation. The primary outcomes were the change in body weight and body mass index (BMI), and the secondary outcomes were the psychiatric symptoms, eating behavior scales, metabolic measures, and electrophysiological to food picture stimuli. STUDY RESULTS The study demonstrated a significant decrease in body weight and BMI after the intervention selectively in the active group (mean = -1.33 kg, P = .002), and this improvement remained at the 1-month follow-up (mean = -2.02 kg, P = .008). The score on the Barratt Impulsivity Scale (mean = -1.78, P = 0.036) decreased in the active group and mediated the effect of accelerated cTBS on body weight. In the food picture cue electroencephalograph task, the late positive potential component, which is related to motivated attention and emotional processing, decreased in frontal brain regions and increased in posterior regions after the active intervention. CONCLUSIONS The accelerated cTBS may offer a promising approach for treating obesity in individuals with schizophrenia. Further research with a larger sample size or individualized stimulation protocol should be promising. TRIAL REGISTRATION Clinical trial registered with clinicaltrials.gov (NCT05086133).
Collapse
Affiliation(s)
- Dongyu Kang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guowei Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chuhan Song
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinjie Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yujun Long
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guo Yu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yawei Gui
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
| | - Quan Wang
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renrong Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
102
|
Woodruff JL, Bykalo MK, Loyo-Rosado FZ, Maissy ES, Sadek AT, Hersey M, Erichsen JM, Maxwell ND, Wilson MA, Wood SK, Hashemi P, Grillo CA, Reagan LP. Differential effects of high-fat diet on endocrine, metabolic and depressive-like behaviors in male and female rats. Appetite 2024:107389. [PMID: 38697221 DOI: 10.1016/j.appet.2024.107389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/04/2024]
Abstract
The complications of obesity extend beyond the periphery to the central nervous system (CNS) and include an increased risk of developing neuropsychiatric co-morbidities like depressive illness. Preclinical studies support this concept, including studies that have examined the effects of high-fat diet (HFD) on depressive-like behaviors. Although women are approximately two-fold more likely to develop depressive illness compared to men, most preclinical studies have focused on the effects of HFD in male rodents. Accordingly, the goal of this study was to examine depressive-like behaviors in male and female rats provided access to a HFD. In agreement with prior studies, male and female rats provided a HFD segregate into an obesity phenotype (i.e., diet-induced obesity; DIO) or a diet resistant (DR) phenotype. Upon confirmation of the DR and DIO phenotypes, behavioral assays were performed in control chow, DR, and DIO rats. In the sucrose preference test, male DIO rats exhibited significant decreases in sucrose consumption (i.e., anhedonia) compared to male DR and male control rats. In the forced swim test (FST), male DIO rats exhibited increases in immobility and decreases in climbing behaviors in the pre-test sessions. Interestingly, male DR rats exhibited these same changes in both the pre-test and test sessions of the FST, suggesting that consumption of a HFD, even in the absence of the development of an obesity phenotype, has behavioral consequences. Female rats did not exhibit differences in sucrose preference, but female DIO rats exhibited increases in immobility exclusively in the test session of the FST, behavioral changes that were not affected by the stage of the estrous cycle. Collectively, these studies demonstrate access to a HFD elicits different behavioral outcomes in male and female rats.
Collapse
Affiliation(s)
- J L Woodruff
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA; Columbia VA Health Care System, Columbia, SC USA
| | - M K Bykalo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - F Z Loyo-Rosado
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - E S Maissy
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - A T Sadek
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - M Hersey
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - J M Erichsen
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - N D Maxwell
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA
| | - M A Wilson
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA; Columbia VA Health Care System, Columbia, SC USA
| | - S K Wood
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA; Columbia VA Health Care System, Columbia, SC USA
| | - P Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA; Department of Bioengineering, Imperial College, London, SW7 2AZ UK
| | - C A Grillo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA; Columbia VA Health Care System, Columbia, SC USA
| | - L P Reagan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC USA; Columbia VA Health Care System, Columbia, SC USA.
| |
Collapse
|
103
|
Yu Z, Li X, Quan Y, Chen J, Liu J, Zheng N, Liu S, Wang Y, Liu W, Qiu C, Wang Y, Zheng R, Qin J. Itaconate alleviates diet-induced obesity via activation of brown adipocyte thermogenesis. Cell Rep 2024; 43:114142. [PMID: 38691458 DOI: 10.1016/j.celrep.2024.114142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/05/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024] Open
Abstract
Despite medical advances, there remains an unmet need for better treatment of obesity. Itaconate, a product of the decarboxylation of the tricarboxylic acid cycle intermediate cis-aconitate, plays a regulatory role in both metabolism and immunity. Here, we show that itaconate, as an endogenous compound, counteracts high-fat-diet (HFD)-induced obesity through leptin-independent mechanisms in three mouse models. Specifically, itaconate reduces weight gain, reverses hyperlipidemia, and improves glucose tolerance in HFD-fed mice. Additionally, itaconate enhances energy expenditure and the thermogenic capacity of brown adipose tissue (BAT). Unbiased proteomic analysis reveals that itaconate upregulates key proteins involved in fatty acid oxidation and represses the expression of lipogenic genes. Itaconate may provoke a major metabolic reprogramming by inducing fatty acid oxidation and suppression of fatty acid synthesis in BAT. These findings highlight itaconate as a potential activator of BAT-mediated thermogenesis and a promising candidate for anti-obesity therapy.
Collapse
Affiliation(s)
- Zihan Yu
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Xianju Li
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Yanni Quan
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Jiawen Chen
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Jiarui Liu
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - Nairen Zheng
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Shuwen Liu
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Yini Wang
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Wanlin Liu
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Chen Qiu
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Yi Wang
- State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China
| | - Ruimao Zheng
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - Jun Qin
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China.
| |
Collapse
|
104
|
Olsen C, Lungu DA. Effectiveness of a Smartphone App (Heia Meg) in Improving Decisions About Nutrition and Physical Activity: Prospective Longitudinal Study. JMIR Form Res 2024; 8:e48185. [PMID: 38687565 DOI: 10.2196/48185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/15/2024] [Accepted: 01/28/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Obesity is a prevalent and serious chronic condition associated with abnormal or excessive fat buildup that poses significant health risks. The rates of overweight and obesity in adults and children continue to rise, with global rates of children with overweight or obesity aged 5-19 years growing from 4% to 18% between 1975 and 2016. Furthermore, in 2017, nearly 4 million people died due to complications arising from being overweight or obese. OBJECTIVE This study aims to investigate the potential impact of the mobile app Heia Meg on promoting healthier lifestyle choices regarding nutrition and physical activity. METHODS A prospective longitudinal study was conducted in collaboration with the Norwegian Directorate of Health. Participants were recruited through the Heia Meg app and were asked to complete a questionnaire before and after using the app. A total of 199 responses were included in the first (preintervention) questionnaire, while 99 valid responses were obtained in the second (postintervention) questionnaire. RESULTS The majority (159/199, 79.9%) of participants were female, and their age ranged from 18 years to 70 years and older. The results show a reduction in BMI after the digital intervention. However, some variables influence the BMI reduction effect: sex, age, education, and smoking. The group that obtained the most benefit from the intervention consisted of those who were male, aged 30-39 years, highly educated, and nonsmokers. Although positive, some of the findings are slightly above the statistical significance threshold and therefore should be interpreted carefully. CONCLUSIONS Our study found weak evidence to support the effectiveness of the Heia Meg app in promoting healthier lifestyle choices. However, limitations and confounding factors suggest that further research in different populations with larger sample sizes is needed to confirm or disprove our findings.
Collapse
Affiliation(s)
- Christine Olsen
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Daniel Adrian Lungu
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
105
|
Espinosa-Montero J, Monterrubio-Flores E, Aguilar-Tamayo M, Macías-Morales N, Sanchez-Dominguez M, Campos-Nonato I. Indicators of Dietary Behavior and Physical Activity Change Associated with Metabolic Control of Obesity, Hypertension, and Type 2 Diabetes Mellitus in Mexican Adults: National Nutrition and Health Survey in Mexico, 2016. Metab Syndr Relat Disord 2024. [PMID: 38683637 DOI: 10.1089/met.2023.0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Introduction: Obesity (OB), type 2 diabetes mellitus (T2D), and hypertension (HTN) are health issues in Mexico linked to unhealthy behaviors. This study investigates the relationship between behavior change indicators and metabolic control in Mexican adults with OB, T2D, and HTN. Methods: We used data from the 2016 National Health and Nutrition Survey Midway (ENSANUT MC-2016), representing ∼59.5 million Mexican adults aged 20-59 with these conditions. We assessed behavior change indicators, including stages of change, self-efficacy, and perceptions of benefits and barriers. In addition, we conducted descriptive analyses and used statistical tests, such as Pearson's chi-squared test and logistic regression models, adjusted for multiple variables. Results: We found that adults in the action and maintenance stages of physical activity (PA) were four times more likely to have adequate HTN control than those in the precontemplation stage. Self-efficacy for PA was related to better control in T2D and HTN. Self-efficacy for reducing the consumption of sugary beverages was positively associated with control in OB and T2D. No significant association was observed with self-efficacy for consuming fruits and vegetables. Conclusion: Behavior-change indicators are significantly linked to metabolic control in adults with HTN. These results support the importance of these indicators in managing chronic diseases such as HTN and their potential use in public health strategies.
Collapse
Affiliation(s)
- Juan Espinosa-Montero
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Eric Monterrubio-Flores
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Manuel Aguilar-Tamayo
- Institute of Education Sciences, Autonomous University of the State of Morelos, Mexico City, Mexico
| | - Nayeli Macías-Morales
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Mario Sanchez-Dominguez
- Health Equity Research Department, Center for Research in Health Systems, National Institute of Public Health, México City, Mexico
| | - Ismael Campos-Nonato
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| |
Collapse
|
106
|
Gage R, Liu W, Pearson AL, Smith M, Barr M, Shortridge A, Signal L. Comparison of ten policy options to equitably reduce children's exposure to unhealthy food marketing. Public Health Nutr 2024:1-24. [PMID: 38680070 DOI: 10.1017/s1368980024000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Reducing children's exposure to unhealthy food marketing is crucial to combat childhood obesity. We aimed to estimate the reduction of children's exposure to food marketing under different policy scenarios and assess exposure differences by socioeconomic status. DESIGN Data on children's exposure to unhealthy food marketing was compiled from a previous cross-sectional study in which children (n=168) wore wearable cameras and GPS units for four consecutive days. For each exposure, we identified the setting, the marketing medium and food/beverage product category. We analyzed the percentage reduction in food marketing exposure for ten policy scenarios and by socioeconomic deprivation: 1) no product packaging, 2) no merchandise marketing, 3) no sugary drink marketing, 4) no confectionary marketing in schools, 5) no sugary drink marketing in schools, 6) no marketing in public spaces, 7) no marketing within 400m of schools, 8) no marketing within 400m of recreation venues, 9) no marketing within 400m of bus stops, and 10) no marketing within 400m of major roads. SETTING Wellington region of New Zealand. PARTICIPANTS 168 children aged 11-14 years. RESULTS Exposure to food marketing varied by setting, marketing medium and product category. Among the 10 policy scenarios, the largest reductions were for plain packaging (60.3%), no sugary drink marketing (28.8%) and no marketing in public spaces (22.2%). There were no differences by socioeconomic deprivation. CONCLUSIONS The results suggest that plain packaging would result in the greatest decrease in children's exposure to food marketing. However, given that children are regularly exposed to unhealthy food marketing in multiple settings through a range of marketing mediums, comprehensive bans are needed to protect children's health.
Collapse
Affiliation(s)
- Ryan Gage
- Department of Public Health, University of Otago, Wellington, 6242, New Zealand
| | - Wei Liu
- Department of Geography, Environment and Spatial Sciences, Michigan State University, East Lansing, MI 48824, USA
- Department of Water Ecology and Environment, China Institute of Water Resources and Hydropower Research, Beijing 100038, China
| | - Amber L Pearson
- Department of Public Health, University of Otago, Wellington, 6242, New Zealand
- Charles Stewart Mott Department of Public Health, Michigan State University, Flint, MI 48502, USA
| | - Moira Smith
- Department of Public Health, University of Otago, Wellington, 6242, New Zealand
| | - Michelle Barr
- Department of Public Health, University of Otago, Wellington, 6242, New Zealand
| | - Ashton Shortridge
- Department of Geography, Environment and Spatial Sciences, Michigan State University, East Lansing, MI 48824, USA
| | - Louise Signal
- Department of Public Health, University of Otago, Wellington, 6242, New Zealand
| |
Collapse
|
107
|
Landry MJ, Ward CP, Cunanan KM, Fielding-Singh P, Crimarco A, Gardner CD. Switching diets after 6-months does not result in renewed weight loss: a secondary analysis of a 12-month crossover randomized trial. Sci Rep 2024; 14:9865. [PMID: 38684815 PMCID: PMC11058757 DOI: 10.1038/s41598-024-60547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/24/2024] [Indexed: 05/02/2024] Open
Abstract
Weight change trajectory from diet and lifestyle interventions typically involves rapid weight loss followed by a weight plateau after approximately 6 months. Changing from one weight-loss diet to another at the time of the plateau could instigate renewed weight loss. Therefore, our secondary analysis aimed to assess trajectory of weight loss in a 12-month, randomized, cross-over study. Forty-two adults were randomized to eat a healthy low-fat or healthy low-carbohydrate diet for 6 months then switched to the opposite diet for an additional 6 months. Regardless of diet assignment, participants experienced rapid initial weight loss, which slowed between 3 to 6 months. After switching diets at 6 months, weight modestly decreased until 9 months, but at a rate slower than the initial 3 months and slower than the rate from 3 to 6 months. This suggests that the weight loss plateau typically seen at 6 months is physiological and cannot be overcome by simply switching to a different weight-loss diet.
Collapse
Affiliation(s)
- Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA.
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, 856 Health Sciences Rd., Irvine, CA, 92697, USA.
| | - Catherine P Ward
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| | - Kristen M Cunanan
- Quantitative Science Unit, School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Anthony Crimarco
- Division of Gastroenterology and Hepatology, Stanford Center for Clinical Research, Stanford University, Redwood City, CA, USA
| | - Christopher D Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
108
|
Yıldız F, Tuğrul Aksakal MZ, Yıldız R, Baş F. The Relationship Between Sleep Quality, Sleep Duration, Social Jet Lag and Obesity in Adolescents. J Clin Res Pediatr Endocrinol 2024:0-0. [PMID: 38683020 DOI: 10.4274/jcrpe.galenos.2024.2024-2-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Objective The frequency of obesity and poor sleep quality among adolescents is increasing and causes many chronic problems. The objective was to investigate the correlation between body mass index (BMI), sleep quality, sleep duration and social jet lag (SJL) among adolescents. Methods This study is cross-sectional. A cohort of 416 adolescents, ranging in age from 12 to 18 participated in the study. Adolescents were divided into three groups according to BMI SDS: adolescents with normal weight, adolescents with overweight and adolescents with obesity. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to determine the sleep quality of the adolescents. The calculation of SJL and sleep-corrected social jet lag (SJLsc) was performed. Results The mean age of the adolescents was 15.0 ± 2.9 years.There were 222 males (53.4%). SJL and PSQI scores were significantly higher in the adolescents with obesity compared to the adolescents with normal weight and overweight (p < 0.001). An analysis of the relationship between the PSQI and BMI SDS revealed a correlation that was statistically significant (r = 0.667; p < 0.001). Conclusion Adolescents with obesity reveal poorer sleep quality and a longer duration of SJL compared to adolescents with normal-weight. Moreover, increased SJL was linked to an increase in BMI. Maintaining good sleep quality and less exposure to SJL may help reduce the risk of obesity.
Collapse
Affiliation(s)
- Funda Yıldız
- Istanbul University, Institute of Child Health, Department of Pediatric Basic Sciences, Division of Adolescent Medicine
| | - Melike Zeynep Tuğrul Aksakal
- Istanbul University, Institute of Child Health, Department of Pediatric Basic Sciences, Division of Adolescent Medicine
| | - Raif Yıldız
- Basaksehir Cam and Sakura City Hospital, Clinic of Pediatric Emergency
| | - Firdevs Baş
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology
| |
Collapse
|
109
|
Nadeem D, Taye M, Still MD, McShea S, Satterfield D, Dove JT, Wood GC, Addissie BD, Diehl DL, Johal AS, Khara HS, Confer BD, Still CD. Effects of Glucagon-like Peptide-1 Receptor Agonists on Upper Endoscopy in Diabetic and Non-Diabetic Patients. Gastrointest Endosc 2024:S0016-5107(24)03159-6. [PMID: 38692518 DOI: 10.1016/j.gie.2024.04.2900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND AND AIMS Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) promote weight loss by suppressing appetite, enhancing satiety, regulating glucose metabolism and delaying gastric motility. We sought to determine whether GLP-1 RA use could impact sedated medical procedures like esophagogastroduodenoscopy (EGD). METHODS We conducted a retrospective study on 35,183 patients who underwent EGD between 2019 and 2023, 922 of which were using a GLP-1-RA. Data were collected regarding demographics, diabetes status, retained gastric contents during EGD (RGC), incidence of aborted EGD, and necessity for repeat EGD. RESULTS GLP-1 RA use was associated with a fourfold increase in the retention of gastric contents (p<0.0001), fourfold higher rates of aborted EGD (p<0.0001), and twice the likelihood of requiring repeat EGD (p=0.0001), even after stratifying for presence of diabetes. CONCLUSIONS GLP-1 RA use can lead to delayed gastric emptying, affecting EGD adequacy regardless of the presence of diabetes, and may warrant dose adjustment to improve safety and efficacy of these procedures.
Collapse
Affiliation(s)
- Danial Nadeem
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center.
| | - Mahdi Taye
- Geisinger Commonwealth School of Medicine
| | | | - Shannon McShea
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - Daniel Satterfield
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - James T Dove
- Center for Obesity and Metabolic Research, Geisinger Medical Center
| | - G Craig Wood
- Center for Obesity and Metabolic Research, Geisinger Medical Center
| | - Benyam D Addissie
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - David L Diehl
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - Amitpal S Johal
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - Harshit S Khara
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - Bradley D Confer
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| | - Christopher D Still
- Department of Gastroenterology, Hepatology and Nutrition, Geisinger Medical Center
| |
Collapse
|
110
|
Huo J, Molkentin JD. MCU genetically altered mice suggest how mitochondrial Ca 2+ regulates metabolism. Trends Endocrinol Metab 2024:S1043-2760(24)00088-2. [PMID: 38688781 DOI: 10.1016/j.tem.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024]
Abstract
Skeletal muscle has a major impact on total body metabolism and obesity, and is characterized by dynamic regulation of substrate utilization. While it is accepted that acute increases in mitochondrial matrix Ca2+ increase carbohydrate usage to augment ATP production, recent studies in mice with deleted genes for components of the mitochondrial Ca2+ uniporter (MCU) complex have suggested a more complicated regulatory scenario. Indeed, mice with a deleted Mcu gene in muscle, which lack acute mitochondrial Ca2+ uptake, have greater fatty acid oxidation (FAO) and less adiposity. By contrast, mice deleted for the inhibitory Mcub gene in skeletal muscle, which have greater acute mitochondrial Ca2+ uptake, antithetically display reduced FAO and progressive obesity. In this review we discuss the emerging concept that dynamic fluxing of mitochondrial matrix Ca2+ regulates metabolism.
Collapse
Affiliation(s)
- Jiuzhou Huo
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Jeffery D Molkentin
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA.
| |
Collapse
|
111
|
Wang Q, Hartig SM, Ballantyne CM, Wu H. The multifaceted life of macrophages in white adipose tissue: Immune shift couples with metabolic switch. Immunol Rev 2024. [PMID: 38683173 DOI: 10.1111/imr.13338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
White adipose tissue (WAT) is a vital endocrine organ that regulates energy balance and metabolic homeostasis. In addition to fat cells, WAT harbors macrophages with distinct phenotypes that play crucial roles in immunity and metabolism. Nutrient demands cause macrophages to accumulate in WAT niches, where they remodel the microenvironment and produce beneficial or detrimental effects on systemic metabolism. Given the abundance of macrophages in WAT, this review summarizes the heterogeneity of WAT macrophages in physiological and pathological conditions, including their alterations in quantity, phenotypes, characteristics, and functions during WAT growth and development, as well as healthy or unhealthy expansion. We will discuss the interactions of macrophages with other cell partners in WAT including adipose stem cells, adipocytes, and T cells in the context of various microenvironment niches in lean or obese condition. Finally, we highlight how adipose tissue macrophages merge immunity and metabolic changes to govern energy balance for the organism.
Collapse
Affiliation(s)
- Qun Wang
- Key Laboratory of Infection and Immunity of Shandong Province, Department of Immunology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Sean M Hartig
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Huaizhu Wu
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
112
|
Greene RK, Gangidi S, Zhao R, Nelson JM, Harms K, Nakamura M. The relationship between acrochordons, obesity, and metabolic syndrome in the pediatric population: A retrospective cohort study. Pediatr Dermatol 2024. [PMID: 38684337 DOI: 10.1111/pde.15639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Acrochordons or skin tags are common benign skin growths. Several studies explored the relationship between obesity and metabolic syndrome in adults but remains unexplored in children. METHODS This was a single-center retrospective cohort study of outpatient dermatology patients between 1 January 2000 to 1 January 2021. Children under 18 years old diagnosed with acrochordons using diagnostic codes International Classification of Diseases, 10th Revision (ICD-10) L91.8 and 9th Revision (ICD-9) 701.8 were included. We collected patient demographics, past medical history, laboratory values, vital signs, and physical exam. Body mass index (BMI) was calculated and stratified into categories based on the Center for Disease Control's BMI-for-Age Growth Charts. Metabolic syndrome was diagnosed when three of the five criteria were met. Data were propensity-matched and compared with NHANES (National Health and Nutrition Examination Survey), which offered a generalizable sample to the US population. RESULTS Fifty-five patients under 18 years old with a diagnosis of acrochordons were mostly Caucasian (76%) and female (64%). The mean BMI was 27.3, with 49.5% categorized as obese and 20% as overweight. The mean age of diagnosis was 10.1 years. Acrochordon predominantly appeared in the axilla. In our cohort, three patients (5.5%) met the criteria for metabolic syndrome. The prevalence of obesity (42% vs. 21%), type 2 diabetes mellitus (4.8% vs. 0.6%), hyperlipidemia (8.1% vs. 0%), and hypertension (1.6% vs. 0%) was greater in our cohort compared with NHANES. CONCLUSIONS Like the adult population, acrochordons may serve as marker for metabolic disease in the pediatric population.
Collapse
Affiliation(s)
- Rachel K Greene
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Suma Gangidi
- Carle Illinois College of Medicine, Urbana, Illinois, USA
| | | | - Jessie M Nelson
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kelly Harms
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mio Nakamura
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
113
|
Abuawwad M, Tibude A, Bansi D, Idris I, Madhok B. A commentary review on endoscopic sleeve gastroplasty: Indications, outcomes and future implications. Diabetes Obes Metab 2024. [PMID: 38685614 DOI: 10.1111/dom.15613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
Metabolic and bariatric surgeries have been shown to be the most effective strategy to induce and maintain significant weight loss for people living with severe obesity. However, ongoing concerns regarding operative risks, irreversibility and excess costs limit their broader clinical use. Endoscopic bariatric therapies are pragmatic alternatives for patients who are not suitable for metabolic and bariatric surgeries or who are concerned regarding their long-term safety. Endoscopic sleeve gastroplasty has emerged as a novel technique of endoscopic bariatric therapies, which have garnered significant interest and evidence in the past few years. Its safety, efficacy and cost-effectiveness have been shown in various studies, while comparisons with sleeve gastrectomy have been widely made. This review brings together current evidence pertaining to the technicality of the procedure itself, current indications, safety and efficacy, cost-effectiveness, as well as its future role and development.
Collapse
Affiliation(s)
- Mahmoud Abuawwad
- East Midlands Bariatric and Metabolic Institute (EMBMI), Royal Derby Hospital, Derby, UK
- Bariatric Surgery - General Surgery Department, Royal Sunderland Hospital, Sunderland, UK
| | - Ameya Tibude
- East Midlands Bariatric and Metabolic Institute (EMBMI), Royal Derby Hospital, Derby, UK
| | - Devinder Bansi
- Honorary Clinical Senior Lecturer, Faculty of Medicine, Imperial College London, London, UK
| | - Iskandar Idris
- East Midlands Bariatric and Metabolic Institute (EMBMI), Royal Derby Hospital, Derby, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute (EMBMI), Royal Derby Hospital, Derby, UK
| |
Collapse
|
114
|
Weir TL, Majumder M, Glastras SJ. A systematic review of the effects of maternal obesity on neonatal outcomes in women with gestational diabetes. Obes Rev 2024:e13747. [PMID: 38679418 DOI: 10.1111/obr.13747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 10/03/2023] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
Maternal obesity and gestational diabetes mellitus (GDM) prevalence are increasing, with both conditions associated with adverse neonatal outcomes. This review aimed to determine the risk of adverse outcomes in women with obesity and GDM, compared with women with obesity alone. A systematic search identified 28 eligible articles. Meta-analysis was conducted using a random effects model, to generate pooled estimates (odds ratios, OR, or mean difference, MD). Compared with normal-weight controls, women with obesity had increased risks of large for gestational age (LGA, OR 1.98, 95% CI: 1.56, 2.52) and macrosomia (OR 2.93, 95% CI: 1.71, 5.03); the latter's risk almost double in women with obesity than GDM. Birth weight (MD 113 g, 95% CI: 69, 156) and shoulder dystocia (OR 1.23, 95% CI: 0.85, 1.78) risk was also higher. GDM significantly amplified neonatal risk in women with obesity, with a three- to four-fold risk of LGA (OR 3.22, 95% CI: 2.17, 4.79) and macrosomia (OR 3.71, 95% CI: 2.76, 4.98), as well as higher birth weights (MD 176 g, 95% CI: 89, 263), preterm delivery (OR 1.49, 95% CI: 1.25, 1.77), and shoulder dystocia (OR 1.99, 95% CI: 1.31, 3.03), when compared with normal-weight controls. Our findings demonstrate that maternal obesity increases serious neonatal adverse risk, magnified by the presence of GDM. Effective strategies are needed to safeguard against neonatal complications associated with maternal obesity, regardless of GDM status.
Collapse
Affiliation(s)
- Tessa L Weir
- Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Department of Endocrinology, Nepean-Blue Mountains Hospital, Kingswood, New South Wales, Australia
| | - Monica Majumder
- Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sarah J Glastras
- Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| |
Collapse
|
115
|
Adamou A, Barkas F, Milionis HJ, Ntaios G. Glucagon-Like Receptor-1 Agonists and Stroke: a Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials. Int J Stroke 2024:17474930241253988. [PMID: 38676552 DOI: 10.1177/17474930241253988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
BACKGROUND In stroke survivors, approximately 15% and 60% exhibit concurrent diabetes mellitus and overweight/obesity, respectively, necessitating heightened secondary prevention efforts. Despite Glucagon-like receptor-1 agonists (GLP-1 RAs) demonstrating improved outcomes for those with diabetes mellitus or obesity, their underutilization persists among eligible individuals. This systematic review and meta-analysis investigated the impact of GLP-1 RAs on stroke risk. The findings aim to optimize the implementation of this therapeutic strategy in stroke survivors with diabetes mellitus or obesity. METHODS Following PRISMA guidelines, we systematically reviewed MEDLINE and Scopus until 15/11/2023. Eligible studies included randomized cardiovascular outcome trials (CVOTs) with individuals, with or without type 2 diabetes, randomized to either GLP-1 RA or placebo. The outcomes were total strokes, non-fatal strokes, and fatal strokes. Analyses were conducted using RevMan 5.4.1. RESULTS Among 1,369 screened studies, 11 were eligible, encompassing 82,140 participants (34.6% women) with a cumulative follow-up of 247,596 person-years. In the GLP-1 RAs group, the stroke rate was significantly lower compared to placebo (RR: 0.85, 95% CI: 0.77-0.93; NNT: 200), showing no heterogeneity or interaction with administration frequency (daily vs. weekly). Additionally, the GLP-1 RAs group exhibited a significantly lower rate of non-fatal strokes compared to placebo (RR: 0.87, 95% CI: 0.79-0.95; NNT: 250), with no heterogeneity or interaction based on administration frequency, route (oral vs subcutaneous), or diabetes presence. CONCLUSION In this meta-analysis of 11 CVOTs with 82,140 participants, GLP-1 RAs demonstrated a 16% relative reduction in stroke risk compared to placebo. This finding may increase implementation of GLP-1 RAs by stroke specialists in individuals with stroke and comorbid diabetes mellitus or obesity.
Collapse
Affiliation(s)
- Anastasia Adamou
- Department of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
- First Department of Propaedeutic Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Haralampos J Milionis
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - George Ntaios
- Department of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| |
Collapse
|
116
|
Bankole T, Ma T, Arora I, Lei Z, Raju M, Li Z, Li Y. The Effect of Broccoli Glucoraphanin Supplementation on Ameliorating High-Fat-Diet-Induced Obesity through the Gut Microbiome and Metabolome Interface. Mol Nutr Food Res 2024:e2300856. [PMID: 38676466 DOI: 10.1002/mnfr.202300856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/22/2024] [Indexed: 04/29/2024]
Abstract
SCOPE Obesity and its metabolic comorbidities pose a major global challenge for public health. Glucoraphanin (GRN) is a natural bioactive compound enriched in broccoli that is known to have potential health benefits against various human chronic diseases. METHODS AND RESULTS This study investigats the effects of broccoli GRN supplementation on body weight, metabolic parameters, gut microbiome and metabolome associated with obesity. The study is conducted on an obese-related C57BL/6J mouse model through the treatment of normal control diet, high-fat diet (HFD)and GRN-supplemented HFD (HFD-GRN) to determine the metabolic protection of GRN. The results shows that GRN treatment alleviates obesity-related traits leading to improved glucose metabolism in HFD-fed animals. Mechanically, the study noticed that GRN significantly shifts the gut microbial diversity and composition to an eubiosis status. GRN supplement also significantly alters plasma metabolite profiles. Further integrated analysis reveal a complex interaction between the gut microbes and host metabolism that may contribute to GRN-induced beneficial effects against HFD. CONCLUSION These results indicate that beneficial effects of broccoli GRN on reversing HFD-induced adverse metabolic parameters may be attributed to its impacts on reprogramming microbial community and metabolites. Identification of the mechanistic functions of GRN further warrants it as a dietary candidate for obesity prevention.
Collapse
Affiliation(s)
- Taiwo Bankole
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
| | - Tianzhou Ma
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, 20742, USA
| | - Itika Arora
- Department of Microbiology and Immunology, University of Miami, Miami, FL, 33136, USA
| | - Zhentian Lei
- Metabolomics Center, University of Missouri at Columbia, Columbia, MO, 65211, USA
| | - Murugesan Raju
- Bioinformatics and Analytics Core, University of Missouri at Columbia, Columbia, MO, 65211, USA
| | - Zhenhai Li
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
| | - Yuanyuan Li
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
| |
Collapse
|
117
|
Bazerbachi F, Baroud S, Levy MJ, Maselli DB, Vargas EJ, Bofill-Garcia A, Law RJ, Chandrasekhara V, Storm AC, Gleeson FC, Rajan E, Iyer PG, Watt KD, Abu Dayyeh BK. Celiac artery mesenteric fat measurement with endosonography (CAMEUS) reliably correlates with obesity and related comorbidities. Gastroenterol Rep (Oxf) 2024; 12:goae039. [PMID: 38681751 PMCID: PMC11052652 DOI: 10.1093/gastro/goae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Background Visceral fat represents a metabolically active entity linked to adverse metabolic sequelae of obesity. We aimed to determine if celiac artery mesenteric fat thickness can be reliably measured during endoscopic ultrasound (EUS), and if these measurements correlate with metabolic disease burden. Methods This was a retrospective analysis of patients who underwent celiac artery mesenteric fat measurement with endosonography (CAMEUS) measurement at a tertiary referral center, and a validation prospective trial of patients with obesity and nonalcoholic steatohepatitis who received paired EUS exams with CAMEUS measurement before and after six months of treatment with an intragastric balloon. Results CAMEUS was measured in 154 patients [56.5% females, mean age 56.5 ± 18.0 years, body mass index (BMI) 29.8 ± 8.0 kg/m2] and was estimated at 14.7 ± 6.5 mm. CAMEUS better correlated with the presence of non-alcoholic fatty liver disease (NAFLD) (R2 = 0.248, P < 0.001) than BMI (R2 = 0.153, P < 0.001), and significantly correlated with metabolic parameters and diseases. After six months of intragastric balloon placement, the prospective cohort experienced 11.7% total body weight loss, 1.3 points improvement in hemoglobin A1c (P = 0.001), and a 29.4% average decrease in CAMEUS (-6.4 ± 5.2 mm, P < 0.001). CAMEUS correlated with improvements in weight (R2 = 0.368), aspartate aminotransferase to platelet ratio index (R2 = 0.138), and NAFLD activity score (R2 = 0.156) (all P < 0.05). Conclusions CAMEUS is a novel measure that is significantly correlated with critical metabolic indices and can be easily captured during routine EUS to risk-stratify susceptible patients. This station could allow for EUS access to sampling and therapeutics of this metabolic region.
Collapse
Affiliation(s)
- Fateh Bazerbachi
- CentraCare, Interventional Endoscopy Program, St Cloud Hospital, St. Cloud, MN, USA
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Serge Baroud
- Department of Internal Medicine, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA
| | - Michael J Levy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Daniel B Maselli
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Eric J Vargas
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Ryan J Law
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Andrew C Storm
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Ferga C Gleeson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth Rajan
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Barham K Abu Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
118
|
Reinhard J, Lang S, Walter N, Schindler M, Bärtl S, Szymski D, Alt V, Rupp M. In-hospital mortality of patients with periprosthetic joint infection. Bone Jt Open 2024; 5:367-373. [PMID: 38663864 PMCID: PMC11045279 DOI: 10.1302/2633-1462.54.bjo-2023-0162.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2024] Open
Abstract
Aims Periprosthetic joint infection (PJI) demonstrates the most feared complication after total joint replacement (TJR). The current work analyzes the demographic, comorbidity, and complication profiles of all patients who had in-hospital treatment due to PJI. Furthermore, it aims to evaluate the in-hospital mortality of patients with PJI and analyze possible risk factors in terms of secondary diagnosis, diagnostic procedures, and complications. Methods In a retrospective, cross-sectional study design, we gathered all patients with PJI (International Classification of Diseases (ICD)-10 code: T84.5) and resulting in-hospital treatment in Germany between 1 January 2019 and 31 December 2022. Data were provided by the Institute for the Hospital Remuneration System in Germany. Demographic data, in-hospital deaths, need for intensive care therapy, secondary diagnosis, complications, and use of diagnostic instruments were assessed. Odds ratios (ORs) with 95% confidence intervals (CIs) for in-hospital mortality were calculated. Results A total of 52,286 patients were included, of whom 1,804 (3.5%) died. Hypertension, diabetes mellitus, and obesity, the most frequent comorbidities, were not associated with higher in-hospital mortality. Cardiac diseases as atrial fibrillation, cardiac pacemaker, or three-vessel coronary heart disease showed the highest risk for in-hospital mortality. Postoperative anaemia occurred in two-thirds of patients and showed an increased in-hospital mortality (OR 1.72; p < 0.001). Severe complications, such as organ failure, systemic inflammatory response syndrome (SIRS), or septic shock syndrome showed by far the highest association with in-hospital mortality (OR 39.20; 95% CI 33.07 to 46.46; p < 0.001). Conclusion These findings highlight the menace coming from PJI. It can culminate in multi-organ failure, SIRS, or septic shock syndrome, along with very high rates of in-hospital mortality, thereby highlighting the vulnerability of these patients. Particular attention should be paid to patients with cardiac comorbidities such as atrial fibrillation or three-vessel coronary heart disease. Risk factors should be optimized preoperatively, anticoagulant therapy stopped and restarted on time, and sufficient patient blood management should be emphasized.
Collapse
Affiliation(s)
- Jan Reinhard
- Department of Orthopaedic Surgery, University Medical Center Regensburg, Regensburg, Germany
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Siegmund Lang
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Nike Walter
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Melanie Schindler
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Susanne Bärtl
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
- Center for Musculoskeletal Surgery, Charité – University Medicine Berlin, Berlin, Germany
| | - Dominik Szymski
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Markus Rupp
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| |
Collapse
|
119
|
Smullin CP, Shenoy RS, Blair KJ, Chandler CF. Descriptive Analysis of Outcomes After Onlay Ventral Hernia Repair in Obese Patients. Am Surg 2024:31348241241706. [PMID: 38676337 DOI: 10.1177/00031348241241706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To determine outcomes after on lay large ventral hernia repair in obese patients. INTRODUCTION Large ventral hernia repairs (VHR) in obese patients remain a challenge. Obesity is a risk factor for intraoperative difficulties and postoperative complications. Recurrence rates after VHR in obese patients range between 12-50% versus 10% in nonobese patients. While results of laparoscopic techniques in VHR compare favorably to open, outcomes in correlation with obesity, technique, and defect size are less understood. METHODS A single surgeon's experience of 329 consecutive VHR between 2013-2022 was retrospectively reviewed. Inclusion criteria were obesity (BMI >30) and large hernia defects (>5 cm). A modified onlay technique was used which included component release and a lightweight monofilament polypropylene mesh. Primary outcome measures were hernia recurrence and wound complications. RESULTS A total of 56 patients met inclusion criteria. Patients were majority male (n=30, 54%), with a median age of 58.5 years (inter quartile range (IQR) 33-83), and median BMI of 36 kg/m2 (IQR: 30-72). Median hernia defect size was 8 cm (IQR: 5-15). Twenty patients had undergone prior mesh repairs. Median follow-up was 52 months (IQR: 6 months-9 years). Two patients experienced recurrence (3.6%) and four experienced wound complications (four seromas, one panniculitis, 8.9%). No patients suffered flap ischemia or necrosis. CONCLUSION Obesity is a risk factor for poor outcomes after VHR. We developed a protocol for obese patients with large defects involving a modified onlay technique which demonstrates comparable results to other VHR techniques in obese patients.
Collapse
Affiliation(s)
- Carolyn P Smullin
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Rivfka S Shenoy
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kevin J Blair
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Charles F Chandler
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| |
Collapse
|
120
|
Blaustein JR, Quisel MJ, Hamburg NM, Wittkopp S. Environmental Impacts on Cardiovascular Health and Biology: An Overview. Circ Res 2024; 134:1048-1060. [PMID: 38662864 PMCID: PMC11058466 DOI: 10.1161/circresaha.123.323613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Environmental stressors associated with human activities (eg, air and noise pollution, light disturbance at night) and climate change (eg, heat, wildfires, extreme weather events) are increasingly recognized as contributing to cardiovascular morbidity and mortality. These harmful exposures have been shown to elicit changes in stress responses, circadian rhythms, immune cell activation, and oxidative stress, as well as traditional cardiovascular risk factors (eg, hypertension, diabetes, obesity) that promote cardiovascular diseases. In this overview, we summarize evidence from human and animal studies of the impacts of environmental exposures and climate change on cardiovascular health. In addition, we discuss strategies to reduce the impact of environmental risk factors on current and future cardiovascular disease burden, including urban planning, personal monitoring, and mitigation measures.
Collapse
Affiliation(s)
- Jacob R. Blaustein
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
| | - Matthew J. Quisel
- Department of Medicine, Boston University Chobanian and Avedision School of Medicine
| | - Naomi M. Hamburg
- Section of Vascular Biology, Whitaker Cardiovascular Institute, Chobanian and Avedisian School of Medicine, Boston University, Boston, USA
| | - Sharine Wittkopp
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
| |
Collapse
|
121
|
Xia J, Xu L, Yu Y, Wu M, Wang X, Wang Y, Li C, Sun J, Lv X, Zhao J, Zhang Y. Associations between weight-adjusted-waist index and telomere length: Results from NHANES: An observational study. Medicine (Baltimore) 2024; 103:e37905. [PMID: 38669426 PMCID: PMC11049720 DOI: 10.1097/md.0000000000037905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Previous studies have demonstrated the connection between obesity and telomere length. A recently devised metric for determining obesity, the weight-adjusted-waist index (WWI), offers a distinct advantage in predicting fat and lean mass by depicting weight-independent abdominal adiposity. This article presents the results of the inaugural study on the relationship between WWI and telomere length in adult populations. The cross-sectional investigation analyzed data from 3479 participants from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2000. To inspect linear and nonlinear correlations, we adopted weighted multiple logistic regression analysis and smooth curve fit, respectively. In addition, threshold effects and subgroup analyses were accomplished. In the fully adapted model, a significant adverse association of WWI with telomere length was detected [β = -0.02, 95% CI: (-0.03, -0.00), P value = 0.01]. The adverse correlation remained consistent across all subcategories. We also discovered an inverted U-shaped curve linking WWI and telomere length, with a conspicuous inflection point of 10.07 cm/√kg. For the first time, our research demonstrated strong links between WWI and telomere length. The inflection point suggests that controlling WWI within an optimum range might be essential for aging and health.
Collapse
Affiliation(s)
- Jiaying Xia
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Lu Xu
- Department of Infectious Diseases, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yihua Yu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Min Wu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xiao Wang
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yangyi Wang
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Chaoxi Li
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Jiemin Sun
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xin Lv
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Jing Zhao
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yue Zhang
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| |
Collapse
|
122
|
Nokes B, Orr JE, White S, Luu S, Chen Z, Alex R, Sands SA, Wojeck BS, Owens RL, Malhotra A, Schmickl CN. The Effect of Obesity on Sleep Apnea Pathogenesis Differs in Women vs Men: Multiple Mediation Analyses in the Retrospective SNOOzzzE Cohort. J Appl Physiol (1985) 2024. [PMID: 38660729 DOI: 10.1152/japplphysiol.00925.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE There are multiple mechanisms underlying obstructive sleep apnea (OSA) development. However, how classic OSA risk factors such as body mass index (BMI) and sex portend to OSA development have not been fully described. Thus, we sought to evaluate how obesity leads to OSA, and assess how these mechanisms differ between men and women. Methods The San Diego Multi-Outcome OSA Endophenotype (SNOOzzzE) cohort includes 3,319 consecutive adults who underwent a clinical in-laboratory polysomnography at the UCSD sleep clinic between 1/2017-12/2019. Using routine polysomnography signals, we determined OSA endotypes. We then performed mediation analyses stratified by sex to determine how BMI influenced apnea hypopnea index (AHI) using OSA endotypic traits as mediators. Results We included 2,146 patients of whom 919 (43%) were women and 1,227 (57%) were obese. BMI was significantly associated with AHI in both women and men. In men, the effect of BMI on AHI was partially mediated by a reduction in upper airway stiffness (31% of total effect, TE), by a reduction in circulatory delay (16%TE), and by an increase in arousal threshold (7%TE). In women, the effect of BMI on AHI was partially mediated by a reduction in circulatory delay (22%TE). Discussion BMI-related OSA pathogenesis differs by sex. An increase in upper airway collapsibility (in men) is consistent with prior studies. A reduction in circulatory delay may lead to shorter and thus more events per hour (i.e., higher AHI), while the association between a higher arousal threshold and higher AHI may reflect reverse causation.
Collapse
Affiliation(s)
- Brandon Nokes
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California, San Diego, La jolla, CA, United States
| | - Jeremy E Orr
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego Medical Center, San Diego, CA, United States
| | - Stephanie White
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego Medical Center, San Diego, CA, United States
| | - Steven Luu
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego Medical Center, San Diego, CA, United States
| | - Zihan Chen
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego Medical Center, San Diego, CA, United States
| | - Raichel Alex
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, United States
| | - Scott A Sands
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital (Boston, Massachusetts, United States), Boston, MA, United States
| | - Brian S Wojeck
- Section of Endocrinology, Yale New Haven Health System, New Haven, CT, United States
| | - Robert L Owens
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Atul Malhotra
- Department of Medicine, University of California San Diego Medical Center, La Jolla, CA, United States
| | - Christopher N Schmickl
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, La Jolla, CALIFORNIA, United States
| |
Collapse
|
123
|
Zhang Y, Li Y, Peila R, Wang T, Xue X, Kaplan RC, Dannenberg AJ, Qi Q, Rohan TE. Associations of lifestyle and genetic risks with obesity and related chronic diseases in the UK Biobank: a prospective cohort study. Am J Clin Nutr 2024:S0002-9165(24)00448-9. [PMID: 38677521 DOI: 10.1016/j.ajcnut.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/01/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Interplay between lifestyle (LRS) and genetic risk scores (GRS) on obesity and related chronic diseases are under-investigated and necessary for understanding obesity causes and developing prevention strategies. OBJECTIVES To investigate independent and joint associations and interactions of LRS and GRS with obesity prevalence and risks of diabetes, cardiovascular disease (CVD), and obesity-related cancer. METHODS In this cohort study of 444,957 UK Biobank participants (age: 56.5 ± 8.1 years, body mass index [BMI]: 27.4 ± 4.7 kg/m2), LRS included physical activity, dietary score, sedentary behavior, sleep duration, and smoking (range: 0-20, each factor has 5 levels). GRS was calculated based on 941 genetic variants related to BMI. Both scores were categorized into quintiles. Obesity (n=106,301) was defined as baseline BMI≥30 kg/m2. Incident diabetes (n=16,311), CVD (n=18,076), and obesity-related cancer (n=17,325) were ascertained through linkage to registries over a median of 12-year follow-up. RESULTS The LRS and GRS were independently positively associated with all outcomes. Additive interactions of LRS and GRS were observed for all outcomes (P<0.021). Comparing the top versus bottom LRS quintile, prevalence differences (95% confidence intervals) for obesity were 17.8% (15.9%, 19.7%) in the top GRS quintile and 10.7% (8.3%, 13.1%) in the bottom GRS quintile; for diabetes, CVD, and obesity-related cancer, incidence rate differences associated with per standard deviation increase in LRS were greater in the top compared to the bottom GRS quintile. Participants from top quintiles of both LRS and GRS had 6.16-, 3.81-, 1.56-, and 1.44-fold higher odds/risks of obesity, diabetes, CVD, and obesity-related cancer, respectively, compared with those from bottom quintiles of both scores. CONCLUSIONS Higher LRS was associated with higher obesity prevalence and risks of related chronic diseases regardless of GRS, highlighting the broad benefits of healthy lifestyles. Additive gene-lifestyle interactions emphasize the public health importance of lifestyle interventions among people with high genetic risks.
Collapse
Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Yang Li
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Rita Peila
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | | | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
| |
Collapse
|
124
|
Bakaes Y, Gonzalez T, Hardin JW, Jackson JB. Body Mass Index, Sex, and Age Are Predictors of Discharge to a Post-acute Care Facility Following Total Ankle Arthroplasty. Foot Ankle Spec 2024:19386400241246936. [PMID: 38660997 DOI: 10.1177/19386400241246936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND The utilization of total ankle arthroplasty (TAA) continues to increase. Discharge to a post-acute care (PAC) facility can increase patient morbidity and postoperative costs. The purpose of this study is to investigate the effects of age and body mass index (BMI) on discharge to a PAC facility and hospital length of stay (LOS) following TAA. METHODS A retrospective review of patients who underwent TAA from the National Surgical Quality Improvement Program (NSQIP) database was performed. Using overweight patients as the reference BMI group, sex- and age-adjusted log-binomial regression models were utilized to estimate risk ratios of BMI categories for being discharged to a PAC facility. A linear regression was utilized to estimate the effect of BMI category on hospital LOS. RESULTS Obese patients had 1.36 times the risk of overweight patients (P = .040), and morbidly obese patients had 2 times risk of overweight patients (P = .001) of being discharged to a PAC facility after TAA. Men had 0.48 times the risk of women (P < .001). Compared with patients aged 18 to 44 years, patients aged ≥65 years had 4.13 times the risk (P = .012) of being discharged to a PAC facility after TAA. Relative to overweight patients, on average there was no difference in hospital LOS for underweight patients, but healthy weight patients stayed an additional 0.30 days (P=.003), obese patients stayed an additional 0.18 days (P = .011), and morbidly obese patients stayed an additional 0.33 days (P = .009). Men stayed 0.29 fewer hospital days than women (P < .001) on average. CONCLUSION Women and patients who are obese or morbidly obese have a longer hospital LOS and an increased chance of being discharged to a PAC facility. Increasing age is also associated with an increased risk of being discharged to a PAC. These may be important factors when developing and discussing the postoperative plan with patients prior to TAA. LEVELS OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Yianni Bakaes
- School of Medicine Columbia, University of South Carolina, Columbia, South Carolina
| | - Tyler Gonzalez
- Department of Orthopaedics, University of South Carolina, Columbia, South Carolina
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - J Benjamin Jackson
- Department of Orthopaedics, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
125
|
Mailhac A, Pedersen L, Pottegård A, Søndergaard J, Mogensen T, Sørensen HT, Thomsen RW. Semaglutide (Ozempic ®) Use in Denmark 2018 Through 2023 ‒ User Trends and off-Label Prescribing for Weight Loss. Clin Epidemiol 2024; 16:307-318. [PMID: 38685990 PMCID: PMC11057509 DOI: 10.2147/clep.s456170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/13/2024] [Indexed: 05/02/2024] Open
Abstract
Purpose A surge in the use of semaglutide injection (Ozempic®) approved to treat type 2 diabetes (T2D) has led to a global supply shortage. We investigated contemporary user rates and clinical characteristics of semaglutide (Ozempic®) users in Denmark, and the extent of "off-label" prescribing for weight loss. Patients and Methods Nationwide population-based cross-sectional study based on linked health registries January 2018 through December 2023. All adults who received a first prescription of semaglutide once weekly (Ozempic®) were included. We examined quarterly rates of new users and total user prevalences, using other glucagon-like peptide-1 receptor agonists and weight loss medications as comparison. We also investigated user characteristics including T2D, glucose control, comedications, and cardiorenal disease. Results The new user rate of semaglutide (Ozempic®) remained stable at approximately 4 per 1000 adult person-years between 2019 and 2021 and then accelerated, peaking at 10 per 1000 in the first quarter of 2023 after which it declined sharply. User prevalence increased to 91,626 users in Denmark in 2023. The proportion of semaglutide (Ozempic®) new users who had a record of T2D declined from 99% in 2018 to only 67% in 2022, increasing again to 87% in 2023. Among people with T2D who initiated semaglutide (Ozempic®) in 2023, 52% received antidiabetic polytherapy before initiation, 39% monotherapy, and 8% no antidiabetic therapy. Most T2D initiators had suboptimal glucose control, with 83% having an HbA1c ≥48 mmol/mol and 68% ≥53 mmol/mol despite use of antidiabetic medication, and 29% had established atherosclerotic cardiovascular disease or kidney disease. Conclusion The use of semaglutide (Ozempic®) in Denmark has increased dramatically. Although not approved for weight loss without T2D, one-third of new users in 2022 did not have T2D. Conversely, most initiators with T2D had a clear medical indication for treatment intensification, and "off-label" use can only explain a minor part of the supply shortage.
Collapse
Affiliation(s)
- Aurélie Mailhac
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Anton Pottegård
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Torben Mogensen
- Danish Pharmacovigilance Council, Danish Medicines Agency, Copenhagen, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Reimar W Thomsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
126
|
Andreassen P, Jensen SD, Bruun JM, Sandbæk A. Managing the new wave of weight loss medication in general practice: A qualitative study. Clin Obes 2024:e12666. [PMID: 38660941 DOI: 10.1111/cob.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
In early 2023, a new type of weight loss medication, Wegovy (semaglutide), was made available in Denmark. Both subsequent media coverage and public demand were huge. Wegovy is only available by prescription, primarily via general practitioners. However, there is very little knowledge about how healthcare professionals (HCPs) in general practice might deal with the great demand for and attention surrounding a new weight loss drug. The aim of this qualitative study was, therefore, to explore how Wegovy is managed and negotiated in general practice, particularly in terms of prescribing and follow-up. We conducted a focused ethnography study based on direct observation of consultations and both formal and informal interviews with seven doctors and four nurses from three general practices in Denmark. Using discourse analysis, we identified four central discourses revolving around trust in medicine, individual responsibility for health, the cost of weight loss medication, and the importance of shared decision-making. This study shows that the availability of a new, sought-after weight loss medication presents both opportunities and challenges for HCPs in general practice. The management of Wegovy involves numerous factors, including medical, economic, organizational, interpersonal and moral concerns.
Collapse
Affiliation(s)
| | - Sissel Due Jensen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jens M Bruun
- The Danish National Center for Obesity, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Annelli Sandbæk
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Unit of General Practice, Aarhus, Denmark
| |
Collapse
|
127
|
Chang HY, Chen SY, Lin JA, Chen YY, Chen YY, Liu YC, Yen GC. Phyllanthus emblica Fruit Improves Obesity by Reducing Appetite and Enhancing Mucosal Homeostasis via the Gut Microbiota-Brain-Liver Axis in HFD-Induced Leptin-Resistant Rats. J Agric Food Chem 2024. [PMID: 38659208 DOI: 10.1021/acs.jafc.4c01226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The impact of leptin resistance on intestinal mucosal barrier integrity, appetite regulation, and hepatic lipid metabolism through the microbiota-gut-brain-liver axis has yet to be determined. Water extract of Phyllanthus emblica L. fruit (WEPE) and its bioactive compound gallic acid (GA) effectively alleviated methylglyoxal (MG)-triggered leptin resistance in vitro. Therefore, this study investigated how WEPE and GA intervention relieve leptin resistance-associated dysfunction in the intestinal mucosa, appetite, and lipid accumulation through the microbiota-gut-brain-liver axis in high-fat diet (HFD)-fed rats. The results showed that WEPE and GA significantly reduced tissues (jejunum, brain, and liver) MG-evoked leptin resistance, malondialdehyde (MDA), proinflammatory cytokines, SOCS3, orexigenic neuropeptides, and lipid accumulation through increasing leptin receptor, tight junction proteins, antimicrobial peptides, anorexigenic neuropeptides, excretion of fecal triglyceride (TG), and short-chain fatty acids (SCFAs) via a positive correlation with the Allobaculum and Bifidobacterium microbiota. These novel findings suggest that WEPE holds the potential as a functional food ingredient for alleviating obesity and its complications.
Collapse
Affiliation(s)
- Hsin-Yu Chang
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Sheng-Yi Chen
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Jer-An Lin
- Graduate Institute of Food Safety, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Ying-Yin Chen
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Ying-Ying Chen
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Yu-Chen Liu
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| | - Gow-Chin Yen
- Department of Food Science and Biotechnology, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan
| |
Collapse
|
128
|
Firth W, Pye KR, Weightman Potter PG. Astrocytes at the intersection of ageing, obesity, and neurodegeneration. Clin Sci (Lond) 2024; 138:515-536. [PMID: 38652065 DOI: 10.1042/cs20230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Once considered passive cells of the central nervous system (CNS), glia are now known to actively maintain the CNS parenchyma; in recent years, the evidence for glial functions in CNS physiology and pathophysiology has only grown. Astrocytes, a heterogeneous group of glial cells, play key roles in regulating the metabolic and inflammatory landscape of the CNS and have emerged as potential therapeutic targets for a variety of disorders. This review will outline astrocyte functions in the CNS in healthy ageing, obesity, and neurodegeneration, with a focus on the inflammatory responses and mitochondrial function, and will address therapeutic outlooks.
Collapse
Affiliation(s)
- Wyn Firth
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, U.K
| | - Katherine R Pye
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K
| | - Paul G Weightman Potter
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K
| |
Collapse
|
129
|
Rydin AA, Severn C, Pyle L, Morelli N, Shoemaker AH, Chung ST, Yanovski JA, Han JC, Higgins JA, Nadeau KJ, Fox C, Kelly AS, Cree MG. Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis. Pediatr Obes 2024:e13123. [PMID: 38658523 DOI: 10.1111/ijpo.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Resting energy expenditure (REE) assessments can help inform clinical treatment decisions in adolescents with elevated body mass index (BMI), but current equations are suboptimal for severe obesity. We developed a predictive REE equation for youth with severe obesity and obesity-related comorbidities and compared results to previously published predictive equations. METHODS Data from indirect calorimetry, clinical measures, and body composition per Dual x-ray absorptiometry (DXA) were collected from five sites. Data were randomly divided into development (N = 438) and validation (N = 118) cohorts. A predictive equation was developed using Elastic Net regression, using sex, race, ethnicity, weight, height, BMI percent of the 95th%ile (BMIp95), waist circumference, hip circumference, waist/hip ratio, age, Tanner stage, fat and fat-free mass. This equation was verified in the validation cohort and compared with 11 prior equations. RESULTS Data from the total cohort (n = 556, age 15 ± 1.7 years, 77% female, BMIp95 3.3 ± 0.94) were utilized. The best fit equation was REE = -2048 + 18.17 × (Height in cm) - 2.57 × (Weight in kg) + 7.88 × (BMIp95) + 189 × (1 = male, 0 = female), R2 = 0.466, and mean bias of 23 kcal/day. CONCLUSION This new equation provides an updated REE prediction that accounts for severe obesity and metabolic complications frequently observed in contemporary youth.
Collapse
Affiliation(s)
- Amy A Rydin
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cameron Severn
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Laura Pyle
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Nazeen Morelli
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ashley H Shoemaker
- Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Stephanie T Chung
- Section on Pediatric Diabetes, Obesity, and Metabolism, National Institutes of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Joan C Han
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine, New York, New York, USA
| | - Janine A Higgins
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Section of Nutrition, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kristen J Nadeau
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Claudia Fox
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Aaron S Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Melanie G Cree
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| |
Collapse
|
130
|
Leon S, Simon V, Lee TH, Steuernagel L, Clark S, Biglari N, Lesté-Lasserre T, Dupuy N, Cannich A, Bellocchio L, Zizzari P, Allard C, Gonzales D, Le Feuvre Y, Lhuillier E, Brochard A, Nicolas JC, Teillon J, Nikolski M, Marsicano G, Fioramonti X, Brüning JC, Cota D, Quarta C. Single cell tracing of Pomc neurons reveals recruitment of 'Ghost' subtypes with atypical identity in a mouse model of obesity. Nat Commun 2024; 15:3443. [PMID: 38658557 PMCID: PMC11043070 DOI: 10.1038/s41467-024-47877-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
The hypothalamus contains a remarkable diversity of neurons that orchestrate behavioural and metabolic outputs in a highly plastic manner. Neuronal diversity is key to enabling hypothalamic functions and, according to the neuroscience dogma, it is predetermined during embryonic life. Here, by combining lineage tracing of hypothalamic pro-opiomelanocortin (Pomc) neurons with single-cell profiling approaches in adult male mice, we uncovered subpopulations of 'Ghost' neurons endowed with atypical molecular and functional identity. Compared to 'classical' Pomc neurons, Ghost neurons exhibit negligible Pomc expression and are 'invisible' to available neuroanatomical approaches and promoter-based reporter mice for studying Pomc biology. Ghost neuron numbers augment in diet-induced obese mice, independent of neurogenesis or cell death, but weight loss can reverse this shift. Our work challenges the notion of fixed, developmentally programmed neuronal identities in the mature hypothalamus and highlight the ability of specialised neurons to reversibly adapt their functional identity to adult-onset obesogenic stimuli.
Collapse
Affiliation(s)
- Stéphane Leon
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Vincent Simon
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Thomas H Lee
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Lukas Steuernagel
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany
| | - Samantha Clark
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Nasim Biglari
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany
| | | | - Nathalie Dupuy
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Astrid Cannich
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Luigi Bellocchio
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Philippe Zizzari
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Camille Allard
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Delphine Gonzales
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Yves Le Feuvre
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Emeline Lhuillier
- University of Toulouse III Paul Sabatier, INSERM, Institut des Maladies Métaboliques et Cardiovasculaires, U1297, 31400, France; GeT-Santé, Plateforme Génome et Transcriptome, GenoToul, Toulouse, France
| | - Alexandre Brochard
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Jean Charles Nicolas
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Jérémie Teillon
- University of Bordeaux, CNRS, INSERM, BIC, US4, UAR 3420, F-33000, Bordeaux, France
| | - Macha Nikolski
- University of Bordeaux, Bordeaux Bioinformatics Center, Bordeaux, France
- University of Bordeaux, CNRS, IBGC UMR 5095, Bordeaux, France
| | - Giovanni Marsicano
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Xavier Fioramonti
- University of Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, F-33000, Bordeaux, France
| | - Jens C Brüning
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany
- Center for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases (CECAD) University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- National Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Daniela Cota
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France
| | - Carmelo Quarta
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, F-33000, Bordeaux, France.
| |
Collapse
|
131
|
Makihara H, Maezawa M, Kaiga K, Satake T, Muto M, Tsunoda Y, Shimada T, Akase T. mRNA expression levels of cytochrome P450 CYP1A2, CYP3A4, and CYP3A5 in the epidermis: a focus on individual differences among Japanese individuals. Xenobiotica 2024:1-7. [PMID: 38646717 DOI: 10.1080/00498254.2024.2344664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024]
Abstract
Various cytochrome P450 enzymes (CYPs) that contribute to drug metabolism are expressed in the skin. However, variation among individuals in CYP expression profiles is not well-understood.To investigate CYPs related to the metabolism of transdermal preparations in Japan, multiple skin tissue specimens of individuals of Japanese descent were prepared, and the mRNA expression levels of CYP1A2, CYP3A4, and CYP3A5 were measured. Associations between the expression patterns of these CYPs and body mass index (BMI) were also investigated.There were considerable individual differences in epidermal CYP1A2 mRNA expression levels, and CYP1A2 showed a weak positive correlation with CYP3A4 mRNA expression levels. In contrast to previous results for other organs, epidermal CYP3A4 mRNA expression levels showed a weak positive correlation with BMI.CYP3A4 in the epidermis may have been locally enhanced as a defence mechanism against xenobiotics in response to impaired barrier function. These differences in mRNA expression in the skin may affect the transdermal absorption of drugs, such as lidocaine and fentanyl, which are metabolised by multiple overlapping CYPs.Our study provides new insights into drug metabolism in the skin. These results are valuable for predicting drug effects and transdermal drug transfer rates in Japanese patients.
Collapse
Affiliation(s)
- Hiroko Makihara
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Mika Maezawa
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kazusa Kaiga
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshihiko Satake
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Toyama, Japan
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yui Tsunoda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tsutomu Shimada
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Tomoko Akase
- Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| |
Collapse
|
132
|
Ye C, Ma X, Shi B, Yan R, Fu S, Wang K, Jia S, Yan R, Cong G. Obesity is associated with acute kidney injury in ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention: A national representative cohort study. Catheter Cardiovasc Interv 2024. [PMID: 38654635 DOI: 10.1002/ccd.31030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/30/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Acute kidney injury (AKI) is a frequent and potentially life-threatening complication after percutaneous coronary intervention (PCI) in patients with ST-segment-elevation myocardial infarction (STEMI). However, the relationship between obesity and the risk of AKI in this specific patient population has not been previously examined. METHODS We queried the National Inpatient Sample (2016-2019) using ICD-10 codes to obtain a sample of adults with STEMI undergoing PCI. All patients were further subcategorized into obese and nonobese cohorts. The primary outcome was the incidence of AKI. Multivariate regression analysis was performed to assess the impact of obesity on AKI. The consistency of this correlation between subgroups was investigated using subgroup analysis and interaction testing. RESULTS A total of 62,599 (weighted national estimate of 529,016) patients were identified, of which 9.80% (n = 6137) had AKI. Obesity comprised 19.78% (n = 1214) of the AKI cohort. Obese patients were on average younger, male, white, and had more comorbidities. Additionally, there was a significant positive association between obesity and AKI incidence (adjusted odds ratio [aOR]: 1.24, 95% confidence interval [CI]: 1.15-1.34), which was more pronounced in female patients (aOR: 1.56, 95% CI: 1.33-1.82, p < 0.001, p-interaction = 0.008). The AKI incidence in these patients increased steadily during the 4-year study period, and it was consistently higher in obese patients than in nonobese patients (p-trend < 0.001 for all). CONCLUSIONS Obesity was independently associated with a greater risk of AKI among adults with STEMI undergoing PCI, particularly in female patients.
Collapse
Affiliation(s)
- Congyan Ye
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xueping Ma
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
- Institute of Cardiovascular Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
- Department of Cardiology, General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, China
| | - Bo Shi
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Rui Yan
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Shizhe Fu
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Kairu Wang
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Shaobin Jia
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
- Institute of Cardiovascular Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
- Department of Cardiology, General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, China
| | - Ru Yan
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
- Institute of Cardiovascular Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
- Department of Cardiology, General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, China
| | - Guangzhi Cong
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
- Institute of Cardiovascular Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
- Department of Cardiology, General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, China
| |
Collapse
|
133
|
Littleton SH, Trang KB, Volpe CM, Cook K, DeBruyne N, Maguire JA, Weidekamp MA, Hodge KM, Boehm K, Lu S, Chesi A, Bradfield JP, Pippin JA, Anderson SA, Wells AD, Pahl MC, Grant SFA. Variant-to-function analysis of the childhood obesity chr12q13 locus implicates rs7132908 as a causal variant within the 3' UTR of FAIM2. Cell Genom 2024:100556. [PMID: 38697123 DOI: 10.1016/j.xgen.2024.100556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 05/04/2024]
Abstract
The ch12q13 locus is among the most significant childhood obesity loci identified in genome-wide association studies. This locus resides in a non-coding region within FAIM2; thus, the underlying causal variant(s) presumably influence disease susceptibility via cis-regulation. We implicated rs7132908 as a putative causal variant by leveraging our in-house 3D genomic data and public domain datasets. Using a luciferase reporter assay, we observed allele-specific cis-regulatory activity of the immediate region harboring rs7132908. We generated isogenic human embryonic stem cell lines homozygous for either rs7132908 allele to assess changes in gene expression and chromatin accessibility throughout a differentiation to hypothalamic neurons, a key cell type known to regulate feeding behavior. The rs7132908 obesity risk allele influenced expression of FAIM2 and other genes and decreased the proportion of neurons produced by differentiation. We have functionally validated rs7132908 as a causal obesity variant that temporally regulates nearby effector genes and influences neurodevelopment and survival.
Collapse
Affiliation(s)
- Sheridan H Littleton
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Cell and Molecular Biology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Khanh B Trang
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Christina M Volpe
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Biology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kieona Cook
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Nicole DeBruyne
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Cell and Molecular Biology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jean Ann Maguire
- Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Mary Ann Weidekamp
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Graduate Group in Genomics and Computational Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kenyaita M Hodge
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Keith Boehm
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sumei Lu
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Alessandra Chesi
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jonathan P Bradfield
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Quantinuum Research LLC, San Diego, CA 92101, USA
| | - James A Pippin
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Stewart A Anderson
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Andrew D Wells
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Matthew C Pahl
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Struan F A Grant
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
| |
Collapse
|
134
|
Barrero JA, Duarte-Zambrano F, Mockus I. The socioeconomic gradient in overweight and obesity among Colombian adult and pediatric populations: A scoping review. Nutr Health 2024:2601060241248307. [PMID: 38651331 DOI: 10.1177/02601060241248307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Background: The imminent increase in overweight and obesity prevalence constitutes a pervasive concern for the adult and pediatric Colombian population. Nonetheless, the unequal distribution across distinct social groups limits the implementation of public health policies targeting these escalating rates. Aim: This study aimed to compile existing evidence regarding the prevalence of overweight and obesity in relation to the socioeconomic status (SES) of the Colombian population. Methods: A scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews parameters in MEDLINE (PubMed), EMBASE, and LILACS databases for inclusion of investigations published up to January 2024. Results: Twenty-two cross-sectional studies were included. A higher prevalence of overweight and obesity was documented in adults with lower SES defined by social stratum and monetary income, while in particular for nonpregnant adult women, the prevalence of excess weight was higher in the medium-low socioeconomic stratum. In the pediatric population, higher SES defined by social stratum was directly related to an increased prevalence and risk of overweight and obesity. The ownership of household assets, however, was positively related to the risk of overweight in both adult and pediatric populations. Conclusion: The findings of this investigation disclose a socioeconomic gradient in overweight and obesity in Colombia that resembles the epidemiological distribution in high-income countries for adults, though similar to low-income countries for the pediatric population. Further intersectoral interventions aimed at the most vulnerable groups are imperative to mitigate the inequalities that condition their predisposition to overweight and obesity.
Collapse
Affiliation(s)
- Jorge A Barrero
- Departamento de Ciencias Fisiológicas, División de Lípidos y Diabetes, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| | - Felipe Duarte-Zambrano
- Departamento de Ciencias Fisiológicas, División de Lípidos y Diabetes, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| | - Ismena Mockus
- Departamento de Ciencias Fisiológicas, División de Lípidos y Diabetes, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| |
Collapse
|
135
|
Wong JH, Burch AE, DeMaria EJ, Pories WJ, Irish WD. Disparities in Access to Bariatric Surgery in North Carolina. Am Surg 2024:31348241248807. [PMID: 38652146 DOI: 10.1177/00031348241248807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND This study sought to identify factors that contribute to disparities in access to bariatric surgery in North Carolina (NC). METHODS Using the rate of bariatric surgery in the county with the best health outcome as the reference, we calculated the Surgical Equity Index (SEI) in the remaining counties in NC. RESULTS Approximately 2.95 million individuals (29%) were obese in NC. There were 992 (.5%) bariatric procedures performed on a population of 194 209 individuals with obesity in the Reference County (RC). The mean SEI for bariatric surgery in NC was .47 (SD .17, range .15-.95). A statistically significant difference was observed in 89 counties. Univariable analyses identified the following variables to be significantly associated with the SEI: percent of population living in rural areas (% rural) (relative rate change in SEI [RR] = .994, 95% CI .92-.997; <.0001), median household income (RR = 1.0, 95% CI = 1.0-1.0; P = .0002), prevalence of diabetes (RR = .947, 95% CI .917-.977; .0006), the primary care physician ratio (RR = .995, 95% CI .991-.998; P = .006), and percent uninsured adults (RR = .955, 95% CI .927-.985; P = .003). By multivariable hierarchical regression analysis, only the % rural remained statistically associated with a low SEI (RR = .995 per 1% increase in % rural, 95% CI = .992, .998; P = .0002). DISCUSSION The percent rural is the most significant predictor of disparities in access to bariatric surgery. For every 1% increase in % rural, the rate of surgery decreased by .5%. Understanding the characteristics of rurality that are barriers to access is crucial to mitigate disparities in bariatric surgical access in NC.
Collapse
Affiliation(s)
- Jan H Wong
- Division of Surgical Research, Department of Surgery, Brody School of Medicine at East Carolina, Greenville, NC, USA
| | - Ashley E Burch
- Department of Health Services and Information Management, East Carolina University, Greenville, NC, USA
- Department of Cardiology, East Carolina University, Greenville, NC, USA
| | - Eric J DeMaria
- Division of General Minimally Invasive and Bariatric Surgery, Department of Surgery, Brody School of Medicine at East Carolina, Greenville, NC, USA
| | - Walter J Pories
- Division of Surgical Research, Department of Surgery, Brody School of Medicine at East Carolina, Greenville, NC, USA
| | - William D Irish
- Division of Surgical Research, Department of Surgery, Brody School of Medicine at East Carolina, Greenville, NC, USA
- Department of Public Health, East Carolina University, Greenville, NC, USA
| |
Collapse
|
136
|
Magalhães MI, Azevedo MJ, Castro F, Oliveira MJ, Costa ÂM, Sampaio Maia B. The link between obesity and the gut microbiota and immune system in early-life. Crit Rev Microbiol 2024:1-21. [PMID: 38651972 DOI: 10.1080/1040841x.2024.2342427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/06/2024] [Indexed: 04/25/2024]
Abstract
In early-life, the gut microbiota is highly modifiable, being modulated by external factors such as maternal microbiota, mode of delivery, and feeding strategies. The composition of the child's gut microbiota will deeply impact the development and maturation of its immune system, with consequences for future health. As one of the main sources of microorganisms to the child, the mother represents a crucial factor in the establishment of early-life microbiota, impacting the infant's wellbeing. Recent studies have proposed that dysbiotic maternal gut microbiota could be transmitted to the offspring, influencing the development of its immunity, and leading to the development of diseases such as obesity. This paper aims to review recent findings in gut microbiota and immune system interaction in early-life, highlighting the benefits of a balanced gut microbiota in the regulation of the immune system.
Collapse
Affiliation(s)
- Maria Inês Magalhães
- Doctoral Program in Biomedical Sciences, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Nephrology and Infectious Diseases R&D group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Tumor and Microenvironment Interactions group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- nBTT, NanoBiomaterials for Targeted Therapies group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- FMDUP - Faculdade de Medicina Dentária da Universidade do Porto, Porto, Portugal
| | - Maria João Azevedo
- Nephrology and Infectious Diseases R&D group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- nBTT, NanoBiomaterials for Targeted Therapies group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- FMDUP - Faculdade de Medicina Dentária da Universidade do Porto, Porto, Portugal
- Academic Center for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Flávia Castro
- Tumor and Microenvironment Interactions group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Maria José Oliveira
- Tumor and Microenvironment Interactions group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Ângela M Costa
- Tumor and Microenvironment Interactions group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Benedita Sampaio Maia
- Nephrology and Infectious Diseases R&D group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- nBTT, NanoBiomaterials for Targeted Therapies group, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- FMDUP - Faculdade de Medicina Dentária da Universidade do Porto, Porto, Portugal
| |
Collapse
|
137
|
Lambooij JM, Tak T, Zaldumbide A, Guigas B. A 30-color spectral flow cytometry panel for comprehensive analysis of immune cell composition and macrophage subsets in mouse metabolic organs. Cytometry A 2024. [PMID: 38651815 DOI: 10.1002/cyto.a.24845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
Obesity-induced chronic low-grade inflammation, also known as metaflammation, results from alterations of the immune response in metabolic organs and contributes to the development of fatty liver diseases and type 2 diabetes. The diversity of tissue-resident leukocytes involved in these metabolic dysfunctions warrants an in-depth immunophenotyping in order to elucidate disease etiology. Here, we present a 30-color, full spectrum flow cytometry panel, designed to (i) identify the major innate and adaptive immune cell subsets in murine liver and white adipose tissues and (ii) discriminate various tissue-specific myeloid subsets known to contribute to the development of metabolic dysfunctions. This panel notably allows for distinguishing embryonically-derived liver-resident Kupffer cells from newly recruited monocyte-derived macrophages and KCs. Furthermore, several adipose tissue macrophage (ATM) subsets, including perivascular macrophages, lipid-associated macrophages, and pro-inflammatory CD11c+ ATMs, can also be identified. Finally, the panel includes cell-surface markers that have been associated with metabolic activation of different macrophage and dendritic cell subsets. Altogether, our spectral flow cytometry panel allows for an extensive immunophenotyping of murine metabolic tissues, with a particular focus on metabolically-relevant myeloid cell subsets, and can easily be adjusted to include various new markers if needed.
Collapse
Affiliation(s)
- Joost M Lambooij
- Leiden University Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cell & Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tamar Tak
- Flow Cytometry Core Facility, Leiden University Medical Center, Leiden, The Netherlands
| | - Arnaud Zaldumbide
- Department of Cell & Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bruno Guigas
- Leiden University Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
138
|
Lee YJ, Jang YN, Han YM, Kim HM, Seo HS, Kim HJ, Jung TW, Jeong JH, Abd El-Aty AM, Jung KO. Aster glehni Extract, Including Caffeoylquinic Acids as the Main Constituents, Induces PPAR β/δ-Dependent Muscle-Type Change and Myogenesis in Apolipoprotein E Knockout Mice. J Med Food 2024. [PMID: 38651680 DOI: 10.1089/jmf.2024.k.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
To probe the functions of Aster glehni (AG) extract containing various caffeoylquinic acids on dyslipidemia, obesity, and skeletal muscle-related diseases focused on the roles of skeletal muscle, we measured the levels of biomarkers involved in oxidative phosphorylation and type change of skeletal muscle in C2C12 cells and skeletal muscle tissues from apolipoprotein E knockout (ApoE KO) mice. After AG extract treatment in cell and animal experiments, western blotting, immunohistochemistry, and enzyme-linked immunosorbent assay (ELISA) were used to estimate the levels of proteins that participated in skeletal muscle type change and oxidative phosphorylation. AG extract elevated protein expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), phosphorylated 5'-AMP-activated protein kinase (p-AMPK), peroxisome proliferator-activated receptor beta/delta (PPARβ/δ), myoblast determination protein 1 (MyoD), and myoglobin in skeletal muscle tissues. Furthermore, it elevated the ATP concentration. However, protein expression of myostatin was decreased by AG treatment. In C2C12 cells, increments of MyoD, myoglobin, myosin, ATP-producing pathway, and differentiation degree by AG were dependent on PPARβ/δ and caffeoylquinic acids. AG extract can contribute to the amelioration of skeletal muscle inactivity and sarcopenia through myogenesis in skeletal muscle tissues from ApoE KO mice, and function of AG extract may be dependent on PPARβ/δ, and the main functional constituents of AG are trans-5-O-caffeoylquinic acid and 3,5-O-dicaffeoylquinic acid. In addition, in skeletal muscle, AG has potent efficacies against dyslipidemia and obesity through the increase of the type 1 muscle fiber content to produce more ATP by oxidative phosphorylation in skeletal muscle tissues from ApoE KO mice.
Collapse
Affiliation(s)
- Yong-Jik Lee
- Cardiovascular Center, Korea University Guro Hospital, Seoul, the Republic of Korea
- Department of Pharmacology, Chung-Ang University College of Medicine, Seoul, the Republic of Korea
| | - Yoo-Na Jang
- Cardiovascular Center, Korea University Guro Hospital, Seoul, the Republic of Korea
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, the Republic of Korea
| | - Yoon-Mi Han
- Cardiovascular Center, Korea University Guro Hospital, Seoul, the Republic of Korea
| | - Hyun-Min Kim
- Cardiovascular Center, Korea University Guro Hospital, Seoul, the Republic of Korea
- Department of Medical Science, BK21 Plus KUMS Graduate Program, Korea University College of Medicine, Seoul, the Republic of Korea
| | - Hong Seog Seo
- Cardiovascular Center, Korea University Guro Hospital, Seoul, the Republic of Korea
| | - Hyoung Ja Kim
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul, the Republic of Korea
| | - Tae Woo Jung
- Department of Pharmacology, Chung-Ang University College of Medicine, Seoul, the Republic of Korea
| | - Ji Hoon Jeong
- Department of Pharmacology, Chung-Ang University College of Medicine, Seoul, the Republic of Korea
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, the Republic of Korea
| | - A M Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
- Department of Medical Pharmacology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Kyung Oh Jung
- Department of Anatomy, Chung-Ang University College of Medicine, Seoul, the Republic of Korea
| |
Collapse
|
139
|
Ma Q, He X, Fu Z, Ren X, Sun R, Zhu S, Bian Y, Li X. Clinical observation of laparoscopic sleeve gastrectomy and metformin treatment in obese PCOS patients. J Med Biochem 2024; 43:226-233. [PMID: 38699692 PMCID: PMC11062340 DOI: 10.5937/jomb0-44411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/09/2023] [Indexed: 05/05/2024] Open
Abstract
Background To observe the basic metabolic characteristics of obese patients with polycystic ovarian syndrome (PCOS), and observe and compare the effect of laparoscopic sleeve gastrectomy and metformin treatment after 3 months. Methods In January to December 2018, the Second Hospital of Hebei Medical University selected 104 women who were classified as obese with a body mass index (BMI) of 28 kg/cm2 or higher and had PCOS. They were divided into obese PCOS group (53 cases) and obese non-PCOS group (51 cases). Results 1. There was no significant difference in waist circumference and WHR between patients who are obese with PCOS and patients who are obese without PCOS (P > 0.05). Obese PCOS patients were significantly higher in anti-Müllerian hormone (AMH), LH/FSH, T, FAI, homa-ir, triglyceride (TG), low density lipoprotein (LDL), Apo-B and uric acid than the group of non-PCOS patients who were obese. (P<0.05). The SHBG levels of obese patients with PCOS were obviously lower when contrasted with the levels in obese patients without PCOS (P < 0.05). 2. Body weight, BMI, INS, homa-ir and TG of obese PCOS patients were significantly decreased 3 months after laparoscopic sleeve gastrectomy compared with that before surgery (P < 0.05). After three months of medical treatment with metformin, the patients' homeostatic model assessment of insulin resistance (HOMA-IR) was obviously reduced when contrasted with the pre-treatment HOMA-IR levels (P < 0.05), and there was no significant difference in the improvement degree of homa-ir between the two groups (P > 0.05). Conclusions 1. Obese patients with PCOS demonstrated higher expression of AMH, LH/FSH, T, SHBG, and FAI when contrasted with the control group. Additionally, they experienced more severe insulin resistance and lipid metabolism disorders. 2. The weight and BMI of obese PCOS patients were significantly decreased after weight loss, while IR and blood lipid were significantly improved, while IR was improved in metformin group, and no significant discrepancy was observed in the degree of improvement of insulin resistance between both groups.
Collapse
Affiliation(s)
- Qingya Ma
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Xiaojing He
- The Second Hospital of Hebei Medical University, Department of Obstetrics and Gynaecology, Shijiazhuang, China
| | - Zijie Fu
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Xiaodong Ren
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Ranran Sun
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Siqi Zhu
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Yahui Bian
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| | - Xiaodong Li
- The First Hospital of Hebei Medical University, Department of Gynecology, Shijiazhuang, China
| |
Collapse
|
140
|
Fernandes C, Forny-Germano L, Andrade MM, Lyra E Silva NM, Ramos-Lobo AM, Meireles F, Tovar-Moll F, Houzel JC, Donato J, De Felice FG. Leptin receptor reactivation restores brain function in early-life Lepr-deficient mice. Brain 2024:awae127. [PMID: 38650574 DOI: 10.1093/brain/awae127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
Obesity is a chronic disease caused by excessive fat accumulation that impacts the body and brain health. Insufficient leptin or leptin receptor (LepR) are involved in the disease pathogenesis. Leptin is involved with several neurological processes, and it has critical developmental roles. We have previously demonstrated that leptin deficiency in early life leads to permanent developmental problems, including energy homeostasis imbalance, melanocortin and reproductive system alterations and brain mass reduction in young adult mice. Since in humans, obesity has been associated with brain atrophy and cognitive impairment, it is important to determine the long-term consequences of early life leptin deficiency in brain structure and memory function. Here, we demonstrate that leptin-deficient mice (LepOb) exhibit altered brain volume, decreased neurogenesis and memory impairment. Similar effects were observed in animals that do not express the LepR (LepRNull). Interestingly, restoring the expression of LepR in 10-week-old mice reverses brain atrophy, as well as neurogenesis and memory impairments in older animals. Our findings indicate that leptin deficiency impairs brain development and memory, which are reversible by restoring leptin signaling in adulthood.
Collapse
Affiliation(s)
- Caroline Fernandes
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leticia Forny-Germano
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mayara M Andrade
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natalia M Lyra E Silva
- Centre for Neuroscience Studies, Department of Biomedical and Molecular Sciences & Department of Psychiatry, Queen's University, Kingston, Canada
| | - Angela M Ramos-Lobo
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | | | - Jean Christophe Houzel
- Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose Donato
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Fernanda G De Felice
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Centre for Neuroscience Studies, Department of Biomedical and Molecular Sciences & Department of Psychiatry, Queen's University, Kingston, Canada
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| |
Collapse
|
141
|
Becattini B, Molinaro A, Henricsson M, Borén J, Solinas G. Adipocyte PI3K links adipostasis with baseline insulin secretion at fasting through an adipoincretin effect. Cell Rep 2024; 43:114132. [PMID: 38656871 DOI: 10.1016/j.celrep.2024.114132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
Insulin-PI3K signaling controls insulin secretion. Understanding this feedback mechanism is crucial for comprehending how insulin functions. However, the role of adipocyte insulin-PI3K signaling in controlling insulin secretion in vivo remains unclear. Using adipocyte-specific PI3Kα knockout mice (PI3KαAdQ) and a panel of isoform-selective PI3K inhibitors, we show that PI3Kα and PI3Kβ activities are functionally redundant in adipocyte insulin signaling. PI3Kβ-selective inhibitors have no effect on adipocyte AKT phosphorylation in control mice but blunt it in adipocytes of PI3KαAdQ mice, demonstrating adipocyte-selective pharmacological PI3K inhibition in the latter. Acute adipocyte-selective PI3K inhibition increases serum free fatty acid (FFA) and potently induces insulin secretion. We name this phenomenon the adipoincretin effect. The adipoincretin effect operates in fasted mice with increasing FFA and decreasing glycemia, indicating that it is not primarily a control system for blood glucose. This feedback control system defines the rates of adipose tissue lipolysis and chiefly controls basal insulin secretion during fasting.
Collapse
Affiliation(s)
- Barbara Becattini
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Angela Molinaro
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Marcus Henricsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Giovanni Solinas
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
142
|
Paczkowska K, Sobczuk J, Zawadzka K, Jędrzejuk D, Zembska A, Konieczny J, Kaszubkiewicz-Wardęga D, Bolanowski M, Daroszewski J. Circulating levels of irisin and Meteorin-like protein in PCOS and its correlation with metabolic parameters. Endokrynol Pol 2024:VM/OJS/J/99111. [PMID: 38646985 DOI: 10.5603/ep.99111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Research on obesity, which results from excessive food consumption and sedentary lifestyle, has focused on increasing energy expenditure. Recently, muscle tissue is being investigated as an endocrine active organ, secreting molecules called myokines. Multiple studies have been performed to assess myokine levels in various disorders, including polycystic ovary syndrome (PCOS) and metabolic syndrome. Irisin and Meteorin-like protein (Metrnl) are particles which, among others, are suggested to play an important role in adipose tissue browning and improving insulin sensitivity. MATERIAL AND METHODS The study population consisted of 31 women with PCOS and 18 healthy individuals. PCOS was diagnosed based on revised 2003 Rotterdam criteria. Multiple anthropometrical, hormonal, and biochemical parameters were assessed, including oral glucose tolerance test and body composition with dual energy X-ray absorptiometry. Serum levels of irisin and Metrnl were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS There were no differences between the PCOS and control groups according to age, body mass index (BMI), waist-to-hip ratio (WHR), fasting glucose, homeostasis model assessment of insulin resistance (HOMA-IR), or body mass composition. Assessment of Metrnl and irisin concentrations revealed no significant differences between PCOS and healthy women. The irisin level was negatively correlated with BMI, body fat mass, fasting glucose, and insulin concentrations. No relationship between Metrnl level and metabolic parameters was found. CONCLUSIONS Although irisin seems to be a promising biomarker, inconsistent research limits its value in clinical use in the assessment or treatment of obesity. Metrnl level was not affected in the study population, but it might be connected to the severity of metabolic disturbances.
Collapse
Affiliation(s)
- Katarzyna Paczkowska
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland.
| | - Joachim Sobczuk
- Department of Endocrinology, Diabetes and Isotope Therapy, University Clinical Hospital, Wroclaw, Poland
| | - Katarzyna Zawadzka
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Diana Jędrzejuk
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Zembska
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Marek Bolanowski
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Daroszewski
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
143
|
Akinyemi OA, Weldeslase TA, Andine TF, Fasokun M, Griffiths Y, Odusanya E, Williams M, Hughes K, Cornwell E, Fullum T. Race, Insurance, and Socioeconomic Influences on Outcomes Following Roux-En-Y Gastric Bypass. Am Surg 2024:31348241248803. [PMID: 38647079 DOI: 10.1177/00031348241248803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The effectiveness of Roux-en-Y gastric bypass (RYGB) might be shadowed by disparities in outcomes related to patient race and insurance type. We determine the influence of patient race/ethnicity and insurance types on complications following RYGB. We performed a retrospective analysis using data sourced from the National Inpatient Sample Database (2010 to 2019). A multivariate analysis was employed to determine the relationship between patient race/ethnicity and insurance type on RYGB complications. The analysis determined the interaction between race/ethnicity and insurance type on RYGB outcomes. We analyzed 277714 patients who underwent RYGB. Most of these patients were White (64.5%) and female (77.3%), with a median age of 46 years (IQR 36-55). Medicaid beneficiaries displayed less favorable outcomes than those under private insurance: Extended hospital stay (OR = 1.68; 95% CI 1.58-1.78), GIT Leak (OR = 1.83; 95% CI 1.35-2.47), postoperative wound infection (OR = 1.88; 95% CI 1.38-2.55), and in-hospital mortality (OR = 2.74; 95% CI 1.90-3.95).
Collapse
Affiliation(s)
- Oluwasegun A Akinyemi
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Terhas A Weldeslase
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Tsion F Andine
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Mojisola Fasokun
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yasmine Griffiths
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Eunice Odusanya
- Department of Surgery Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA
| | - Mallory Williams
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Kakra Hughes
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Edward Cornwell
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Terrence Fullum
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| |
Collapse
|
144
|
Yang W, Jiang W, Liao W, Yan H, Ai W, Pan Q, Brashear WA, Xu Y, He L, Guo S. An estrogen receptor α-derived peptide improves glucose homeostasis during obesity. Nat Commun 2024; 15:3410. [PMID: 38649684 PMCID: PMC11035554 DOI: 10.1038/s41467-024-47687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Estrogen receptor α (ERα) plays a crucial role in regulating glucose and energy homeostasis during type 2 diabetes mellitus (T2DM). However, the underlying mechanisms remain incompletely understood. Here we find a ligand-independent effect of ERα on the regulation of glucose homeostasis. Deficiency of ERα in the liver impairs glucose homeostasis in male, female, and ovariectomized (OVX) female mice. Mechanistic studies reveal that ERα promotes hepatic insulin sensitivity by suppressing ubiquitination-induced IRS1 degradation. The ERα 1-280 domain mediates the ligand-independent effect of ERα on insulin sensitivity. Furthermore, we identify a peptide based on ERα 1-280 domain and find that ERα-derived peptide increases IRS1 stability and enhances insulin sensitivity. Importantly, administration of ERα-derived peptide into obese mice significantly improves glucose homeostasis and serum lipid profiles. These findings pave the way for the therapeutic intervention of T2DM by targeting the ligand-independent effect of ERα and indicate that ERα-derived peptide is a potential insulin sensitizer for the treatment of T2DM.
Collapse
Affiliation(s)
- Wanbao Yang
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Wen Jiang
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Wang Liao
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Hui Yan
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Weiqi Ai
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Quan Pan
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Wesley A Brashear
- High Performance Research Computing, Texas A&M University, College Station, TX, USA
| | - Yong Xu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ling He
- Departments of Pediatrics and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shaodong Guo
- Department of Nutrition, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, 77843, USA.
| |
Collapse
|
145
|
Buscemi C, Randazzo C, Barile AM, Bo S, Ponzo V, Caldarella R, Malavazos AE, Caruso R, Colombrita P, Lombardo M, Buscemi S. Factors associated with body weight gain and insulin-resistance: a longitudinal study. Nutr Diabetes 2024; 14:21. [PMID: 38649714 PMCID: PMC11035547 DOI: 10.1038/s41387-024-00283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Obesity is the result of energy intake (EI) chronically exceeding energy expenditure. However, the potential metabolic factors, including insulin resistance, remain unclear. This study longitudinally investigated factors associated with changes in body weight. SUBJECTS A cohort of 707 adults without diabetes were investigated at the 4-year follow-up visit. The habitual intake of energy and macronutrients during the past 12 months was assessed using a validated Food Frequency Questionnaire for the local population. Homeostatic model assessment of β-cell function and insulin resistance (HOMA-IR) was used as a surrogate measure of insulin resistance. Additionally, PNPLA3 was genotyped. RESULTS Eighty-seven participants were weight gainers (G; cutoff value = 5 kg), and 620 were non-gainers (NG). Initial anthropometric (G vs. NG: age, 44 ± 13 vs 51 ± 13 years, P < 0.001; body mass index, 27.8 ± 6.5 vs 28.1 ± 5.1 kg/m2, P = ns; body weight, 76.7 ± 22.1 vs 74.2 ± 14.7 kg, P = ns; final body weight, 86.3 ± 23.7 vs 72.9 ± 14.2 kg, P < 0.001) and diet characteristics, as well as insulin concentrations and HOMA-IR values, were similar in both groups. Four years later, G showed significantly increased EI, insulin concentrations, and HOMA-IR values. G had a higher prevalence of the PNPLA3 CG and GG alleles than NG (P < 0.05). The presence of G was independently associated with age (OR = 1.031), EI change (OR = 2.257), and unfavorable alleles of PNPLA3 gene (OR = 1.700). Final body mass index, waist circumference, and EI were independently associated with final HOMA-IR (P < 0.001). CONCLUSIONS EI is associated with body weight gain, and genetic factors may influence the energy balance. Insulin resistance is a consequence of weight gain, suggesting a possible intracellular protective mechanism against substrate overflow. CLINICAL TRIAL REGISTRATION ISRCTN15840340.
Collapse
Affiliation(s)
- Carola Buscemi
- Unit of Internal Medicine, "V. Cervello Hospital", Palermo, Italy
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Cristiana Randazzo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy.
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy.
| | - Anna Maria Barile
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Simona Bo
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Valentina Ponzo
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Rosalia Caldarella
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Laboratory Medicine, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Alexis Elias Malavazos
- Endocrinology Unit, Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Roberta Caruso
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Piero Colombrita
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Martina Lombardo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
| | - Silvio Buscemi
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy
- Unit of Clinical Nutrition, Obesity and Metabolic Diseases; AOU Policlinico "P. Giaccone", Palermo, Italy
| |
Collapse
|
146
|
Gul MA, Tozcu D, Tekcan A, Capraz M, Demir HD. Serum adiponectin and peroxisome proliferator-activated receptors-γ levels in obese patients with and without prediabetes. Rev Assoc Med Bras (1992) 2024; 70:e20231000. [PMID: 38655997 PMCID: PMC11045203 DOI: 10.1590/1806-9282.20231000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Obesity is an increasingly prevalent global health problem, which is generally caused by the increase in body fat mass above normal and observed in all societies. If the blood glucose level is higher than normal but not high enough to diagnose diabetes, this condition is defined as prediabetes. Adiponectin increases fatty acid oxidation and insulin sensitivity and is closely associated with obesity. One of the nuclear receptor superfamily member peroxisome proliferator-activated receptors is shown to have an important role in various metabolic reactions. This study aimed to investigate the serum levels of adiponectin and peroxisome proliferator-activated receptors-gamma parameters, which are closely related to adipose tissue, energy metabolism, and insulin sensitivity, in obese patients with and without prediabetes. METHODS For this purpose, 52 obese patients with prediabetes, 48 obese patients with non-prediabetes, and 76 healthy individuals were included in this study. Serum adiponectin and peroxisome proliferator-activated receptors-γ levels were analyzed by ELISA. RESULTS Serum adiponectin levels were significantly higher in obese patients with prediabetes (18.15±15.99) compared with the control group (15.17±15.67; p=0.42). No significant difference was observed in both adiponectin and peroxisome proliferator-activated receptors-γ levels in the obese patients with the non-prediabetes group compared with the control group. However, no significant difference was observed in the obese patients with prediabetes group and obese patients with non-prediabetes group. CONCLUSION Our results suggest that adiponectin may serve as an indicator of prediabetes. This implies that examining adiponectin levels in individuals diagnosed with prediabetes may enhance our understanding of the metabolic processes closely linked to prediabetes and related conditions.
Collapse
Affiliation(s)
- Mehmet Ali Gul
- Amasya University, Faculty of Medicine, Department of Medical
Biochemistry – Amasya, Turkey
| | - Duygu Tozcu
- Amasya University, Faculty of Medicine, Department of Physiology
– Amasya, Turkey
| | - Akın Tekcan
- Amasya University, Faculty of Medicine, Department of Medical
Biology – Amasya, Turkey
| | - Mustafa Capraz
- Amasya University, Faculty of Medicine, Department of Internal
Diseases – Amasya, Turkey
| | - Hatice Dortok Demir
- Amasya University, Faculty of Medicine, Department of Medical
Biochemistry – Amasya, Turkey
| |
Collapse
|
147
|
Song M, Kang S, Kang H. The Association Between Obesity Measures and Metabolic Syndrome Risk in Korean Adolescents Aged 10-18 Years. J Multidiscip Healthc 2024; 17:1769-1776. [PMID: 38680877 PMCID: PMC11048366 DOI: 10.2147/jmdh.s461406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Childhood obesity is strongly linked to an increased risk of metabolic syndrome (MetS), type 2 diabetes, and cardiovascular disease in adulthood, endangering the global healthcare system. No single tool for detecting MetS is suitable for all pediatric populations. This study aimed to investigate the association between obesity measures and MetS in Korean children and adolescents. Method and Materials The data were obtained from 1663 children and adolescents aged 10-19 years (771 girls) who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHtR) were included as obesity measures. Fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, and resting blood pressure were included as metabolic risk factors. MetS was defined as the clustering of metabolic risk factors such as elevated fasting blood glucose, elevated mean arterial pressure, elevated triglycerides, and low high-density lipoprotein cholesterol. Results Regardless of the obesity measures used, obese children and adolescents were more likely to have a clustering of metabolic risk factors compared to their non-obese counterparts: BMI-based obesity (odds ratio, OR=4.151, 95% confidence interval, CI=2.763~6.238, p<0.001), WC-based obesity (OR=1.917, 95% CI=1.066~3.446, p=0.010), and WHtR-based obesity (OR=2.160 and 95% CI=1.203~3.878, p=0.003). A receiver operating curve analysis showed that BMI (area under the curve, AUC=0.849, 95% CI=0.8270.871) outperformed WC (AUC=0.833, 95% CI=0.8090.856) and WHtR (AUC=0.794, 95% CI=0.7670.821) in detecting the presence of MetS. Conclusion and Recommendation Study findings suggest that obese teenagers are more likely to have metabolic syndrome than non-obese teens. Concerning accuracy, convenience, and ease of use and calculation, BMI is the best screening tool for detecting MetS in Korean children and adolescents.
Collapse
Affiliation(s)
- Munku Song
- College of Sport Science, Sungkyunkwan University, Suwon, South Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, Suwon, South Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon, South Korea
| |
Collapse
|
148
|
Martinez de Morentin PB, Gonzalez JA, Dowsett GKC, Martynova Y, Yeo GSH, Sylantyev S, Heisler LK. A brainstem to hypothalamic arcuate nucleus GABAergic circuit drives feeding. Curr Biol 2024; 34:1646-1656.e4. [PMID: 38518777 DOI: 10.1016/j.cub.2024.02.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/05/2024] [Accepted: 02/29/2024] [Indexed: 03/24/2024]
Abstract
The obesity epidemic is principally driven by the consumption of more calories than the body requires. It is therefore essential that the mechanisms underpinning feeding behavior are defined. Neurons within the brainstem dorsal vagal complex (DVC) receive direct information from the digestive system and project to second-order regions in the brain to regulate food intake. Although γ-aminobutyric acid is expressed in the DVC (GABADVC), its function in this region has not been defined. In order to discover the unique gene expression signature of GABADVC cells, we used single-nucleus RNA sequencing (Nuc-seq), and this revealed 19 separate clusters. We next probed the function of GABADVC cells and discovered that the selective activation of GABADVC neurons significantly controls food intake and body weight. Optogenetic interrogation of GABADVC circuitry identified GABADVC → hypothalamic arcuate nucleus (ARC) projections as appetite suppressive without creating aversion. Electrophysiological analysis revealed that GABADVC → ARC stimulation inhibits hunger-promoting neuropeptide Y (NPY) neurons via GABA release. Adopting an intersectional genetics strategy, we clarify that the GABADVC → ARC circuit curbs food intake. These data identify GABADVC as a new modulator of feeding behavior and body weight and a controller of orexigenic NPY neuron activity, thereby providing insight into the neural underpinnings of obesity.
Collapse
Affiliation(s)
- Pablo B Martinez de Morentin
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen AB25 2ZD, UK; School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Woodhouse LS2 9JT, UK.
| | - J Antonio Gonzalez
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen AB25 2ZD, UK
| | - Georgina K C Dowsett
- MRC Metabolic Diseases Unit, Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Yuliia Martynova
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen AB25 2ZD, UK
| | - Giles S H Yeo
- MRC Metabolic Diseases Unit, Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Sergiy Sylantyev
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen AB25 2ZD, UK; Odesa National Mechnikov University, Biological Department, 2 Shampansky Ln., Odesa 65015, Ukraine.
| | - Lora K Heisler
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen AB25 2ZD, UK
| |
Collapse
|
149
|
Alrasheedi AA. Glycaemic control among adults with type 2 diabetes mellitus in the Gulf Cooperation Council countries: an updated review. Endokrynol Pol 2024:VM/OJS/J/99519. [PMID: 38646983 DOI: 10.5603/ep.99519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/01/2024] [Indexed: 04/25/2024]
Abstract
Type 2 diabetes mellitus (T2DM) has become a major public health concern, causing significant disability and death worldwide. Fuelled by a modern sedentary lifestyle and poor dietary practices, T2DM affects at least 10.5% of the world's population. This paper seeks to review the progress made by the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in addressing T2DM, focusing on glycaemic control proportions and comparing it with the 2015 review. The results indicate no significant improvement in glycaemic control proportions since the last review, with only 9.2% to 56.9% of patients having good control (glycosylated haemoglobin < 7%). However, there are no significant differences in glycaemic control between the GCC countries and other places worldwide despite being considered hotbeds of T2DM. Many factors contribute to poor glycaemic control. Specifically, evidence shows that being overweight or obese is the most common modifiable risk factor for T2DM incidence and poor glycaemic control. The GCC countries have higher rates of obesity. Additionally, poor glycaemic control is mainly related to a lack of adherence to insulin and medication use. Poor diet, rich in calories and low in fruits and vegetables, and a sedentary lifestyle also significantly contribute to poor glycaemic control and obesity. Therefore, to reduce the incidence of disease and improve glycaemic control in diabetic patients, educational programs promoting lifestyle changes should be implemented. Ongoing research is also necessary to assess the trend of glycaemic control and its risk factors in our region.
Collapse
Affiliation(s)
- Ahmad Ali Alrasheedi
- Department of Family and Community Medicine, College of Medicine, Qassim University, Saudi Arabia.
| |
Collapse
|
150
|
Ellidag HY, Aslankoç R, Kök M, Aykal G, Aydın Ö, Özmen Ö, Çakır RC, Doğan U. Serum testosterone levels and oxidative stress in type 1 diabetes, type 2 diabetes, and obesity. Endokrynol Pol 2024:VM/OJS/J/98190. [PMID: 38646988 DOI: 10.5603/ep.98190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/06/2024] [Accepted: 01/25/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Obesity, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) are metabolic diseases that continue to be a global problem. Testosterone levels in men are affected by several factors, including obesity and DM. Although the relationship between diabetes and testosterone is not fully understood, oxidative stress is thought to play a major role. The aim of this study was to compare serum testosterone levels and oxidative stress markers [total antioxidant status (TAS), total oxidant capacity (TOS), oxidative stress index (OSI), and ischaemic modified albumin (IMA)] among the control group and experimentally induced obese, T1DM, and T2DM rats. MATERIAL AND METHODS The study included 28 male Sprague-Dawley rats divided into 4 groups: the obesity group were fed a high-fat diet (HFD), the T2DM group received a HFD plus a single dose of streptozocin (STZ), the T1DM group received only STZ, and there was a control group. Serum testosterone, TAS, TOS, OSI, and IMA were analysed. RESULTS Serum testosterone levels were lower in the T1DM and T2DM groups compared to the control and obesity groups. The TOS levels were highest in the T2DM group, followed by the T1DM group, the obesity group, and finally the control group. No significant difference was found between the obesity group and the control group in terms of TOS levels. Regarding TAS levels, the order observed was control group > obesity group > T2DM > T1DM. Testosterone was positively correlated with TAS and negatively correlated with TOS and OSI. CONCLUSIONS Increased oxidative stress in diabetes may be an important factor that decreases serum testosterone levels.
Collapse
Affiliation(s)
- Hamit Yasar Ellidag
- Department of Clinical Biochemistry, Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye.
| | - Rahime Aslankoç
- Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Türkiye
| | - Mehmet Kök
- Department of Internal Medicine, Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye
| | - Güzin Aykal
- Department of Clinical Biochemistry, Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye
| | - Özgür Aydın
- Department of Clinical Biochemistry, Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye
| | - Özlem Özmen
- Department of Pathology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University, Burdur, Türkiye
| | - Remzi Can Çakır
- Department of General Surgery Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye
| | - Uğur Doğan
- Department of General Surgery Antalya Education and Research Hospital of Ministry of Health, Antalya, Türkiye
| |
Collapse
|