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Knowles AJ. Advocating for Enhanced Patient Engagement in Breast Cancer Care: Impact of Residual Increased Lateral Adiposity and Consideration of the Pursuit of "Living Flat". Clin Breast Cancer 2024; 24:e186-e194. [PMID: 38326163 DOI: 10.1016/j.clbc.2024.01.003] [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: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
Breast cancer is a significant health concern, accounting for a substantial proportion of cancer cases. Despite improvements in cancer survivorship, many women still require mastectomy as part of their therapeutic treatment. Mastectomy alone or delayed breast reconstruction (DBR) are two options available to women not suitable for immediate breast reconstruction at initial mastectomy. However, the presence of increased lateral adiposity (ILA) following mastectomy, commonly referred to as ``dog-ears,'' can lead to discomfort and aesthetic concerns. This paper explores the benefits and harms of ILA postmastectomy and its impact on patient satisfaction when choosing between mastectomy alone or DBR. A literature search was completed within OVID Medline, 1946-current, with the following terms, filtered for relevance: "mastectomy," "autologous reconstruction," "scar," "body image/dysmorphia," "patient-reported outcomes," "reconstructive surgical procedures/excess skin," "surgical flaps/dog ear." The disparity between clinical support and educational resources available for patients considering DBR options compared to those choosing mastectomy alone or pursuit of "living flat" is discussed. A common theme from qualitative research was the reported feeling of lack of inclusion in reconstruction planning by the patient. There were instances reported of residual skin remaining postmastectomy, against patient wishes. The findings emphasized the importance of shared decision-making and comprehensive preoperative education to ensure that patients are well-informed and satisfied with their chosen treatment approach. Further research is needed to address the specific needs and preferences of patients opting for mastectomy and to improve surgical techniques and education regarding living-flat options.
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Affiliation(s)
- Aaron J Knowles
- Pioneer Wound healing and Lymphoedema Centres, Eastbourne, United Kingdom.
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Yao X, Kaler M, Qu X, Kalidhindi RSR, Sviridov D, Dasseux A, Barr E, Keeran K, Jeffries KR, Yu ZX, Gao M, Gordon S, Barochia AV, Mills J, Shahid S, Weir NA, Kalchiem-Dekel O, Theard P, Playford MP, Stylianou M, Fitzgerald W, Remaley AT, Levine SJ. Asthmatic patients with high serum amyloid A have proinflammatory HDL: Implications for augmented systemic and airway inflammation. J Allergy Clin Immunol 2024; 153:1010-1024.e14. [PMID: 38092139 PMCID: PMC10999351 DOI: 10.1016/j.jaci.2023.11.917] [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: 03/07/2023] [Revised: 10/26/2023] [Accepted: 11/10/2023] [Indexed: 01/15/2024]
Abstract
RATIONALE Serum amyloid A (SAA) is bound to high-density lipoproteins (HDL) in blood. Although SAA is increased in the blood of patients with asthma, it is not known whether this modifies asthma severity. OBJECTIVE We sought to define the clinical characteristics of patients with asthma who have high SAA levels and assess whether HDL from SAA-high patients with asthma is proinflammatory. METHODS SAA levels in serum from subjects with and without asthma were quantified by ELISA. HDLs isolated from subjects with asthma and high SAA levels were used to stimulate human monocytes and were intravenously administered to BALB/c mice. RESULTS An SAA level greater than or equal to 108.8 μg/mL was defined as the threshold to identify 11% of an asthmatic cohort (n = 146) as being SAA-high. SAA-high patients with asthma were characterized by increased serum C-reactive protein, IL-6, and TNF-α; older age; and an increased prevalence of obesity and severe asthma. HDL isolated from SAA-high patients with asthma (SAA-high HDL) had an increased content of SAA as compared with HDL from SAA-low patients with asthma and induced the secretion of IL-6, IL-1β, and TNF-α from human monocytes via a formyl peptide receptor 2/ATP/P2X purinoceptor 7 axis. Intravenous administration to mice of SAA-high HDL, but not normal HDL, induced systemic inflammation and amplified allergen-induced neutrophilic airway inflammation and goblet cell metaplasia. CONCLUSIONS SAA-high patients with asthma are characterized by systemic inflammation, older age, and an increased prevalence of obesity and severe asthma. HDL from SAA-high patients with asthma is proinflammatory and, when intravenously administered to mice, induces systemic inflammation, and amplifies allergen-induced neutrophilic airway inflammation. This suggests that systemic inflammation induced by SAA-high HDL may augment disease severity in asthma.
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Affiliation(s)
- Xianglan Yao
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Maryann Kaler
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Xuan Qu
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | | | - Denis Sviridov
- Lipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Amaury Dasseux
- Lipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Eric Barr
- Animal Surgery and Resources Core Facility, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Karen Keeran
- Animal Surgery and Resources Core Facility, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Kenneth R Jeffries
- Animal Surgery and Resources Core Facility, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Zu-Xi Yu
- Pathology Core Facility, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Meixia Gao
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Scott Gordon
- Lipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Amisha V Barochia
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Joni Mills
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Shahid Shahid
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Nargues A Weir
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Or Kalchiem-Dekel
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Patricia Theard
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Martin P Playford
- Section on Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Mario Stylianou
- Office of Biostatistics Research, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, National Institute of Child Health and Development, National Institutes of Health, Bethesda, Md
| | - Alan T Remaley
- Lipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, Bethesda, Md
| | - Stewart J Levine
- Laboratory of Asthma and Lung Inflammation, Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Md.
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Codazzi V, Frontino G, Galimberti L, Giustina A, Petrelli A. Mechanisms and risk factors of metabolic syndrome in children and adolescents. Endocrine 2024; 84:16-28. [PMID: 38133765 PMCID: PMC10987369 DOI: 10.1007/s12020-023-03642-x] [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] [Received: 10/18/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Metabolic syndrome (MetS) is a complex disorder characterized by abdominal obesity, elevated blood pressure, hyperlipidemia, and elevated fasting blood glucose levels. The diagnostic criteria for MetS in adults are well-established, but there is currently no consensus on the definition in children and adolescents. The etiology of MetS is believed to involve a complex interplay between genetic predisposition and environmental factors. While genetic predisposition explains only a small part of MetS pathogenesis, modifiable environmental risk factors play a significant role. Factors such as maternal weight during pregnancy, children's lifestyle, sedentariness, high-fat diet, fructose and branched-chain amino acid consumption, vitamin D deficiency, and sleep disturbances contribute to the development of MetS. Early identification and treatment of MetS in children and adolescents is crucial to prevent the development of chronic diseases later in life. In this review we discuss the latest research on factors contributing to the pathogenesis of MetS in children, focusing on non-modifiable and modifiable risk factors, including genetics, dysbiosis and chronic low-grade inflammation.
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Cornu E, Gaulier C, Juttet P, Beauvy J, Mezzarobba V, Proust AL, Le Berre JP, Paepegaey AC. Closed-Loop Insulin Delivery May Help Prevent Metabolic Complications During Bariatric Surgery in Patients with Type 1 Diabetes: A Case Report. Diabetes Technol Ther 2024; 26:279-282. [PMID: 38194228 DOI: 10.1089/dia.2023.0551] [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] [Indexed: 01/10/2024]
Abstract
Introduction: Obesity in patients with type 1 diabetes (T1D) may worsen their prognosis. Bariatric surgery in these patients can be associated with complications such as diabetic ketoacidosis and severe hypoglycemic episodes. Closed-loop insulin delivery could be a solution to avoid them. Case Report: A 45-year-old woman with T1D and obesity (body mass index of 38.4 kg/m2) was included in our preoperative course of bariatric surgery. Three months before surgery, a closed-loop insulin delivery was instituted due to one prior severe hypoglycemia. Patient did not have immediate or late postoperative hypoglycemia despite consuming a weak amount of carbohydrate. Three months after surgery glycemic control was on target with 86% of time in range 70-180 mg/dL and no time below 70 mg/dL. Conclusion: This case report shows that the use of a closed-loop insulin delivery made it possible to perform bariatric surgery in complete safety for our patient.
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Affiliation(s)
- Erika Cornu
- Department of Endocrinology and Medipole, Lyon Villeurbanne, Villeurbanne, France
| | - Camille Gaulier
- Department of Endocrine Surgery, Medipole, Lyon Villeurbanne, Villeurbanne, France
| | - Pauline Juttet
- Department of Endocrinology and Medipole, Lyon Villeurbanne, Villeurbanne, France
| | - Julie Beauvy
- Department of Endocrinology and Medipole, Lyon Villeurbanne, Villeurbanne, France
| | - Vincent Mezzarobba
- Department of Endocrinology and Medipole, Lyon Villeurbanne, Villeurbanne, France
| | - Anne-Laure Proust
- Department of Endocrine Surgery, Medipole, Lyon Villeurbanne, Villeurbanne, France
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155
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Zhang X, Ravichandran S, Gee GC, Dong TS, Beltrán-Sánchez H, Wang MC, Kilpatrick LA, Labus JS, Vaughan A, Gupta A. Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms. JAMA Netw Open 2024; 7:e244855. [PMID: 38573637 DOI: 10.1001/jamanetworkopen.2024.4855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Importance Perceived social isolation is associated with negative health outcomes, including increased risk for altered eating behaviors, obesity, and psychological symptoms. However, the underlying neural mechanisms of these pathways are unknown. Objective To investigate the association of perceived social isolation with brain reactivity to food cues, altered eating behaviors, obesity, and mental health symptoms. Design, Setting, and Participants This cross-sectional, single-center study recruited healthy, premenopausal female participants from the Los Angeles, California, community from September 7, 2021, through February 27, 2023. Exposure Participants underwent functional magnetic resonance imaging while performing a food cue viewing task. Main Outcomes and Measures The main outcomes included brain reactivity to food cues, body composition, self-reported eating behaviors (food cravings, reward-based eating, food addiction, and maladaptive eating behaviors), and mental health symptoms (anxiety, depression, positive and negative affect, and psychological resilience). Results The study included 93 participants (mean [SD] age, 25.38 [7.07] years). Participants with higher perceived social isolation reported higher fat mass percentage, lower diet quality, increased maladaptive eating behaviors (cravings, reward-based eating, uncontrolled eating, and food addiction), and poor mental health (anxiety, depression, and psychological resilience). In whole-brain comparisons, the higher social isolation group showed altered brain reactivity to food cues in regions of the default mode, executive control, and visual attention networks. Isolation-related neural changes in response to sweet foods correlated with various altered eating behaviors and psychological symptoms. These altered brain responses mediated the connection between social isolation and maladaptive eating behaviors (β for indirect effect, 0.111; 95% CI, 0.013-0.210; P = .03), increased body fat composition (β, -0.141; 95% CI, -0.260 to -0.021; P = .02), and diminished positive affect (β, -0.089; 95% CI, -0.188 to 0.011; P = .09). Conclusions and Relevance These findings suggest that social isolation is associated with altered neural reactivity to food cues within specific brain regions responsible for processing internal appetite-related states and compromised executive control and attentional bias and motivation toward external food cues. These neural responses toward specific foods were associated with an increased risk for higher body fat composition, worsened maladaptive eating behaviors, and compromised mental health. These findings underscore the need for holistic mind-body-directed interventions that may mitigate the adverse health consequences of social isolation.
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Affiliation(s)
- Xiaobei Zhang
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Soumya Ravichandran
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- School of Medicine, University of California, San Diego, La Jolla, California
| | - Gilbert C Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
- California Center for Population Research, University of California, Los Angeles
| | - Tien S Dong
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Hiram Beltrán-Sánchez
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
- California Center for Population Research, University of California, Los Angeles
| | - May C Wang
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | - Lisa A Kilpatrick
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Jennifer S Labus
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Allison Vaughan
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
| | - Arpana Gupta
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
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156
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Chen Q, Sun T, He Q, Yu J, Zhang X, Han L, Ren Y. Study of decreased serum levels of C1q/TNF-related protein 4 (CTRP4) in major depressive disorder. J Psychiatr Res 2024; 172:274-280. [PMID: 38417323 DOI: 10.1016/j.jpsychires.2024.01.046] [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: 08/10/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND The adipokines secreted by adipocytes might play an important role through crossing the blood brain barrier to the brain, which could mediate the common physiological pathway between depression and obesity. CTRP4, a member of the CTRP family, is highly expressed in human adipose tissue and brain tissue. OBJECTIVE this study aimed to measure serum C1q/TNF-related protein 4 (CTRP4) levels in depressive patients to explore the association between CTRP4 levels and depression. METHODS depressive patients (n = 138), healthy controls (n = 100) were enrolled from September 2020 to December 2021. The level of serum CTRP4 was measured by enzymes linked to immunosorbent assay (ELISA). Other biochemical indicators were measured by Advia 2400 automatic biochemistry analyzer. Depressive symptoms of patients were assessed using the Hamilton Depression Scale-24 item (HAMD-24). RESULTS this study found that serum CTRP4 levels in the MDD group were lower than that of the health control (P < 0.001). Serum CTRP4 levels were negatively correlated with HAMD-24 scores (r = -0.368; P = 0.001). The serum CTRP4 levels were negatively correlated with Total Cholesterol (TC), Triglyceride (TG) and Low-Density Lipoprotein Cholesterol (LDL-C), but were positively associated with high density lipid-cholesterol (HDL-C) (r = -0.267, r = -0.255, r = -0.312 and r = 0.280; P = 0.017, P = 0.023, P = 0.005 and P = 0.012). The ROC curve of CTRP4 showed that the Area Under Curve (AUC) was 0.856, P < 0.001. CONCLUSION the serum CTRP4 levels in MDD patients were lower than that in health control, which might mediate the physiological progress of MDD patients.
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Affiliation(s)
- Qian Chen
- Department of Clinical Laboratory, Wuhan Pulmonary Hospital, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
| | - Ting Sun
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuhan, 430000, China
| | - Qian He
- Department of Clinical Laboratory, Wuhan Pulmonary Hospital, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
| | - Jian Yu
- Department of Clinical Laboratory, Wuhan Pulmonary Hospital, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
| | - Xuechao Zhang
- Department of Clinical Laboratory, Wuhan Pulmonary Hospital, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
| | - Lu Han
- Department of Clinical Laboratory, Wuhan Blood Center, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
| | - Yi Ren
- Department of Clinical Laboratory, Wuhan Pulmonary Hospital, Baofeng Road, Qiaokou District, Wuhan, 430030, China.
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Molfino A, Imbimbo G, Picconi O, Tartaglione L, Amabile MI, Lai S. Muscularity and adiposity are differently associated with inflammatory and nutritional biomarkers among patients on hemodialysis and peritoneal dialysis. Eur J Intern Med 2024; 122:109-112. [PMID: 37981526 DOI: 10.1016/j.ejim.2023.11.015] [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: 05/22/2023] [Revised: 11/02/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE Nutritional alterations are prevalent in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). We aimed at evaluating whether body composition parameters in HD vs PD are differently associated with nutritional and inflammatory biomarkers. METHODS Body composition was assessed by bioimpedance analysis. Neutrophil to lymphocyte ratio (NLR), serum albumin and C-reactive protein were used as nutritional and inflammatory biomarkers. Multivariable linear regression analysis was used to determine association(s) of body composition parameters with biomarkers. RESULTS We enrolled a total of 108 patients, 58 on HD and 50 on PD. Fat free mass percent was higher in HD patients than PD (p = 0.006) and higher extracellular water (ECW)/intracellular water (ICW) in HD compared to PD patients (p = 0.023), as well as fat mass index was greater in PD than HD (p = 0.004). In HD patients, albumin positively correlated with fat free mass (r = 0.42; p = 0.001) and ICW/h2 (r = 0.31; p = 0.02). In PD, NLR positively correlated with fat mass (r = 0.36; p = 0.01), fat mass index (r = 0.37; p = 0.01) and ECW (r = 0.41; p = 0.005), and negatively correlated with fat free mass percent (r = -0.30; p = 0.04) and ICW percent (r = -0.34; p = 0.02). By linear regression analysis, in HD fat free mass index was associated with albumin and the absence of diabetes. In PD, the association of fat free mass index was present with NLR. Regarding adiposity, in HD we found no association of ECW/ICW with NLR and CRP, whereas in PD the ECW/ICW was associated with NLR. CONCLUSION Inflammation drives body composition changes with differences according to the type of dialysis, as expressed by the modulation of some circulating biomarkers.
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Affiliation(s)
- Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
| | - Giovanni Imbimbo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Orietta Picconi
- National HIV/AIDS Center, Istituto Superiore di Sanità, Rome, Italy
| | - Lida Tartaglione
- Division of Nephrology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Lai
- Division of Nephrology, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Olerich KLW, Sewaybricker LE, Kee S, Melhorn SJ, Chandrasekaran S, Schur EA. In utero exposure to maternal diabetes or hypertension and childhood hypothalamic gliosis. Int J Obes (Lond) 2024; 48:594-597. [PMID: 38273035 DOI: 10.1038/s41366-024-01463-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
Exposure to maternal diabetes (DM) or hypertension (HTN) during pregnancy impacts offspring metabolic health in childhood and beyond. Animal models suggest that induction of hypothalamic inflammation and gliosis in the offspring's hypothalamus is a possible mechanism mediating this effect. We tested, in children, whether in utero exposures to maternal DM or HTN were associated with mediobasal hypothalamic (MBH) gliosis as assessed by brain magnetic resonance imaging (MRI). The study included a subsample of 306 children aged 9-11 years enrolled in the ABCD Study®; 49 were DM-exposed, 53 were HTN-exposed, and 204 (2:1 ratio) were age- and sex-matched children unexposed to DM and/or HTN in utero. We found a significant overall effect of group for the primary outcome of MBH/amygdala (AMY) T2 signal ratio (F(2,300):3.51, p = 0.03). Compared to unexposed children, MBH/AMY T2 signal ratios were significantly higher in the DM-exposed (β:0.05, p = 0.02), but not the HTN-exposed children (β:0.03, p = 0.13), findings that were limited to the MBH and independent of adiposity. We concluded that children exposed to maternal DM in utero display evidence of hypothalamic gliosis, suggesting that gestational DM may have a distinct influence on offspring's brain development and, by extension, children's long-term metabolic health.
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Affiliation(s)
- Kelsey L W Olerich
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Washington, Seattle, WA, USA
| | | | - Sarah Kee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Susan J Melhorn
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Ellen A Schur
- Department of Medicine, University of Washington, Seattle, WA, USA
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Affiliation(s)
- Benjamin D Horne
- Intermountain Medical Center Heart Institute, Salt Lake City, UT, USA.
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
- Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA.
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160
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Fong M, McSweeney L, Adamson A, Mathews C, Lloyd S, Rothwell C. A cross-sectional survey study exploring provision and delivery of expanded community tier 2 behavioural weight management services in England. Clin Obes 2024; 14:e12629. [PMID: 38049928 DOI: 10.1111/cob.12629] [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] [Received: 06/30/2023] [Revised: 09/01/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023]
Abstract
Guidelines recommend provision of local behavioural weight management (tier 2) programmes for adults living with overweight and obesity. Following the publication of the UK Government's publication 'Tackling Obesity: empowering adults and children to live healthier lives' in July 2021, Government invested around £30 million of additional funding to support the expansion of local authority commissioned tier 2 provision for adults living with excess weight. We conducted a cross-sectional survey study to scope the types of services available, to whom they were made available, and barriers and facilitators to service delivery. An e-survey was disseminated to local authority commissioned tier 2 service providers in England from September to October 2022. Through a combination of closed and open (qualitative) questions, the survey collected data on referral routes, participant eligibility criteria, service content and format, and challenges and enablers to service delivery. Quantitative data were analysed descriptively whilst thematic content analysis was applied to qualitative data. We received 52 responses (estimated response rate = 59%) representing all nine England regions and 89 unique local authorities. Most services were multi-component (84.3%), were 12 weeks duration (78.0%), were group-based (90.0%), were primarily delivered in-person (86.0%), and were free to participants (90.2%). Five responses indicated provision of support for other health and wellbeing issues, for example, mental health, assistance with debt. To improve future WMS service commissioning and delivery, WMS providers need to be allowed adequate time and resource to properly prepare for service delivery. Referral systems and criteria should be made clear and straightforward to both referrers and service users, and strategies to manage surplus referrals should be explored.
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Affiliation(s)
- Mackenzie Fong
- NIHR Applied Research Collaboration, North East and North Cumbria, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Ashley Adamson
- NIHR Applied Research Collaboration, North East and North Cumbria, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Mathews
- Department of Health and Social Care, Office for Health Improvement and Disparities, UK
| | - Scott Lloyd
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Public Health South Tees, The Live Well Centre, Middlesbrough, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Charlotte Rothwell
- NIHR Applied Research Collaboration, North East and North Cumbria, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Powell LH, Daniels BT, Drees BM, Karavolos K, Lohse B, Masters KS, Nicklas JM, Ruder EH, Suzuki S, Trabold N, Zimmermann LJ. Enhancing Lifestyles in the Metabolic syndrome (ELM) multisite behavioral efficacy trial. Design and baseline cohort. Am Heart J 2024; 270:136-155. [PMID: 38215918 DOI: 10.1016/j.ahj.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Prevalence of metabolic syndrome (MetS) increased from one-quarter to one-third of the U.S. adult population over 8 years and is spreading to young adults and Asian and Hispanic Americans. Diagnosed when >3 out of 5 cardiometabolic risk factors are present, there is widespread agreement that its fundamental roots are in a lifestyle characterized by poor dietary quality and physical inactivity. Past lifestyle trials for MetS produce benefits that have limited sustainability, suggesting the need for new treatment approaches. METHODS This is the design and baseline cohort of the Enhancing Lifestyles in the Metabolic Syndrome (ELM) multi-site trial. The trial tests the hypothesis that a habit-based lifestyle treatment offered over 6 months, followed by 18 monthly maintenance contacts, can produce 4 new diet, physical activity, and mindfulness habits and, if so, sustained MetS remission. The design is an individually randomized, partially clustered group treatment trial of 618 participants with the MetS recruited from 5 sites in the U.S. and randomized to a small group lifestyle treatment or an enhanced standard of care education comparator. The primary outcome is MetS remission at 24 months. Secondary outcomes compare arms at 6, 15, and 24 months on MetS components, lifestyle targets, weight, body mass index, hemoglobin A1c, LDL cholesterol, medications, quality of life, psychosocial factors, and cost-effectiveness. RESULTS The cohort of 618 participants was recruited by screening 14,817 over 2.5 years (screening to enrollment ratio 24:1). Recruitment exceeded the target of 600 despite 2 COVID-19 pauses. The mean age was 55.5 years, 24.3% were male, 25.5% were a racial minority, 9.7% identified as Hispanic, and 83.0% were classified as obese (body mass index >30). The most common MetS components were abdominal obesity (97.7%) and elevated blood pressure or antihypertensive medication (86.2%). CONCLUSIONS The geographic, sociodemographic, and clinical diversity of the cohort, combined with rigorous behavioral efficacy trial methods, will provide a conclusive answer to the question of whether this habit-based lifestyle program can produce sustained 24-month remission of the MetS and thereby help to curb a significant and growing public health problem.
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Elavsky S, Burda M, Cipryan L, Kutáč P, Bužga M, Jandackova V, Chow SM, Jandacka D. Physical activity and menopausal symptoms: evaluating the contribution of obesity, fitness, and ambient air pollution status. Menopause 2024; 31:310-319. [PMID: 38377450 PMCID: PMC10959689 DOI: 10.1097/gme.0000000000002319] [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] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The menopausal transition is accompanied by transient symptoms that have been linked to subclinical cardiovascular disease (CVD); CVD has also been linked to air pollution. Physical activity (PA) reduces CVD, improves body composition, and can reduce menopausal symptoms. The purpose of this study was to assess the links between PA and menopausal symptoms and whether obesity, fitness, and air pollution status play a role in this relationship. METHODS Women (40-60 y; N = 243; mean [SD] age, 47.8 [5.6] y) from areas with high versus low air pollution enrolled in the Healthy Aging in Industrial Environment Program 4 prospective cohort study completed psychological, cardiorespiratory fitness, body composition, and menopausal status screening followed by a 14-day prospective assessment of menopausal symptoms (Menopause Rating Scale) using a mobile application. Daily PA was assessed objectively across 14 days via Fitbit Charge 3 monitor. General linear mixed models were conducted and controlled for age, menopausal status, day in the study, wear time, and neuroticism. RESULTS Peri/postmenopausal women ( β = 0.43, P < 0.001) and those residing in a high-air-pollution environment ( β = 0.45, P < 0.05) reported more somatovegetative symptoms. Hot flashes alone were associated with peri/postmenopausal status ( β = 0.45, P < 0.001), and for women residing in a high-air-pollution environment, lower reporting of hot flashes was observed on days when a woman was more physically active than usual ( β = -0.15, P < 0.001). No associations were found for cardiorespiratory fitness and visceral fat with any of the symptoms. CONCLUSIONS PA may enhance resilience to hot flashes, especially when residing in high-air-pollution environments where we also observed higher reporting of somatovegetative menopausal symptoms.
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Affiliation(s)
- Steriani Elavsky
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Michal Burda
- Institute for Research and Applications of Fuzzy Modeling, University of Ostrava, Czech Republic IT4Innovations
| | - Lukáš Cipryan
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Petr Kutáč
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Marek Bužga
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Vera Jandackova
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Sy-Miin Chow
- Department of Human Development and Family Studies, College of Health and Human Development, Penn State University, USA
| | - Daniel Jandacka
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
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Alfaiate MI, Tavares RS, Ramalho-Santos J. A ripple effect? The impact of obesity on sperm quality and function. Reprod Fertil Dev 2024; 36:RD23215. [PMID: 38589340 DOI: 10.1071/rd23215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024] Open
Abstract
Infertility affects approximately 15% of couples trying to conceive. Male-related causes account for roughly 50% of cases, with obesity emerging as a possible significant factor. Obesity, defined as a body mass index of 30.0 or higher, has become a widespread epidemic associated with numerous health issues, including a decrease of fertility. This review discusses the relationship between obesity and male infertility, particularly focusing on sperm quality and function. An overview of the literature suggests that obesity may influence the male reproductive system via disruptions in hormonal profiles, oxidative stress, and inflammation, leading to changes in sperm parameters. Several studies have discussed if obesity causes a decrease in sperm concentration, motility, and normal morphology, so far without a consensus being reached. However, available evidence suggests an impairment of sperm function in obese men, due to an increase in DNA damage and oxidative stress, impaired mitochondrial function and acrosome reaction in response to progesterone. Finally, the relationship between obesity and assisted reproductive technologies outcomes remains debatable, with conflicting evidence regarding the influence on fertilisation, pregnancy, and live birth rates. Therefore, the actual impact of obesity on human spermatozoa still needs to be clarified, due to the multiple factors potentially in play.
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Affiliation(s)
- Maria Inês Alfaiate
- University of Coimbra, CNC-UC, Center for Neuroscience and Cell Biology, CIBB, Coimbra, Portugal; and University of Coimbra, Institute for Interdisciplinary Research, Doctoral Programme in Experimental Biology and Biomedicine (PDBEB), Coimbra, Portugal
| | - Renata Santos Tavares
- University of Coimbra, CNC-UC, Center for Neuroscience and Cell Biology, CIBB, Coimbra, Portugal; and Department of Life Sciences, University of Coimbra, Coimbra 3000-456, Portugal
| | - João Ramalho-Santos
- University of Coimbra, CNC-UC, Center for Neuroscience and Cell Biology, CIBB, Coimbra, Portugal; and Department of Life Sciences, University of Coimbra, Coimbra 3000-456, Portugal
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Doustmohammadian A, Amirkalali B, Esfandyari S, Motamed N, Maadi M, Shivappa N, Gholizadeh E, Hébert JR, Zamani F. The association between dietary inflammatory index (DII) scores and c-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) in a general population cohort. Clin Nutr ESPEN 2024; 60:156-164. [PMID: 38479904 DOI: 10.1016/j.clnesp.2024.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/10/2023] [Revised: 11/29/2023] [Accepted: 01/16/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND AIMS Although there is extensive literature showing the ability of the dietary inflammation index (DII®) to predict concentrations of plasma inflammatory markers, few studies are testing the association between DII scores and nonalcoholic fatty liver disease (NAFLD). Considering the high prevalence of NAFLD and its complications, we conducted a validation study of DII scores and examined its association with NAFLD in the general adult population of Iran. METHODS This cross-sectional study was conducted on 3110 adult participants in the Amol Cohort Study (AmolCS) who underwent abdominal ultrasonography to diagnose NAFLD. DII and energy-adjusted DII (E-DII™) scores were computed using data from a valid semi-quantitative 168-item food frequency questionnaire (FFQ). Multivariable logistic regression adjusting for socio-demographic, lifestyle, and health-related factors was used to assess association. RESULTS The EDII was associated with CRP inflammatory biomarker. Participants in the highest, i.e., most pro-inflammatory tertile had the highest odds of NAFLD by ultrasound in all models [fully adjusted model: OR (95 % CI) tertile3vs.1:1.54 (1.05-2.05); Ptrend = 0.04, and 1.63 (1.19-2.21); Ptrend = 0.03 in women and men, respectively]. The highest tertile had the highest OR for NAFLD by fatty liver index (FLI) only in men [fully adjusted model OR (95 % CI) tertile3vs.1: 1.77 (1.15-2.71); Ptrend = 0.01]. Similar results were also obtained for NAFLD by hepatic steatosis index (HSI) in women [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.70 (1.12-2.58); Ptrend = 0.03]. The results of the fully adjusted multivariable model of liver markers and NAFLD status, stratified by gender and abdominal obesity, revealed that the highest tertiles had the highest OR for NAFLD by ultrasound and NAFLD by FLI only in men without abdominal obesity [fully adjusted model: OR (95 % CI) tertile3vs.1: 1.83 (1.17-2.84); Ptrend = 0.03, and, respectively]. NAFLD by FLI tended to increase strongly with tertile E-DII scores in men without abdominal obesity in crude and three adjusted models [full-adjusted model: OR (95 % CI) tertile3vs.1: 3.64 (1.56-8.46); Ptrend = 0.005]. By contrast, women with abdominal obesity in the highest tertile had the highest OR for NAFLD by ultrasound in all models [full-adjusted model: OR (95 % CI) tertile3vs.1: 1.67 (1.07-2.62); Ptrend = 0.02]. CONCLUSIONS Our results suggest that diet plays a role in regulating inflammation. Additionally, we observed an inflammatory diet predicts the risk of NAFLD in Iranian adults. However, longitudinal studies are required in order to further substantiate the utility of the DII in the development of more effective dietary interventions among populations at risk of chronic disease.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Amirkalali
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Esfandyari
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mansooreh Maadi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nitin Shivappa
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA
| | - Esmaeel Gholizadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - James R Hébert
- Cancer Prevention & Control Program, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA; Department of Nutrition, Connecting Health Innovations LLC (CHI), Columbia, SC 29201, USA
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Das-Earl P, Schreihofer DA, Sumien N, Schreihofer AM. Temporal and region-specific tau hyperphosphorylation in the medulla and forebrain coincides with development of functional changes in male obese Zucker rats. J Neurophysiol 2024; 131:689-708. [PMID: 38416718 DOI: 10.1152/jn.00409.2023] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/01/2024] Open
Abstract
Metabolic syndrome (MetS) is associated with development of tauopathies that contribute to cognitive decline. Without functional leptin receptors, male obese Zucker rats (OZRs) develop MetS, and they have increased phosphorylated tau (ptau) with impaired cognitive function. In addition to regulating energy balance, leptin enhances activation of the hippocampus, which is essential for spatial learning and memory. Whether spatial learning and memory are always impaired in OZRs or develop with MetS is unknown. We hypothesized that male OZRs develop MetS traits that promote regional increases in ptau and functional deficits associated with those brain regions. In the medulla and cortex, tau-pSer199,202 and tau-pSer396 were comparable in juvenile (7-8 wk old) lean Zucker rats (LZRs) and OZRs but increased in 18- to 19-wk-old OZRs. Elevated tau-pSer396 was concentrated in the dorsal vagal complex of the medulla, and by this age OZRs had hypertension with increased arterial pressure variability. In the hippocampus, tau-pSer199,202 and tau-pSer396 were still comparable in 18- to 19-wk-old OZRs and LZRs but elevated in 28- to 29-wk-old OZRs, with emergence of deficits in Morris water maze performance. Comparable escape latencies observed during acquisition in 18- to 19-wk-old OZRs and LZRs were increased in 28- to 29-wk-old OZRs, with greater use of nonspatial search strategies. Increased ptau developed with changes in the insulin/phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway in the hippocampus and cortex but not medulla, suggesting different underlying mechanisms. These data demonstrate that leptin is not required for spatial learning and memory in male OZRs. Furthermore, early development of MetS-associated autonomic dysfunction by the medulla may be predictive of later hippocampal dysfunction and cognitive impairment.NEW & NOTEWORTHY Male obese Zucker rats (OZRs) lack functional leptin receptors and develop metabolic syndrome (MetS). At 16-19 wk, OZRs are insulin resistant, with increased ptau in dorsal medulla and impaired autonomic regulation of AP. At 28-29 wk OZRs develop increased ptau in hippocampus with deficits in spatial learning and memory. Juvenile OZRs lack elevated ptau and these deficits, demonstrating that leptin is not essential for normal function. Elevated ptau and deficits emerge before the onset of diabetes in insulin-resistant OZRs.
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Affiliation(s)
- Paromita Das-Earl
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Derek A Schreihofer
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Nathalie Sumien
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Ann M Schreihofer
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, United States
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Zaifu LG, Niculescu DA, Kremer AE, Caragheorgheopol A, Sava M, Iordachescu CN, Dusceac R, Burcea IF, Poiana C. Glucose intolerance in acromegaly is driven by low insulin secretion; results from an intravenous glucose tolerance test. Pituitary 2024; 27:178-186. [PMID: 38381238 DOI: 10.1007/s11102-024-01386-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE Insulin sensitivity (Si) and its role in glucose intolerance of acromegaly has been extensively evaluated. However, data on insulin secretion is limited. We aimed to assess stimulated insulin secretion using an intravenous glucose tolerance test (IVGTT) in active acromegaly. METHODS We performed an IVGTT in 25 patients with active acromegaly (13 normal glucose tolerance [NGT], 6 impaired glucose tolerance [IGT] and 6 diabetes mellitus [DM]) and 23 controls (8 lean NGT, 8 obese NGT and 7 obese IGT). Serum glucose and insulin were measured at 20 time points along the test to calculate Si and acute insulin response (AIRg). Medical treatment for acromegaly or diabetes was not allowed. RESULTS In acromegaly, patients with NGT had significantly (p for trend < 0.001) higher AIRg (3383 ± 1082 pmol*min/L) than IGT (1215 ± 1069) and DM (506 ± 600). AIRg was higher in NGT (4764 ± 1180 pmol*min/L) and IGT (3183 ± 3261) controls with obesity than NGT (p = 0.01) or IGT (p = 0.17) acromegaly. Si was not significantly lower in IGT (0.68 [0.37, 0.88] 106*L/pmol*min) and DM (0.60 [0.42, 0.84]) than in NGT (0.81 [0.58, 1.55]) patients with acromegaly. NGT (0.33 [0.30, 0.47] 106*L/pmol*min) and IGT (0.37 [0.21, 0.66]) controls with obesity had lower Si than NGT (p = 0.001) and IGT (p = 0.43) acromegaly. CONCLUSION We demonstrated that low insulin secretion is the main driver behind glucose intolerance in acromegaly. Compared to NGT and IGT controls with obesity, patients with NGT or IGT acromegaly had higher Si. Together, these findings suggest that impaired insulin secretion might be a specific mechanism for glucose intolerance in acromegaly.
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Affiliation(s)
- Laura Georgiana Zaifu
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 34-38 Aviatorilor blvd, Bucharest, 011863, Romania
| | - Dan Alexandru Niculescu
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 34-38 Aviatorilor blvd, Bucharest, 011863, Romania.
- First Endocrinology Department, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania.
| | - Andreea Elena Kremer
- Research Laboratory, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Andra Caragheorgheopol
- Research Laboratory, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Mariana Sava
- Clinical Laboratory, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | | | - Roxana Dusceac
- First Endocrinology Department, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Iulia Florentina Burcea
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 34-38 Aviatorilor blvd, Bucharest, 011863, Romania
- First Endocrinology Department, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
| | - Catalina Poiana
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 34-38 Aviatorilor blvd, Bucharest, 011863, Romania
- First Endocrinology Department, C. I. Parhon National Institute of Endocrinology, Bucharest, Romania
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Vaughan KL, Cade JE, Hetherington MM, Webster J, Evans CEL. The impact of school-based cooking classes on vegetable intake, cooking skills and food literacy of children aged 4-12 years: A systematic review of the evidence 2001-2021. Appetite 2024; 195:107238. [PMID: 38331100 DOI: 10.1016/j.appet.2024.107238] [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: 11/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Many children consume a poor quality diet with only a third of children aged 6-9 years eating vegetables daily. A high quality diet is important for good health in childhood; however, the prevalence of children living with obesity has doubled from 10% to 23% during primary school in the UK. Cooking lessons have the potential to improve diet quality and reduce obesity prevalence in childhood, both of which are associated with improved cardiometabolic outcomes in adulthood. The aim of this systematic review is to investigate the impact of school-based cooking classes on cooking skills, food literacy and vegetable intake of children aged 4-12 years. METHODS We conducted a systematic review of OVID Medline, OVID Embase, EBSCO CINHAL and EBSCO ERIC for comparative studies that evaluated outcomes of children receiving cooking classes compared to a control group. Interventions included contained food preparation or a cooking activities and took place on school premises. Risk of bias was assessed using ROB2 and Robins-I. Outcomes were pooled in a meta-analysis using a random-effects model using standardised mean differences or reviewed using narrative synthesis. Certainty of evidence was assessed using GRADE. RESULTS We included 21 studies, (6 randomised). Meta-analysis showed a small positive effect on cooking self-efficacy of 0.39 units (95% CI 0.05 to 0.54), and a small positive effect on vegetable intake of 0.25 units (95% CI 0.05 to 0.45). Programmes with more than 6 h of cooking showed the greatest effects. CONCLUSIONS Children's cooking programmes result in small improvements in cooking efficacy and vegetable intake, particularly those with more than 6 h of classes. It is recommended that future interventions use consistent measurement for children's food literacy and cooking confidence.
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Peng LH, Tan Y, Bajinka O. The influence of maternal diet on offspring's gut microbiota in early life. Arch Gynecol Obstet 2024; 309:1183-1190. [PMID: 38057588 DOI: 10.1007/s00404-023-07305-0] [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: 08/29/2023] [Accepted: 11/12/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The influence of maternal diet on offspring's health is an area of study that is linked to epigenetics. Maternal diet contributes to determining the health status of offspring and maternally linked mechanisms and is a global health challenge that requires attention. The impact of gut microbiota on host metabolism and offspring health is still not established. OBJECTIVE In this review, we intend to discuss the evidence on the impact of maternal diet and the health of offspring gut microbiota. The paper focuses on the gut microbiome of animal models. It captures the maternal diet and its influence on the offspring's gut microbiota, behavior that is supported by cell experimental results. Both inflammation and immune status of offspring induced by maternal diet are discussed. Finally, this review used predicted biological pathways involved in maternal diet and offspring health, and the influence of maternal diet on gut microbiota and offspring behavior. Obesity, diabetes, asthma and allergies, and neurodegenerative disorders and prospects for maternal diet, and microbiota and offspring health were discussed. CONCLUSION The review was able to gather that a high-fat diet during pregnancy created a long-lasting metabolic signature on the infant's innate immune system, altering inflammation in the offspring microbiota, which predisposed offspring to obesity and metabolic diseases in adulthood.
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Affiliation(s)
- Li-Hua Peng
- Department of Physiology, Hunan Yongzhou Vocational Technical College, Yongzhou, China
| | - Yurong Tan
- Department of Medical Microbiology, Xiangya School of Medicine, Central South University, Changsha, 410078, Hunan, China.
- China-Africa Research Centre of Infectious Diseases, School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China.
| | - Ousman Bajinka
- Department of Medical Microbiology, Xiangya School of Medicine, Central South University, Changsha, 410078, Hunan, China.
- China-Africa Research Centre of Infectious Diseases, School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China.
- School of Medicine and Allied Health Sciences, University of The Gambia, Serrekunda, Gambia.
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Lins-Filho O, Germano-Soares AH, Aguiar JLP, de Almedia JRV, Felinto EC, Lyra MJ, Leite DB, Drager LF, Farah BQ, Pedrosa RP. Effect of 12-week high-intensity interval training on hemodynamic variables at rest and during exercise in patients with obstructive sleep apnoea. J Hypertens 2024; 42:742-745. [PMID: 38230605 DOI: 10.1097/hjh.0000000000003654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This study aimed to investigate the impact of 12 weeks of high-intensity interval training (HIIT) on hemodynamic variables at rest and during exercise in patients with obstructive sleep apnoea. Twenty-six obese adults with moderate-to-severe OSA (AHI = 42 ± 22.9 e/h) were randomly assigned to HIIT or a control group. Sleep parameters, ambulatorial, aortic, and during-exercise SBP and DBP were assessed at baseline and after 12 weeks. Generalized estimated equations assessed differences between groups over time. When compared with control group, HIIT reduced AHI (17.1 ± 6.2; e/h, P < 0.01), SBP nighttime (10.2 ± 5.0 mmHg; P = 0.034), DBP nighttime (7.9 ± 4.0 mmHg; P = 0.038), DBP aortic (5.5 ± 2.9 mmHg; P = 0.048), and SBP max (29.6 ± 11.8 mmHg; P = 0.045). In patients with OSA, 12 weeks of HIIT decreases sleep apnoea severity and blood pressure in rest and during exercise.
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Affiliation(s)
- Ozeas Lins-Filho
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Departamento de Educação Física
| | | | - José Lucas Porto Aguiar
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
| | - José Ricardo Vieira de Almedia
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
| | - Elton Carlos Felinto
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
| | | | - Danielle Batista Leite
- Departamento de ergometria, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco, Recife
| | - Luciano Ferreira Drager
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo
| | - Breno Quintella Farah
- Programa de pós-graduação em educação física, Universidade Federal de Pernambuco
- Departamento de educação física, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Rodrigo Pinto Pedrosa
- Laboratório do Sono e Coração, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco
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Takenoshita M, Weir McCall JR, Barker AP, Suresh S, Celik H, Vuylsteke A. Association between body composition and mortality in patients requiring extracorporeal membrane oxygenation support. Clin Radiol 2024; 79:272-278. [PMID: 38278741 DOI: 10.1016/j.crad.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/16/2023] [Accepted: 12/14/2023] [Indexed: 01/28/2024]
Abstract
AIM To ascertain the association between body composition, including muscle mass and adiposity, and patient mortality in those requiring extracorporeal membrane oxygenation (ECMO) for acute respiratory failure. MATERIALS AND METHODS A retrospective study was undertaken of all patients with acute respiratory failure requiring veno-venous (VV) ECMO between January 2015 and December 2019. Automated image segmentation software was used to quantify the cross-sectional area and average radiodensity (in Hounsfield units) of different muscle and fat compartments at the L3 level of whole-body computed tomography (CT) images taken within 48 h of initiation of ECMO support. The primary endpoint was 30-day post-ECMO initiation all-cause mortality. Logistic regression was used to analyse the correlation between CT measurements, co-morbidities, and 30-day survival. RESULTS The study included 189 patients (age = 43.8 ± 14.6, sex = 42.3% female). There was no significant association between 30-day survival status and cross-sectional area of muscle or fat. Muscle attenuation (psoas, long spine, and abdominal muscles respectively) at the L3 level were significantly lower in those who died within 30 days of ECMO cannulation (p<0.05). On multivariable analysis including age, sex, and pre-existing respiratory comorbidities, psoas muscle attenuation was an independent predictor of survival at 30 days (OR 0.97; 95% CI 0.94 to 1.00; p=0.047). CONCLUSIONS Reduced psoas muscle attenuation is associated with poorer survival outcomes at 30 days post-ECMO cannulation in patients who received VV ECMO support for respiratory failure. Cross-sectional areas of muscle and fat compartments did not correlate with survival outcomes at 30 days even when corrected for height and sex.
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Affiliation(s)
- M Takenoshita
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - J R Weir McCall
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
| | - A P Barker
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - S Suresh
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - H Celik
- University of Massachusetts Chan Medical School, Massachusetts, USA
| | - A Vuylsteke
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
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171
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Wang J, Chehrehasa F, Moody H, Beecher K. Does neuroscience research change behaviour? A scoping review and case study in obesity neuroscience. Neurosci Biobehav Rev 2024; 159:105598. [PMID: 38401576 DOI: 10.1016/j.neubiorev.2024.105598] [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: 11/09/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
The language employed by researchers to define and discuss diseases can itself be a determinant of health. Despite this, the framing of diseases in medical research literature is largely unexplored. This scoping review examines a prevalent medical issue with social determinants influenced by the framing of its pathogenesis: obesity. Specifically, we compare the currently dominant framing of obesity as an addiction to food with the emerging frame of obesity developing from neuroinflammation. We triangulate both corpus linguistic and bibliometric analysis of the top 200 most engaging neuroscience journal articles discussing obesity that were published open access in the past 10 years. The constructed Neurobesity Corpus is available for public use. The scoping review analysis confirmed that neuroinflammation is an emerging way for obesity to be framed in medical research. Importantly, the articles analysed that discussed neuroinflammation were less likely to use crisis terminology, such as referring to an obesity "epidemic". We highlight a potential relationship between the adoption of addiction frames and the use of stigmatising language in medical research.
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Affiliation(s)
- Joshua Wang
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia.
| | - Fatemeh Chehrehasa
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia
| | - Hayley Moody
- Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia
| | - Kate Beecher
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Building 71/918 Royal Brisbane and Women's Hospital Campus, Herston, QLD 4029, Australia
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172
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Li Y, Wu S, Gao J, Zhang Y, Zuo Y, Tian X, Chen S, Xing A, Wang A, He Y. Association of Stroke With Metabolic Dysfunction-Associated Fatty Liver Disease With and Without CKD. Am J Kidney Dis 2024; 83:477-488. [PMID: 37838141 DOI: 10.1053/j.ajkd.2023.08.016] [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: 05/04/2023] [Revised: 08/09/2023] [Accepted: 08/26/2023] [Indexed: 10/16/2023]
Abstract
RATIONALE & OBJECTIVE Metabolic dysfunction-associated fatty liver disease (MAFLD), a risk factor for stroke and all-cause mortality, is highly prevalent among patients with chronic kidney disease (CKD), but it is unclear whether the association of MAFLD with stroke and all-cause mortality differs within and outside of the setting of CKD. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS We enrolled 95,353 participants from the Kailuan Cohort Study, among whom 35,749 had CKD at baseline or developed CKD during the follow-up period, and 59,604 individuals who had no CKD at baseline or during the follow-up period. EXPOSURE MAFLD. OUTCOME Stroke (ischemic stroke, hemorrhagic stroke), all-cause mortality. ANALYTICAL APPROACH Adjusted Cox regression models were used to estimate the influence of MAFLD on stroke outcomes within the subgroups defined by the presence of CKD. RESULTS After a median follow-up of 12.8 years, 6,140 strokes (6.4%) and 11,975 deaths from any cause (12.6%) occurred. After adjusting for potential confounders, MAFLD was associated with an increased incidence of stroke among the participants with CKD (HR, 1.34 [95% CI, 1.23-1.45]) but not among those without CKD (HR, 1.05 [95% CI, 0.97-1.15]; Pinteraction<0.001). This association was principally related to ischemic stroke (HR, 1.38 [95% CI, 1.26-1.51]) and not hemorrhagic stroke (HR, 1.04 [95% CI, 0.85-1.26]). No association was found between MAFLD and all-cause mortality in the participants with CKD (HR,1.04 [95% CI, 0.98-1.10]) or those without CKD (HR,1.03 [95% CI, 0.97-1.09]). Among the participants with CKD, compared with non-MAFLD, MAFLD with diabetes (HR,1.36 [95% CI, 1.23-1.50]) or overweight/obesity (HR,1.30 [95% CI, 1.14-1.50]) was associated with a higher risk of stroke whereas MAFLD without overweight/obesity or diabetes was not associated with a higher risk (HR,1.08 [95% CI, 0.81-1.43]). LIMITATIONS This was an observational study and included individuals with CKD who had a relatively high estimated glomerular filtration rate. CONCLUSIONS MAFLD was associated with an increased risk of stroke in individuals with CKD but not in those without CKD. PLAIN-LANGUAGE SUMMARY Metabolic dysfunction-associated fatty liver disease (MAFLD), which is recognized as a risk factor for stroke in the general population, is highly prevalent among individuals with chronic kidney disease (CKD). However, the impact of MAFLD on the risk of stroke in patients with CKD remains uncertain. We investigated the association of MAFLD with stroke in individuals with and without CKD. Our analysis revealed that MAFLD was associated with a significantly increased risk of stroke in individuals with CKD, and the magnitude of this increased risk was greater in the setting of CKD. These findings highlight the need for increased attention to MAFLD in patients with CKD and emphasize that addressing and preventing MAFLD in this population may contribute to reduced morbidity from stroke.
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Affiliation(s)
- Yuhao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, People's Republic of China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People's Republic of China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Jingli Gao
- Department of Intensive Care Unit, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Yijun Zhang
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, People's Republic of China; Department of Neurology, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yingting Zuo
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xue Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, People's Republic of China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People's Republic of China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Anxin Wang
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, People's Republic of China; Department of Neurology, Capital Medical University, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Yan He
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, People's Republic of China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People's Republic of China.
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173
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Koenig JB, Burnett LA. Understanding the Role of Obesity and Metabolism in Pelvic Floor Disorders. Urogynecology (Phila) 2024; 30:389-393. [PMID: 38564623 DOI: 10.1097/spv.0000000000001478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Jenny B Koenig
- From the Department of Obstetrics, Gynecology, and Reproductive Sciences
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174
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Wu Y, Ma Y. CCL2-CCR2 signaling axis in obesity and metabolic diseases. J Cell Physiol 2024; 239:e31192. [PMID: 38284280 DOI: 10.1002/jcp.31192] [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: 10/14/2023] [Revised: 12/10/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024]
Abstract
Obesity and metabolic diseases, such as insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, and cardiovascular ailments, represent formidable global health challenges, bearing considerable implications for both morbidity and mortality rates. It has become increasingly evident that chronic, low-grade inflammation plays a pivotal role in the genesis and advancement of these conditions. The involvement of C-C chemokine ligand 2 (CCL2) and its corresponding receptor, C-C chemokine receptor 2 (CCR2), has been extensively documented in numerous inflammatory maladies. Recent evidence indicates that the CCL2/CCR2 pathway extends beyond immune cell recruitment and inflammation, exerting a notable influence on the genesis and progression of metabolic syndrome. The present review seeks to furnish a comprehensive exposition of the CCL2-CCR2 signaling axis within the context of obesity and metabolic disorders, elucidating its molecular mechanisms, functional roles, and therapeutic implications.
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Affiliation(s)
- Yue Wu
- Shandong Provincial Key Laboratory of Animal Resistance Biology, Center for Cell Structure and Function, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan, China
| | - Yanchun Ma
- Shandong Provincial Key Laboratory of Animal Resistance Biology, Center for Cell Structure and Function, Collaborative Innovation Center of Cell Biology in Universities of Shandong, College of Life Sciences, Shandong Normal University, Jinan, China
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175
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De Leon A, Roemmich JN, Casperson SL. Daily Dietary Protein Distribution Does Not Influence Changes in Body Composition During Weight Loss in Women of Reproductive Years with Overweight or Obesity: A Randomized Controlled Trial. J Nutr 2024; 154:1347-1355. [PMID: 38365118 DOI: 10.1016/j.tjnut.2024.02.009] [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: 09/14/2023] [Revised: 02/01/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Preservation of fat-free mass (FFM) during intentional weight loss is challenging yet important to maintain a resting metabolic rate. A balanced protein distribution of 25-30 g per meal improves 24-h muscle protein synthesis, which may promote FFM maintenance and greater reductions in fat mass (FM) during weight loss in women. OBJECTIVES We aimed to determine whether the daily dietary protein distribution pattern during energy restriction influences changes in body composition in women of reproductive age. We hypothesized that evenly distributing protein across meals compared with the usual intake pattern of consuming most of the protein at the dinner meal would be superior in preserving FFM while reducing FM during weight loss. METHODS Healthy women (n = 43) aged 20-44 y with a BMI of 28-45 kg/m2 completed a randomized parallel feeding study testing 2 patterns of daily protein intake (even distribution across all meals compared with a skewed distribution with most protein consumed at the evening meal). Participants completed an 8-wk controlled 20% energy restriction (all foods provided), followed by an 8-wk self-choice phase in which participants were asked to maintain a similar diet and dietary pattern when purchasing and consuming their own foods. Body composition was measured at baseline, week 8, and week 16. Data were analyzed using mixed models. Statistical significance was set at P < 0.05. Data are presented as differences in least squares means ± SE. RESULTS No significant main effects of group or group-by-time interactions were observed. All measures exhibited the main effect of time (P < 0.001). Overall, body weight, FFM, FM, and body fat percentage decreased 5.6 ± 0.4, 1.0 ± 0.2, 4.6 ± 0.4 kg, and 2.3 ± 0.2%, respectively, during this 16-wk study. CONCLUSION Daily dietary protein distribution at a fixed protein level does not appear to influence changes in body composition during weight loss in women of reproductive age. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE WHERE IT WAS OBTAINED NCT03202069 https://classic. CLINICALTRIALS gov/ct2/show/NCT03202069.
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Affiliation(s)
- Angela De Leon
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - James N Roemmich
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - Shanon L Casperson
- USDA Agricultural Research Services, Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States.
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176
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Gao D, Zhang C, Guo H, Xu H, Liu H, Wang Z, Xu B, Gang W. Low-dose polystyrene microplastics exposure impairs fertility in male mice with high-fat diet-induced obesity by affecting prostate function. Environ Pollut 2024; 346:123567. [PMID: 38367694 DOI: 10.1016/j.envpol.2024.123567] [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] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
The harmful effects of microplastics (MPs) on male fertility are receiving more and more attention. However, the impact of low-dose MPs exposure on the reproductive function of male mice is still unclear. In this study, we exposed male mice to low-dose MPs (25-30 μg/kg body weight/day) or low-dose MPs combined with high-fat diet (HFD) feeding. Our results showed that low-dose MPs exposure or HFD feeding significantly reduced sperm quality and the number of offspring born, while low-dose MPs exposure combined with HFD feeding further enhanced the above effects. The combination of low-dose MPs exposure and HFD feeding resulted in a notable elevation of inflammatory level within the prostate of mice and induced apoptosis of prostate epithelium and a decrease in nutrients (zinc, citrate) in seminal plasma fluid. Our findings in this study could provide valuable clues for better understanding the influence of low-dose MPs exposure on the reproductive system under metabolic disorders and facilitate the development of the prevention of reproductive toxicity caused by MPs exposure.
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Affiliation(s)
- Dajun Gao
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Caoxu Zhang
- Department of Molecular Diagnostics, The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Huaqi Guo
- Department of Respiratory Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Lu, Shanghai, 200011, China.
| | - Huan Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Hui Liu
- Bengbu Medical College Key Laboratory of Cancer Research and Clinical Laboratory Diagnosis, Department of Biochemistry and Molecular Biology, School of Laboratory Medicine, Bengbu Medical College, Bengbu, 233030, China.
| | - Zhong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Bin Xu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Wei Gang
- Beijing Key Laboratory of Diabetes Research and Care, Department of Endocrinology, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, 100005, China; Department of Endocrinology and Metabolism, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
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177
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Hosseinirad S, van Heusden K, Dumont GA. Evaluating inter-individual variability captured by the Eleveld pharmacokinetics model. J Clin Monit Comput 2024; 38:505-518. [PMID: 37934309 DOI: 10.1007/s10877-023-01083-5] [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] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/25/2023] [Indexed: 11/08/2023]
Abstract
Inter-individual variability in Pharmacokinetic (PK) and Pharmacodynamic (PD) models significantly affects the accuracy of Target Controlled Infusion and closed-loop control of anesthesia. We hypothesize that the novel Eleveld PK model captures more inter-individual variability relevant to both open-loop and closed-loop control design, resulting in reduced variability in PD models identified using the Eleveld PK model's plasma prediction compared to the Schuttler or Schnider PK model. We used a dataset of propofol infusion rates and Depth of Hypnosis measurements across three demographic groups: elderly, obese, and adult. PD models are identified based on plasma concentration prediction using three PK models (Schuttler, Schnider, and Eleveld). Validation methods are presented to confirm acceptable predictive performance and comparable PK-PD model variability within each demographic group. To test our hypothesis, we compared coefficient variations in step responses for open-loop control and multiplicative uncertainty of PD model sets for closed-loop control. Validated PKPD models using the Schuttler and Schnider PK model showed no significant differences in predictive response and multiplicative uncertainty compared to the Eleveld PK model. The coefficient variations in step responses of PD model sets and the frequency ranges, corresponding to uncertainty below one, were comparable for all three PK models. The comparison of the accumulated coefficient of variation in the step-response and the uncertainty of the PD model sets indicated that the Eleveld PK model does not offer any advantage for the design of open-loop or closed-loop control of anesthesia.
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Affiliation(s)
- Sara Hosseinirad
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
| | - Klaske van Heusden
- School of Engineering, The University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Guy A Dumont
- Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
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178
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Ibáñez CA, Correa F, Lira-León G, Reyes-Castro LA, Roldán FJ, Silva-Palacios A, Buelna-Chontal M, Rodríguez-González GL, Nathanielsz PW, Zazueta C, Zambrano E. Impaired Ischemia-Reperfusion Responses in the Hearts of Aged Male and Female Offspring of Obese Rats. Arch Med Res 2024; 55:102983. [PMID: 38492326 DOI: 10.1016/j.arcmed.2024.102983] [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: 10/24/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
Maternal obesity predisposes offspring (F1) to cardiovascular disease. To evaluate basal heart function and ischemia-reperfusion (IR) responses in F1 males and females of obese mothers, female Wistar rats (F0) were fed chow or an obesogenic (MO) diet from weaning through pregnancy and lactation. Non-sibling F1 males and females were weaned to chow at postnatal day (PND) 21 and euthanized at PND 550. Offspring of MO mothers (MOF1) rarely survive beyond PND 650. Hearts were immediately isolated from euthanized F1s and subjected to 30 min ischemia with 20 min reperfusion. Retroperitoneal fat, serum triglycerides, glucose, insulin, and insulin resistance were measured. Baseline left ventricular developed pressure (LVDP) was lower in male and female MOF1 than in controls. After global ischemia, LVDP in control (C) male and female F1 recovered 78 and 83%, respectively, while recovery in MO male and female F1 was significantly lower at 28 and 52%, respectively. Following the IR challenge, MO hearts showed a higher functional susceptibility to reperfusion injury, resulting in lower cardiac reserve than controls in both sexes. Female hearts were more resistant to IR. Retroperitoneal fat was increased in male MOF1 vs. CF1. Circulating triglycerides and insulin resistance were increased in male and female MOF1 vs. CF1. These data show that MO programming reduces F1 cardiac reserve associated with age-related insulin resistance in a sex-specific manner.
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Affiliation(s)
- Carlos A Ibáñez
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Francisco Correa
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Gabriela Lira-León
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Luis A Reyes-Castro
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Francisco Javier Roldán
- Departamento de Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Alejandro Silva-Palacios
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Mabel Buelna-Chontal
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Guadalupe L Rodríguez-González
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Peter W Nathanielsz
- Animal Science, University of Wyoming, Laramie, Wyoming, USA; Texas Pregnancy and Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Cecilia Zazueta
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Elena Zambrano
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico; Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico.
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179
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Izda V, Schlupp L, Prinz E, Dyson G, Barrett M, Dunn CM, Nguyen E, Sturdy C, Jeffries MA. Murine cartilage microbial DNA deposition occurs rapidly following the introduction of a gut microbiome and changes with obesity, aging, and knee osteoarthritis. GeroScience 2024; 46:2317-2341. [PMID: 37946009 PMCID: PMC10828335 DOI: 10.1007/s11357-023-01004-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: 08/24/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
Cartilage microbial DNA patterns have been recently characterized in osteoarthritis (OA). The objectives of this study were to evaluate the gut origins of cartilage microbial DNA, to characterize cartilage microbial changes with age, obesity, and OA in mice, and correlate these to gut microbiome changes. We used 16S rRNA sequencing performed longitudinally on articular knee cartilage from germ-free (GF) mice following oral microbiome inoculation and cartilage and cecal samples from young and old wild-type mice with/without high-fat diet-induced obesity (HFD) and with/without OA induced by destabilization of the medial meniscus (DMM) to evaluate gut and cartilage microbiota. Microbial diversity was assessed, groups compared, and functional metagenomic profiles reconstructed. Findings were confirmed in an independent cohort by clade-specific qPCR. We found that cartilage microbial patterns developed at 48 h and later timepoints following oral microbiome inoculation of GF mice. Alpha diversity was increased in SPF mouse cartilage samples with age (P = 0.013), HFD (P = 5.6E-4), and OA (P = 0.029) but decreased in cecal samples with age (P = 0.014) and HFD (P = 1.5E-9). Numerous clades were altered with aging, HFD, and OA, including increases in Verrucomicrobia in both cartilage and cecal samples. Functional analysis suggested changes in dihydroorotase, glutamate-5-semialdehyde dehydrogenase, glutamate-5-kinase, and phosphoribosylamine-glycine ligase, in both cecum and cartilage, with aging, HFD, and OA. In conclusion, cartilage microbial DNA patterns develop rapidly after the introduction of a gut microbiome and change in concert with the gut microbiome during aging, HFD, and OA in mice. DMM-induced OA causes shifts in both cartilage and cecal microbiome patterns independent of other factors.
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Affiliation(s)
- Vladislav Izda
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
- Icahn School of Medicine, Mt. Sinai, New York, NY, USA
| | - Leoni Schlupp
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Emmaline Prinz
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Gabby Dyson
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Montana Barrett
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Christopher M Dunn
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
- Department of Internal Medicine, Division of Rheumatology, Immunology, and Allergy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Emily Nguyen
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Cassandra Sturdy
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA
| | - Matlock A Jeffries
- Oklahoma Medical Research Foundation, Arthritis & Clinical Immunology Program, 825 NE 13th Street, Laboratory MC400, Oklahoma City, OK, 73104, USA.
- Department of Internal Medicine, Division of Rheumatology, Immunology, and Allergy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- VA Medical Center, Oklahoma City, OK, USA.
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Ler P, Ploner A, Finkel D, Reynolds CA, Zhan Y, Jylhävä J, Dahl Aslan AK, Karlsson IK. Interplay of body mass index and metabolic syndrome: association with physiological age from midlife to late-life. GeroScience 2024; 46:2605-2617. [PMID: 38102440 PMCID: PMC10828240 DOI: 10.1007/s11357-023-01032-9] [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: 09/26/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65-85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65-85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging.
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Affiliation(s)
- Peggy Ler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna, 171 65, Stockholm, Sweden.
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna, 171 65, Stockholm, Sweden
| | - Deborah Finkel
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
- Institute of Gerontology, Jönköping University, Jönköping, Sweden
| | - Chandra A Reynolds
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Yiqiang Zhan
- School of Public Health, Sun Yat-Sen University, Shenzhen Campus, Shenzhen, Guandong, China
| | - Juulia Jylhävä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna, 171 65, Stockholm, Sweden
- Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, University of Tampere, Tampere, Finland
| | | | - Ida K Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Solna, 171 65, Stockholm, Sweden
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181
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Öztürk ME, Yabanci Ayhan N. The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status. J Intellect Disabil Res 2024; 68:325-339. [PMID: 38183317 DOI: 10.1111/jir.13114] [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] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. METHODS The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5 ± 7 years (range 18-60 years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30 kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. RESULTS Participants had mild (42.3%; n = 30), moderate (29.6%; n = 21) or severe IDD (28.2%; n = 20). They were underweight (12.7%; n = 9), normal weight (59.2%; n = 42) or overweight and/or obese (28.2%; n = 20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. CONCLUSIONS While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.
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Affiliation(s)
- M E Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - N Yabanci Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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182
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Kamel AY. Measurement and estimation of energy in the critically ill. Curr Opin Crit Care 2024; 30:186-192. [PMID: 38441116 DOI: 10.1097/mcc.0000000000001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE OF REVIEW Recent changes in guidelines recommendation during early phase of critical illness and use of indirect calorimetry. The aim of this review is to discuss methods of determining energy requirements in the critically ill and highlight factors impacting resting energy expenditure. RECENT FINDING An appraisal of recent literature discussing indirect calorimetry guided-nutrition potential benefits or pitfalls. Recent attempts to devise strategy and pilot indirect calorimetry use in the critically ill patients requiring continuous renal replacement therapy or extracorporeal membrane oxygenation are also discussed. Additionally, we briefly touched on variability between guidelines recommended energy target and measured energy expenditure for adult critically ill patients with obesity. SUMMARY While energy requirement in the critically ill continues to be an area of controversy, recent guidelines recommendations shift toward providing less aggressive calories during acute phase of illness in the first week of ICU.Use of indirect calorimetry may provide more accurate energy target compared to the use of predictive equations. Despite the absence of literature to support long term mortality benefits, there are many potential benefits for the use of indirect calorimetry when available.
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Affiliation(s)
- Amir Y Kamel
- Department of Pharmacy, UF Health Shands Hospital, University of Florida College of Pharmacy, Gainesville, Florida, USA
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183
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Taheri S. Type 2 diabetes remission: weight maintenance in the spotlight. Lancet Diabetes Endocrinol 2024; 12:216-217. [PMID: 38430914 DOI: 10.1016/s2213-8587(24)00036-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Shahrad Taheri
- Weill Cornell Medicine Qatar, PO 24144 Doha, Qatar; Weill Cornell Medicine New York, NY, USA; Hamad Medical Corporation, Dohar, Qatar.
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184
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Kowal M, Woźniacka R, Ścisłowska‐Czarnecka A, Homa J, Głodzik W. The effect of physical activity on cytokine levels in adults living with type 1 diabetes-a preliminary study. Physiol Rep 2024; 12:e15985. [PMID: 38639648 PMCID: PMC11027896 DOI: 10.14814/phy2.15985] [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: 09/26/2023] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
The aim of this study is to investigate whether physical activity and the level of body fat are factors reducing the level of pro-inflammatory cytokines in people with T1DM. Twenty-five men (27.8 ± 9.4 years old; 178.9 ± 6.9 cm; 80.6 ± 12 kg) and 18 women (28.1 ± 12.5 years old; 162.4 ± 5.5; 63.1 ± 9.9 kg) were divided into four groups based on body fat percentage and level of physical activity (AN-active people with normal body fat; IAN-inactive people with normal body fat; AO-active people with excessive body fat, IAO-inactive people with excessive body fat). The level of cytokines in the blood serum was assessed. The level of IL-8 was higher (measurable) in inactive men, regardless of adiposity degree and in women, only in the inactive group with normal body fat. IL-6 was found only in active men with excessive adiposity. In conclusion, the findings from this study allow to indicate that moderate level of physical activity may contribute to a reduction in the development of systemic low-grade inflammation in patients with T1DM, and thus, may reduce the risk of CVD.
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Affiliation(s)
- Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education and SportBronislaw Czech University of Physical EducationKrakówPoland
| | - Renata Woźniacka
- Department at Cosmetology, Faculty of Motor RehabilitationBronislaw Czech University of Physical Education in KrakowKrakowPoland
| | - Anna Ścisłowska‐Czarnecka
- Department at Cosmetology, Faculty of Motor RehabilitationBronislaw Czech University of Physical Education in KrakowKrakowPoland
| | - Joanna Homa
- Department of Evolutionary ImmunologyInstitute of Zoology and Biomedical Research, Jagiellonian UniversityKrakowPoland
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185
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Olsen SF. A follow-up from a randomized controlled trial suggests that fish oil in pregnancy may increase the risk of obesity and metabolic syndrome in the offspring-a reason for concern? Am J Clin Nutr 2024; 119:863-864. [PMID: 38569781 DOI: 10.1016/j.ajcnut.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Sjurdur Frodi Olsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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186
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Batis C. Taxes to sugar-sweetened beverages: are changes in obesity and diabetes observable? Am J Clin Nutr 2024; 119:874-875. [PMID: 38569784 DOI: 10.1016/j.ajcnut.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Carolina Batis
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
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187
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Button AM, Staiano AE, Beyl RA, Stein RI, Newton RL, Baker A, Lima A, Lindros J, Conn AM, Welch RR, Cook SR, Wilfley DE. Validation of remote child weight and height measurements within a weight management trial. Obesity (Silver Spring) 2024; 32:660-666. [PMID: 38108115 DOI: 10.1002/oby.23972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE The aim of this substudy within the Treatment Efforts Addressing Child Weight Management by Unifying Patients, Parents, and Providers (TEAM UP) pragmatic clinical trial was to compare the validity of anthropometric measurements collected remotely versus in person (≤7 days apart) among youth with obesity who were 6 to 15 years of age. METHODS Child (n = 37) weight and height were measured in person by a trained data assessor. These were compared with measurements taken remotely by the child's parent with live videoconferencing observation by a study data assessor. In-person and remote measurements were compared using Bland-Altman plots, Pearson correlations, and two one-sided paired t tests. A priori bounds of acceptability were set at ±0.68 kg to allow for typical weight fluctuations within the 7-day comparison period. RESULTS Measurements were highly correlated (height: r = 0.991, p < 0.0001; weight: r = 0.999; p = 0.03). For height, two one-sided t tests for upper, t(36) = 3.95, and lower, t(36) = -2.63, bounds (-1, 1) revealed an overall p = 0.006; absolute error was 3.5 cm. For weight, two one-sided t tests for upper, t(36) = 1.93, and lower, t(36) = -7.91, bounds (-0.68, 0.68) revealed an overall p = 0.03; absolute error was 1.7 kg. CONCLUSIONS The present findings support the utility and interpretation of remotely assessed weight management outcomes for both research and clinical purposes. These procedures may offer greater accessibility to evidence-based measurement.
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Affiliation(s)
- Alyssa M Button
- Pennington Biomedical Research Center, Population and Public Health Science, Baton Rouge, Louisiana, USA
| | - Amanda E Staiano
- Pennington Biomedical Research Center, Population and Public Health Science, Baton Rouge, Louisiana, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Population and Public Health Science, Baton Rouge, Louisiana, USA
| | - Richard I Stein
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Robert L Newton
- Pennington Biomedical Research Center, Population and Public Health Science, Baton Rouge, Louisiana, USA
| | - Alison Baker
- American Academy of Pediatrics, Child and Community Health, Itasca, Illinois, USA
| | - Angela Lima
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jeanne Lindros
- American Academy of Pediatrics, Child and Community Health, Itasca, Illinois, USA
| | - Anne-Marie Conn
- University of Rochester Medical Center, Rochester, New York, USA
| | - R Robinson Welch
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stephen R Cook
- University of Rochester Medical Center, Rochester, New York, USA
| | - Denise E Wilfley
- Washington University School of Medicine, St. Louis, Missouri, USA
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188
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Robino JJ, Plekhanov AP, Zhu Q, Jensen MD, Scherer PE, Roberts CT, Varlamov O. Adipose Tissue Analysis Toolkit (ATAT) for automated analysis of adipocyte size and extracellular matrix in white adipose tissue. Obesity (Silver Spring) 2024; 32:723-732. [PMID: 38321231 DOI: 10.1002/oby.23992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVE The pathological expansion of white adipose tissue (WAT) in obesity involves adipocyte hypertrophy accompanied by expansion of the collagen-rich pericellular extracellular matrix (ECM) and development of crown-like structures (CLS). Traditionally, WAT morphology is assessed through immunohistochemical analysis of WAT sections. However, manual analysis of large histological sections is time-consuming, and the available digital tools for analyzing adipocyte size and pericellular ECM are limited. To address this gap, the authors developed the Adipose Tissue Analysis Toolkit (ATAT), an ImageJ plugin facilitating analysis of adipocyte size, WAT ECM, and CLS. METHODS AND RESULTS ATAT utilizes local and image-level differentials in pixel intensity to independently threshold image background, distinguishing adipocyte-free tissue without user input. It accurately captures adipocytes in histological sections stained with common dyes and automates the analysis of adipocyte cross-sectional area, total-field, and localized region-of-interest ECM. ATAT allows fully automated batch analysis of histological images using default or user-defined adipocyte detection parameters. CONCLUSIONS ATAT provides several advantages over existing WAT image analysis tools, enabling high-throughput analyses of adipocyte-specific parameters and facilitating the assessment of ECM changes associated with WAT remodeling due to weight changes and other pathophysiological alterations that affect WAT function.
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Affiliation(s)
- Jacob J Robino
- Division of Metabolic Health and Disease, Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Alexander P Plekhanov
- Division of Metabolic Health and Disease, Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Qingzhang Zhu
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Philipp E Scherer
- Touchstone Diabetes Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Charles T Roberts
- Division of Metabolic Health and Disease, Oregon National Primate Research Center, Beaverton, Oregon, USA
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Oleg Varlamov
- Division of Metabolic Health and Disease, Oregon National Primate Research Center, Beaverton, Oregon, USA
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189
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Alberton CL, Fonseca BA, Nunes GN, Bergamin M, Pinto SS. Magnitude of vertical ground reaction force during water-based exercises in women with obesity. Sports Biomech 2024; 23:470-483. [PMID: 33568003 DOI: 10.1080/14763141.2021.1872690] [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: 03/28/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
Individuals with obesity are recommended to practice physical activity with reduced weight bearing, such as water-based exercises. However, the magnitude of the vertical ground reaction force (Fz) during these exercises is unknown in this population. This study aimed to verify the magnitude of peak Fz (Fzpeak) in women with obesity during different exercises performed in water and on land and at different intensities. Ten adult women with obesity class 1 (body mass index: 31.6 ± 0.57 kg·m-2) completed two randomised sessions, one performed on land and other in water, composed by three exercises (stationary running, frontal kick, butt kick) performed at cadences of 80 b·min-1, 100 b·min-1 and maximal. Fzpeak value was determined in each situation. Data were analysed using repeated-measures three-way ANOVA (α = 0.05). Significant lower Fzpeak values were observed in water (p < 0.001), with no significant differences between the exercises. A significant difference in the Fzpeak was verified between maximal cadence and 80 b·min-1 (p = 0.01). Water-based exercises performed by women with obesity revealed a Fzpeak reduction from land to water corresponding to 41-67%. Also, the three water-based exercises resulted in similar Fzpeak values, while an increase was observed 80 b·min-1 to the maximal cadence.
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Affiliation(s)
| | | | | | - Marco Bergamin
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
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190
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Fox CK, Molitor SJ, Vock DM, Peterson CB, Crow SJ, Gross AC. Appetitive and psychological phenotypes of pediatric patients with obesity. Pediatr Obes 2024; 19:e13101. [PMID: 38290813 DOI: 10.1111/ijpo.13101] [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: 06/13/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted interventions and improved outcomes. OBJECTIVE Identify empirically derived phenotypes of pediatric patients with obesity based on appetitive and psychological correlates of obesity. METHODS This cross-sectional study included patients aged 5-12 years who were treated in a weight management clinic and completed standard intake questionnaires including Child Eating Behavior Questionnaire (CEBQ), Vanderbilt ADHD Scale and Pediatric Symptom Checklist. Phenotypes were elicited using latent profile analysis of 12 indicators: eight CEBQ subscales, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. RESULTS Parents/guardians of 384 patients (mean age 9.8 years, mean BMI 30.3 kg/m2 ) completed the intake questionnaires. A 4-phenotype model best fits the data. Hedonic Impulsive phenotype (42.5%) exhibited high food enjoyment and hyperactivity/impulsivity. Inattentive Impulsive phenotype (27.4%) exhibited overall low food approach and high food avoid behaviours, and highest inattention. Hedonic Emotional phenotype (20.8%) scored the highest on food enjoyment, internalizing and externalizing symptoms. Picky Eating phenotype (9.3%) scored the lowest on food approach, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. CONCLUSION Appetitive traits and psychological symptoms appear to cluster in distinct patterns, giving rise to four unique phenotypic profiles, which, if replicated, may help inform the development of tailored treatment plans.
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Affiliation(s)
- Claudia K Fox
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen J Molitor
- Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David M Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Amy C Gross
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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191
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DiBrog AM, Kern KA, Demieri E, Mietlicki-Baase EG. The alpha-7 nicotinic acetylcholine receptor agonist PHA-543613 reduces food intake in male rats. Pharmacol Biochem Behav 2024; 237:173723. [PMID: 38331049 DOI: 10.1016/j.pbb.2024.173723] [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: 12/08/2023] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
Obesity is a prevalent disease, but effective treatment options remain limited. Agonists of the alpha-7 nicotinic acetylcholine receptor (α7nAChR) promote negative energy balance in mice, but these effects are not well-studied in rats. We tested the hypothesis that central administration of the α7nAChR agonist PHA-543613 (PHA) would decrease food intake and body weight in adult male Sprague Dawley rats. Intracerebroventricular (ICV) PHA administration in chow-fed rats produced a suppression of energy intake and weight gain over 24 h. Next, to evaluate effects of ICV PHA on palatable food intake, rats were maintained on a choice diet of rodent chow and 45 % high fat diet (HFD); under these conditions, ICV PHA produced no significant changes in energy intake from either food, or body weight gain, in the 24 h post-injection. However, when given a choice of chow or a higher-fat 60 % HFD, ICV PHA reduced intake of 60 % HFD, but not chow; body weight gain was also suppressed. Further experiments evaluating conditioned taste avoidance (CTA) and pica in response to ICV PHA suggested that the suppressive food intake and body weight effects after ICV injection of PHA were not due to nausea/malaise. Finally, an operant conditioning study showed that responding on a progressive ratio schedule of reinforcement for high-fat food pellets decreased after ICV PHA. Collectively, these studies show that PHA reduces energy intake under some but not all dietary conditions. Importantly, central PHA decreases both food intake as well as motivation for highly palatable, energy dense foods in rats without inducing nausea/malaise, suggesting that the α7nAChR could be a viable target for developing treatments for obesity.
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Affiliation(s)
- Adrianne M DiBrog
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Katherine A Kern
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Emily Demieri
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Elizabeth G Mietlicki-Baase
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY 14260, USA.
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192
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Wong RS, Tung KTS, Ho FKW, Rao N, Chan KL, Ip P. Longitudinal associations between child discipline methods and physical growth patterns across preschool years. Obesity (Silver Spring) 2024; 32:778-787. [PMID: 38233354 DOI: 10.1002/oby.23977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/16/2023] [Accepted: 12/02/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Research has documented the associations of child maltreatment with a range of physical health problems, but little is known about the physical growth patterns of children who experience maltreatment in early childhood. This study aimed to examine the association between various discipline approaches and physical growth in preschool-aged children. METHODS In the first year of preschool, parents of 661 Chinese preschool-aged children completed a questionnaire with items pertaining to the frequency of using physical maltreatment, psychological aggression, neglect, and nonviolent discipline toward the child. Children's weight and height were assessed annually using direct assessment in the first and two subsequent years. Longitudinal analyses were performed using multiple regression models. RESULTS More frequent neglect and psychological aggression during the first year of preschool were associated with a higher likelihood of a decreased BMI z score in subsequent years. Conversely, increased experience of physical maltreatment in the first year was associated with an increased likelihood of having overweight or obesity in the third year. CONCLUSIONS Results indicate that early maltreatment experience can impact physical growth. This highlights the importance of preventing abusive parenting and encouraging healthy habits in young children who have experienced maltreatment to decrease their future risk for weight problems.
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Affiliation(s)
- Rosa S Wong
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
| | - Keith T S Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Frederick K W Ho
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Nirmala Rao
- Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
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Quint EE, Liu Y, Shafaat O, Ghildayal N, Crosby H, Kamireddy A, Pol RA, Orandi BJ, Segev DL, Weiss CR, McAdams-DeMarco MA. Abdominal computed tomography measurements of body composition and waitlist mortality in kidney transplant candidates. Am J Transplant 2024; 24:591-605. [PMID: 37949413 PMCID: PMC10982050 DOI: 10.1016/j.ajt.2023.11.002] [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: 05/09/2023] [Revised: 10/10/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
Body mass index is often used to determine kidney transplant (KT) candidacy. However, this measure of body composition (BC) has several limitations, including the inability to accurately capture dry weight. Objective computed tomography (CT)-based measures may improve pre-KT risk stratification and capture physiological aging more accurately. We quantified the association between CT-based BC measurements and waitlist mortality in a retrospective study of 828 KT candidates (2010-2022) with clinically obtained CT scans using adjusted competing risk regression. In total, 42.5% of candidates had myopenia, 11.4% had myopenic obesity (MO), 68.8% had myosteatosis, 24.8% had sarcopenia (probable = 11.2%, confirmed = 10.5%, and severe = 3.1%), and 8.6% had sarcopenic obesity. Myopenia, MO, and sarcopenic obesity were not associated with mortality. Patients with myosteatosis (adjusted subhazard ratio [aSHR] = 1.62, 95% confidence interval [CI]: 1.07-2.45; after confounder adjustment) or sarcopenia (probable: aSHR = 1.78, 95% CI: 1.10-2.88; confirmed: aSHR = 1.68, 95% CI: 1.01-2.82; and severe: aSHR = 2.51, 95% CI: 1.12-5.66; after full adjustment) were at increased risk of mortality. When stratified by age, MO (aSHR = 2.21, 95% CI: 1.28-3.83; P interaction = .005) and myosteatosis (aSHR = 1.95, 95% CI: 1.18-3.21; P interaction = .038) were associated with elevated risk only among candidates <65 years. MO was only associated with waitlist mortality among frail candidates (adjusted hazard ratio = 2.54, 95% CI: 1.28-5.05; P interaction = .021). Transplant centers should consider using BC metrics in addition to body mass index when a CT scan is available to improve pre-KT risk stratification at KT evaluation.
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Affiliation(s)
- Evelien E Quint
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Yi Liu
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Omid Shafaat
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nidhi Ghildayal
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Helen Crosby
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Arun Kamireddy
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert A Pol
- Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Babak J Orandi
- Division of Endocrinology, Joan & Sanford Weill Medical College of Cornell University, New York, NY, USA
| | - Dorry L Segev
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Clifford R Weiss
- Division of Vascular and Interventional Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
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Sajic T, Ferreira Gomes CK, Gasser M, Caputo T, Bararpour N, Landaluce-Iturriria E, Augsburger M, Walter N, Hainard A, Lopez-Mejia IC, Fracasso T, Thomas A, Gilardi F. SMYD3: a new regulator of adipocyte precursor proliferation at the early steps of differentiation. Int J Obes (Lond) 2024; 48:557-566. [PMID: 38148333 PMCID: PMC10978492 DOI: 10.1038/s41366-023-01450-x] [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: 06/29/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND In obesity, adipose tissue undergoes a remodeling process characterized by increased adipocyte size (hypertrophia) and number (hyperplasia). The ability to tip the balance toward the hyperplastic growth, with recruitment of new fat cells through adipogenesis, seems to be critical for a healthy adipose tissue expansion, as opposed to a hypertrophic growth that is accompanied by the development of inflammation and metabolic dysfunction. However, the molecular mechanisms underlying the fine-tuned regulation of adipose tissue expansion are far from being understood. METHODS We analyzed by mass spectrometry-based proteomics visceral white adipose tissue (vWAT) samples collected from C57BL6 mice fed with a HFD for 8 weeks. A subset of these mice, called low inflammation (Low-INFL), showed reduced adipose tissue inflammation, as opposed to those developing the expected inflammatory response (Hi-INFL). We identified the discriminants between Low-INFL and Hi-INFL vWAT samples and explored their function in Adipose-Derived human Mesenchymal Stem Cells (AD-hMSCs) differentiated to adipocytes. RESULTS vWAT proteomics allowed us to quantify 6051 proteins. Among the candidates that most differentiate Low-INFL from Hi-INFL vWAT, we found proteins involved in adipocyte function, including adiponectin and hormone sensitive lipase, suggesting that adipocyte differentiation is enhanced in Low-INFL, as compared to Hi-INFL. The chromatin modifier SET and MYND Domain Containing 3 (SMYD3), whose function in adipose tissue was so far unknown, was another top-scored hit. SMYD3 expression was significantly higher in Low-INFL vWAT, as confirmed by western blot analysis. Using AD-hMSCs in culture, we found that SMYD3 mRNA and protein levels decrease rapidly during the adipocyte differentiation. Moreover, SMYD3 knock-down before adipocyte differentiation resulted in reduced H3K4me3 and decreased cell proliferation, thus limiting the number of cells available for adipogenesis. CONCLUSIONS Our study describes an important role of SMYD3 as a newly discovered regulator of adipocyte precursor proliferation during the early steps of adipogenesis.
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Affiliation(s)
- Tatjana Sajic
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland
- Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Marie Gasser
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland
- Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Tiziana Caputo
- Section on Integrative Physiology and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Nasim Bararpour
- Stanford Center for Genomics and Personalized Medicine, Stanford, CA, USA
- Department of Genetics, Stanford University, Stanford, CA, USA
| | | | - Marc Augsburger
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland
| | - Nadia Walter
- Proteomics Core Facility, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre Hainard
- Proteomics Core Facility, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Tony Fracasso
- Unit of Forensic Medicine, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland
| | - Aurélien Thomas
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland
- Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Federica Gilardi
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Lausanne, Geneva, Switzerland.
- Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
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195
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Kawada T. Comment on Zuraikat et al. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care 2024;47:117-125. Diabetes Care 2024; 47:e36. [PMID: 38527121 DOI: 10.2337/dc23-2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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196
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Liu LP, Shapira N, Halliburton SS, Meyer S, Perkins A, Litt HI, Kauczor HU, Leiner T, Stiller W, Noël PB. Spectral performance evaluation of a second-generation spectral detector CT. J Appl Clin Med Phys 2024; 25:e14300. [PMID: 38386967 PMCID: PMC11005977 DOI: 10.1002/acm2.14300] [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: 08/08/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE The aim of this study was to characterize a second-generation wide-detector dual-layer spectral computed tomography (CT) system for material quantification accuracy, acquisition parameter and patient size dependencies, and tissue characterization capabilities. METHODS A phantom with multiple tissue-mimicking and material-specific inserts was scanned with a dual-layer spectral detector CT using different tube voltages, collimation widths, radiation dose levels, and size configurations. Accuracy of iodine density maps and virtual monoenergetic images (MonoE) were investigated. Additionally, differences between conventional and MonoE 70 keV images were calculated to evaluate acquisition parameter and patient size dependencies. To demonstrate material quantification and differentiation, liver-mimicking inserts with adipose and iron were analyzed with a two-base decomposition utilizing MonoE 50 and 150 keV, and root mean square error (RMSE) for adipose and iron content was reported. RESULTS Measured inserts exhibited quantitative accuracy across a wide range of MonoE levels. MonoE 70 keV images demonstrated reduced dependence compared to conventional images for phantom size (1 vs. 27 HU) and acquisition parameters, particularly tube voltage (4 vs. 37 HU). Iodine density quantification was successful with errors ranging from -0.58 to 0.44 mg/mL. Similarly, inserts with different amounts of adipose and iron were differentiated, and the small deviation in values within inserts corresponded to a RMSE of 3.49 ± 1.76% and 1.67 ± 0.84 mg/mL for adipose and iron content, respectively. CONCLUSION The second-generation dual-layer CT enables acquisition of quantitatively accurate spectral data without compromises from differences in patient size and acquisition parameters.
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Affiliation(s)
- Leening P. Liu
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Nadav Shapira
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Sebastian Meyer
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Harold I. Litt
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Hans Ulrich Kauczor
- Diagnostic and Interventional Radiology (DIR)Heidelberg University HospitalHeidelbergGermany
| | - Tim Leiner
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Wolfram Stiller
- Diagnostic and Interventional Radiology (DIR)Heidelberg University HospitalHeidelbergGermany
| | - Peter B. Noël
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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197
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Son TG, Seo Y, Kim WT, Kim M, Choi SJ, Choi SH, Sung BJ, Min JS, Han EC, Kim HS. Characterization of 3D Organotypic Culture of Mouse Adipose-Derived Stem Cells. Int J Mol Sci 2024; 25:3931. [PMID: 38612741 PMCID: PMC11011465 DOI: 10.3390/ijms25073931] [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: 01/22/2024] [Revised: 03/05/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Although stem cells are a promising avenue for harnessing the potential of adipose tissue, conventional two-dimensional (2D) culture methods have limitations. This study explored the use of three-dimensional (3D) cultures to preserve the regenerative potential of adipose-derived stem cells (ADSCs) and investigated their cellular properties. Flow cytometric analysis revealed significant variations in surface marker expressions between the two culture conditions. While 2D cultures showed robust surface marker expressions, 3D cultures exhibited reduced levels of CD44, CD90.2, and CD105. Adipogenic differentiation in 3D organotypic ADSCs faced challenges, with decreased organoid size and limited activation of adipogenesis-related genes. Key adipocyte markers, such as lipoprotein lipase (LPL) and adipoQ, were undetectable in 3D-cultured ADSCs, unlike positive controls in 2D-cultured mesenchymal stem cells (MSCs). Surprisingly, 3D-cultured ADSCs underwent mesenchymal-epithelial transition (MET), evidenced by increased E-cadherin and EpCAM expression and decreased mesenchymal markers. This study highlights successful ADSC organoid formation, notable MSC phenotype changes in 3D culture, adipogenic differentiation challenges, and a distinctive shift toward an epithelial-like state. These findings offer insights into the potential applications of 3D-cultured ADSCs in regenerative medicine, emphasizing the need for further exploration of underlying molecular mechanisms.
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Affiliation(s)
- Tae Gen Son
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Yoojin Seo
- Department of Oral Biochemistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea;
| | - Won-Tae Kim
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Meesun Kim
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Seon Jeong Choi
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Si Ho Choi
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Byung-Jun Sung
- Research Center, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (W.-T.K.); (M.K.); (S.J.C.); (S.H.C.); (B.-J.S.)
| | - Jae-Seok Min
- Department of Surgery, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (J.-S.M.); (E.C.H.)
| | - Eon Chul Han
- Department of Surgery, Dongnam Institute of Radiological and Medical Science, Busan 46033, Republic of Korea; (J.-S.M.); (E.C.H.)
| | - Hyung-Sik Kim
- Department of Oral Biochemistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea;
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Warger J, Lucas M, Lucas A. Assessing the contribution of plastic-associated obesogenic compounds to cardiometabolic diseases. Curr Opin Endocrinol Diabetes Obes 2024; 31:98-103. [PMID: 38054472 PMCID: PMC10911259 DOI: 10.1097/med.0000000000000852] [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] [Indexed: 12/07/2023]
Abstract
PURPOSE OF REVIEW To present recent evidence that strengthens the concept that exogenous pollutants contribute to adipose dysfunction and increased rates of disease and to highlight the ineffective regulation of this risk as industry switches to related but similarly toxic variants. RECENT FINDINGS Substitutes for common phthalates and the highly regulated bisphenol A (BPA) show similar deleterious effects on adipocytes. The well tolerated limit for BPA exposure has been reduced in Europe to below the level detected in recent population studies. Additionally, the role for BPA-induced inflammation mediated by interleukin 17a has been described in animal and human studies. SUMMARY Despite experimental and associative evidence that supports plastics and plastic associated chemicals deleteriously influencing adipose homeostatasis and contributing to metabolic diseases, structurally related alternate chemicals are being substituted by manufacturers to circumvent trailing regulatory actions.
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Affiliation(s)
- Jacob Warger
- Medical School, The University of Western Australia
| | - Michaela Lucas
- Medical School, The University of Western Australia
- Department of Immunology PathWest
- Department of Immunology, Sir Charles Gairdner Hospital & Perth Childrens Hospital
| | - Andrew Lucas
- School of Biomedical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
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Ghosh D, Yaron JR, Abedin MR, Godeshala S, Kumar S, Kilbourne J, Berthiaume F, Rege K. Bioactive nanomaterials kickstart early repair processes and potentiate temporally modulated healing of healthy and diabetic wounds. Biomaterials 2024; 306:122496. [PMID: 38373363 DOI: 10.1016/j.biomaterials.2024.122496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/15/2024] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
Slow-healing and chronic wounds represent a major global economic and medical burden, and there is significant unmet need for novel therapies which act to both accelerate wound closure and enhance biomechanical recovery of the skin. Here, we report a new approach in which bioactives that augment early stages of wound healing can kickstart and engender effective wound closure in healthy and diabetic, obese animals, and set the stage for subsequent tissue repair processes. We demonstrate that a nanomaterial dressing made of silk fibroin and gold nanorods (GNR) stimulates a pro-neutrophilic, innate immune, and controlled inflammatory wound transcriptomic response. Further, Silk-GNR, lasered into the wound bed, in combination with exogeneous histamine, accelerates early-stage processes in tissue repair leading to effective wound closure. Silk-GNR and histamine enhanced biomechanical recovery of skin, increased transient neoangiogenesis, myofibroblast activation, epithelial-to-mesenchymal transition (EMT) of keratinocytes and a pro-resolving neutrophilic immune response, which are hitherto unknown activities for these bioactives. Predictive and temporally coordinated delivery of growth factor nanoparticles that modulate later stages of tissue repair further accelerated wound closure in healthy and diabetic, obese animals. Our approach of kickstarting healing by delivering the "right bioactive at the right time" stimulates a multifactorial, pro-reparative response by augmenting endogenous healing and immunoregulatory mechanisms and highlights new targets to promote tissue repair.
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Affiliation(s)
- Deepanjan Ghosh
- Biological Design Graduate Program, Arizona State University, Tempe, AZ 85287, USA
| | - Jordan R Yaron
- Center for Biomaterials Innovation and Translation (CBIT), The Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA; Chemical Engineering, School for Engineering of Matter, Transport and Energy, Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Muhammad Raisul Abedin
- Center for Biomaterials Innovation and Translation (CBIT), The Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA; Chemical Engineering, School for Engineering of Matter, Transport and Energy, Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Sudhakar Godeshala
- Center for Biomaterials Innovation and Translation (CBIT), The Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA; Chemical Engineering, School for Engineering of Matter, Transport and Energy, Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Suneel Kumar
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Jacquelyn Kilbourne
- Department of Animal Care and Technologies, Arizona State University, Tempe, AZ 85287, USA
| | - Francois Berthiaume
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Kaushal Rege
- Biological Design Graduate Program, Arizona State University, Tempe, AZ 85287, USA; Center for Biomaterials Innovation and Translation (CBIT), The Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA; Chemical Engineering, School for Engineering of Matter, Transport and Energy, Ira A. Fulton Schools of Engineering, Arizona State University, Tempe, AZ 85287, USA.
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Pop VJM, Krabbe JG, Broeren M, Wiersinga W, Rayman MP. Hypothyroxinaemia during gestation is associated with low ferritin and increased levels of inflammatory markers. Eur Thyroid J 2024; 13:e230163. [PMID: 38330593 PMCID: PMC10959042 DOI: 10.1530/etj-23-0163] [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] [Received: 08/30/2023] [Accepted: 02/07/2024] [Indexed: 02/10/2024] Open
Abstract
Objective Pregnancy is a state of physiological inflammation facilitating implantation. Early isolated hypothyroxinaemia (IH) and increased inflammation (including obesity) have been associated with severe obstetric complications. The current study evaluated the association between IH, low ferritin and inflammation parameters (interleukin 6 (IL-6), C-reactive protein (CRP), human chorionic gonadotrophin (hCG) and obesity. Moreover, the course of these parameters throughout pregnancy was evaluated in relation to IH. Methods In the cross-sectional study (A) at 12 weeks, 2759 women participated and 2433 participated in the longitudinal study (B) with assessments at 12, 20 and 28 weeks gestation. At the first trimester, 122 (4.4%) IH women (free thyroxine (FT4) <5th percentile, normal TSH levels) were compared with 2114 (76.6%) reference women (FT4 between tenth and 90th percentiles, normal thyrotrophin (TSH) levels), in study B these figures were 99 (4.1%) and 1847 (75.9%), respectively. Results Cross-sectionally, compared to reference women, IH was independently associated with low ferritin (<5th percentile, OR: 2.6, 95% CI: 1.4-4.9), high CRP (>95th percentile: OR: 1.9, 95% CI: 1.04-3.7), low hCG ( 30, OR: 1.7, 95% CI: 1.12.9) and higher age (OR: 1.1, 95% CI: 1.04-1.15). Longitudinally, compared to reference women, women with IH at 12 weeks gestation showed persistently and significantly lower ferritin and hCG levels, and persistently higher CRP and IL-6 levels throughout gestation. Conclusion Gestational IH could be viewed as a condition of increased inflammation, as reported in non-thyroidal illness syndrome. Less favourable inflammation parameters and low iron status during early gestation in IH women seem to persist throughout gestation.
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Affiliation(s)
- Victor J M Pop
- Department of Medical Psychology, Tilburg University, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands
| | - Maarten Broeren
- Department of Clinical Chemistry, Maxima Medical Centre, Veldhoven, The Netherlands
| | - Wilmar Wiersinga
- Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Margaret P Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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