Epidemiology, Predisposing Factors, Biomarkers, and Prevention Mechanism of Obesity: A Systematic Review

The modulatory effect of oat on brain-derived neurotrophic factor, orexigenic neuropeptides, and dopaminergic signaling in obesity-induced rat model: a comparative study to orlistat

BACKGROUND

Obesity is a non-communicable complex disease that is the fifth leading cause of death worldwide. According to a novel viewpoint, the brain plays a significant role in the central regulation of satiety and energy homeostasis. Because of its rich nutritional profile and versatile uses, oat (Avena sativa) is one of the most popular functional foods recommended by many nutritionists. The anti-obesity effect of oat was hypothesized, focusing on the brain as the target organ. In the current study, the interplay between brain biomarkers, obesity, and its related complications was evaluated in diet-induced obese rats for 25 weeks, in which 60 adult male white albino Wistar rats were divided into three control and seven treatment groups given oat extracts in a dose-dependent manner.

RESULTS

Oat significantly improved obesity-related metabolic complications. In terms of brain function, oat significantly increased dopaminergic signaling, brain-derived neurotrophic factor levels, vaspin, irisin, and uncoupling protein-1 brain levels, while decreasing the expression of agouti-related peptide and neuropeptide Y (P-value < 0.05).

CONCLUSION

The current study proposes oat supplementation as a new conceptual framework with numerous implications for hedonic and homeostatic mechanisms that control satiety. © 2024 Society of Chemical Industry.

Anti-Obesogenic and Antioxidant Potential of Lychee Seed Flour in Zebrafish Fed a High-Fat Diet

OBJECTIVE

Obesity has become one of the major public health issues and is associated with various comorbidities, including type 2 diabetes mellitus, dyslipidemia, and hypertension. Lychee seeds are considered promising ingredients for developing functional foods owing to their nutraceutical properties and phytochemical composition. This study aimed to induce obesity in zebrafish (Danio rerio) through a hyperlipidic diet supplemented with different concentrations of lychee seed flour and to evaluate its effects on adipose tissue, biochemical parameters, oxidative stress, and caudal fin regeneration.

METHODS

A total of 200 adult zebrafish were u anded and divided into five experimental groups: control, hyperlipidic diet (HFD), and HFD supplemented with 2%, 4%, and 6% lychee seed flour. After 12 wk of feeding, biochemical parameters (glycemia, triglycerides, total cholesterol, high-density lipoprotein-HDL, aspartate aminotransferase-AST, alanine aminotransferase-ALT, and cortisol) and oxidative stress biomarkers, such as Catalase (CAT), Superoxide Dismutase (SOD), Glutathione-S-Transferase (GST), Glutathione (GSH), and Reactive Oxygen Species (ROS), were evaluated.

RESULTS

The results showed that the HFD4% group exhibited a significant reduction in the diameter of visceral adipocytes compared with the control, HFD, and HFD2% groups. There was a higher prevalence of severe steatosis in the control and HFD groups and mild steatosis in the HFD6% group. The HFD4% and HFD6% groups had the lowest glycemic levels, whereas the HFD6% group had the highest HDL levels. Supplementation with lychee seed flour also positively modulated oxidative stress biomarkers, with increased CAT and GST activity in the HFD6% group and reduced ROS in the HFD4% and HFD6% groups compared with the HFD group.

CONCLUSION

It was concluded that adding 4 to 6% lychee seed flour may have beneficial effects on biochemical parameters and oxidative stress markers in HFD-fed zebrafish. The results indicate that lychee seed flour shows promise for use in foods and supplements targeting obesity prevention and management.

Subphenotypes of body composition and their association with cardiometabolic risk - Magnetic resonance imaging in a population-based sample

BACKGROUND

For characterizing health states, fat distribution is more informative than overall body size. We used population-based whole-body magnetic resonance imaging (MRI) to identify distinct body composition subphenotypes and characterize associations with cardiovascular disease (CVD) risk.

METHODS

Bone marrow, visceral, subcutaneous, cardiac, renal, hepatic, skeletal muscle and pancreatic adipose tissue were measured by MRI in n = 299 individuals from the population-based KORA cohort. Body composition subphenotypes were identified by data-driven k-means clustering. CVD risk was calculated by established scores.

RESULTS

We identified five body composition subphenotypes, which differed substantially in CVD risk factor distribution and CVD risk. Compared to reference subphenotype I with favorable risk profile, two high-risk phenotypes, III&V, had a 3.8-fold increased CVD risk. High-risk subphenotype III had increased bone marrow and skeletal muscle fat (26.3 % vs 11.4 % in subphenotype I), indicating ageing effects, whereas subphenotype V showed overall high fat contents, and particularly elevated pancreatic fat (25.0 % vs 3.7 % in subphenotype I), indicating metabolic impairment. Subphenotype II had a 2.7-fold increased CVD risk, and an unfavorable fat distribution, probably smoking-related, while BMI was only slightly elevated. Subphenotype IV had a 2.8-fold increased CVD risk with comparably young individuals, who showed high blood pressure and hepatic fat (17.7 % vs 3.0 % in subphenotype I).

CONCLUSIONS

Whole-body MRI can identify distinct body composition subphenotypes associated with different degrees of cardiometabolic risk. Body composition profiling may enable a more comprehensive risk assessment than individual fat compartments, with potential benefits for individualized prevention.

Effect of Diet on HDL in Obesity

Alterations of plasma lipoprotein levels and oxidative stress are frequently observed in obese patients, including low high-density lipoprotein (HDL) cholesterol (HDL-C) levels and alterations of HDL composition. Dysfunctional HDL with lower antioxidant and anti-inflammatory properties have also been demonstrated in obesity. There is increasing evidence that white adipose tissue (WAT) participates in several metabolic activities and modulates HDL-C levels and function. In obese subjects, the changes in morphology and function of adipose tissue lead to impaired regulatory function and are associated with a state of low-grade chronic inflammation, with increased release of pro-inflammatory adipokines and cytokines. These alterations may affect HDL metabolism and functions; thus, adipose tissue is considered a potential target for the prevention and treatment of obesity. A cornerstone of obesity prevention and therapy is lifestyle modification through dietary changes, which is reflected in the modulation of plasma lipoprotein metabolism. Some dietary components and metabolites directly affect the composition and structure of HDL and modulate its anti-inflammatory and vasoprotective properties. The aims of the review are to summarize the crosstalk between adipocytes and HDL dysfunction in human obesity and to highlight recent discoveries on beneficial dietary patterns as well as nutritional components on inflammation and HDL function in human obesity.

Effectiveness of acupuncture and a cumin-based herbal formula on anthropometric indices of overweight patients: a randomized double-blind placebo-controlled clinical trial

Objectives

To evaluate the effectiveness of a Persian Medicine herbal formula and a Traditional Chinese Medicine intervention (acupuncture) on the improvement of weight and anthropometric indices of overweight patients.

Methods

This study was a randomized placebo-controlled double-blind clinical trial. A total of 200 overweight patients were randomly divided into 4 groups receiving either (1) Herbal capsule, (2) placebo capsule, (3) acupuncture, or (4) sham acupuncture. Herbal capsules were filled with hydroethanolic extract of Cuminum cyminum L. seed, Apium graveolens L. seed, Ruta graveolens L. seed, Trachyspermum ammi (L.) Sprague seed, Origanum majorana L. leaf, and sodium tetraborate and placebo capsules with avicel. Patients received two 500mg capsules or 12 acupuncture sessions over 8 weeks. Study outcomes, consisted of weight, body mass index (BMI), anthropometric indices including chest, arm, wrist, waist, hip, and leg circumferences, and waist/hip ratio (WHR), were evaluated 3 times: before treatment, after 4 weeks, and after 8 weeks.

Results

The herbal formula significantly reduced weight, BMI, WHR, and chest and waist circumferences compared to the placebo capsule (P < 0.05). Furthermore, acupuncture improved all study outcomes, except WHR, compared to sham acupuncture (P < 0.05). Despite the effects of herbal formula and acupuncture were the same on WHR and chest, waist, and leg circumferences (P < 0.05), acupuncture reduced weight, BMI, and arm, wrist, and hip circumferences more than herbal formula (P < 0.05).

Conclusion

Complementary and alternative therapeutic methods, such as herbal treatments and acupuncture, show promising effects in improving weight and anthropometric indices of overweight patients.

Relationship of visceral adiposity index (VAI) and visceral body fat among metabolically obese normal weight individuals from Pakistan

Background

An increasing number of people throughout the world are suffering with visceral obesity. Accumulation of visceral fat is a pathogenic manifestation of global fat dysfunction, that leads to inflammation, atherosclerosis, abnormal lipid levels, and high blood pressure.

Methods

This association study was conducted at Department of Medicine, Mayo Hospital Lahore, Pakistan. 30 participants who meet the selection criteria were recruited after taking written consent. Then patients were evaluated for their height, weight and waist circumference body mass index. Visceral fat was calculated by using machine for bio-impendence analysis. Visceral adiposity index was calculated. 5 cc venous blood sample was' collected under aseptic measures and all samples were sent to the hospital's laboratory for assessment of lipid profile and blood sugar levels.

Results

We have studied 30 patients (43.8 % female and 56.3 % male), mean age of study population calculated was 40.6 ± 11.80 years. The mean Visceral Body Fat was found to be 13.53 ± 1.41, High-Density Lipoprotein cholesterol mean calculated was 36.91 ± 9.18 mg/dL, and mean Visceral Adiposity Index calculated was 16.75 ​± ​7.55. Pearson Correlation was used, to find correlation between Visceral Adiposity Index and Visceral Body fat. The value turned out to be 00.899∗∗ shows positive correlation, p-value was 0. 001 significant.

Conclusion

In this study we found positive correlation of visceral adiposity index and visceral body fat by use of Bio impedance analysis machine among metabolically obese normal weight individuals. Visceral adiposity index requires many blood tests while Bio impedance analysis machine can be used in simple outdoor settings hence, we can isolate high risk patient in outdoor settings without any invasive procedures or laboratory investigations.

Putative mechanism of a multivitamin treatment against insulin resistance

Insulin resistance is caused by the abnormal secretion of proinflammatory cytokines in adipose tissue, which is induced by an increase in lipid accumulation in adipocytes, hepatocytes, and myocytes. The inflammatory pathway involves multiple targets such as nuclear factor kappa B, inhibitor of nuclear factor κ-B kinase, and mitogen-activated protein kinase. Vitamins are micronutrients with anti-inflammatory activities that have unclear mechanisms. The present study aimed to describe the putative mechanisms of vitamins involved in the inflammatory pathway of insulin resistance. The strategy to achieve this goal was to integrate data mining and analysis, target prediction, and molecular docking simulation calculations to support our hypotheses. Our results suggest that the multitarget activity of vitamins A, B1, B2, B3, B5, B6, B7, B12, C, D3, and E inhibits nuclear factor kappa B and mitogen-activated protein kinase, in addition to vitamins A and B12 against inhibitor of nuclear factor κ-B kinase. The findings of this study highlight the pharmacological potential of using an anti-inflammatory and multitarget treatment based on vitamins and open new perspectives to evaluate the inhibitory activity of vitamins against nuclear factor kappa B, mitogen-activated protein kinase, and inhibitor of nuclear factor κ-B kinase in an insulin-resistant context.

Effects of weekend-focused exercise on obesity-related hormones and metabolic syndrome markers in male high school students

To examine the changes in obesity-related hormones and metabolic syndrome markers in male high school students with obesity following a weekend-focused moderate- or high-intensity exercise program at the recommended weekly physical activity level, or a program of regular exercise 3 times a week at moderate intensity, over a 10-week period. Forty-eight male high school students who were obese with a body fat percentage of ≥25% were randomly assigned to one of three groups: a regular moderate-intensity exercise group (n=17) that freely selected and performed moderate-intensity aerobic and resistance training exercises, every Monday, Wednesday, and Friday, for a total of 150-300 min/wk; a weekend-focused moderate-intensity exercise group (n=15) that freely selected and performed aerobic and resistance training exercises every Saturday for 150-300 min; and a week-end-focused high-intensity exercise group (n=16) that freely selected and performed aerobic and resistance training exercises every Sunday for 75-150 min. Insulin and leptin levels significantly decreased in all the groups, with the greatest reduction in the regular exercise group. Abdominal circumference and triglyceride levels significantly decreased in all the groups. Fasting glucose decreased only in the regular exercise group. High-density lipoprotein cholesterol significantly increased in both the regular and weekend-focused moderate-intensity exercise groups. No significant differences in adiponectin levels, and systolic and diastolic blood pressure were observed between the groups. A weekend-focused exercise program has health effects similar to those of regular exercise, highlighting the importance of meeting the recommended weekly physical activity levels.

An Analysis of the Digestive and Reproductive Tract Microbiota in Infertile Women with Obesity

Previous studies have linked the microbiome of distinct body habitats to obesity and infertility; however, the often-divergent results observed have left the role of the so-called "second genome" in obese infertile patients incompletely explored. Here, we present a prospective observational multicenter study of oral, gut, endometrial, and vaginal microbiota of infertile patients classified according to BMI. Patients collected saliva/fecal samples, while vaginal/endometrial fluid samples were collected in the clinic. Total bacterial DNA was extracted, and microbiota profiles were analyzed by 16S rRNA gene sequencing. Our results showed no differences in the Bacteroidetes/Firmicutes ratio (proposed obesity hallmark) in the gut microbiota between patients with obesity and normal weight; however, a tendency for higher levels of genera such as Escherichia-Shigella in normal-weight patients was observed; in comparison, patients with obesity possessed increased numbers of Parasutterella and Roseburia. In the reproductive tract, vaginal samples possessed a similar microbiota to endometrial fluid, both largely colonised by Lactobacillus, Gardnerella, and Streptococcus, supporting the hypothesis that uterine colonisation proceeds from vaginal bacteria ascension. Additionally, higher prevalence of a Streptococcus-dominated (>50%) endometrial microbiota was observed among patients with obesity. This first description of the human digestive and reproductive tract microbiota in infertile women with obesity may explain their poor reproductive outcomes.

Demystifying Obesity: Understanding, Prevention, Treatment, and Stigmas

Obesity is a complex chronic disease that affects millions of people worldwide. There is still significant stigma associated with it, which can lead to discrimination and create additional barriers for people who are already in treatment. On the other hand, it is noted that it can have serious implications for health and predisposition to noncommunicable chronic diseases. In this sense, the objective of this study was to carry out a narrative review involving all current elements for understanding, prevention, treatment, and debate of stigmas related to obesity. A search was conducted in 2024 for original articles, randomized or nonrandomized clinical trials, systematic reviews, meta-analyses, and guidelines in the following databases: Pubmed, Scielo, Web of Science, CrossRef, and Google Scholar. The publication period was from 2014 to 2024. Obesity is influenced by a complex combination of genetic, environmental, and psychological factors. It is encouraging to see that various emerging points have been identified across different fields such as histology, physiology, genetics, weight loss, and public policy. These obesity areas certainly warrant attention and future studies. Researchers can delve into these topics to deepen their understanding and potentially uncover novel insights. The management should be multifactorial and individualized for each patient. Public policies also play a crucial role in combating obesity, including health promotion, prevention of excessive weight gain, early diagnosis, and proper care of patients. It is crucial that society begins to see the disease as an extremely complex element and not as a moral failure or lack of willpower. This requires a change in the way people talk about obesity, as well as practices that support people instead of stigmatizing them. Obesity does not have a specific address, color, or race. It belongs to everyone and should be regarded as a global public health problem.

Exploring Public Emotions on Obesity During the COVID-19 Pandemic Using Sentiment Analysis and Topic Modeling: Cross-Sectional Study

BACKGROUND

Obesity is a chronic, multifactorial, and relapsing disease, affecting people of all ages worldwide, and is directly related to multiple complications. Understanding public attitudes and perceptions toward obesity is essential for developing effective health policies, prevention strategies, and treatment approaches.

OBJECTIVE

This study investigated the sentiments of the general public, celebrities, and important organizations regarding obesity using social media data, specifically from Twitter (subsequently rebranded as X).

METHODS

The study analyzes a dataset of 53,414 tweets related to obesity posted on Twitter during the COVID-19 pandemic, from April 2019 to December 2022. Sentiment analysis was performed using the XLM-RoBERTa-base model, and topic modeling was conducted using the BERTopic library.

RESULTS

The analysis revealed that tweets regarding obesity were predominantly negative. Spikes in Twitter activity correlated with significant political events, such as the exchange of obesity-related comments between US politicians and criticism of the United Kingdom's obesity campaign. Topic modeling identified 243 clusters representing various obesity-related topics, such as childhood obesity; the US President's obesity struggle; COVID-19 vaccinations; the UK government's obesity campaign; body shaming; racism and high obesity rates among Black American people; smoking, substance abuse, and alcohol consumption among people with obesity; environmental risk factors; and surgical treatments.

CONCLUSIONS

Twitter serves as a valuable source for understanding obesity-related sentiments and attitudes among the public, celebrities, and influential organizations. Sentiments regarding obesity were predominantly negative. Negative portrayals of obesity by influential politicians and celebrities were shown to contribute to negative public sentiments, which can have adverse effects on public health. It is essential for public figures to be mindful of their impact on public opinion and the potential consequences of their statements.

ACTION Teens Saudi Arabia: Perceptions, attitudes, motivators, and barriers among adolescents living with obesity, caregivers, and healthcare professionals in Saudi Arabia

Obesity is predicted to affect approximately one-quarter of children/adolescents in Saudi Arabia by 2030, but there is limited evidence regarding the perceptions, attitudes, behaviours, and barriers to effective obesity care for adolescents living with obesity (ALwO), caregivers of ALwO, and healthcare professionals (HCPs). We report data from 500 ALwO (aged 12-<18 years), 500 caregivers, and 200 HCPs surveyed in Saudi Arabia as part of the global, cross-sectional ACTION Teens study (NCT05013359). Nearly all respondents recognized that obesity has a strong impact on overall health (ALwO 88%; caregivers 85%; HCPs 90%). Most ALwO and caregivers were aware of the ALwO's obesity status (95% and 99%, respectively) and worried about weight impacting the ALwO's future health (both ≥99%), and social media was their most commonly used source of weight-management information (60% and 53%, respectively). Among ALwO and caregivers who had discussed weight with an HCP in the past year, most experienced ≥1 negative feeling following their most recent discussion (61% and 59%, respectively). Although 81% of HCPs felt motivated to help their ALwO patients lose weight, 57% believed weight loss was completely the ALwO's responsibility (compared with only 37% of ALwO and 35% of caregivers). This may reflect the finding that only 24% of HCPs had received advanced training in obesity/weight management after medical school. Overall, while respondents had similar perceptions of the impact of obesity, we found HCPs' attitudes towards weight loss were not aligned with those of ALwO and caregivers, suggesting a need for improved communication and obesity education.

A growth curve model to estimate longitudinal effects of parental BMI on Indonesian children's growth patterns

The global surge in childhood obesity is also evident in Indonesia. Parental body mass index (BMI) values were found to be one of the major determinants of the increasing prevalence of childhood obesity. It is uncertain if parental BMI during their offspring's childhood significantly affects their children's BMI trajectories into adulthood. We aimed to investigate the influence of parental BMI Z-scores on BMI trajectories of Indonesian school-aged children, with a focus on sex-specific effects. This study utilized data from the Indonesian Family Life Survey and tracked the same respondents over four time points, from wave 2 (1997-1998) to wave 5 (2014-2015). The sample of this study consisted of children aged 5-12 years in wave 2 for whom height and weight data were available. We utilized a two-level growth curve model to account for the hierarchical structure of the data, with time nested within individual children. Fathers' BMI Z-scores in wave 2 had a pronounced influence (β = 0.31) on female children's BMI Z-scores compared to the influence of mothers' BMI Z-scores (β = 0.17). Mothers' BMI Z-scores in wave 2 showed a stronger positive association with male children's BMI Z-scores (β = 0.22) than did the father's BMI Z-scores (β = 0.19). A significant interaction of fathers' BMI Z-scores and years of follow-up was found for male children. As male children's BMI Z-scores increased by year, this effect was stronger in those whose fathers' BMI Z-scores were at a higher level. In conclusion, we found that parental BMI values profoundly influenced their children's BMI trajectories.

Circulating miRNAs as Biomarkers of Subclinical Atherosclerosis Associated with Severe Obesity before and after Bariatric Surgery

INTRODUCTION

Severe obesity results in high cardiovascular risk (CVR), increasing morbidity, and mortality. New and improved methods are needed to detect cardiovascular diseases rapidly in severe obesity. microRNAs (miRNAs) has shown promise as diagnostic tools. This study aimed to identify plasma miRNAs useful as biomarkers of CVR in people with severe obesity.

METHODS

The study included 66 people with severe obesity classified in groups with atheroma (n = 32) and free of plaques (n = 34). Plasma samples were collected 1 month before bariatric surgery and at 6 and 12 months of follow-up. Participants were screened for the levels of 188 miRNAs, and 24 promising candidates were individually validated by quantitative polymerase chain reaction.

RESULTS

After validation, 5 of the 24 miRNAs showed significant differences over time in both groups: miR-375 increased after bariatric surgery, whereas miR-144-5p, miR-20a-3p, miR-145-5p, and miR-21-3p exhibited decreased expression after bariatric surgery. The expression of 3 of the 24 miRNAs also differed between patients with and without atheroma: subjects with plaque had lower miR-126 but higher miR-21-3p and miR-133a-3p. Only miR-133a-3p exhibited exceptional discriminatory ability between subjects with and without plaque (area under the curve, 0.90; 95% confidence interval, 0.81-0.99).

CONCLUSION

A specific signature of c-miRNA comprising miR-375, miR-144-5p, miR-20a-3p, miR-145-5p, and miR-21-3p may facilitate CVR monitoring after bariatric surgery. Furthermore, miR-21-3p, miR-126-3p, and miR-133a-3p show potential as specific biomarkers for subclinical atherosclerosis, with miR-133a-3p potentially able to diagnose subclinical atherosclerosis early in severe obesity.

Association of obesity to reaction time and visual memory in schizophrenia

Background

Both overweight and cognitive deficits are common among people with schizophrenia (SZ) and schizoaffective disorder. The results in earlier studies have been inconsistent on whether overweight is associated with cognitive deficits in psychotic disorders.

Aims

Our aim in this study was to detect possible associations between obesity and cognitive deficits among study participants with SZ and schizoaffective disorder.

Methods

The study sample included 5382 participants with a clinical diagnosis of SZ or schizoaffective disorder selected from the Finnish SUPER study. Obesity was measured both with body-mass index and waist circumference. The cognitive performance was evaluated with two tests from the Cambridge automated neuropsychological test battery: Reaction time was evaluated with the 5-choice serial reaction time task. Visual memory was evaluated with the paired associative learning test. The final analysis included a total sample of 4498 participants applicable for the analysis of the reaction time and 3967 participants for the analysis of the visual memory.

Results

Obesity measured with body-mass index was associated with better performance in reaction time task among both female and male participants. Among male participants, overweight was associated with better performance in the visual memory test. The waist circumference was not associated with cognitive measures.

Conclusions

The results suggest that obesity in people with SZ or schizoaffective disorder might not be associated with cognitive deficits but instead with better cognitive performance. The results were opposite from earlier literature on the general population. More research is required to better understand whether the results might be partly caused by the differences in the etiology of obesity between the general population and people with SZ.

The Impact of Negative Emotional Dysregulation on the Outcome of Bariatric Surgery in Patients with Severe Obesity: An Observational One-Year Follow-Up Study

Background: Psychiatric symptoms are highly prevalent in patients with severe obesity, often representing pivotal factors in the development and progression of this condition. This study examines the association between negative emotional dysregulation (NED) and weight loss following bariatric surgery. Methods: Ninety-nine patients were consecutively enrolled at the Obesity Center of the Pisa University Hospital between March 2019 and February 2021, during a routine psychiatric evaluation before bariatric surgery. Psychopathological dimensions were assessed using the Mini-International Neuropsychiatric Interview (MINI), the Reactivity, Intensity, Polarity, and Stability questionnaire in its 40-item version (RIPoSt-40), the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) and the Barratt Impulsiveness Scale (BIS-11). Based on a RIPoSt-40 cut-off score of 70, subjects were divided into two groups: with (NED+) and without (NED-) NED. Results: NED+ subjects had a higher rate of psychiatric comorbidities and eating disorders than NED- patients. Of the total sample, 76 underwent bariatric surgery, and 65 of them were re-evaluated one-year after surgery. Among them, 10 of 28 NED+ subjects (37.5%) had inadequate weight loss one year after surgery compared to 5 of 37 NED- subjects (13.5%) (p = 0.035, OR 3.55, 95%, C.I. 1.05-12.03). Conclusions: Our results suggest a significant association between NED and inadequate weight loss at one-year post surgery.

C-peptide: an essential ally in microvascular complications of type 2 diabetes mellitus and obesity

BACKGROUND

In order to investigate microvascular complications in metabolic diseases, we aimed to investigate cerebral and peripheral microcirculation in relation to peripheral neuropathy and laboratory biomarkers in type 2 diabetes mellitus (T2DM) and obesity.

METHODS

Based on the degree of neuropathy (NP), study participants (40 T2DM and 30 obese individuals) were classified into no-NP, mild-NP and severe-NP subgroups. After the injection of Technetium-99 m hexamethylpropylene amine oxime, both T2DM and obese participants underwent single-photon emission computed tomography/computed tomography ([99mTc]Tc-HMPAO SPECT/CT) and SPECT-only examinations to assess lower limb and brain perfusion; respectively. Peripheral nerve function was evaluated with a neurometer and glycaemic markers were measured from plasma in both groups.

RESULTS

Compared to the obese individuals, lower extremity perfusion was significantly reduced in the diabetic subjects (p < 0.005), while it showed a positive correlation with C-peptide levels and negative association with HbA1c values. A U-shape pattern of peripheral microcirculation was observed between the NP groups, indicating a surprisingly better perfusion in the severe-NP group than in the mild one, with the highest levels in obese patients. Since changes in the C-peptide levels exhibited a similar U-shaped trend across the NP subgroups, we suggest a positive correlation between C-peptide levels and the extent of peripheral perfusion. Although, C-peptide values and cerebral microcirculation correlated positively (rho = 0.27), brain perfusion did not show any differences neither between the diabetic and the obese patients, nor between the NP subgroups (at p < 0.05).

CONCLUSIONS

Establishing the link between neuropathy and peripheral microcirculation, C-peptide seems to be a promising biomarker for the prediction of microvascular alterations in metabolic diseases. Of note, the dominance of metabolic factors over microvascular damage in the development of obesity-related neuropathy should be emphasized as well.

Is oxidative stress - antioxidants imbalance the physiopathogenic core in pediatric obesity?

Despite the early recognition of obesity as an epidemic with global implications, research on its pathogenesis and therapeutic approach is still on the rise. The literature of the 21st century records an excess weight found in up to 1/3 of children. Both the determining factors and its systemic effects are multiple and variable. Regarding its involvement in the potentiation of cardio-vascular, pulmonary, digestive, metabolic, neuro-psychic or even dermatological diseases, the information is already broadly outlined. The connection between the underlying disease and the associated comorbidities seems to be partially attributable to oxidative stress. In addition to these, and in the light of the recent COVID-19 pandemic, the role played by oxidative stress in the induction, maintenance and potentiation of chronic inflammation among overweight children and adolescents becomes a topic of interest again. Thus, this review's purpose is to update general data on obesity, with an emphasis on the physiopathological mechanisms that underlie it and involve oxidative stress. At the same time, we briefly present the latest principles of pathology diagnosis and management. Among these, we will mainly emphasize the impact played by endogenous and exogenous antioxidants in the evolutionary course of pediatric obesity. In order to achieve our objectives, we will refer to the most recent studies published in the specialized literature.

Measuring Overweight and Obesity in Persons with Spinal Cord Injury: What Do Health Providers Use and What are the Challenges?

INTRODUCTION

Obesity is a significant health concern for veterans and individuals with spinal cord injury, yet screening for overweight/obesity can be challenging. This study examines how healthcare providers screen for overweight/obesity and the challenges encountered in identifying overweight/obesity in veterans and persons with spinal cord injury.

MATERIALS AND METHODS

Healthcare providers who provide care for persons with spinal cord injury completed a semi-structured interview. The interview explored their perspectives on measuring overweight/obesity in persons with spinal cord injury and the challenges they faced. Thematic analysis was used to identify themes that emerged from the interviews.

RESULTS

Twenty-five providers (88% female with an average experience of 9.6 ± 7.3 years in providing care for spinal cord injury patients) participated in the interviews. The themes described the health indicators and equipment used to assess overweight/obesity, provider concerns regarding measurement, and criteria for classifying overweight/obesity. Body weight and body mass index were the most commonly used indicators. However, concerns were raised regarding accuracy of these measures for spinal cord injury patients, as well as issues related to the accessibility, calibration, and usability of the equipment. Many providers reported using standard body mass index ranges and categories instead of those specific to spinal cord injury.

CONCLUSION

This study identified the most commonly used indicators of weight or body composition in veterans and persons with spinal cord injury and highlighted providers' concerns with these measures. Future research is needed to identify the most feasible, accurate, and appropriate health indicators that could be used in a clinical setting to identify overweight and obesity in this population.

Changes in Obesity Prevalence Among U.S. Adults After the COVID-19 Pandemic by State and Territorial Stay-at-Home Order Level and Sociodemographic Characteristics

PURPOSE

To examine changes in obesity prevalence among US adults after the COVID-19 pandemic by level of stay-at-home order and sociodemographic characteristics.

DESIGN

Quasi-experimental study using repeated cross-sectional data.

SETTING

Behavioral Risk Factor Surveillance System (BRFSS).

SAMPLE

Pooled data for US adults ages ≥26 years (n = 1,107,673) from BRFSS (2018-2021).

MEASURES

States/territories were classified into three levels of stay-at-home order: none, advisory/only for persons at risk, or mandatory for all. Individual-level sociodemographic characteristics were self-reported.

ANALYSIS

The difference-in-differences method was conducted with weighted multiple logistic regression analysis to examine obesity (body mass index ≥30 kg/m2) prevalence by stay-at-home order level and sociodemographic characteristics before/after the COVID-19 pandemic (January 2018-February 2020 vs March 2020-February 2022).

RESULTS

After adjusting for a secular trend and multiple covariates, adults in states/territories with mandatory stay-at-home orders experienced a larger increase in obesity prevalence (adjusted odds ratio: 1.05; 95% confidence interval: 1.01, 1.11) than adults in states/territories with no stay-at-home order. Younger adults (vs ≥65 years) and individuals with

CONCLUSION

Increases in obesity prevalence were perpetuated 2 years after implementation of stay-at-home orders, indicating that longer-term health implications are co-occurring during the pandemic recovery period. Future research should focus on successful methods for staying active and healthy during social distancing and beyond.

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Key Words

• COVID-19
• age
• education
• health policy
• obesity
• sociodemographic characteristic
• stay-at-home order

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MESH Headings

• Humans
• COVID-19/epidemiology
• Obesity/epidemiology
• Male
• United States/epidemiology
• Female
• Prevalence
• Adult
• Middle Aged
• Cross-Sectional Studies
• Behavioral Risk Factor Surveillance System
• Sociodemographic Factors
• Aged
• SARS-CoV-2
• Socioeconomic Factors
• Pandemics
• Young Adult

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Affiliation(s)

Beomyoung Cho Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
Yining Pan Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
McKinley Chapman Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
Aaron Spaulding Division of Health Care Delivery Research, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
Sericea Stallings-Smith Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA

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Genetic association of FTO gene polymorphisms with obesity and its related phenotypes: A case-control study

Introduction

FTO gene belongs to the non-heme Fe (II) and 2 oxoglutarate-dependent dioxygenase superfamily. Polymorphisms within the first intron of the FTO gene have been examined across various populations, yielding disparate findings.The present study aimed to determine the impact of two intronic polymorphisms FTO 30685T/G (rs17817449) and -23525T/A (rs9939609) on the risk of obesity in Punjab, India.

Methods

Genotypic and biochemical analysis were done for 671 unrelated participants (obese=333 and non-obese=338) (age≥18 years). Genotyping of the polymorphisms was done by PCR-RFLP method. However, 50% of the samples were sequenced by Sanger sequencing.

Results

Both the FTO variants 30685 (TT vs GG: odds ratio (OR), 2.30; 95% confidence interval (CI), 1.39-3.79) and -23525 (TT vs AA: odds ratio (OR), 2.78; 95% confidence interval (CI), 1.37-5.64) showed substantial risk towards obesity by conferring it 2 times and 3 times, respectively. The analysis by logistic regression showed a significant association for both the variants 30685T/G (rs17817449) and -23525T/A (rs9939609) (OR=2.29; 95%CI: 1.47-3.57) and (OR=5.25; 95% CI: 2.68-10.28) under the recessive genetic model, respectively. The haplotype combination TA (30685; -23525) develops a 4 times risk for obesity (P=0.0001). Among obese, the G allele of 30685T/G and A- allele of -23525T/A showed variance in Body mass index (BMI), waist circumference (WC), waist-to-height ratio(WHtR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and triglyceride(TG).

Conclusion

The present investigation indicated that both the FTO 30685T/G (rs17817449) and -23525T/A (rs9939609) polymorphisms have a key impact on an individual's vulnerability to obesity in this population.

Relationship between the level of physical activity and body mass index to blood pressure among overweight and obese young adults in the Northern Emirates city: A cross-sectional study

BACKGROUND

Obesity affects both adults and children all over the world and it is a major causative factor for diabetes, cardiovascular disease, different types of cancer, and even death. Therefore, this study aimed to assess the level of PA and BMI to the risk of developing high BP among overweight and obese young adults.

METHODOLOGY

A cross-sectional study was carried out in the Thumbay Medi-city Northern Emirates, Ajman, UAE. Participants enrolled in the study under the convenient sampling method and inclusion criteria: young overweight and obese individuals, male and female, aged between 18 to 30 years. Approval was obtained from the Institutional Review Board (CoHS, GMU (IRB-COHS-STD-110-JUNE-2023). The blood pressure and body mass index were clinically measured using standard tools whereas the GPAQ questionnaire was used to determine the level of physical activity of all participants.

RESULTS

Out of 206 participants, 139 were overweight and 67 were obese. Further, 89 were found to have high normal BP, 93 normal BP, and 24 were found to have optimal blood pressure. The mean GPA scores were 322.8±62.28 in overweight individuals and 301.17±49.05 in obese individuals. Furthermore, among overweight and obese participants there is a weak correlation between PA & BMI (r = 0.06, p = 0.88) and (r = 0.15, p = 0.44) and the BP and BMI (r = 0.18, p = 1.02) and (r = 0.16, p = 0.90) were found.

CONCLUSION

Although PA, BMI, and BP are assumed to be related variables leading to various non-communicable diseases the present study showed a weak correlation between the level of PA and BMI to the risk of developing BP among overweight and obese young adults in the Northern Emirates.

Associations of role, area deprivation index, and race with health behaviors and body mass index among localized prostate cancer patients and their partners

PURPOSE

To examine the associations of role (localized prostate cancer (PCa) patient vs. their intimate partner), area deprivation index (ADI-higher scores indicating higher neighborhood deprivation levels), and race (Black/African American (AA) vs. White) with health behaviors and body mass index (BMI) among PCa patients and partners. The behaviors include smoking, alcohol consumption, diet quality, sedentary behaviors, and physical activity (PA).

METHODS

This study used the baseline data collected in a clinical trial. Given the nested structure of the dyadic data, multi-level models were used.

RESULTS

Significant role-race interaction effects on smoking, ADI-race effects on alcohol consumption, and role-ADI effects on BMI were found. Meanwhile, patients smoked more cigarettes, decreased alcohol consumption, had less healthful diets, spent longer time watching TV, did fewer sedentary hobbies, had more confidence in PA, and had higher BMIs than their partners. High ADI was independently associated with lower odds of drinking alcohol, using computer/Internet, and doing non-walking PA, and higher BMI compared to low ADI controlling for role and race. Black/AA dyads had less smoking amount and alcohol consumption and higher sedentary time and BMI than White dyads when adjusted for role and ADI.

CONCLUSIONS

This study identified significant interaction and main effects of role, ADI, or race on health behaviors and BMI.

IMPLICATIONS FOR CANCER SURVIVORS

Future behavioral interventions should address divergent individual needs between patients and partners, social and neighborhood barriers, and cultural indicators of racial groups to promote healthful behaviors and improve the quality of survivorship for PCa patients and partners.

The Assessment of the Nutritional Status among the Young-Old and Old-Old Population with Alimentary-Dependent Diseases

Background and Objectives: Unhealthy nutrition can contribute to the development or progression of various alimentary-dependent diseases, including obesity, type 2 diabetes mellitus, metabolic syndrome, anaemia, and arterial hypertension. Young-old and old-old individuals often have diets deficient in essential vitamins, minerals, and macronutrients, characterized by high consumption of carbohydrate-rich foods and insufficient intake of plant-based products like vegetables and fruits. This study aims to identify key parameters of nutritional status among the young-old (aged 60-74 years) and old-old (aged 75-90 years) populations in central Kazakhstan, particularly in relation to specific alimentary-dependent diseases. Materials and Methods: The study involved 300 participants aged 60-90 years. The study incorporated a dietary questionnaire, food consumption records (such as 24 h recalls), and measurements of anthropometric indicators including weight and skinfold measurements. Results: Residents in the surveyed regions typically consumed food 3-4 times daily, with breakfast, lunch, and dinner being eaten at consistent times. A significant proportion of individuals, especially older adults, followed this meal schedule. About one-third ate before bedtime, and more than half believed they adhere to a specific diet. The mean BMI for men aged 60-74 years was 28.3 (95% CI: 20.1-43.2) and, for those aged 75-90 years, it was 29.0 (95% CI: 22.1-40.8). Caloric intake among individuals aged 60-74 was higher compared to those aged 75-90, with males consuming an average of 2372.7 kcal and females consuming 2236.78 kcal versus 2101.5 kcal for males and 2099.9 kcal for females in the older age group. Conclusions: The dietary patterns observed among old-old individuals were marked by excessive calorie intakes and imbalances in macronutrient composition, with a predominant emphasis on high-carbohydrate foods at the expense of essential nutrients like proteins, fats, and key vitamins (such as C, E, B vitamins) and minerals (such as potassium, calcium, and iron).

Living with obesity in Ireland: determinants, policy and future perspectives

Globally, the prevalence of those living with obesity (≥30 kg/m2) is rising, with this trend expected to continue if firm and decisive policy interventions are not introduced. Across Europe, despite many consecutive policies aiming to reverse rising trends in weight status over recent decades, no country is currently on track to halt and reverse current trends in the coming years. This is evident in Ireland too, whereby the reporting of nationally representative weight status data show that targets have not been achieved since reporting began. The aim of this review is to critically appraise recent evidence relating to the key determinants of obesity including weight status, diet quality and physical activity with an emphasis on socioeconomic inequalities. And to consider these in the context of respective policy measures and propose future-focused recommendations. Furthermore, as with the complex nature of obesity, multifaceted approaches that shift the focus from the individual and place responsibility at a societal level will be reviewed.

Interleukin-27 is positively correlated with obesity and a decrease in insulin resistance after weight loss

OBJECTIVE

Interleukin-27 (IL-27), a potential mediator linking obesity to inflammatory diseases, is considered an important candidate for regulating obesity. The present study evaluated the relationship of IL-27 with obesity and insulin resistance (IR) and further investigated the changes in IL-27 levels after weight loss.

METHODS

The study analyzed 405 participants, of whom 62 with overweight or obesity completed one year of lifestyle intervention. The body compositions, including percent of body fat (PBF), visceral fat area (VFA), skeletal muscle mass (SMM), and visceral fat area to skeletal muscle mass ratio (VSR), were assessed using the bioelectrical impedance analysis method. Serum IL-27 levels were measured using the enzyme-linked immunosorbent assay (ELISA).

RESULTS

IL-27 levels increased significantly with the increase in body mass index (BMI) (P < 0.001). Moreover, IL-27 levels were positively correlated with PBF, VFA, and VSR. Homeostatic model assessment for insulin resistance (HOMA-IR), the inverse of hepatic insulin sensitivity (1/HISI), adipose tissue insulin resistance (Adipo-IR), and homeostasis model assessment-adiponectin (HOMA-AD) increased significantly with each quartile of IL-27 levels (all P < 0.001). IL-27 levels significantly decreased after weight loss (P < 0.001).

CONCLUSIONS

IL-27 was positively correlated with obesity, HOMA-IR, 1/HISI, Adipo-IR, and HOMA-AD. IL-27 levels significantly decreased after weight loss.

EGR3 reduces podocyte inflammatory damage in obesity related glomerulopathy by inhibiting the PRMT1pSTAT3 pathway

OBJECTIVES

Obesity related glomerulopathy (ORG) is induced by obesity, but the pathogenesis remains unclear. This study aims to investigate the expression of early growth response protein 3 (EGR3) in the renal cortex tissues of ORG patients and high-fat diet-induced obese mice, and to further explore the molecular mechanism of EGR3 in inhibiting palmitic acid (PA) induced human podocyte inflammatory damage.

METHODS

Renal cortex tissues were collected from ORG patients (n=6) who have been excluded from kidney damage caused by other diseases and confirmed by histopathology, and from obese mice induced by high-fat diet (n=10). Human and mouse podocytes were intervened with 150 μmol/L PA for 48 hours. EGR3 was overexpressed or silenced in human podocytes. Enzyme linked immunosorbent assay (ELISA) was used to detcet the levels of interleukin-6 (IL-6) and interleukin-1β (IL-1β). Real-time RT-PCR was used to detect the mRNA expressions of EGR3, podocytes molecular markers nephrosis 1 (NPHS1), nephrosis 2 (NPHS2), podocalyxin (PODXL), and podoplanin (PDPN). RNA-seq was performed to detect differentially expressed genes (DEGs) after human podocytes overexpressing EGR3 and treated with 150 μmol/L PA compared with the control group. Co-immunoprecipitation (Co-IP) combined with liquid chromatography tandem mass spectrometry (LC-MS) was used to detect potential interacting proteins of EGR3 and the intersected with the RNA-seq results. Co-IP confirmed the interaction between EGR3 and protein arginine methyltransferases 1 (PRMT1), after silencing EGR3 and PRMT1 inhibitor intervention, the secretion of IL-6 and IL-1β in PA-induced podocytes was detected. Western blotting was used to detect the expression of phosphorylated signal transducer and activator of transcription 3 (p-STAT3) after overexpression or silencing of EGR3.

RESULTS

EGR3 was significantly upregulated in renal cortex tissues of ORG patients and high-fat diet-induced obese mice (both P<0.01). In addition, after treating with 150 μmol/L PA for 48 hours, the expression of EGR3 in human and mouse podocytes was significantly upregulated (both P<0.05). Overexpression or silencing of EGR3 in human podocytes inhibited or promoted the secretion of IL-6 and IL-1β in the cell culture supernatant after PA intervention, respectively, and upregulated or downregulated the expression of NPHS1, PODXL, NPHS2,and PDPN (all P<0.05). RNA-seq showed a total of 988 DEGs, and Co-IP+LC-MS identified a total of 238 proteins that may interact with EGR3. Co-IP confirmed that PRMT1 was an interacting protein with EGR3. Furthermore, PRMT1 inhibitors could partially reduce PA-induced IL-6 and IL-1β secretion after EGR3 silencing in human podocytes (both P<0.05). Overexpression or silencing of EGR3 negatively regulated the expression of PRMT1 and p-STAT3.

CONCLUSIONS

EGR3 may reduce ORG podocyte inflammatory damage by inhibiting the PRMT1/p-STAT3 pathway.

Physiopathology and Treatment of Obesity and Overweight: A Proposal for a New Anorectic

The "new epidemic," as WHO calls obesity, is caused by overeating, which, having exceeded the body's actual needs, accumulates in the form of health-damaging fat deposits. Moving more and eating less is the main remedy, but eating belongs to vital instincts, which are beyond the control of reason. In this sense, eating is different from drinking and breathing because without food it is possible to survive for a few weeks, without water for a few days, without oxygen for a few minutes. The first part of this article provides an overview of obesity and its treatment, focusing on the new anorectic anticipated in the title. The second part focuses on compulsive obesity, typically represented by constitutional obesity and food addiction. The article concludes with a discussion of the pharmacological treatment of compulsive diseases, to which some forms of obesity belong.

Role of Leptin in Obesity, Cardiovascular Disease, and Type 2 Diabetes

Diabetes mellitus (DM) is a highly prevalent disease worldwide, estimated to affect 1 in every 11 adults; among them, 90-95% of cases are type 2 diabetes mellitus. This is partly attributed to the surge in the prevalence of obesity, which has reached epidemic proportions since 2008. In these patients, cardiovascular (CV) risk stands as the primary cause of morbidity and mortality, placing a substantial burden on healthcare systems due to the potential for macrovascular and microvascular complications. In this context, leptin, an adipocyte-derived hormone, plays a fundamental role. This hormone is essential for regulating the cellular metabolism and energy balance, controlling inflammatory responses, and maintaining CV system homeostasis. Thus, leptin resistance not only contributes to weight gain but may also lead to increased cardiac inflammation, greater fibrosis, hypertension, and impairment of the cardiac metabolism. Understanding the relationship between leptin resistance and CV risk in obese individuals with type 2 DM (T2DM) could improve the management and prevention of this complication. Therefore, in this narrative review, we will discuss the evidence linking leptin with the presence, severity, and/or prognosis of obesity and T2DM regarding CV disease, aiming to shed light on the potential implications for better management and preventive strategies.

Pharmacist-led biometric screenings: A retrospective chart review in a community pharmacy

BACKGROUND

Biometric screenings have gained popularity in employer-based wellness programs and are increasingly offered at community pharmacies.

OBJECTIVE

This study aimed to analyze biometric screening data collected at a community pharmacy in North Alabama to examine the prevalence of risk factors and the role of pharmacist-led screenings in identifying at-risk individuals and facilitating referrals to primary care providers.

METHODS

A retrospective chart review was conducted using biometric screening data collected between 2020 and 2021. Descriptive statistics were calculated to analyze the data.

RESULTS

A total of 801 patients were included in the analysis. The mean age was 45.4 years, and 56.2 % were female. The mean systolic blood pressure was 132 mmHg, and the mean diastolic blood pressure was 84 mmHg. Mean total cholesterol was 174 mg/dL, and the mean blood glucose was 109 mg/dL. Mean BMI was 35.1 kg/m2. Among the screened patients, 22.5 % were referred to a primary care provider due to an elevated level of at least one of the measured variables, with BMI being the most common reason for referral.

CONCLUSION

This study provides valuable insights into the prevalence of risk factors in a population undergoing pharmacist-led biometric screenings in a community pharmacy. The findings emphasize the important role of pharmacists in identifying at-risk individuals and facilitating appropriate referrals to primary care. Further research is needed to evaluate the long-term impact of these referrals and explore the feasibility of similar programs in diverse healthcare settings.

Understanding Obesity in African American Women Using Leininger's Theory

In the United States, African American (AA) women suffer from higher rates of obesity as compared with Caucasians or Asians. Unfortunately, most weight management interventions have been unsuccessful in maintaining weight loss. Prior research has revealed that AA women face unique barriers in managing obesity; therefore, more research is warranted to address this problem. Leininger's theory is used to understand obesity through a cultural lens. The constructs of the sunrise model are defined as a means to intervene when providing nursing care through cultural preservation, accommodation, and repatterning. We conclude that culture care theory offers a theoretical framework to assist nurses in providing culturally sensitive care to Black women with obesity. Nurses caring for this population can utilize this theory to tailor interventions specific to the cultural needs of women to improve outcomes in the management of obesity. In this article, we use AA and Black interchangeably to represent Americans whose ancestors originate from Africa.

Tirzepatide reduces the predicted risk of atherosclerotic cardiovascular disease and improves cardiometabolic risk factors in adults with obesity or overweight: SURMOUNT-1 post hoc analysis

AIM

To assess the effect of tirzepatide on long-term risk of atherosclerotic cardiovascular disease (ASCVD) among people with obesity or overweight without diabetes from SURMOUNT-1.

MATERIALS AND METHODS

SURMOUNT-1, a phase 3 trial, evaluated the efficacy and safety of tirzepatide in adults with body mass index ≥30 or ≥27 kg/m2 and at least one weight-related complication, excluding diabetes. Participants were randomly assigned to tirzepatide (5/10/15 mg) or placebo. Changes from baseline in cardiometabolic variables were assessed. The predicted 10-year ASCVD risk scores were calculated (American College of Cardiology/American Heart Association risk engine) at baseline, week 24, and week 72 in SURMOUNT-1 participants without a history of ASCVD. Percent change in risk scores from baseline to weeks 24 and 72 was compared between tirzepatide and placebo using mixed model for repeated measures analysis. Analyses were also conducted in participants with intermediate to high risk at baseline.

RESULTS

Tirzepatide-treated groups demonstrated reductions in cardiometabolic variables over 72 weeks. In participants without a history of ASCVD (N = 2461), the baseline median risk score was low and did not differ across groups (1.5%-1.6%). Relative change in risk from baseline to week 72 was greater for tirzepatide (-23.5% to -16.4%) than placebo (12.7%; P < 0.001). Relative change among participants with intermediate-to-high baseline risk was significantly greater for tirzepatide (P < 0.05). Intermediate-to-high-risk participants demonstrated similar relative change but greater absolute risk reduction compared to the overall population.

CONCLUSION

Tirzepatide treatment significantly reduced the 10-year predicted risk of ASCVD versus placebo in patients with obesity or overweight without diabetes.

Identification and analysis of key genes in adipose tissue for human obesity based on bioinformatics

BACKGROUND

Obesity is a complex condition that is affected by a variety of factors, including the environment, behavior, and genetics. However, the genetic mechanisms underlying obesity remains poorly elucidated. Therefore, our study aimed at identifying key genes for human obesity using bioinformatics analysis.

METHODS

The microarray datasets of adipose tissue in humans were downloaded from the Gene Expression Omnibus (GEO) database. After the selection of differentially expressed genes (DEGs), we used Lasso regression and Support Vector Machine (SVM) algorithm to further identify the feature genes. Moreover, immune cell infiltration analysis, gene set variation analysis (GSVA), GeneCards database and transcriptional regulation analysis were conducted to study the potential mechanisms by which the feature genes may impact obesity. We utilized receiver operating characteristic (ROC) curve to analysis the diagnostic efficacy of feature genes. Finally, we verified the feature genes in cell experiments and animal experiments. The statistical analyses in validation experiments were conducted using SPSS version 28.0, and the graph were generated using GraphPad Prism 9.0 software. The bioinformatics analyses were conducted using R language (version 4.2.2), with a significance threshold of p < 0.05 used.

RESULTS

199 DEGs were selected using Limma package, and subsequently, 5 feature genes (EGR2, NPY1R, GREM1, BMP3 and COL8A1) were selected through Lasso regression and SVM algorithm. Through various bioinformatics analyses, we found some signaling pathways by which feature genes influence obesity and also revealed the crucial role of these genes in the immune microenvironment, as well as their strong correlations with obesity-related genes. Additionally, ROC curve showed that all the feature genes had good predictive and diagnostic efficiency in obesity. Finally, after validation through in vitro experiments, EGR2, NPY1R and GREM1 were identified as the key genes.

CONCLUSIONS

This study identified EGR2, GREM1 and NPY1R as the potential key genes and potential diagnostic biomarkers for obesity in humans. Moreover, EGR2 was discovered as a key gene for obesity in human adipose tissue for the first time, which may provide novel targets for diagnosing and treating obesity.

L-carnitine and Acetyl-L Carnitine: A Possibility for Treating Alterations Induced by Obesity in the Central Nervous System

Excessive consumption of nutrients, as well as obesity, leads to an inflammatory process, especially in adipose tissue. This inflammation reaches the systemic level and, subsequently, the central nervous system (CNS), which can lead to oxidative stress and mitochondrial dysfunction, resulting in brain damage. Thus, adequate treatment for obesity is necessary, including lifestyle changes (diet adequation and physical activity) and pharmacotherapy. However, these drugs can adversely affect the individual's health. In this sense, searching for new therapeutic alternatives for reestablishing metabolic homeostasis is necessary. L-carnitine (LC) and acetyl-L-carnitine (LAC) have neuroprotective effects against oxidative stress and mitochondrial dysfunction in several conditions, including obesity. Therefore, this study aimed to conduct a narrative review of the literature on the effect of LC and LAC on brain damage caused by obesity, in particular, on mitochondrial dysfunction and oxidative stress. Overall, these findings highlight that LC and LAC may be a promising treatment for recovering REDOX status and mitochondrial dysfunction in the CNS in obesity. Future work should focus on better elucidating the molecular mechanisms behind this treatment.

Scientific and Public Interest in Bariatric Surgery for Obesity: The Italian Scenario

Background: Obesity is an escalating concern in our society. Bariatric surgery appears to be the only feasible alternative for severe obesity. This study aims to conduct an integrative analysis of the Italian context concerning bariatric surgery, with a specific focus on the surgical procedures of sleeve gastrectomy, mini-gastric bypass, and gastric bypass. Methods: The analysis is based on bibliometric data extracted from the Scopus database to find Italian publications in this field from 2012 to 2022. Along with scientific interest, it is essential to assess the level of public interest in these topics. Google Trends is the most extensively utilized free tool for the analysis of online behavior. Using Google Trends data, we analyzed the amount of internet volume searches (Relative Search Volume = RSV) for the Italian terms “sleeve gastrectomy”, “mini-gastric bypass” and “gastric bypass”, both temporally (from 2012 to 2022 years) and geographically. Furthermore, to illustrate the Italian landscape, we compared Google Trends data with data from the Italian registry “Società Italiana di Chirurgia dell’Obesità e delle malattie metaboliche” (SICOB), which includes information about bariatric surgery procedures performed in the country. Results: Over the past decade, there has been a significant increase in the scientific literature on sleeve gastrectomy, mini-gastric bypass, and gastric bypass surgeries in Italy. Google Trends data has shown an increase in online public interest in these surgical procedures, from 2012 to 2022. The examination of the Google Trends information combined with the SICOB data demonstrated a remarkable association between the two data sets. Conclusions: Bariatric surgery has increased quickly in Italy in terms of scientific research and surgical interventions. The analysis of Google Trends data in conjunction with data from SICOB has revealed an interesting correlation between the two datasets therefore, Google Trends can be useful for estimating the demand for bariatric surgical procedures.

Nutrition, DNA methylation and obesity across life stages and generations

Obesity is a complex multifactorial condition that often manifests in early life with a lifelong burden on metabolic health. Diet, including pre-pregnancy maternal diet, in utero nutrition and dietary patterns in early and late life, can shape obesity development. Growing evidence suggests that epigenetic modifications, specifically DNA methylation, might mediate or accompany these effects across life stages and generations. By reviewing human observational and intervention studies conducted over the past 10 years, this work provides a comprehensive overview of the evidence linking nutrition to DNA methylation and its association with obesity across different age periods, spanning from preconception to adulthood and identify future research directions in the field.

Mental Health Variables Impact Weight Loss, Especially in Patients with Obesity and Binge Eating: A Mediation Model on the Role of Eating Disorder Pathology

BACKGROUND

Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI).

METHODS

General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without.

RESULTS

In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect.

DISCUSSION

Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.

A Balanced Dietary Ratio of n-6:n-3 Polyunsaturated Fatty Acids Exerts an Effect on Total Fatty Acid Profile in RBCs and Inflammatory Markers in Subjects with Obesity

The n-3 polyunsaturated fatty acids (PUFAs) can reduce inflammatory markers and may therefore be useful in obesity management. The aim of this study was to analyze the effect of supplementation with n-3 PUFAs on total fatty acid profile in red blood cells (RBCs), as well as biochemical and inflammatory markers, in subjects with obesity. The study consisted in a randomized placebo-controlled, double-blind clinical trial involving 41 subjects with obesity during a 4-month follow-up. Individuals were randomly assigned to two groups: n-3 PUFA supplementation (1.5 g fish oil) and placebo (1.5 g sunflower oil). Anthropometric, biochemical, dietetic, cytokine and total fatty acid profiles in RBCs were measured. Both groups increased their PUFA intake and DHA incorporation in RBCs. However, the placebo group showed a reduction in serum IL-8 and MCP-1 at the end of the study. A multiple linear regression model adjusted by body fat mass and sex showed that an increase in DHA in RBCs decreased the serum IL-8 levels in both study groups at the end of the study. Our results highlight the role of dietary DHA and n-3 supplementation usefulness in exerting beneficial anti-inflammatory effects.

Management of gastropleural leak by video-assisted thoracoscopy after sleeve gastrectomy

Obesity is a major public health issue with various comorbidities. Sleeve gastrectomy has become a popular treatment for obesity, but it carries the risk of complications, particularly staple line leakage. This case study focused on a 32-year-old woman with grade II obesity and hiatal hernia who underwent laparoscopic sleeve gastrectomy. Four days after surgery, she presented with abdominal pain, revealing leakage from the gastric sleeve into the thoracic cavity. Diagnostic procedures and interventions were performed, including cavity lavage, drainage placement, and stent placement. The patient showed clinical improvement after video-assisted thoracoscopic surgery and a multidisciplinary approach involving nutrition support and antibiotics. Despite the challenges, the patient's clinical course improved, leading to discharge with no evidence of leakage on follow-up endoscopy. Careful monitoring and timely interventions are essential to manage complications in sleeve gastrectomy procedures and ensure optimal patient outcomes.

Dietary Fat Modulation of Gut Microbiota and Impact on Regulatory Pathways Controlling Food Intake

Obesity is a multifactorial disease that continues to increase in prevalence worldwide. Emerging evidence has shown that the development of obesity may be influenced by taxonomic shifts in gut microbiota in response to the consumption of dietary fats. Further, these alterations in gut microbiota have been shown to promote important changes in satiation signals including gut hormones (leptin, ghrelin, GLP-1, peptide YY and CCK) and orexigenic and anorexigenic neuropeptides (AgRP, NPY, POMC, CART) that influence hyperphagia and therefore obesity. In this review, we highlight mechanisms by which gut microbiota can influence these satiation signals both locally in the gastrointestinal tract and via microbiota-gut-brain communication. Then, we describe the effects of dietary interventions and associated changes in gut microbiota on satiety signals through microbiota-dependent mechanisms. Lastly, we present microbiota optimizing therapies including prebiotics, probiotics, synbiotics and weight loss surgery that can help restore beneficial gut microbiota by enhancing satiety signals to reduce hyperphagia and subsequent obesity. Overall, a better understanding of the mechanisms by which dietary fats induce taxonomical shifts in gut microbiota and their impact on satiation signaling pathways will help develop more targeted therapeutic interventions in delaying the onset of obesity and in furthering its treatment.

Acute post sleeve surgery bleeding as rare cause of acute renal failure: a case report

BACKGROUND

Bariatric surgeries have been considered as one of the most important treatment procedures in recent years. Being aware of the side effects of this surgery will lead to better results after the surgery.

CASE PRESENTATION

A 37-year-old Iranian male patient presented one day after sleeve surgery with symptoms of weakness, lethargy, and shortness of breath, which hospitalization and workup to were done to rule out pulmonary embolism. Because of the high creatinine and anuria, we couldn't perform computed tomography angiography. A bedside ultrasound was done for the patient and showed a mild to moderate amount of fluid around the spleen and some blood clots. Due to the progressive clinical findings and suspected internal bleeding, the patient was a candidate for laparoscopic revision procedure. Gradually, after performing the surgery, removing the blood clot and reducing the compressive effect of that on the inferior verna cava which was the main reason of renal failure, the patient was able to urinate afterwards and was discharged in good general condition.

CONCLUSION

Surgeons should be aware of the management of rare surgical complications after bariatric surgeries. To be best of our knowledge, this was the first case report of a patient with acute renal failure after bariatric surgery and the rare cause of clot compression on inferior vena cava and raised abdominal compartment pressure.

Peri-implantitis and systemic inflammation: A critical update

Peri-implantitis is an inflammatory condition induced by bacterial biofilm that affects the soft and hard tissues surrounding dental implants, compromising the success of implant therapy. Recent studies have highlighted the potential links between peri-implant health and systemic inflammation, including uncontrolled diabetes mellitus, psychological stress, cardiovascular disease, obesity, and infectious diseases such as COVID-19. As an inflammatory disease, peri-implantitis may trigger systemic inflammation by elevating circulating levels of pro-inflammatory cytokines, which could have unknown impacts on overall health. While the relationship between periodontal health and systemic conditions is better understood, the association between peri-implant disease and systemic inflammation remains unclear. Therefore, this comprehensive review aims to summarize the most recent evidence on the relationship between peri-implantitis and systemic inflammation, focusing on biological complications, microbiology, and biomarkers. This review aims to enhance our understanding of the links between peri-implantitis and systemic inflammation and promote further research in this field by discussing the latest insights and clinical implications.

Lower abdominal adipose tissue cannabinoid type 1 receptor availability in young men with overweight

OBJECTIVE

Cannabinoid type 1 receptors (CB1R) modulate feeding behavior and energy homeostasis, and the CB1R tone is dysgulated in obesity. This study aimed to investigate CB1R availability in peripheral tissue and brain in young men with overweight versus lean men.

METHODS

Healthy males with high (HR, n = 16) or low (LR, n = 20) obesity risk were studied with fluoride 18-labeled FMPEP-d₂ positron emission tomography to quantify CB1R availability in abdominal adipose tissue, brown adipose tissue, muscle, and brain. Obesity risk was assessed by BMI, physical exercise habits, and familial obesity risk, including parental overweight, obesity, and type 2 diabetes. To assess insulin sensitivity, fluoro-[¹⁸ F]-deoxy-2-D-glucose positron emission tomography during hyperinsulinemic-euglycemic clamp was performed. Serum endocannabinoids were analyzed.

RESULTS

CB1R availability in abdominal adipose tissue was lower in the HR than in the LR group, whereas no difference was found in other tissues. CB1R availability of abdominal adipose tissue and brain correlated positively with insulin sensitivity and negatively with unfavorable lipid profile, BMI, body adiposity, and inflammatory markers. Serum arachidonoyl glycerol concentration was associated with lower CB1R availability of the whole brain, unfavorable lipid profile, and higher serum inflammatory markers.

CONCLUSIONS

The results suggest endocannabinoid dysregulation already in the preobesity state.

Systematic review and meta-analysis of the effectiveness of chatbots on lifestyle behaviours

Chatbots (also known as conversational agents and virtual assistants) offer the potential to deliver healthcare in an efficient, appealing and personalised manner. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of chatbot interventions designed to improve physical activity, diet and sleep. Electronic databases were searched for randomised and non-randomised controlled trials, and pre-post trials that evaluated chatbot interventions targeting physical activity, diet and/or sleep, published before 1 September 2022. Outcomes were total physical activity, steps, moderate-to-vigorous physical activity (MVPA), fruit and vegetable consumption, sleep quality and sleep duration. Standardised mean differences (SMD) were calculated to compare intervention effects. Subgroup analyses were conducted to assess chatbot type, intervention type, duration, output and use of artificial intelligence. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment tool. Nineteen trials were included. Sample sizes ranged between 25-958, and mean participant age ranged between 9-71 years. Most interventions (n = 15, 79%) targeted physical activity, and most trials had a low-quality rating (n = 14, 74%). Meta-analysis results showed significant effects (all p < 0.05) of chatbots for increasing total physical activity (SMD = 0.28 [95% CI = 0.16, 0.40]), daily steps (SMD = 0.28 [95% CI = 0.17, 0.39]), MVPA (SMD = 0.53 [95% CI = 0.24, 0.83]), fruit and vegetable consumption (SMD = 0.59 [95% CI = 0.25, 0.93]), sleep duration (SMD = 0.44 [95% CI = 0.32, 0.55]) and sleep quality (SMD = 0.50 [95% CI = 0.09, 0.90]). Subgroup analyses showed that text-based, and artificial intelligence chatbots were more efficacious than speech/voice chatbots for fruit and vegetable consumption, and multicomponent interventions were more efficacious than chatbot-only interventions for sleep duration and sleep quality (all p < 0.05). Findings from this systematic review and meta-analysis indicate that chatbot interventions are efficacious for increasing physical activity, fruit and vegetable consumption, sleep duration and sleep quality. Chatbot interventions were efficacious across a range of populations and age groups, with both short- and longer-term interventions, and chatbot only and multicomponent interventions being efficacious.

Maternal and perinatal outcomes in women conceiving after bariatric surgery: A cohort study

Obesity in women, a global issue, is being widely managed with bariatric surgery worldwide. According to recommended guidelines, pregnancy should be avoided for 12 to 24 months following surgery due to various risks. We assessed if surgery-to-conception time has a relation with pregnancy outcomes taking into account gestational weight gain. A cohort study between 2015 and 2019 followed-up pregnancies after various types of bariatric surgeries performed (e.g. Roux-en-Y gastric bypass, sleeve gastrectomy, gastric banding, gastric bypass with Roux-en-Y gastroenterostomy) in Tawam Hospital, Al Ain, United Arab Emirates. There were 5 surgery-to-conception groups: <6 months, 6 to 12 months, 13 to 18 months, 19 to 24 months, and >24 months. There were 3 gestational weight gain groups: inadequate, adequate, or excessive (based on the National Academy of Medicine classification). Maternal and neonatal outcomes were compared using analysis of variance and chi-square tests. There were 158 pregnancies. Booking maternal body mass index and weight were higher among mothers who conceived <6 months following surgery (P < .001). Gestational weight gain was not related to the type of bariatric surgery (P = .24), but it was far more often inadequate in mothers who conceived <12 months following surgery (P = .002). Maternal (including pregnancy-induced hypertension and gestational diabetes mellitus) and neonatal outcomes were not statistically significantly associated with surgery-to-conception duration. However, birth weight was lower when gestational weight gain was inadequate (P = .03). There is a negative relationship between shorter bariatric surgery-to-conception interval and gestational weight gain, a feature related to neonatal birth weight. Conception should be delayed to improve pregnancy outcomes following bariatric surgery.

Reduced Striatal Dopamine Transporter Availability and Heightened Response to Natural and Pharmacological Stimulation in CCK-1R-Deficient Obese Rats

Alterations in dopamine neurotransmission are associated with obesity and food preferences. Otsuka Long-Evans Tokushima Fatty (OLETF) rats that lack functional cholecystokinin receptor type-1 (CCK-1R), due to a natural mutation, exhibit impaired satiation, are hyperphagic, and become obese. In addition, compared to lean control Long-Evans Tokushima (LETO) rats, OLETF rats have pronounced avidity for over-consuming palatable sweet solutions, have greater dopamine release to psychostimulants, reduced dopamine 2 receptor (D2R) binding, and exhibit increased sensitivity to sucrose reward. This supports altered dopamine function in this strain and its general preference for palatable solutions such as sucrose. In this study, we examined the relationship between OLETF's hyperphagic behavior and striatal dopamine signaling by investigating basal and amphetamine stimulated motor activity in prediabetic OLETF rats before and after access to sucrose solution (0.3 M) compared to non-mutant control LETO rats, as well as availability of dopamine transporter (DAT) using autoradiography. In the sucrose tests, one group of OLETF rats received ad libitum access to sucrose while the other group received an amount of sucrose equal to that consumed by the LETO. OLETFs with ad libitum access consumed significantly more sucrose than LETOs. Sucrose exerted a biphasic effect on basal activity in both strains, i.e., reduced activity for 1 week followed by increased activity in weeks 2 and 3. Basal locomotor activity was reduced (-17%) in OLETFs prior to sucrose, compared to LETOs. Withdrawal of sucrose resulted in increased locomotor activity in both strains. The magnitude of this effect was greater in OLETFs and the activity was increased in restricted compared to ad-libitum-access OLETFs. Sucrose access augmented AMPH-responses in both strains with a greater sensitization to AMPH during week 1, an effect that was a function of the amount of sucrose consumed. One week of sucrose withdrawal sensitized AMPH-induced ambulatory activity in both strains. In OLETF with restricted access to sucrose, withdrawal resulted in no further sensitization to AMPH. DAT availability in the nucleus accumbens shell was significantly reduced in OLETF compared with aged-matched LETO. Together, these findings show that OLETF rats have reduced basal DA transmission and a heightened response to natural and pharmacological stimulation.

Nutritional and medicinal plants as potential sources of enzyme inhibitors toward the bioactive functional foods: an updated review

Enzymes are biologically active complex protein molecules that catalyze most chemical reactions in living organisms, and their inhibitors accelerate biological processes. This review emphasizes medicinal food plants and their isolated chemicals inhibiting clinically important enzymes in common diseases. A mechanistic overview was investigated to explain the mechanism of these food bases enzyme inhibitors. The enzyme inhibition potential of medicinal food plants and their isolated substances was searched in Ovid, PubMed, Science Direct, Scopus, and Google Scholar. Cholinesterase, amylase, glucosidase, xanthine oxidase, tyrosinase, urease, lipoxygenase, and others were inhibited by crude extracts, solvent fractions, or isolated pure chemicals from medicinal food plants. Several natural compounds have shown tyrosinase inhibition potential, including quercetin, glabridin, phloretin-4-O-β-D-glucopyranoside, lupinalbin, and others. Some of these compounds' inhibitory kinetics and molecular mechanisms are also discussed. Phenolics and flavonoids inhibit enzyme activity best among the secondary metabolites investigated. Several studies showed flavonoids' significant antioxidant and anti-inflammatory activities, highlighting their medicinal potential. Overall, many medicinal food plants, their crude extracts/fractions, and isolated compounds have been studied, and some promising compounds depending on the enzyme have been found. Still, more studies are recommended to derive potential pharmacologically active functional foods.

The Effect of Guisangyou Tea on Abnormal Lipid Metabolism in Mice Induced by High-Fat Diet

This study was aimed to investigate the effect of Guisangyou tea (GSY tea) in improving abnormal lipid metabolism in mice with obesity induced by a high-fat diet (HFD). The results showed that intervention of the water extract of GSY tea (WE) decreased serum levels of lipids, and positively regulated the related antioxidant enzyme activities and the inflammatory factors in the serum and liver. In the liver, the mRNA and protein expression levels of sterol regulatory element-binding proteins-1 (SREBP-1), stearoyl-CoA desaturase-1 (SCD-1), fatty acid synthase (FASN), and acetyl CoA carboxylase (ACC) related to lipid synthesis were downregulated, and the mRNA and protein expression levels of the farnesoid X receptor (FXR) and small heterodimer partner (SHP) related to bile acid production were upregulated. The results demonstrate that GSY tea can improve abnormal lipid metabolism in obese mice by improving the body's antioxidant capacity, regulating the inflammatory state, and reducing the synthesis of lipids and increasing the production of bile acids. GSY tea can be processed and utilized as a safe and effective resource for improving abnormal lipid metabolism.

Translational Research on Bee Pollen as a Source of Nutrients: A Scoping Review from Bench to Real World

The emphasis on healthy nutrition is gaining a forefront place in current biomedical sciences. Nutritional deficiencies and imbalances have been widely demonstrated to be involved in the genesis and development of many world-scale public health burdens, such as metabolic and cardiovascular diseases. In recent years, bee pollen is emerging as a scientifically validated candidate, which can help diminish conditions through nutritional interventions. This matrix is being extensively studied, and has proven to be a very rich and well-balanced nutrient pool. In this work, we reviewed the available evidence on the interest in bee pollen as a nutrient source. We mainly focused on bee pollen richness in nutrients and its possible roles in the main pathophysiological processes that are directly linked to nutritional imbalances. This scoping review analyzed scientific works published in the last four years, focusing on the clearest inferences and perspectives to translate cumulated experimental and preclinical evidence into clinically relevant insights. The promising uses of bee pollen for malnutrition, digestive health, metabolic disorders, and other bioactivities which could be helpful to readjust homeostasis (as it is also true in the case of anti-inflammatory or anti-oxidant needs), as well as the benefits on cardiovascular diseases, were identified. The current knowledge gaps were identified, along with the practical challenges that hinder the establishment and fructification of these uses. A complete data collection made with a major range of botanical species allows more robust clinical information.