51
|
Mosaad YO, Hussein MA, Ateyya H, Mohamed AH, Ali AA, Ramadan Youssuf A, Wink M, El-Kholy AA. Vanin 1 Gene Role in Modulation of iNOS/MCP-1/TGF-β1 Signaling Pathway in Obese Diabetic Patients. J Inflamm Res 2022; 15:6745-6759. [PMID: 36540060 PMCID: PMC9760040 DOI: 10.2147/jir.s386506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2024] Open
Abstract
INTRODUCTION Cysteamine, a powerful endogenous antioxidant, is produced mostly by the vanin-1 with pantetheinase activity. With regard to glycemic, inflammatory, and redox factors, the current study sought to evaluate the association between the expression of the vanin-1 gene, oxidative stress, and inflammatory and iNOS signaling pathway in obese diabetic patients. METHODS We enrolled 67 male subjects with an average age of 53.5 ± 5.0 years, divided into 4 groups according to the WHO guideline. We determined their plasma levels of glucose, insulin, IRI, HbA1c, TC, TG, HDL-C, TNF- α, MCP-1, TGF-β1, SOD, CAT, and TBARs, as well as expression of the iNOS and Vanin1 genes. RESULTS Overweight and obese class I and II diabetics had significantly higher levels of plasma glucose, insulin, HbA1c, TNF-α, MCP-1, TGF-β1, CAT, and TBAR as well as iNOS and vanin-1 gene expression compared to healthy control individuals. In addition, as compared to healthy control individuals, overweight obese class I and II diabetics' plasma HDL-C levels and blood SOD activity were significantly lower. In addition, ultrasound and computed tomography showed that the presence of a mild obscuring fatty liver with mild hepatic echogenicity appeared in overweight, class I and II obese diabetic patients. CONCLUSION These findings provide important information for understanding the correlation between Vanin 1 and glycemic, inflammatory, and redox factors in obese patients. Furthermore, US and CT analysis were performed to visualize the observed images of fatty liver due to obesity.
Collapse
Affiliation(s)
- Yasser O Mosaad
- Department of Pharmacy, Practice & Clinical Pharmacy, Faculty of Pharmacy, Future University, Cairo, Egypt
| | - Mohammed Abdalla Hussein
- Department of Biotechnology, Faculty of Applied Health Science, October 6th University, October 6th City, Egypt
| | - Hayam Ateyya
- Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University, Cairo, Egypt
| | - Ahmed H Mohamed
- Department of Radiology and Medical Imaging, Faculty of Applied Health Science Technology, October 6th University, October 6th City, Egypt
| | - Ali A Ali
- Food Sciences Department, Faculty of Agriculture, Ain Shams University, Cairo, Egypt
| | - Alaa Ramadan Youssuf
- Consultant and Head of Cardiology Department, AL-AHRAR Teaching Hospital, Zagazig University, Zagazig, Egypt
| | - Michael Wink
- Heidelberg University, Institute of Pharmacy and Molecular Biotechnology, Heidelberg, Germany
| | - Amal A El-Kholy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain-Shams University, Cairo, Egypt
| |
Collapse
|
52
|
Assessment of a consensus definition of obesity and metabolic health phenotypes in children at different pubertal stages. Sci Rep 2022; 12:21129. [PMID: 36477173 PMCID: PMC9729631 DOI: 10.1038/s41598-022-25771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
Not all individuals with obesity develop metabolic complications, which has brought about the concepts of metabolically healthy and unhealthy obesity (MHO/MUO). However, inconsistent definitions of these conditions have limited their understanding. We assessed whether a recently-proposed consensus definition for MHO/MUO correlates with adiposity and reflects metabolic risk parameters during puberty. Low-middle income children from the Growth and Obesity Cohort Study (Santiago, Chile) were included (n = 949; 1692 visits at Tanner (T)2, T4 and/or one-year post menarche (1YPM)). Anthropometry, body composition and metabolic parameters were compared between MUO and MHO, and also in children without obesity. The risk for presenting MUO phenotype was significantly elevated with higher waist-height ratio (T2), zBMI (T2, T4), trunk fat, and C-reactive protein (T4). Elevated cardiometabolic indices were important predictors of the "unhealthy" phenotype allocation in children with or without obesity. Our observations suggest that the consensus definition in children at T2, T4 and 1YPM reflects metabolic risk and central obesity. Metabolic health phenotype allocation by this equation enables easy detection of risk factors that call for action to prevent long-term metabolic derangements in children with obesity and, importantly, also those without obesity.
Collapse
|
53
|
Murlasits Z, Kupai K, Kneffel Z. Role of physical activity and cardiorespiratory fitness in metabolically healthy obesity: a narrative review. BMJ Open Sport Exerc Med 2022; 8:e001458. [PMID: 36484059 PMCID: PMC9723844 DOI: 10.1136/bmjsem-2022-001458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 12/11/2022] Open
Abstract
Obesity has been associated with a multitude of metabolic disorders, often clustering with risk factors of cardiovascular disease and type 2 diabetes mellitus, hypertension, dyslipidaemia. Overall, obesity is a worldwide, growing health concern. However, a subgroup of obese individuals with a low burden of metabolic abnormalities have been identified and described as metabolically healthy obese (MHO). Whether the MHO phenotype is protective against obesity-related metabolic disorders in the long-term is presently unclear, and current research examining the potential transition has yielded inconsistent results. In this current narrative review, we aim to provide insights on the role of physical activity (PA) and cardiorespiratory fitness (CRF) in MHO. Lifestyle factors such as PA and CRF may influence the MHO phenotype. Limited studies have characterised energy expenditure and CRF in MHO and metabolically unhealthy obese. However, higher levels of PA, less sedentary behaviour and higher CRF have been observed in MHO individuals. Considering the multiple benefits of PA, it is high time to advocate this lifestyle change beyond its influence on energy balance in a weight loss programme to improve cardiovascular and metabolic risk factors irrespective of body weight and fat mass changes. Improved CRF via increased PA, especially exercise participation, while avoiding weight gain is not only a realistic goal, but should be the primary intervention for MHO populations to prevent the transition to an abnormal metabolic state.
Collapse
Affiliation(s)
- Zsolt Murlasits
- Institute of Sport Science and Physical Education, University of Pécs, Pecs, Hungary
| | - Krisztina Kupai
- Department of Internal Medicine, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Kneffel
- Department of Health Sciences and Sport Medicine, Hungarian University of Sports Science, Budapest, Hungary
| |
Collapse
|
54
|
Choi HN, Lim H, Kim YS, Rhee SY, Yim JE. Differences of Regional Fat Distribution Measured by Magnetic Resonance Imaging According to Obese Phenotype in Koreans. Metab Syndr Relat Disord 2022; 20:551-557. [PMID: 36269325 DOI: 10.1089/met.2022.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Obesity is commonly associated with a high risk of metabolic disorders, and obesity-related metabolic abnormalities are affected by some specific obesity phenotypes, regional fat distribution, and body mass index. However, few studies have investigated the relationship between obesity phenotypes and regional fat distribution in Korean subjects. This study aimed to assess regional fat distribution by gender using magnetic resonance imaging (MRI), and to identify a link between fat distribution and metabolic disorders in Korean subjects. Methods: This study included 35 Korean subjects (20 women, 15 men) who were classified into two groups by gender, and further divided into two groups based on their obesity phenotype: a metabolically abnormal obesity (MAO) and metabolically healthy obesity (MHO) group. Fat distribution was measured using MRI. The blood parameters were measured using a commercially available kit. Results: Women in the MAO group had more risk factors for metabolic abnormalities than those in the MHO group. Serum glucose, triglyceride, and high-density lipoprotein cholesterol (HDL-C) levels were also significantly higher in women with MAO than in those with MHO. The intermuscular adipose tissue (IMAT) of women with MAO was significantly higher than that of women with MHO. Serum HDL-C level was negatively correlated with IMAT, whereas leptin showed a positive correlation with IMAT in all subjects. Conclusions: Metabolic abnormalities according to obesity phenotype posed a higher risk in women than that in men. These findings suggest that an understanding of gender differences in relation to the association between obesity and metabolic risk would be helpful to reduce the prevalence of obesity.
Collapse
Affiliation(s)
- Ha-Neul Choi
- Department of Food and Nutrition, Changwon National University, Changwon, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-in, Korea.,Research Institute of Medical Nutrition, Kyung Hee University, Seoul, Korea
| | - Young-Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang-Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon, Korea.,Interdisciplinary Program in Senior Human Ecology (BK21 Four Program), Changwon National University, Changwon, Korea
| |
Collapse
|
55
|
Dietary Intakes and Eating Behavior between Metabolically Healthy and Unhealthy Obesity Phenotypes in Asian Children and Adolescents. Nutrients 2022; 14:nu14224796. [PMID: 36432482 PMCID: PMC9697734 DOI: 10.3390/nu14224796] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Diet plays a critical role in the development of obesity and obesity-related morbidities. Our study aimed to evaluate the dietary food groups, nutrient intakes and eating behaviors of metabolically healthy and unhealthy obesity phenotypes in an Asian cohort of children and adolescents. Participants (n = 52) were asked to record their diet using a 3-day food diary and intakes were analyzed using a nutrient software. Eating behavior was assessed using a validated questionnaire. Metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) were defined based on criteria of metabolic syndrome. Children/adolescents with MUO consumed fewer whole grains (median: 0.00 (interquartile range: 0.00-0.00 g) vs. 18.5 g (0.00-69.8 g)) and less polyunsaturated fat (6.26% kcal (5.17-7.45% kcal) vs. 6.92% kcal (5.85-9.02% kcal)), and had lower cognitive dietary restraint (15.0 (13.0-17.0) vs. 16.0 (14.0-19.0)) compared to children/adolescents with MHO. Deep fried food, fast food and processed convenience food were positively associated with both systolic (β: 2.84, 95%CI: 0.95-6.62) and diastolic blood pressure (β: 4.83, 95%CI: 0.61-9.04). Higher polyunsaturated fat intake (OR: 0.529, 95%CI: 0.284-0.986) and cognitive dietary restraint (OR: 0.681, 95%CI: 0.472-0.984) were associated with a lower risk of the MUO phenotype. A healthier diet composition and positive eating behavior may contribute to favorable metabolic outcomes in children and adolescents with obesity.
Collapse
|
56
|
Kakinami L, Plummer S, Cohen TR, Santosa S, Murphy J. Body-composition phenotypes and their associations with cardiometabolic risks and health behaviours in a representative general US sample. Prev Med 2022; 164:107282. [PMID: 36183799 DOI: 10.1016/j.ypmed.2022.107282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022]
Abstract
Body mass index is poor at distinguishing between adiposity and muscle. Based on dual energy X-ray absorptiometry data, a diagnostic framework to analyze body composition by categorizing fat- and muscle-mass body composition into four phenotypes has been proposed. The objective of this study was to assess the association between body-composition phenotypes with adiposity measures, health behaviours and cardiometabolic risks in a representative U.S. adult population. Data were from NHANES (1999-2006: n = 9867; 2011-2018: n = 10,454). Four phenotypes based on being above/below the 50th percentile of age- and sex- adjusted reference curves of fat-mass and muscle-mass were identified. Multiple linear and logistic regressions were used to assess phenotypes (high [H] or low [L] adiposity [A] or muscle mass [M]) against adiposity measures, health behaviours, cardiometabolic risk, and dietary intake. Low-adiposity/high-muscle (LA-HM) was the referent. Analyses incorporated the complex sampling design and survey weights, and were adjusted for age, sex, race, and education. Compared to the LA-HM reference group, the HA-LM phenotype was less physically active, had higher total and lower high-density lipoprotein cholesterol, and had lower intake of all examined nutrients (all p < 0.01). For the HA-HM phenotype, unfavourable values were detected for all adiposity and cardiometabolic measures compared to the LA-HM phenotype (all p < 0.01). The two high adiposity phenotypes were associated with poorer health behaviours and cardiovascular risk factors, regardless of muscle-mass, but associations differed across the phenotypes. Results further underscores the importance of accounting for both adiposity and muscle mass in measurement and analysis. Further longitudinal investigation is needed.
Collapse
Affiliation(s)
- Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montreal, Quebec, Canada; PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
| | - Sabine Plummer
- Department of Chemistry, Concordia University, Montreal, Quebec, Canada
| | - Tamara R Cohen
- Faculty of Land and Food Systems, Food, Nutrition and Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sylvia Santosa
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Metabolism, Obesity, Nutrition Lab, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Jessica Murphy
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Metabolism, Obesity, Nutrition Lab, PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| |
Collapse
|
57
|
Lopes S, Fontes T, Tavares RG, Rodrigues LM, Ferreira-Pêgo C. Bioimpedance and Dual-Energy X-ray Absorptiometry Are Not Equivalent Technologies: Comparing Fat Mass and Fat-Free Mass. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13940. [PMID: 36360820 PMCID: PMC9657485 DOI: 10.3390/ijerph192113940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Bioimpedance (BIA) is the most frequently used technology for body composition assessment at a daily clinical level, mostly due to its low price and user-friendly operation. However, many doubts persist regarding its physiological meaning and applicability. The present study aimed to compare one BIA system and the Dual-Energy X-ray Absorptiometry (DXA) for the characterization of body composition in a previously selected cohort of healthy adult participants. A descriptive observational cross-sectional study included a final sample of 121 participants, 93 women and 28 men, with a mean age of 28.26 ± 9.72 years old and a mean body mass index (BMI) of 22.68 ± 3.13 kg/m2. Statistics involved paired t-tests and agreement analysis by the Bland-Altman method. BIA underestimated the percent body fat (%BF) by 5.56% and overestimated Fat-Free Mass (FFM) by 2.90 kg. A strong positive correlation between both technologies was found for FFM (r = 0.980) and the %BF (r = 0.932), but the disagreement was statistically significant (p < 0.001). Although DXA and BIA seem to correlate, these technologies are not congruent. Therefore, the risk of (mis)interpretation and bias is clear with BIA, potentially impacting the nutritional planning of clinical dietitians and the further results of its patients.
Collapse
|
58
|
Killeen SL, Byrne DF, Geraghty AA, Yelverton CA, van Sinderen D, Cotter PD, Murphy EF, O’Reilly SL, McAuliffe FM. Recruiting and Engaging Women of Reproductive Age with Obesity: Insights from A Mixed-Methods Study within A Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13832. [PMID: 36360712 PMCID: PMC9658053 DOI: 10.3390/ijerph192113832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Engaging women with obesity in health-related studies during preconception is challenging. Limited data exists relating to their participation. The aim of this study is to explore the experiences and opinions of women participating in a weight-related, preconception trial. This is an explanatory sequential (quan-QUAL) mixed-methods Study Within A Trial, embedded in the GetGutsy randomized controlled trial (ISRCTN11295995). Screened participants completed an online survey of eight questions (single or multiple choice and Likert scale) on recruitment, motivations and opinions on study activities. Participants with abdominal obesity (waist circumference ≥ 80 cm) were invited to a subsequent semi-structured, online focus group (n = 2, 9 participants) that was transcribed and analyzed using inductive thematic analysis, with a pragmatic epistemological approach. The survey (n = 102) showed the main research participation motivations were supporting health research (n = 38, 37.3%) and wanting health screening (n = 30, 29.4%). Most participants were recruited via email (n = 35, 34.7%) or social media (n = 15, 14.7%). In the FGs, participants valued flexibility, convenience and. research methods that aligned with their lifestyles. Participants had an expanded view of health that considered emotional well-being and balance alongside more traditional medical assessments. Clinical trialists should consider well-being, addressing the interconnectedness of health and incorporate a variety of research activities to engage women of reproductive age with obesity.
Collapse
Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - David F. Byrne
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Aisling A. Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Cara A. Yelverton
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Douwe van Sinderen
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- School of Microbiology, National University of Ireland, T12 K8AF Cork, Ireland
| | - Paul D. Cotter
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland
| | - Eileen F. Murphy
- Precision Biotics Ltd. (Novozymes Cork), Cork Airport Business Park, Kinsale Road, T12 D292 Cork, Ireland
| | - Sharleen L. O’Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
- APC Microbiome Ireland, Biosciences Research Institute, National University of Ireland, T12 K8AF Cork, Ireland
| |
Collapse
|
59
|
Karimi S, Pasdar Y, Hamzeh B, Ayenehpour A, Heydarpour F, Goudarzi F. Obesity phenotypes related to musculoskeletal disorders; a cross-sectional study from RaNCD cohort. Arch Public Health 2022; 80:185. [PMID: 35941605 PMCID: PMC9361550 DOI: 10.1186/s13690-022-00947-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study was evaluated the association between obesity phenotypes and risk of lower torso musculoskeletal disorders including low back pain (LBP), low back stiffness (LBS), arthralgia, and joint stiffness in Ravansar non-communicable diseases (RaNCD) cohort study.
Methods
In this cross-sectional study, 6940 adults were examined for the presence of lower torso musculoskeletal disorders by a physician. Obesity phenotypes including metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) were defined based on the International Diabetes Federation, as well as, body mass index > 30 kg/m2. Metabolically unhealthy non-obesity (MUNO) phenotype was considered as unhealthy metabolic without obesity.
Results
The prevalence of LBP, LBS, arthralgia, and joint stiffness in MHO, MUO, and MUNO were significantly higher than in healthy participants compared to obesity phenotypes. Logistic regression showed that MHO phenotype was significantly increased with risk of LBP (OR: 1.19, CI 95%: 1.01–1.41), LBS (OR: 1.44, CI 95%: 1.12–1.86), arthralgia (OR: 1.54, CI 95%: 1.33–1.78), and joint stiffness (OR: 1.84, CI 95%: 1.35–2.52). Moreover, MUO phenotype was positively associated with risk of LBS (OR: 1.46, CI 95%: 1.09–1.94) and arthralgia (OR: 1.66, CI 95%: 1.41–1.96). In addition, MUNO phenotype was associated with a higher risk of arthralgia (OR: 1.21, CI 95%: 1.06–1.37).
Conclusion
All three phenotypes, MHO, MUO and MUNO were significantly increased the risk of arthralgia. However, MHO phenotype was significantly associated with a higher risk of all examined lower torso musculoskeletal disorders in the current study.
Collapse
|
60
|
Alcazar M, Escribano J, Ferré N, Closa-Monasterolo R, Selma-Royo M, Feliu A, Castillejo G, Luque V, Closa-Monasterolo R, Escribano J, Luque V, Feliu-Rovira A, Ferré N, Muñoz-Hernando J, Gutiérrez-Marín D, Zaragoza-Jordana M, Gispert-Llauradó M, Rubio-Torrents M, Núñez-Roig M, Alcázar M, Sentís S, Esteve M, Monné-Gelonch R, Basora J, Flores G, Hsu P, Rey-Reñones C, Alegret C, Guillen N, Alegret-Basora C, Ferre R, Arasa F, Alejos A, Diéguez M, Serrano M, Mallafré M, González-Hidalgo R, Braviz L, Resa A, Palacios M, Sabaté A, Simón L, Losilla A, De La Torre S, Rosell L, Adell N, Pérez C, Tudela-Valls C, Caro-Garduño R, Salvadó O, Pedraza A, Conchillo J, Morillo S, Garcia S, Mur E, Paixà S, Tolós S, Martín R, Aguado F, Cabedo J, Quezada L, Domingo M, Ortega M, Garcia R, Romero O, Pérez M, Fernández M, Villalobos M, Ricomà G, Capell E, Bosch M, Donado A, Sanchis F, Boix A, Goñi X, Castilla E, Pinedo M, Supersaxco L, Ferré M, Contreras J, Sanz-Manrique N, Lara A, Rodríguez M, Pineda T, Segura S, Vidal S, Salvat M, Mimbrero G, Albareda A, Guardia J, Gil S, Lopez M, Ruiz-Escusol S, Gallardo S, Machado P, Bocanegra R, Espejo T, Vendrell M, Solé C, Urbano R, Vázquez M, Fernández-Antuña L, Barrio M, Baudoin A, González N, Olivé R, Lara R, Dinu C, Vidal C, González S, Ruiz-Morcillo E, Ainsa M, Vilalta P, Aranda B, Boada A, Balcells E. Gut microbiota is associated with metabolic health in children with obesity. Clin Nutr 2022; 41:1680-1688. [DOI: 10.1016/j.clnu.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 06/04/2022] [Indexed: 11/03/2022]
|
61
|
Body Mass Index Is Independently Associated with the Presence of Ischemia in Myocardial Perfusion Imaging. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58080987. [PMID: 35893102 PMCID: PMC9332284 DOI: 10.3390/medicina58080987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022]
Abstract
Background and Objectives: Obesity has been linked to various cardiovascular risk factors, increased incidence of coronary artery disease, and myocardial perfusion defects. The aim of this study was to investigate if body mass index (BMI) and waist circumference (WC) were associated with myocardial perfusion defects. Materials and Methods: A total of 308 consecutive patients who had myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) and a complete medical record on file were studied retrospectively. Results: The median age was 69 (61−76) years, the BMI was 27.6 (24.4−30.7) kg/m2, and the WC was 110 (102−118) cm. Of the 308 patients, 239 patients (77.6%) had myocardial ischemia. A positive test for ischemia was more frequent in men compared to women (72 vs. 28%, p < 0.001). Within the male group, BMI and WC were not significantly different between the ischemia and non-ischemia groups. In contrast, within the female group, both BMI (30.2 vs. 27.1 kg/m2, p = 0.002) and WC (112 vs. 105.5 cm, p = 0.020) were significantly higher in the ischemia group. Multivariable logistic regression showed that male sex and BMI were the only two independent predictors of ischemia in our patient population. Conclusions: This study showed that BMI was an independent predictor of ischemia in our patient population.
Collapse
|
62
|
Effects of Strength Training on Body Fat in Children and Adolescents with Overweight and Obesity: A Systematic Review with Meta-Analysis. CHILDREN 2022; 9:children9070995. [PMID: 35883978 PMCID: PMC9319224 DOI: 10.3390/children9070995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/27/2022]
Abstract
Childhood overweight and obesity represent a growing public health problem worldwide. Since the 1980s, the global prevalence of overweight and obesity in childhood and adolescence has increased by 47%. The promotion of exercise is an important intervention to reduce the physical damage of obesity. The meta-analysis was conducted in accordance with the general guidelines for the reporting of systematic reviews and meta-analyses (PRISMA). The PubMed, SciELO, ScienceDirect and Google Scholar databases were searched from August to December 2021. The search yielded 722 titles published between 2000 and 2021. After screening the titles and abstracts, 64 duplicate articles were detected, and 27 articles were ultimately included in the systematic review, including 26 articles published in English and one published in Spanish. There was a statistically significant effect of the strength training interventions on the percentage of body fat, Test of 0 i = (p = 0.00, z = 6.92), Test of 0 = (p = 0.00, Q (9) = 42.63). The findings reveal that strength training has a positive impact on the treatment of body fat in children and adolescents with overweight and obesity.
Collapse
|
63
|
Yang Q, Wang K, Tian Q, Zhang J, Qi L, Chen T. Effect of Diet and Exercise-Induced Weight Loss among Metabolically Healthy and Metabolically Unhealthy Obese Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106120. [PMID: 35627657 PMCID: PMC9141466 DOI: 10.3390/ijerph19106120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 12/17/2022]
Abstract
Objective: To study the effect of diet- and exercise-based lifestyle intervention on weight loss (WL) and cardiovascular risk among metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) children and adolescents. Methods: The sample included 282 obese individuals (54% males, age (±SD) 12.9 (±2.3) years) who completed a 3- to 4-week WL camp program between 2017 and 2019. MUO was defined according to the consensus-based definition of pediatric MHO in 2018. Results: The intervention exhibited significantly benefits in improving body weight, body mass index, body fat ratio, waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), triglycerides (TG), total cholesterol, and low-density lipoprotein−cholesterol levels in both MHO and MUO groups (for all comparisons, p < 0.01). However, the beneficial high-density lipoprotein−cholesterol (HDL-C) level (both p < 0.01) decreased evidently in both groups after intervention. In addition, percent changes in SBP (p < 0.001), DBP (p < 0.001), RHR (p = 0.025), fasting blood glucose (p = 0.011), and TG (p < 0.001) were more profound in MUO group than that in MHO group. Conclusion: Metabolical health is a mutable and transient state during childhood. Although both groups gained comparable WL benefits from diet- and exercise-based lifestyle intervention, the MUO group may benefit more than the MHO group. Strategies aiming at lowering blood pressure and preventing the decrease of HDL-C level should be considered for the precise treatment of childhood obesity in clinical practice, with the goal of improving metabolically healthy state.
Collapse
Affiliation(s)
- Qin Yang
- International College of Football, Tongji University, Shanghai 200092, China; (Q.Y.); (J.Z.); (L.Q.)
| | - Kun Wang
- Shanghai Dianfeng Sports Management Co., Ltd., Shanghai 200441, China
- Correspondence: (K.W.); (T.C.)
| | - Qianqian Tian
- Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- China Hospital Management Institute, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Jian Zhang
- International College of Football, Tongji University, Shanghai 200092, China; (Q.Y.); (J.Z.); (L.Q.)
| | - Linyu Qi
- International College of Football, Tongji University, Shanghai 200092, China; (Q.Y.); (J.Z.); (L.Q.)
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai 200092, China
- Correspondence: (K.W.); (T.C.)
| |
Collapse
|
64
|
Leone A, De Amicis R, Battezzati A, Bertoli S. Adherence to the Mediterranean Diet and Risk of Metabolically Unhealthy Obesity in Women: A Cross-Sectional Study. Front Nutr 2022; 9:858206. [PMID: 35548567 PMCID: PMC9084308 DOI: 10.3389/fnut.2022.858206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/09/2022] [Indexed: 01/13/2023] Open
Abstract
Some obese individuals do not present any metabolic alteration and are considered metabolically healthy (MHO). Adherence to high-quality dietary pattern may favor this phenotype. We aimed to evaluate the association between the adherence to the Mediterranean diet and risk of metabolically unhealthy obesity (MUO) in women. We conducted a cross-sectional study on 2,115 obese women. All patients underwent a medical examination, anthropometric evaluation, bioelectrical impedance, ultrasound measurements of abdominal visceral (VAT) and subcutaneous (SAT) fat, blood sampling and evaluation of adherence to the Mediterranean diet through MEDAS questionnaire. The diagnosis of MHO and MUO was made using the harmonized criteria. A multivariable logistic regression adjusted for age, BMI, fat free mass, ultrasound-estimated VAT:SAT ratio, marital status, education, past diet, antidepressant use, family history of diabetes and cardiovascular disease, menopausal status, smoking, and physical activity was used to assess the association between Mediterranean diet and MUO risk. The prevalence of MHO was 21.2% (N = 449). Compared to MUO women, MHO women were younger, had lower BMI and VAT, and had higher fat free mass and SAT. In the multivariable model, the adherence to the Mediterranean diet was not associated with the risk of MUO (OR = 0.91, 95%CI: 0.62; 1.34, P = 0.624). Given the impact of menopause on metabolic health we also carried out the analysis in pre- and post-menopausal women separately. Higher adherence to the Mediterranean diet was associated with a lower risk of MUO in postmenopausal women (OR = 0.55, 95%CI: 0.31; 0.96, P = 0.034). No association was found in premenopausal women (OR = 1.18, 95%CI: 0.70; 1.99, P = 0.532). In conclusion, adherence to the Mediterranean diet was associated with a better metabolic health in postmenopausal women. Further studies are needed to confirm the ability of the Mediterranean diet in promoting maintenance of the healthy phenotype and reversion from MUO.
Collapse
Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy.,Lab of Nutrition and Obesity Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| |
Collapse
|
65
|
Abulmeaty MMA, Aldisi D, Aljuraiban GS, Almajwal A, El Shorbagy E, Almuhtadi Y, Albaran B, Aldossari Z, Alsager T, Razak S, Berika M, Al Zaben M. Association of Gastric Myoelectrical Activity With Ghrelin, Gastrin, and Irisin in Adults With Metabolically Healthy and Unhealthy Obesity. Front Physiol 2022; 13:815026. [PMID: 35547577 PMCID: PMC9081643 DOI: 10.3389/fphys.2022.815026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/22/2022] [Indexed: 12/03/2022] Open
Abstract
Background and Objective: Functional disturbances of gastric myoelectrical activity (GMA) might exist in obesity. However, studies on its association with the gastric hormones in obesity phenotypes are lacking. The objective was to study the association of GMA with the serum levels of key gastric hormones in different obesity phenotypes. Methods: A total of 139 adults (31.00 ± 11.12 years) were classified into different metabolic phenotypes of obesity: 1) normal weight-lean (NWL group): BMI <25 kg/m2 and the fat-mass index (FMI) ≤9.7 kg/m2 in females and ≤6.3 kg/m2 in males; 2) metabolically obese normal weight (MONW group): BMI <25 kg/m2 and FMI >9.7 kg/m2 in females and >6.3 kg/m2 in males; 3) metabolically healthy obese (MHO group): BMI ≥25 and FMI ≤9.7 kg/m2 in females and ≤6.3 kg/m2 in males; and 4) metabolically unhealthy obese (MUO group): BMI ≥25 and FMI >9.7 kg/m2 in females and >6.3 kg/m2 in males. The GMA was measured at the baseline and post-prandial state using a multichannel electrogastrography with a water load satiety test. The average power distribution by the frequency region and the average dominant frequency were used for analysis. Anthropometric measurements and bioelectric impedance analysis were performed to calculate the FMI and fat-free mass index (FFMI). Serum levels of ghrelin, gastrin, and irisin were measured by ELISA kits according to the manufacturer’s protocol. Results: Compared to the NWL group, gastrin and ghrelin levels were significantly low in the MUO participants, while irisin was significantly high. The EGG showed significantly lower baseline and 20-min normogastria frequencies in the MHO and MUO groups. In the MHO group, baseline duodenal frequency was positively correlated with the gastrin level, while normogastria times were positively associated with the irisin level and negatively associated with the ghrelin level. In the MUO group, percentages of bradygastria frequencies at 10, 20, and 30 min were positively correlated with the BMI and FFMI. This bradygastria was correlated positively with the irisin level and negatively with the ghrelin level. Conclusion: The EGG patterns might be associated with obesity-related gastric hormones in different obesity phenotypes. EGG may be a promising clinical tool in obesity assessment. The association of the EGG patterns with hormonal levels needs further investigation for potential practical uses.
Collapse
Affiliation(s)
- Mahmoud M A Abulmeaty
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Obesity Management Unit, Medical Physiology Department, School of Medicine, Zagazig University, Zagazig, Egypt
| | - Dara Aldisi
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ghadeer S Aljuraiban
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali Almajwal
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Eman El Shorbagy
- Obesity Management Unit, Medical Physiology Department, School of Medicine, Zagazig University, Zagazig, Egypt
| | - Yara Almuhtadi
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Batool Albaran
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaid Aldossari
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Thamer Alsager
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Berika
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed Al Zaben
- Surgery Department, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| |
Collapse
|
66
|
Pisoni S, Marrachelli VG, Morales JM, Maestrini S, Di Blasio AM, Monleón D. Sex Dimorphism in the Metabolome of Metabolic Syndrome in Morbidly Obese Individuals. Metabolites 2022; 12:metabo12050419. [PMID: 35629923 PMCID: PMC9147578 DOI: 10.3390/metabo12050419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Adult morbid obesity is defined as abnormal or excessive fat accumulation, mostly resulting from a long-term unhealthy lifestyle. Between 10% and 30% of people with obesity exhibit low cardiometabolic risk. The metabolic syndrome has been suggested as an indicator of obesity-related metabolic dysregulation. Although the prevalence of obesity does not seem to be sex-related and metabolic syndrome occurs at all ages, in the last few years, sex-specific differences in the pathophysiology, diagnosis, and treatment of metabolic syndrome have received attention. The aim of this study was to determine the prevalence of metabolic syndrome and its components in different sex and age groups in people with metabolic unhealthy obesity and to compare them with people with metabolic healthy obesity. We analyzed the metabolome in 1350 well-phenotyped morbidly obese individuals and showed that there is a strong sex-dependent association of metabolic syndrome with circulating metabolites. Importantly, we demonstrated that metabolic dysregulation in women and men with severe obesity and metabolic syndrome is age-dependent. The metabolic profiles from our study showed age-dependent sex differences in the impact of MetS which are consistent with the cardiometabolic characterization. Although there is common ground for MetS in the metabolome of severe obesity, men older than 54 are affected in a more extensive and intensive manner. These findings strongly argue for more studies aimed at unraveling the mechanisms that underlie this sex-specific metabolic dysregulation in severe obesity. Moreover, these findings suggest that women and men might benefit from differential sex and age specific interventions to prevent the adverse cardiometabolic effects of severe obesity.
Collapse
Affiliation(s)
- Serena Pisoni
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
| | - Vannina G. Marrachelli
- Department of Physiology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain;
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
| | - Jose M. Morales
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
| | - Sabrina Maestrini
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy; (S.M.); (A.M.D.B.)
| | - Anna M. Di Blasio
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy; (S.M.); (A.M.D.B.)
| | - Daniel Monleón
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
- Correspondence:
| |
Collapse
|
67
|
Treviño S, Cortezano-Esteban S, Hernández-Fragoso H, Díaz A, Vázquez-Roque R, Enrique Sarmiento-Ortega V, Moroni-González D, Pelayo R, Brambila E. Clinical monitored in subjects metabolically healthy and unhealthy before and during a SARS-CoV-2 infection– A cross-sectional study in Mexican population. Cytokine 2022; 153:155868. [PMID: 35358903 PMCID: PMC8958098 DOI: 10.1016/j.cyto.2022.155868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 12/14/2022]
Abstract
The COVID-19 disease has forced us to consider the physiologic role of obesity and metabolically healthy and unhealthy status in response to SARS-CoV-2 infection. Hematological, coagulation, biochemical, and immunoinflammatory changes have been informed with a disparity in morbidity and mortality. Therefore, we aimed to investigate the influence of metabolic health on clinical features in a cross-sectional study in Mexican subjects with and without SARS-CoV-2 infection in non-severe stages after a rigorous classification of obese and non-obese subjects who were metabolically healthy and unhealthy. Four groups were formed: 1) metabolically healthy with normal BMI (MHN); 2) metabolically unhealthy with normal BMI (MUN); 3) metabolically healthy obese (MHO); 4) metabolically unhealthy obese (MUO). Serum proinflammatory (TNF-α, MCP-1, IL-1β, and IL-6) and anti-inflammatory (TGF-β, IL-1Ra, IL-4, and IL-10) cytokines, hematological parameters, coagulation, and acute phase components were evaluated. Our results showed that MHO people live with inflammaging. Meanwhile, MUN and MUO subjects develop metaflammation. Both inflammaging and metaflammation cause imperceptible modifications on hematological parameters, mainly in leukocyte populations and platelets, as well as acute phase and coagulation components. The statistical analysis revealed that many clinical features are dependent on metabolic health. In conclusion, MHO subjects seem to be transitioning from metabolically healthy to unhealthy, which is accelerated in acute processes, such as SARS-CoV-2 infection. Meanwhile, metabolically unhealthy subjects independently of BMI have a deteriorating immunometabolic status associated with a hyperinflammatory state leading to multi-organ dysfunction, treatment complications, and severe COVID-19 disease.
Collapse
Affiliation(s)
- Samuel Treviño
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico; Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico.
| | - Steffany Cortezano-Esteban
- Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico
| | - Hugo Hernández-Fragoso
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico; Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico
| | - Alfonso Díaz
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla. 22 South. FCQ9, University City, Puebla, C.P. 72560, Mexico
| | - Rubén Vázquez-Roque
- Neuropsychiatry laboratory, Physiology Institute, University Autonomous of Puebla. 14 South. University City, Puebla, C.P. 72560, Mexico
| | - Victor Enrique Sarmiento-Ortega
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
| | - Diana Moroni-González
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
| | - Rosana Pelayo
- Eastern Biomedical Research Center CIBIOR, Mexican Institute for Social Security, Puebla, Mexico
| | - Eduardo Brambila
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
| |
Collapse
|
68
|
Meng M, Guo Y, Kuang Z, Liu L, Cai Y, Ni X. Risk of Stroke Among Different Metabolic Obesity Phenotypes: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:844550. [PMID: 35548434 PMCID: PMC9081493 DOI: 10.3389/fcvm.2022.844550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose Overweight/obesity is a modified risk factor for stroke. This systematic review and meta-analysis aimed to assess the impact of different obesity phenotypes on stroke risk in adults. Methods The PubMed, Embase, and Cochrane Library databases were searched from their inception to 7 March 2021 to identify the prospective cohort studies investigating stroke risk among different metabolic overweight/obesity phenotypes. The methodological quality of the included studies was evaluated using the Newcastle–Ottawa Scale. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results A total of eleven prospective cohorts (n = 5,609,945 participants) were included in the systematic review, nine of which were included in the meta-analysis. All metabolically unhealthy phenotypes had a higher risk of stroke than the metabolically healthy normal-weight phenotypes, including metabolically unhealthy normal weight (HR = 1.63, 95% CI: 1.41–1.89, I2 = 89.74%, n = 7 cohort studies, 1,042,542 participants), metabolically unhealthy overweight (HR = 1.94, 95% CI: 1.58–2.40, I2 = 91.17%, n = 4 cohort studies, 676,166 participants), and metabolically unhealthy obese (HR = 1.99, 95% CI: 1.66–2.40, I2 = 93.49%, n = 6 cohort studies, 1,035,420 participants) phenotypes. However, no risk of stroke was observed in the populations with metabolically healthy overweight (MHOW) (HR = 1.07, 95% CI: 1.00–1.14, I2 = 69.50%, n = 5 studies, 4,171,943 participants) and metabolically healthy obese (MHO) (HR = 1.07, 95% CI: 0.99–1.16, I2 = 54.82%, n = 8 studies, 5,333,485 participants) phenotypes. The subgroup analyses for the MHO studies suggested that the risk of stroke increased only when the MHO participants were mainly females, from North America, and when the World Health Organization standard was applied to define obesity. In the subgroup analysis of the risk of stroke in MHOW, a longer follow-up duration was also associated with a higher risk of stroke. Conclusion The risk of stroke increase for all metabolically unhealthy phenotypes irrespective of the body mass index (BMI). The associated risk of stroke with metabolic health but high BMI shows substantial heterogeneity, which requires future research considering the impact of sex and transition of the metabolic status on the risk of stroke. Systematic Review Registration The study protocol was prospectively registered in PROSPERO (No. CRD42021251021).
Collapse
Affiliation(s)
- Miaomiao Meng
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yixin Guo
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhuoran Kuang
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Lingling Liu
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Yefeng Cai
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Xiaojia Ni
- The Second Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- *Correspondence: Xiaojia Ni,
| |
Collapse
|
69
|
Galli C, Li T. Racial Differences in Diagnosis of Overweight and Obesity: Results from the National Health and Nutrition Examination Survey (NHANES) 2009-2016. J Racial Ethn Health Disparities 2022; 10:1096-1107. [PMID: 35394620 DOI: 10.1007/s40615-022-01297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diagnostic standards and codes related to excessive weight exist so that clinicians may inform patients that they are overweight: a status which may be a harbinger of more severe obesity and negative health outcomes. Equipped with this knowledge, patients may pursue medical interventions or behavioral changes to reduce their risk. However, diagnoses of overweight are unequally applied in the United States along racial lines. METHODS Binary logistic regression was used to analyze National Health and Nutrition Examination Survey (NHANES) 2009-2016 data from 7460 participants to examine the relationship between race of non-Hispanic White and non-Hispanic Black Americans and having ever been told that one is overweight by a clinician when controlling for demographic and socioeconomic factors. The body mass index (BMI) of participants along with obesity-associated comorbidities was then incorporated into the model to see if physical size or disease status mediated the primary relationship. RESULTS Black Americans are significantly less likely to report being told that they are overweight by a clinician than are White Americans regardless of clinical weight status and weight-associated comorbidities. We find that these racial differences are greatest when respondents' BMIs approach the lower threshold for clinical obesity. CONCLUSIONS Our findings suggest that the lower likelihood of Black Americans to be told they are overweight compared to their White counterparts can result in serious health implications. We posit that implicit biases among clinicians may partly explain this disparity, which may exacerbate health outcome inequalities.
Collapse
Affiliation(s)
- Chuck Galli
- Department of Sociology, Sussex County Community College, 1 College Hill Rd., Newton, NJ, 07860, USA.
| | - Tiffany Li
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA, 19140, USA
| |
Collapse
|
70
|
Vidal P, Baer LA, Félix-Soriano E, Yang FT, Branch DA, Baskin KK, Stanford KI. Distinct Effects of High-Fat and High-Phosphate Diet on Glucose Metabolism and the Response to Voluntary Exercise in Male Mice. Nutrients 2022; 14:nu14061201. [PMID: 35334860 PMCID: PMC8951123 DOI: 10.3390/nu14061201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
The prevalence of metabolic diseases is rapidly increasing and a principal contributor to this is diet, including increased consumption of energy-rich foods and foods with added phosphates. Exercise is an effective therapeutic approach to combat metabolic disease. While exercise is effective to combat the detrimental effects of a high-fat diet on metabolic health, the effects of exercise on a high-phosphate diet have not been thoroughly investigated. Here, we investigated the effects of a high-fat or high-phosphate diet in the presence or absence of voluntary exercise on metabolic function in male mice. To do this, mice were fed a low-fat, normal-phosphate diet (LFPD), a high-phosphate diet (HPD) or a high-fat diet (HFD) for 6 weeks and then subdivided into either sedentary or exercised (housed with running wheels) for an additional 8 weeks. An HFD severely impaired metabolic function in mice, increasing total fat mass and worsening whole-body glucose tolerance, while HPD did not induce any notable effects on glucose metabolism. Exercise reverted most of the detrimental metabolic adaptations induced by HFD, decreasing total fat mass and restoring whole-body glucose tolerance and insulin sensitivity. Interestingly, voluntary exercise had a similar effect on LFPD and HPD mice. These data suggest that a high-phosphate diet does not significantly impair glucose metabolism in sedentary or voluntary exercised conditions.
Collapse
|
71
|
Šebeková K, Gurecká R, Csongová M, Koborová I, Repiská G, Podracká Ľ. Lean insulin-resistant young adults display increased cardiometabolic risk: A retrospective cross-sectional study. Diabetes Res Clin Pract 2022; 185:109217. [PMID: 35114297 DOI: 10.1016/j.diabres.2022.109217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/01/2021] [Accepted: 01/24/2022] [Indexed: 11/17/2022]
Abstract
AIM We investigated whether lean insulin-resistant individuals manifest increased cardiometabolic risk. METHODS 2,341 (51.8% females) healthy 16-23-year-old subjects were categorized as lean or overweight/obese; and insulin-sensitive or insulin-resistant, and compared. RESULTS In both sexes, lean insulin-sensitive and insulin-resistant subjects displayed similar measures of obesity (e.g., males, waist-to-height ratio: lean insulin-sensitive: 0.42 ± 0.03, lean insulin-resistant: 0.43 ± 0.03, overweight/obese insulin-sensitive: 0.49 ± 0.05, overweight/obese insulin-resistant: 0.53 ± 0.06). Lean insulin-sensitive individuals were more insulin-sensitive compared with their overweight/obese peers; insulin-resistant groups presented similar insulin-sensitivity (males, the Quantitative insulin-sensitivity check index (QUICKI): lean insulin-sensitive: 0.354 ± 0.022, lean insulin-resistant: 0.304 ± 0.013, overweight/obese insulin-sensitive: 0.343 ± 0.019, overweight/obese insulin-resistant: 0.299 ± 0.015). The two-factor analysis of variance indicated an independent effect of insulin sensitivity, overweight/obesity, and their interaction on the continuous metabolic syndrome score (p < 0.001, all; males, lean insulin-sensitive: 1.87 ± 0.35, lean insulin-resistant: 2.14 ± 0.42, overweight/obese insulin-sensitive: 2.15 ± 0.40, overweight/obese insulin-resistant: 2.75 ± 0.69). C-reactive protein, leukocyte count, and glomerular filtration rate in both sexes; uric acid, asymmetric dimethyl-arginine, and soluble vascular adhesion protein-1 in males; and soluble receptor for advanced glycation end-products in females were independently associated with insulin resistance. Among phenotypes associated with low QUICKI, the distribution of insulin-resistant individuals was random. CONCLUSION Later clinical consequences of insulin resistance in lean subjects remain to be elucidated in longitudinal studies.
Collapse
Affiliation(s)
- Katarína Šebeková
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
| | - Radana Gurecká
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Melinda Csongová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Ivana Koborová
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Gabriela Repiská
- Institute of Physiology, Comenius University, Bratislava, Slovakia
| | - Ľudmila Podracká
- Department of Pediatrics of the Faculty of Medicine, Comenius University, and of The National Institute of Children's Health, Bratislava, Slovakia
| |
Collapse
|
72
|
Kouvari M, Chrysohoou C, Skoumas J, Pitsavos C, Panagiotakos DB, Mantzoros CS. The presence of NAFLD influences the transition of metabolically healthy to metabolically unhealthy obesity and the ten-year cardiovascular disease risk: A population-based cohort study. Metabolism 2022; 128:154893. [PMID: 34600906 DOI: 10.1016/j.metabol.2021.154893] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND/OBJECTIVES We evaluated the role of the presence of non-alcoholic fatty liver disease (NAFLD) at baseline in the transition from metabolically healthy to metabolically unhealthy obesity (MHO to MUO) ten years later. METHODS A prospective cohort study (ATTICA study, Greece) was performed between 2002 and 2012 studying a sample from the greater metropolitan Athens area. In total, 1514 (49·8%) men and 1528 (50.2%) women (aged >18 years old) free-of-CVD were included. Healthy metabolic status was defined as absence of all NCEP ATP III (2005) metabolic syndrome components. NAFLD was defined according to validated liver steatosis indices. Follow-up CVD assessment (2011-2012) was achieved in n = 2020 participants (n = 317 cases). RESULTS NAFLD prevalence among MHO participants ranged from 29% to 39% according to the specific NAFLD score used. MHO participants who developed metabolically unhealthy status had about two times higher odds to have NAFLD at baseline compared with their metabolically healthy normal weight counterparts whereas stable MHO was not associated significantly with NAFLD. Moreover, MHO status accompanied by NAFLD was associated with increased CVD risk (Hazard Ratio = 2.90 95% Confidence Interval (1.35, 5.40)) in comparison to their non-NAFLD MHO counterparts. Further analysis revealed that in the obese, NAFLD indices and not simply visceral adiposity increased significantly the ability of metabolic status (using standard definition) to predict long-term CVD incidence. CONCLUSIONS Considering NAFLD, even when assessed using validated indices only, in the clinical assessment of apparently healthy obese individuals predicts who is to develop MUO and contributes independently and more accurately to defining future cardiometabolic risk.
Collapse
Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Australia
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Greece, Greece
| | - John Skoumas
- First Cardiology Clinic, School of Medicine, University of Athens, Greece, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Greece, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Australia.
| | - Christos S Mantzoros
- Department of Medicine, Boston VA Healthcare System and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| |
Collapse
|
73
|
Oguoma VM, Abu-Farha M, Coffee NT, Alsharrah S, Al-Refaei FH, Abubaker J, Daniel M, Al-Mulla F. Metabolically Healthy and Unhealthy Obese Phenotypes among Arabs and South Asians: Prevalence and Relationship with Cardiometabolic Indicators. Nutrients 2022; 14:nu14050915. [PMID: 35267891 PMCID: PMC8912281 DOI: 10.3390/nu14050915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 12/27/2022] Open
Abstract
Obesity is a public health crisis in Kuwait. However, not all obese individuals are metabolically unhealthy (MuHO) given the link between obesity and future cardiovascular events. We assessed the prevalence of the metabolically healthy obese (MHO) phenotype and its relationship with high sensitivity C-reactive protein (hs-CRP), serum alanine aminotransferase (ALT), and insulin resistance (HOMA-IR) in Arab and South Asian ethnic groups in Kuwait. The national cross-sectional survey of diabetes and obesity in Kuwait adults aged 18–60 years were analysed. The harmonised definition of metabolic syndrome was used to classify metabolic health. Multinomial logistic regression analysis was used to model the relationship between the MHO and MuHO phenotypes and hs-CRP, ALT and HOMA-IR levels. Overall, the prevalence of MHO for body mass index (BMI)- and waist circumference (WC)-defined obesity was 30.8% and 56.0%, respectively; it was greater in women (60.4% and 61.8%, respectively) than men (39.6% and 38.2%, respectively). Prevalence rates were also lower for South Asians than for Arabs. The MHO phenotype had hs-CRP values above 3 µg/mL for each age group category. Men compared to women, and South Asians compared to Arabs had a lower relative risk for the MHO group relative to the MuHO group. This study shows there is high prevalence of MHO in Kuwait.
Collapse
Affiliation(s)
- Victor M. Oguoma
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
- Correspondence:
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (J.A.)
| | - Neil T. Coffee
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
| | - Saad Alsharrah
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Geohealth Laboratory, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
| | | | - Jehad Abubaker
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (J.A.)
| | - Mark Daniel
- Faculty of Health, Health Research Institute, University of Canberra, Canberra 2617, Australia; (N.T.C.); (S.A.); (M.D.)
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Melbourne 3010, Australia
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait;
| |
Collapse
|
74
|
Wang M, Ma W, Wang Q, Yang Q, Yan X, Tang H, Li Z, Li Y, Feng S, Wang Z. Flavonoid-enriched extract from Millettia speciosa Champ prevents obesity by regulating thermogenesis and lipid metabolism in high-fat diet-induced obese C57BL/6 mice. Food Sci Nutr 2022; 10:445-459. [PMID: 35154681 PMCID: PMC8825741 DOI: 10.1002/fsn3.2664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/13/2021] [Accepted: 10/27/2021] [Indexed: 01/01/2023] Open
Abstract
Millettia speciosa (M. speciosa) Champ is a medicinal and edible plant. The roots are rich in flavonoids, which possess multiple biological activities, including lipid-lowering effects. This study aimed to explore the effect of flavonoid-enriched extract from M. speciosa (FMS) on obesity. The UPLC-Q-TOF-MS analysis and chromatographic analysis were adopted to identify flavonoid compounds in FMS. Male C57BL/6J mice were fed with a high-fat diet for 3 months and were then treated with FMS (50 or 100 mg/kg/d) or Orlistat (10 mg kg-1 d-1) for another 8 weeks. A total of 35 flavonoids were identified in the extract of M. speciosa root. FMS reduced body weight gain, liver weight gain, white adipose tissue, lipid accumulation, and blood glucose. The levels of TG, ALT, AST, and inflammatory-related adipokines (TNF-α and IL-6) in serum were also reduced by FMS. In addition, FMS promoted thermogenesis in brown adipose tissue and induced the activation of lipolysis, fatty acid oxidation, and oxidative phosphorylation in white adipose tissues. In summary, long-term administration of FMS could ameliorate high-fat diet-induced obesity by stimulating adipose thermogenesis and lipid metabolism.
Collapse
Affiliation(s)
- Mao‐Yuan Wang
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Wen‐Yu Ma
- Key Laboratory of South Subtropical Plant DiversityFairy Lake Botanical GardenShenzhen & Chinese Academy of SciencesShenzhenChina
| | - Qing‐Long Wang
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Qing Yang
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Xiao‐Xia Yan
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Huan Tang
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Zhi‐Ying Li
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Ying‐Ying Li
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| | - Shi‐Xiu Feng
- Key Laboratory of South Subtropical Plant DiversityFairy Lake Botanical GardenShenzhen & Chinese Academy of SciencesShenzhenChina
| | - Zhu‐Nian Wang
- Chinese Academy of Tropical Agricultural Sciences/Key Laboratory of Crop Gene Resources and Germplasm Enhancement in Southern ChinaTropical Crops Genetic Resources InstituteMinistry of AgricultureHaikouChina
- Tropical Wild Plant Gene ResourceMinistry of Agriculture/National Genebank of Tropical CropsDanzhouChina
| |
Collapse
|
75
|
Damanhoury S, Morrison KM, Mian R, McPhee PG, Kozyrskyj AL, Newton AS, Buchholz A, Chanoine JP, Hamilton J, Ho J, Laberge AM, Legault L, Thabane L, Tremblay MS, Zenlea I, Ball GDC. Metabolically healthy obesity in children enrolled in the CANadian Pediatric Weight management Registry (CANPWR): An exploratory secondary analysis of baseline data. Clin Obes 2022; 12:e12490. [PMID: 34617401 DOI: 10.1111/cob.12490] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/06/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Our study purpose was to determine the prevalence of metabolically healthy obesity (MHO) and examine factors associated with MHO in children with obesity. This cross-sectional study was a secondary, exploratory analysis of data that included 2-17 years old with a body mass index (BMI) ≥85th percentile from the CANadian Pediatric Weight management Registry. Children were classified as having MHO or metabolically unhealthy obesity (MUO) using consensus-based criteria. Those with MHO had normal triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose. Logistic regression was used to examine factors associated with MHO, which included calculating odds ratios (ORs) and 95% confidence intervals (CIs). In total, 945 children were included (mean age: 12.3 years; 51% female). The prevalence of MHO was 31% (n = 297), with lower levels across increasing age categories (2-5 years [n = 18; 43%], 6-11 years [n = 127; 35%], 12-17 years [n = 152; 28%]). Children with MHO were younger, weighed less, and had lower BMI z-scores than their peers with MUO (all p < 0.01). MHO status was positively associated with physical activity (OR: 1.18; 95% CI: 1.01-1.38), skim milk intake (OR: 1.10; 95% CI: 1.01-1.19), and fruit intake (OR: 1.12; 95% CI: 1.01-1.24) and negatively associated with BMI z-score (OR: 0.69; 95% CI: 0.60-0.79), total screen time in hours (OR: 0.79; 96% CI: 0.68-0.92), and intake of fruit flavoured drinks (OR: 0.91; 95% CI: 0.84-0.99). These findings may help guide clinical decision-making regarding obesity management by focusing on children with MUO who are at relatively high cardiometabolic risk.
Collapse
Affiliation(s)
- Samah Damanhoury
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Katherine M Morrison
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Rajibul Mian
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Patrick G McPhee
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Amanda S Newton
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Annick Buchholz
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jill Hamilton
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Josephine Ho
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anne-Marie Laberge
- Department of Pediatrics, Université de Montréal, Montréal, Quebec, Canada
- CHU Sainte-Justine, Montréal, Quebec, Canada
| | - Laurent Legault
- Department of Pediatrics, Endocrine Division, Montreal Children's Hospital, McGill University, Montréal, Quebec, Canada
| | - Lehana Thabane
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Zenlea
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
76
|
Masi D, Risi R, Biagi F, Vasquez Barahona D, Watanabe M, Zilich R, Gabrielli G, Santin P, Mariani S, Lubrano C, Gnessi L. Application of a Machine Learning Technology in the Definition of Metabolically Healthy and Unhealthy Status: A Retrospective Study of 2567 Subjects Suffering from Obesity with or without Metabolic Syndrome. Nutrients 2022; 14:nu14020373. [PMID: 35057554 PMCID: PMC8779369 DOI: 10.3390/nu14020373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/31/2021] [Accepted: 01/13/2022] [Indexed: 12/13/2022] Open
Abstract
The key factors playing a role in the pathogenesis of metabolic alterations observed in many patients with obesity have not been fully characterized. Their identification is crucial, and it would represent a fundamental step towards better management of this urgent public health issue. This aim could be accomplished by exploiting the potential of machine learning (ML) technology. In a single-centre study (n = 2567), we used an ML analysis to cluster patients with metabolically healthy (MHO) or metabolically unhealthy (MUO) obesity, based on several clinical and biochemical variables. The first model provided by ML was able to predict the presence/absence of MHO with an accuracy of 66.67% and 72.15%, respectively, and included the following parameters: HOMA-IR, upper body fat/lower body fat, glycosylated haemoglobin, red blood cells, age, alanine aminotransferase, uric acid, white blood cells, insulin-like growth factor 1 (IGF-1) and gamma-glutamyl transferase. For each of these parameters, ML provided threshold values identifying either MUO or MHO. A second model including IGF-1 zSDS, a surrogate marker of IGF-1 normalized by age and sex, was even more accurate with a 71.84% and 72.3% precision, respectively. Our results demonstrated high IGF-1 levels in MHO patients, thus highlighting a possible role of IGF-1 as a novel metabolic health parameter to effectively predict the development of MUO using ML technology.
Collapse
Affiliation(s)
- Davide Masi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
- Correspondence: ; Tel.: +39-06-499-707-16
| | - Renata Risi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
- MRC Metabolic Diseases Unit, MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 1TN, UK
| | - Filippo Biagi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| | - Daniel Vasquez Barahona
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| | | | | | | | - Stefania Mariani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy; (R.R.); (F.B.); (D.V.B.); (M.W.); (S.M.); (C.L.); (L.G.)
| |
Collapse
|
77
|
Talebpour M, Najari K, Kichi RA, Zabihi-Mahmoudabadi H. Letter to the Editor: How Bad Is "Bad"? A Cost Consideration and Review of Laparoscopic Gastric Plication Versus Laparoscopic Sleeve Gastrectomy. Obes Surg 2022; 32:542-543. [PMID: 35001255 DOI: 10.1007/s11695-021-05816-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/19/2021] [Accepted: 11/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Mohammad Talebpour
- Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Hasanabad square, Tehran, Iran
| | - Khosrow Najari
- Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Hasanabad square, Tehran, Iran
| | - Raziyeh Abedi Kichi
- Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Hasanabad square, Tehran, Iran
| | - Hossein Zabihi-Mahmoudabadi
- Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Hasanabad square, Tehran, Iran.
| |
Collapse
|
78
|
Prioreschi A, Koethe JR, Aronoff DM, Goldstein JA, Norris SA. Relationships between adiposity distribution and metabolic health in preconception women in South Africa. Obes Sci Pract 2022; 8:500-509. [PMID: 35949276 PMCID: PMC9358758 DOI: 10.1002/osp4.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Adipose tissue is a central regulator of metabolic health and a contributor to systemic inflammation. Patterns of adiposity deposition are important to understand for optimizing health. This study aimed to asses relationships between adiposity deposition and metabolic and inflammatory biomarkers in South African women prior to conception. Methods Non‐pregnant, healthy women (n = 298) were recruited for this cross‐sectional study via home visits. Body composition was measured by Dual X‐ray Absorptiometry. Inflammation markers C‐reactive protein (CRP), alpha1‐acid glycoprotein (AGP), hemoglobin A1c (HbA1c), and blood pressure were scored according to risk. A summative metabolic health risk score was created for women with obesity. Generalized regression models assessed relationships between adiposity deposition and outcomes with adjustment for potential confounders. Results Obesity was present in 22% of women (mean age = 20.93 years). Fat mass index was associated with inflammation and metabolic health risk (β = 0.58; p < 0.01). Visceral fat, trunk:limb ratio, android:gynoid ratio, body mass index, weight, and waist circumference were positively associated with CRP, AGP, and metabolic health risk (p < 0.01). Weight was associated with Hba1c (β < 0.01; p < 0.05). Participants with obesity and low metabolic health risk had lower fat mass index and visceral fat than participants with obesity and higher metabolic health risk. Conclusions Black South African women accumulated excess adipose tissue in abdominal regions. While fat mass and body mass were associated with inflammation and metabolic health risk, women with obesity and with lower fat mass index and lower visceral adipose tissue were metabolically protected. Identification of women at risk for metabolic disease preconception could help ensure future healthy pregnancies and prevent transference of risk to offspring.
Collapse
Affiliation(s)
- Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit Department of Paediatrics Faculty of Health Sciences School of Clinical Medicine University of the Witwatersrand Johannesburg South Africa
| | - John R. Koethe
- Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA
- Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville Tennessee USA
| | - David M. Aronoff
- SAMRC/Wits Developmental Pathways for Health Research Unit Department of Paediatrics Faculty of Health Sciences School of Clinical Medicine University of the Witwatersrand Johannesburg South Africa
- Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA
- Department of Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville Tennessee USA
- Department of Obstetrics and Gynecology Vanderbilt University Medical Center Nashville Tennessee USA
| | - Jeffrey A. Goldstein
- Department of Pathology Feinberg School of Medicine Northwestern University Chicago Illinois USA
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit Department of Paediatrics Faculty of Health Sciences School of Clinical Medicine University of the Witwatersrand Johannesburg South Africa
| |
Collapse
|
79
|
Noori S, Mirzababaei A, Shiraseb F, Bagheri R, Clark CCT, Wong A, Suzuki K, Mirzaei K. The Association of Inflammatory Markers, IL-1 α and TGF- β, with Dietary Insulin Load and Dietary Insulin Index in Overweight and Obese Women with Healthy and Unhealthy Metabolic Phenotypes: A Cross-Sectional Study. Int J Clin Pract 2022; 2022:3407320. [PMID: 36311488 PMCID: PMC9584723 DOI: 10.1155/2022/3407320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/31/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Abstract
Context Research has shown IL-1α might play a role in the associations between the MH group and DII and DIL. Objective. We evaluated the association of inflammatory markers, IL-1α and TGF-β, with dietary insulin load and index in women with healthy and unhealthy obesity phenotypes. Materials and Methods. 228 obese/overweight women aged 18-48 years were included in this study. Biochemical factors were obtained from blood samples. Body composition, anthropometric measures, and physical activity assessments were performed. Dietary intakes, DII, and DIL were assessed. Results. Significant associations were observed between the MH group and the DII group (OR = 2.142, 95% CI = 1.421, 2.850, and p = 0.040), in which IL-1α may play a role. Discussion and Conclusion. Significant associations were observed between the MH group and DII. IL-1α might play a role in these associations.
Collapse
Affiliation(s)
- Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, USA
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
80
|
Wan Mohd Zin RM, Jalaludin MY, Yahya A, Nur Zati Iwani AK, Md Zain F, Hong JYH, Mokhtar AH, Wan Mohamud WN. Prevalence and clinical characteristics of metabolically healthy obese versus metabolically unhealthy obese school children. Front Endocrinol (Lausanne) 2022; 13:971202. [PMID: 36072927 PMCID: PMC9441792 DOI: 10.3389/fendo.2022.971202] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Children with obesity in the absence of traditional cardiometabolic risk factors (CRF) have been described as metabolically healthy obese (MHO). Children with MHO phenotype has a favorable metabolic profile with normal glucose metabolism, lipids, and blood pressure compared to children with metabolically unhealthy obese (MUO) phenotype. This study aimed to compare several parameters related to obesity between these two groups and to examine the predictors associated with the MHO phenotype. METHODS This study included a cross-sectional baseline data of 193 children with obesity (BMI z-score > +2 SD) aged 8-16 years enrolled in MyBFF@school program, a school-based intervention study conducted between January and December 2014. Metabolic status was defined based on the 2018 consensus-based criteria with MHO children had no CRF (HDL-cholesterol > 1.03 mmol/L, triglycerides ≤ 1.7 mmol/L, systolic and diastolic blood pressure ≤ 90th percentile, and fasting plasma glucose ≤ 5.6 mmol/L). Those that did not meet one or more of the above criteria were classified as children with MUO phenotype. RESULTS The prevalence of MHO was 30.1% (95% CI 23.7 - 37.1) among schoolchildren with obesity and more common in younger and prepubertal children. Compared to MUO, children with MHO phenotype had significantly lower BMI, lower waist circumference, lower uric acid, higher adiponectin, and higher apolipoprotein A-1 levels (p < 0.01). Multivariate logistic regression showed that adiponectin (OR: 1.33, 95% CI 1.05 - 1.68) and apolipoprotein A-1 (OR: 1.02, 95% CI 1.01 - 1.03) were independent predictors for MHO phenotype in this population. CONCLUSIONS MHO phenotype was more common in younger and prepubertal children with obesity. Higher serum levels of adiponectin and apolipoprotein A-1 increased the possibility of schoolchildren with obesity to be classified into MHO phenotype.
Collapse
Affiliation(s)
- Ruziana Mona Wan Mohd Zin
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin,
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Kamil Nur Zati Iwani
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Fuziah Md Zain
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Janet Yeow Hua Hong
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wan Nazaimoon Wan Mohamud
- Endocrine and Metabolic Unit, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| |
Collapse
|
81
|
Xi B, Cadenas-Sanchez C. Editorial: Metabolically healthy and unhealthy obese children and adolescents, volume II. Front Endocrinol (Lausanne) 2022; 13:1111060. [PMID: 36601013 PMCID: PMC9807135 DOI: 10.3389/fendo.2022.1111060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Cristina Cadenas-Sanchez
- Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Cristina Cadenas-Sanchez,
| |
Collapse
|
82
|
Sex differences in white adipose tissue expansion: emerging molecular mechanisms. Clin Sci (Lond) 2021; 135:2691-2708. [PMID: 34908104 DOI: 10.1042/cs20210086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022]
Abstract
The escalating prevalence of individuals becoming overweight and obese is a rapidly rising global health problem, placing an enormous burden on health and economic systems worldwide. Whilst obesity has well described lifestyle drivers, there is also a significant and poorly understood component that is regulated by genetics. Furthermore, there is clear evidence for sexual dimorphism in obesity, where overall risk, degree, subtype and potential complications arising from obesity all differ between males and females. The molecular mechanisms that dictate these sex differences remain mostly uncharacterised. Many studies have demonstrated that this dimorphism is unable to be solely explained by changes in hormones and their nuclear receptors alone, and instead manifests from coordinated and highly regulated gene networks, both during development and throughout life. As we acquire more knowledge in this area from approaches such as large-scale genomic association studies, the more we appreciate the true complexity and heterogeneity of obesity. Nevertheless, over the past two decades, researchers have made enormous progress in this field, and some consistent and robust mechanisms continue to be established. In this review, we will discuss some of the proposed mechanisms underlying sexual dimorphism in obesity, and discuss some of the key regulators that influence this phenomenon.
Collapse
|
83
|
Dong Y, Bai L, Cai R, Zhou J, Ding W. Visceral adiposity index performed better than traditional adiposity indicators in predicting unhealthy metabolic phenotype among Chinese children and adolescents. Sci Rep 2021; 11:23850. [PMID: 34903825 PMCID: PMC8668984 DOI: 10.1038/s41598-021-03311-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/26/2021] [Indexed: 01/23/2023] Open
Abstract
The relationship between visceral adiposity index (VAI) and unhealthy metabolic phenotype remained unclear in children and adolescents. This study aimed to investigate their association and compared the ability of VAI and traditional adiposity indicators (body mass index, waist circumference and waist-to-height ratio) to predict metabolically unhealthy phenotype among normal-weight, overweight and obese children and adolescents. In this cross-sectional study, 1722 children and adolescents aged 12-18 years were selected by cluster random sampling, underwent a questionnaire survey, physical examination and biochemical tests. Participants were divided into four phenotypes according to the combination of the weight status determined by body mass index (BMI) and metabolic syndrome components. Receiver operating characteristic (ROC) analysis and multivariate logistic regression were used to compare the predictive capacity between VAI and traditional adiposity indicators and their relationship with metabolically unhealthy phenotype. We found that VAI had better performance in predicting metabolically unhealthy phenotype than traditional adiposity indicators, the area under the receiver-operating characteristic curve (AUC) were 0.808 and 0.763 for boys and girls with normal-weight, 0.829 and 0.816 for boys and girls with overweight and obese (all P < 0.001). VAI was most strongly related to metabolically unhealthy phenotype whether or not to adjust the age, the adjusted OR and 95%CI was 6.15 (4.13-9.14) in boys with normal weight, and 5.90 (3.06-11.36), 4.95 (2.35-10.41) in boys and girls with overweight and obese, respectively (all P < 0.001). Our findings suggested VAI could be used as a comprehensive predictor to identify unhealthy metabolic phenotype in children and adolescents.
Collapse
Affiliation(s)
- Yangyang Dong
- School of Public Health and Management, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China
| | - Ling Bai
- School of Public Health and Management, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China
| | - Rongrong Cai
- School of Public Health and Management, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China
| | - Jinyu Zhou
- School of Public Health and Management, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China.,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China
| | - Wenqing Ding
- School of Public Health and Management, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China. .,Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, China.
| |
Collapse
|
84
|
Evolution of Metabolic Phenotypes of Obesity in Coronary Patients after 5 Years of Dietary Intervention: From the CORDIOPREV Study. Nutrients 2021; 13:nu13114046. [PMID: 34836298 PMCID: PMC8624211 DOI: 10.3390/nu13114046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Obesity phenotypes with different metabolic status have been described previously. We analyzed metabolic phenotypes in obese coronary patients during a 5-year follow-up, and examined the factors influencing this evolution. Methods: The CORDIOPREV study is a randomized, long-term secondary prevention study with two healthy diets: Mediterranean and low-fat. All obese patients were classified as either metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO). We evaluated the changes in the metabolic phenotypes and related variables after 5 years of dietary intervention. Results: Initially, 562 out of the 1002 CORDIOPREV patients were obese. After 5 years, 476 obese patients maintained their clinical and dietary visits; 71.8% of MHO patients changed to unhealthy phenotypes (MHO-Progressors), whereas the MHO patients who maintained healthy phenotypes (MHO-Non-Progressors) lost more in terms of their body mass index (BMI) and had a lower fatty liver index (FLI-score) (p < 0.05). Most of the MUO (92%) patients maintained unhealthy phenotypes (MUO-Non-Responders), but 8% became metabolically healthy (MUO-Responders) after a significant decrease in their BMI and FLI-score, with improvement in all metabolic criteria. No differences were found among dietary groups. Conclusions: A greater loss of weight and liver fat is associated with a lower progression of the MHO phenotype to unhealthy phenotypes. Likewise, a marked improvement in these parameters is associated with regression from MUO to healthy phenotypes.
Collapse
|
85
|
Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition. Nutrients 2021; 13:nu13113925. [PMID: 34836180 PMCID: PMC8624317 DOI: 10.3390/nu13113925] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 01/08/2023] Open
Abstract
Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m2 and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (p < 0.001), testosterone (p < 0.001), and insulin (p < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (p < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (p < 0.001) in spite of the same total energy intake (p = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, p < 0.001), more severe hyperandrogenism and cardio-metabolic indices (p < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, p < 0.001), and smaller PhAs (OR = 0.04, p < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (p < 0.001), followed by VAI (p < 0.001), and FLI (p = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (p < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.
Collapse
|
86
|
Gökçay Canpolat A, Demir Ö, Şahin M, Emral R, Çorapçıoğlu D. The missing link between inflammation and arterial stiffness among different metabolic phenotypes. Int J Clin Pract 2021; 75:e14727. [PMID: 34383387 DOI: 10.1111/ijcp.14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/27/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Although metabolically healthy obesity (MHO) has begun to be seen as a being benign phenomenon, this conclusion is still not completely certain. Obesity is also associated with low-grade systemic inflammation and endothelial dysfunction. Thus, we aimed to assess Pulse Wave Velocity (PWV) as a marker of arterial stiffness and CV risk among individuals with MHO, metabolically unhealthy obesity (MUO), and metabolically healthy normal-weight (MHN). METHODS 150 participants (n = 50 MHO, n = 50 MUO, n = 50 MHN) who had been admitted to our outpatient clinics were enrolled in this cross-sectional study. Demographic, anthropometric, clinical, and laboratory data, including hs-CRP and PWV, were recorded for all subjects. RESULTS hs-CRP and PWV were higher in MUO and MHO than MHN individuals (P < .05). hs-CRP showed a strong positive correlation with PWV (r = 0.85, P < .001). After adjusting for other risk factors, multivariate linear regression analysis showed that the PWV was independently associated with BMI (β = 0.08, P = .03), WC (β = 0.04, P = .04) and hs-CRP (β = 6.08, P < .001). CONCLUSIONS PWV, which is an important non-invasive marker of cardiovascular risk, is higher in MHO than in MHN as in MUO individuals. Moreover, PWV was positively correlated with the serum hs-CRP level as a conventional marker for systemic inflammation. Thus, MHO can be seen as a cardiometabolic risk marker.
Collapse
Affiliation(s)
- Asena Gökçay Canpolat
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özgür Demir
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Rıfat Emral
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
87
|
Kesztyüs D, Lampl J, Kesztyüs T. The Weight Problem: Overview of the Most Common Concepts for Body Mass and Fat Distribution and Critical Consideration of Their Usefulness for Risk Assessment and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111070. [PMID: 34769593 PMCID: PMC8583287 DOI: 10.3390/ijerph182111070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
The prevalence of obesity already reached epidemic proportions many years ago and more people may die from this pandemic than from COVID-19. However, the figures depend on which measure of fat mass is used. The determination of the associated health risk also depends on the applied measure. Therefore, we will examine the most common measures for their significance, their contribution to risk assessment and their applicability. The following categories are reported: indices of increased accumulation of body fat; weight indices and mortality; weight indices and risk of disease; normal weight obesity and normal weight abdominal obesity; metabolically healthy obesity; the obesity paradox. It appears that BMI is still the most common measure for determining weight categories, followed by measures of abdominal fat distribution. Newer measures, unlike BMI, take fat distribution into account but often lack validated cut-off values or have limited applicability. Given the high prevalence of obesity and the associated risk of disease and mortality, it is important for a targeted approach to identify risk groups and determine individual risk. Therefore, in addition to BMI, a measure of fat distribution should always be used to ensure that less obvious but risky manifestations such as normal weight obesity are identified.
Collapse
Affiliation(s)
- Dorothea Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
- Correspondence: ; Tel.: +49-731-37873521
| | - Josefine Lampl
- General Practitioner Centre Arnold & Liffers, Albstr. 6, 89081 Jungingen, Germany;
| | - Tibor Kesztyüs
- Department of Medical Informatics at the University Medical Centre Göttingen, Georg August University, Von-Siebold-Str. 3, 37075 Göttingen, Germany;
| |
Collapse
|
88
|
De Maio F, Boru CE, Avallone M, Velotti N, Bianco DM, Capoccia D, Greco F, Guarisco G, Nogara M, Sanguinetti M, Verrastro O, Capaldo B, Musella M, Raffaelli M, Delogu G, Silecchia G, Leonetti F. Characterization of gut microbiota in patients with metabolic syndrome candidates for bariatric/metabolic surgery: Preliminary findings of a multi-center prospective study. Diabetes Res Clin Pract 2021; 180:109079. [PMID: 34599974 DOI: 10.1016/j.diabres.2021.109079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION gut microbiota (GM) seems to be involved in the pathophysiology and progression of both metabolic syndrome (MS) and obesity. The aim was to investigate GM's composition in patients with severe obesity, candidates for bariatric/metabolic surgery BMS. MATERIALS AND METHODS Multicentre, prospective, cohort study, enrolling 84 patients with BMI 40-55 kg/m2, divided bymetabolic status (MS) inhealthy(group A), pre-MS (B), or MS (C). RESULTS No differences were foundregarding anthropometric,nutritional parameters, except for vitamin D.As a whole the alpha and beta diversity examinations showed no statistical differences in GM profile. A total of 5/7 phyla with relative frequencies were identified above 0.1% (Actinobacteria,Bacteroidetes,Firmicutes,Proteobacteria,Verrucomicrobia).FusobacteriaandPatescibacteriarepresented the less abundant. There were no significant differences in the top ten genera.Data onBacteroidetes(inversely related to triglycerides and LDL and directly related to HDL levels) and onFirmicutes(opposite trend) relative abundances suggest no differences among the three conditions.No correlation between the relative abundance of themain phylaand plasmatic glucose levels was observed. CONCLUSIONS In a selected cohort of patients with obesity, MS did not affect the preoperative GM's profile. Severe obesity, per se, seems to be an independent condition affecting GM.
Collapse
Affiliation(s)
- Flavio De Maio
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Facoltà di Medicina, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Cristian Eugeniu Boru
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy.
| | - Marcello Avallone
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy.
| | - Nunzio Velotti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Delia Mercedes Bianco
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Danila Capoccia
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy
| | - Francesco Greco
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del S. Cuore, Rome, Italy
| | - Gloria Guarisco
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy
| | - Manuela Nogara
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Facoltà di Medicina, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Ornella Verrastro
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del S. Cuore, Rome, Italy.
| | - Brunella Capaldo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Mario Musella
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Marco Raffaelli
- Division of Endocrine and Metabolic Surgery, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del S. Cuore, Rome, Italy.
| | - Giovanni Delogu
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Facoltà di Medicina, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Mater Olbia Hospital, Olbia, Italy.
| | - Gianfranco Silecchia
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy.
| | - Frida Leonetti
- Division of General Surgery and Bariatric Center of Excellence IFSO-EC, Department of Medico-Surgical Sciences and Biotechnologies, University "La Sapienza" of Rome, Italy.
| |
Collapse
|
89
|
Chen TP, Lin WY, Chiang CH, Shen TH, Huang KC, Yang KC. Metabolically healthy obesity and risk of non-alcoholic fatty liver disease severity independent of visceral fat. J Gastroenterol Hepatol 2021; 36:2903-2910. [PMID: 33973273 DOI: 10.1111/jgh.15544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Obesity and metabolic conditions may be related to non-alcoholic fatty liver disease (NAFLD). The study assesses the risk of NAFLD according to obesity and metabolic health status in a community-based population. METHODS A total of 1651 subjects were recruited from the community. Individuals were categorized into four groups according to obesity status (defined as a body mass index ≥ 25 kg/m2 ) and metabolically healthy status: metabolically healthy nonobesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy nonobesity (MUHNO), and metabolically unhealthy obesity (MUHO). NAFLD was diagnosed based on a semiquantitative ultrasonography measurement. Visceral fat was assessed through bioelectrical impedance analysis and is shown by tertile (T1, T2, and T3). A proportional odds model was used to assess the cumulative risk of NAFLD. RESULTS The NAFLD prevalence was 26.7%, 62.8%, 47.0%, and 76.7% in subjects with MHNO, MHO, MUHNO, and MUHO, respectively (P < 0.0001). After adjustment for age, sex, exercise habits, alcohol consumption, cigarette smoking, and visceral fat, the odds ratios for more severe NAFLD were 2.44 (95% confidence interval [CI]: 1.64-3.65), 2.75 (95% CI: 1.91-3.94), and 7.41 (95% CI: 4.94-11.12) in the MHO, MUHNO, and MUHO groups, respectively, compared with the MHNO group. In addition, the odds ratios for more severe NAFLD significantly increased with the increase in visceral fat level (T2 vs T1: 3.83, 95% CI: 2.65-5.53; T3 vs T1: 9.17, 95% CI: 5.33-15.79). CONCLUSION Both obesity and metabolically unhealthy status were associated with a higher risk of NAFLD independent of visceral fat level.
Collapse
Affiliation(s)
- Tsung-Po Chen
- Department of Community and Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- Department of Community and Family Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Hsieh Chiang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Hsin Shen
- Department of Community and Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuen-Cheh Yang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
90
|
Barrea L, Vetrani C, Caprio M, El Ghoch M, Frias-Toral E, Mehta RJ, Mendez V, Moriconi E, Paschou SA, Pazderska A, Savastano S, Colao A, Muscogiuri G. Nutritional management of type 2 diabetes in subjects with obesity: an international guideline for clinical practice. Crit Rev Food Sci Nutr 2021; 63:2873-2885. [PMID: 34554038 DOI: 10.1080/10408398.2021.1980766] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Type 2 diabetes mellitus (T2DM) and obesity represent a global public health problem. Current nutritional recommendations focused on weight loss and overall dietary quality. However, there is no consensus on the optimal macronutrient composition of the diet, particularly for the long-term management of T2DM in subjects with obesity. An international panel of experts reviewed and critically appraised the updated literature published on the topic. This review primarily examines the evidence for areas of consensus and uncertainty about nutritional therapy in patients with T2DM and obesity. The aim of this article is to provide nutritional advice to manage these patients in clinical practice.
Collapse
Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, Italy.,Centro Italiano per la cura e il benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Rome, Italy.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | | | | | - Verna Mendez
- Endocrinology Department, Mexican Institute of Social Security, Los Mochis, Sinaloa, Mexico
| | - Eleonora Moriconi
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Agnieszka Pazderska
- St James's Hospital, Dublin, Ireland.,Trinity College Dublin, Dublin, Ireland
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University of Naples "Federico II", Naples, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University of Naples "Federico II", Naples, Italy
| |
Collapse
|
91
|
Serbis A, Giapros V, Paschou SA, Siomou E. Children with metabolically healthy obesity have a worse metabolic profile compared to normal-weight peers: a cross-sectional study. Endocrine 2021; 73:580-587. [PMID: 34023981 DOI: 10.1007/s12020-021-02762-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/10/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE A phenotype of metabolically healthy obesity (MHO) has been described in youth with obesity, but data are still scarce in this age group. The aim of the current study was to describe and compare clinical and laboratory parameters related to obesity among three different groups of youth, namely youth with normal weight (NW), with MHO, and with metabolically unhealthy obesity (MUO). METHODS One hundred and three youngsters with obesity were divided according to 2018 consensus-based criteria into those with MHO [n = 49, age (±SD): 10.9 ± 2.9 years] and those with MUO [n = 54, 11.5 ± 2.7 years] and were compared to age-, sex- and Tanner-matched NW [n = 69, 11.3 ± 2.9 years]. Several obesity-related parameters were investigated for all three groups of children. Comparisons were made by analysis of variance (ANOVA) followed by the Fisher's PLSD test. RESULTS Youth with MHO had lower systolic (p < 0.001) and diastolic (p < 0.01) blood pressure z-score and triglycerides (p < 0.01), but higher HDL-C (p < 0.001), total cholesterol (p < 0.05), and apo-A1 (p < 0.05) compared to those with MUO. Compared to controls, both children with MHO and MUO showed higher fasting insulin (p < 0.05), HOMA-IR (p < 0.05), and QUICKI (p < 0.001). Similarly, both groups had higher hsCRP, fibrinogen, uric acid, and leptin compared to controls (for all, p < 0.001), while their adiponectin was lower (p < 0.05). Visfatin was higher in children with MUO compared to controls (p < 0.01), and it showed a trend to be lower in children with MHO compared to those with MUO (p = 0.1). CONCLUSION This study provides evidence that children identified as having MHO by the consensus-based criteria had better metabolic profiles than youth with MUO, but worse than NW. Further research is needed in pediatric populations both regarding MHO criteria and the nature of the MHO phenotype per se.
Collapse
Affiliation(s)
- Anastasios Serbis
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
| | - Vasilieios Giapros
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ekaterini Siomou
- Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| |
Collapse
|
92
|
Oxidative Stress in Association with Metabolic Health and Obesity in Young Adults. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9987352. [PMID: 34257828 PMCID: PMC8257366 DOI: 10.1155/2021/9987352] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 12/13/2022]
Abstract
Introduction Obesity is one of the most important public health problems in the world. Among obese people, there are those who, apart from excessive body weight, do not exhibit other metabolic dysfunctions, have a lower risk of developing cardiovascular diseases (CVDs), and show lower mortality. According to the theory, they are referred as metabolically healthy obese (MHO), in contrast to metabolically unhealthy obese (MUO). Metabolic disturbances occurring with obesity have been well established to be associated with oxidative stress. Aim The purpose of this study was to analyse the association between selected anthropometric and biochemical parameters with oxidative stress in MHO, MUO, and normal weight young adults. Material and Methods. Individuals with age between 18 and 36 years with no history of chronic diseases and use of medicaments, with or without obesity, participated in the study. Complete blood counts, biochemical measurements, and parameters of oxidative stress such as total antioxidant capacity (TAC), total oxidative status (TOS), oxidative stress index (OSI), serum concentration of malondialdehyde (MDA), ceruloplasmin, thiol groups and lipid hydroperoxides (LPH), concentration of lipofuscin (LPS) in erythrocytes, and the activity of superoxide dismutase (SOD) were measured. Results 422 patients who met the inclusion criteria were enrolled in the study. Among the study participants, 208 people (49.29%) were offspring of patients with angiographically confirmed coronary artery disease. Among the participants, 16 patients have been included in the group of metabolically healthy obese (MHO) people and 61 patients in the group of metabolically unhealthy obese (MUO) people and 345 patients had normal body weight. Significant differences between metabolically unhealthy obese and normal weight patients, as well as between women and men, have been found. Conclusions We showed significant differences in the selected parameters of oxidative stress between metabolically unhealthy obese (MUO) individuals and young volunteers with normal body weight as well as without significant medical history.
Collapse
|
93
|
Abstract
This Review focuses on the mechanistic evidence for a link between obesity, dysregulated cellular metabolism and breast cancer. Strong evidence now links obesity with the development of 13 different types of cancer, including oestrogen receptor-positive breast cancer in postmenopausal women. A number of local and systemic changes are hypothesized to support this relationship, including increased circulating levels of insulin and glucose as well as adipose tissue-derived oestrogens, adipokines and inflammatory mediators. Metabolic pathways of energy production and utilization are dysregulated in tumour cells and this dysregulation is a newly accepted hallmark of cancer. Dysregulated metabolism is also hypothesized to be a feature of non-neoplastic cells in the tumour microenvironment. Obesity-associated factors regulate metabolic pathways in both breast cancer cells and cells in the breast microenvironment, which provides a molecular link between obesity and breast cancer. Consequently, interventions that target these pathways might provide a benefit in postmenopausal women and individuals with obesity, a population at high risk of breast cancer.
Collapse
Affiliation(s)
- Kristy A Brown
- Sandra and Edward Meyer Cancer Center and Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| |
Collapse
|
94
|
Liu J, Zhang L, Fu J, Wang Q, Wang G. Circulating prolactin level is increased in metabolically healthy obesity. Endocr Connect 2021; 10:484-491. [PMID: 33794504 PMCID: PMC8111314 DOI: 10.1530/ec-21-0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Prolactin (PRL) has been demonstrated as a metabolic hormone to regulate energy metabolism recently. The present study aims to investigate the association between PRL and metabolic alterations in different obesity phenotypes. METHODS A total of 451 drug-naive participants were recruited, comprising 351 obese patients and 100 age- and sex-matched healthy participants with normal weight. PRL, anthropometric, and clinical parameters were measured. RESULTS In the obesity group, 15.1% (53/351) were categorized as 'metabolically healthy obesity (MHO)'. Besides favorable blood pressure, glucose, and lipids profiles, the MHO group exhibited increased PRL, and lower levels of high-sensitivity C-reactive protein (hsCRP), homeostasis model assessment of insulin resistance (HOMA-IR), and adipose tissue insulin resistance (adipo-IR) than the metabolically unhealthy obesity (MUHO) group (PRL, HOMA-IR, and adipo-IR: P < 0.01; hsCRP: P < 0.05). The severe MUHO group showed significantly decreased PRL levels than the mild MUHO group (P < 0.05). Multivariate linear regression analysis indicated that fasting plasma glucose (FBG) and adipo-IR were significantly associated with PRL (FBG: β = -0.263, P < 0.05; adipo-IR: β = -0.464, P < 0.01). Multivariable logistic regression analysis showed that hsCRP (OR = 0.824) and PRL (OR = 1.211) were independent predictors of MHO (all P < 0.01). CONCLUSION The MHO group had significantly increased circulating PRL levels when compared with the control and MUHO groups, and multivariable logistic regression analysis showed that PRL was independent predictors of MHO. Our findings suggested that increased circulating PRL might be a compensatory response for favoring energy metabolism during obesity.
Collapse
Affiliation(s)
- Jia Liu
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Lin Zhang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Jing Fu
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Qiu Wang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China
- Correspondence should be addressed to G Wang:
| |
Collapse
|
95
|
Atakan MM, Koşar ŞN, Güzel Y, Tin HT, Yan X. The Role of Exercise, Diet, and Cytokines in Preventing Obesity and Improving Adipose Tissue. Nutrients 2021; 13:nu13051459. [PMID: 33922998 PMCID: PMC8145589 DOI: 10.3390/nu13051459] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/17/2022] Open
Abstract
The prevalence of obesity continues to rise worldwide despite evidence-based public health recommendations. The promise to adopt a healthy lifestyle is increasingly important for tackling this global epidemic. Calorie restriction or regular exercise or a combination of the two is accepted as an effective strategy in preventing or treating obesity. Furthermore, the benefits conferred by regular exercise to overcome obesity are attributed not only to reduced adiposity or reduced levels of circulating lipids but also to the proteins, peptides, enzymes, and metabolites that are released from contracting skeletal muscle or other organs. The secretion of these molecules called cytokines in response to exercise induces browning of white adipose tissue by increasing the expression of brown adipocyte-specific genes within the white adipose tissue, suggesting that exercise-induced cytokines may play a significant role in preventing obesity. In this review, we present research-based evidence supporting the effects of exercise and various diet interventions on preventing obesity and adipose tissue health. We also discuss the interplay between adipose tissue and the cytokines secreted from skeletal muscle and other organs that are known to affect adipose tissue and metabolism.
Collapse
Affiliation(s)
- Muhammed Mustafa Atakan
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Şükran Nazan Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Yasemin Güzel
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, 06800 Ankara, Turkey; (M.M.A.); (Ş.N.K.); (Y.G.)
| | - Hiu Tung Tin
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
| | - Xu Yan
- Institute for Health and Sport (iHeS), Victoria University, P.O. Box 14428, Melbourne 8001, Australia;
- Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia
- Correspondence: ; Tel.: +61-3-9919-4024; Fax: +61-3-9919-5615
| |
Collapse
|
96
|
Muscogiuri G, Barrea L, Caprio M, Ceriani F, Chavez AO, El Ghoch M, Frias-Toral E, Mehta RJ, Mendez V, Paschou SA, Pazderska A, Savastano S, Colao A. Nutritional guidelines for the management of insulin resistance. Crit Rev Food Sci Nutr 2021; 62:6947-6960. [PMID: 33797999 DOI: 10.1080/10408398.2021.1908223] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Obesity and its related co-morbidities, namely type 2 diabetes (T2D), pose a significant global public health problem. Insulin resistance (IR) in muscle and liver is the core pathophysiologic defect that underlies obesity preceding and predicting the onset of T2D in susceptible humans. There is a broad population with IR that has no indication for prescription of medications, who still need medical consultation and specific advice in this respect. This prevalent need can be achieved by appropriate diet, exercise, and other behavioral therapies for lifestyle interventions. Despite a well-recognized role of IR in the progression to metabolic diseases, no specific nutritional recommendations exist to manage this condition, to the best of our knowledge. An international panel of experts reviewed and critically appraised the updated literature published about this topic. This review primarily examines the evidence for areas of consensus and ongoing uncertainty or controversy about diet and exercise approaches for IR. The aim of this article is to present the most common IR states, namely obesity and Polycystic Ovary Syndrome (PCOS), and provide nutritional advice to manage IR, hyperinsulinemia, and reactive hypoglycemia. These nutritional guidelines could prevent progression or worsening of IR with resultant beta-cell failure and, as a result, T2D.
Collapse
Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", Federico II University, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy.,Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Napoli, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Rome, Italy.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Florencia Ceriani
- Nutrition School, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Alberto O Chavez
- Division of Diabetes, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador
| | | | - Verna Mendez
- Department of Internal Medicine, Hospital General de Zona 49, Mexican Institute of Social Security, Los Mochis, Sinaloa, México
| | - Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Agnieszka Pazderska
- Endocrinology Unit, St James's Hospital, Dublin, Ireland.,Clinical Senior Lecturer, Trinity College Dublin, Dublin, Ireland
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy.,Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", Federico II University, Naples, Italy.,Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Via Sergio Pansini, 5, Naples, Italy
| |
Collapse
|
97
|
Effects of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 Supplementation on Nutritional and Metabolic Parameters in the Early Postoperative Period after Roux-en-Y Gastric Bypass: a Randomized, Double-Blind, Placebo-Controlled Trial. Obes Surg 2021; 31:2105-2114. [DOI: 10.1007/s11695-021-05222-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022]
|
98
|
Cano-García L, Mena-Vázquez N, Manrique Arija S, Hernández-Sánchez MD, Segura-Ruiz R, Domínguez-Quesada C, Fernández-Nebro A. Psychological factors associated with sleep disorders in patients with axial spondyloarthritis or psoriatic arthritis: A multicenter cross-sectional observational study. J Clin Nurs 2020; 30:266-275. [PMID: 33113279 DOI: 10.1111/jocn.15546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/26/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies in axial spondyloarthritis (AxSp) have shown that intensity of pain, anxiety, depression and inflammatory activity are associated with poor sleep quality. AIM To describe mood and sleep disorders and positive psychological factors in patients with AxSp and psoriatic arthritis (PsA) and to evaluate the psychological factors that are potentially involved in sleep disorders. DESIGN Multicenter cross-sectional observational study based on a series of patients with AxSp and PsA. PARTICIPANTS Participants were selected consecutively from patients aged ≥18 years with AxSp or PsA followed at the rheumatology department of 4 Spanish hospitals. INCLUSION CRITERIA age ≥18 years, AxSp (ASAS criteria) or PsA (CASPAR criteria), ability to understand the study and prepared to complete the questionnaires. METHODS Main outcomes: Oviedo Sleep Quality questionnaire result. SECONDARY OUTCOMES psychological status evaluated using the Hospital Anxiety and Depression Scale (HADS) questionnaire, health-related quality of life evaluated using SF-36, perception of pain evaluated using the short questionnaire for assessment of pain (BDU) and fatigue evaluated using the Fatigue Scale (FACIT) questionnaire. We performed a descriptive multivariate linear regression analysis to study factors that were independently associated with sleep disorders. The STROBE guidelines were adopted. RESULTS We included 301 patients (152 [50.5%] with AxSp and 149 [49.5%] with PsA). The multivariate linear regression analysis for the whole sample showed that insomnia was inversely associated with emotional recovery and biologic disease-modifying antirheumatic drugs and directly associated with depression in both groups. The analysis by disease (AxSp and PsA) showed that insomnia was independently associated with depression and emotional recovery. CONCLUSIONS Insomnia may be associated with other mood disorders, quality of life and inflammatory activity in the patients studied here. RELEVANCE TO CLINICAL PRACTICE A nurse intervention can be carried out to prevent sleep disorders knowing the consequences and triggers of the problem.
Collapse
Affiliation(s)
- Laura Cano-García
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Natalia Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Sara Manrique Arija
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | | | | | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain.,Departamento de Medicina, Universidad de Málaga, Málaga, Spain
| |
Collapse
|
99
|
Prevention of Diabetes and Cardiovascular Disease in Obesity. Int J Mol Sci 2020; 21:ijms21218178. [PMID: 33142938 PMCID: PMC7663329 DOI: 10.3390/ijms21218178] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022] Open
Abstract
Obesity is one of the major risk factors for the development of both impaired glucose tolerance (IGT, or prediabetes) and type 2 diabetes (T2D), and its prevalence worldwide drives toward an increased rate of cardiovascular morbidity and mortality. Given the estimations of the World Health Organization (WHO) and the recommendation of the Diabetes Prevention Program (DPP), where IGT and diabetes are considered as risk factors for the development of cardiovascular complications and obesity, the development of diabetes should be treated because of its potential reversibility. In this view, several interventions such as diet, lifestyle changes, and pharmacological treatment are effective, including bariatric metabolic surgery (BMS), which is the most incisive way to efficiently lower body weight. In this review, we sought to summarize some of the major aspects linked to diabetes prevention in overweight/obesity, focusing on the use of surgery; we also attempted to elucidate molecular pathways involved in a variety of obesity-induced processes able to favor the progression of chronic diseases, such as diabetes and its complications.
Collapse
|
100
|
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) can begin in youth. Prevention is essential to reducing the burden of CVD-related risk factors in childhood and disease development in adulthood. This review addresses the clinical scope of CVD prevention, including a review of conditions encountered, proposed diagnostic criteria, and management strategies. We also highlight the impact of the intrauterine environment on the development of CVD risk. Finally, we highlight the potential role of telehealth in the management of pediatric patients with risk factors for premature CVD. RECENT FINDINGS Growing evidence suggests that maternal obesity, diabetes, and preeclampsia may play an important role in the development of CVD risk among offspring contributing to the development of known traditional CVD risk factors among offspring. As the prevalence of CVD continues to rise, knowledge as well as appropriate diagnosis and management of primordial and traditional risk factors for CVD is needed. The diagnosis and management of CVD risk factors is a central role of the preventive pediatric cardiologist, but it is imperative that the general physician and other pediatric subspecialists be aware of these risk factors, diagnoses, and management strategies. Finally, telehealth may offer an additional method for providing preventive care, including screening and counseling of at risk children and adolescents for traditional risk factors and for providing education regarding risk factors in cases of long distance care and/or during periods of social distancing.
Collapse
|