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Magri CJ, Xuereb S, Xuereb RA, Fava S. Metabolic Health and Carotid Intima-Media Thickness: Association of Different Definitions in Women. Am J Cardiol 2023; 206:35-39. [PMID: 37677881 DOI: 10.1016/j.amjcard.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023]
Abstract
The concept of metabolic health and the metabolic syndrome is to identify subjects at a higher cardiovascular risk. However, many definitions are currently in use, and it is uncertain which is the best in identifying at-risk subjects. We performed a cross-sectional study whereby women were invited to participate and were assessed for several anthropometric and biochemical parameters. Carotid intima-media thickness (CIMT) was measured in both common carotid arteries in each participant. The study cohort consisted of 203 white premenopausal women with a mean age of 38.3 ± 5.4 years. The prevalence of the metabolically unhealthy varied from 7.3% to 61.6%, according to the definition used. The prevalence of the metabolic syndrome, as defined by the International Diabetes Federation, was 20.7%. Women with a metabolically unhealthy phenotype had a higher referent CIMT for all definitions of metabolic health. Defining metabolically unhealthy phenotype as having <2 abnormalities using the National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (NCEP-ATPIII) cutoffs had the highest odds ratio for an abnormal CIMT. In conclusion, we found that in a contemporary cohort of middle-aged women, the NCEP-ATPIII definition of the metabolic syndrome was more strongly associated with atherosclerosis as determined by the CIMT than the International Diabetes Federation definition or other definitions of metabolic health; it was also more strongly associated than body mass index or waist circumference. Our results need to be validated by other investigators in other populations.
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Affiliation(s)
- Caroline Jane Magri
- University of Malta Medical School, Msida, Malta; Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Sara Xuereb
- Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Rachel-Anne Xuereb
- University of Malta Medical School, Msida, Malta; Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | - Stephen Fava
- University of Malta Medical School, Msida, Malta; Department of Medicine, Mater Dei Hospital, Msida, Malta.
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52
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Preda A, Carbone F, Tirandi A, Montecucco F, Liberale L. Obesity phenotypes and cardiovascular risk: From pathophysiology to clinical management. Rev Endocr Metab Disord 2023; 24:901-919. [PMID: 37358728 PMCID: PMC10492705 DOI: 10.1007/s11154-023-09813-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/27/2023]
Abstract
Obesity epidemic reached the dimensions of a real global health crisis with more than one billion people worldwide living with obesity. Multiple obesity-related mechanisms cause structural, functional, humoral, and hemodynamic alterations with cardiovascular (CV) deleterious effects. A correct assessment of the cardiovascular risk in people with obesity is critical for reducing mortality and preserving quality of life. The correct identification of the obesity status remains difficult as recent evidence suggest that different phenotypes of obesity exist, each one associated with different degrees of CV risk. Diagnosis of obesity cannot depend only on anthropometric parameters but should include a precise assessment of the metabolic status. Recently, the World Heart Federation and World Obesity Federation provided an action plan for management of obesity-related CV risk and mortality, stressing for the instauration of comprehensive structured programs encompassing multidisciplinary teams. In this review we aim at providing an updated summary regarding the different obesity phenotypes, their specific effects on CV risk and differences in clinical management.
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Affiliation(s)
| | - Federico Carbone
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132, Genoa, Italy
| | - Amedeo Tirandi
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132, Genoa, Italy
| | - Fabrizio Montecucco
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy.
- Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132, Genoa, Italy.
| | - Luca Liberale
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132, Genoa, Italy
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Salmón-Gómez L, Catalán V, Frühbeck G, Gómez-Ambrosi J. Relevance of body composition in phenotyping the obesities. Rev Endocr Metab Disord 2023; 24:809-823. [PMID: 36928809 PMCID: PMC10492885 DOI: 10.1007/s11154-023-09796-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
Obesity is the most extended metabolic alteration worldwide increasing the risk for the development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. Body mass index (BMI) remains the most frequently used tool for classifying patients with obesity, but it does not accurately reflect body adiposity. In this document we review classical and new classification systems for phenotyping the obesities. Greater accuracy of and accessibility to body composition techniques at the same time as increased knowledge and use of cardiometabolic risk factors is leading to a more refined phenotyping of patients with obesity. It is time to incorporate these advances into routine clinical practice to better diagnose overweight and obesity, and to optimize the treatment of patients living with obesity.
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Affiliation(s)
- Laura Salmón-Gómez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Irunlarrea 1, Pamplona, 31008, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain.
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Pamplona, Spain.
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54
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Boakye E, Grandhi GR, Dardari Z, Adhikari R, Soroosh G, Jha K, Dzaye O, Tasdighi E, Erhabor J, Kumar SJ, Whelton S, Blumenthal RS, Albert M, Rozanski A, Berman DS, Budoff MJ, Miedema MD, Nasir K, Rumberger JA, Shaw LJ, Blaha M. Cardiovascular risk stratification among individuals with obesity: The Coronary Artery Calcium Consortium. Obesity (Silver Spring) 2023; 31:2240-2248. [PMID: 37534563 PMCID: PMC10524261 DOI: 10.1002/oby.23832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/24/2023] [Accepted: 05/16/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE The effectiveness of coronary artery calcification (CAC) for risk stratification in obesity, in which imaging is often limited because of a reduced signal to noise ratio, has not been well studied. METHODS Data from 9334 participants (mean age: 53.3 ± 9.7 years; 67.9% men) with BMI ≥ 30 kg/m2 from the CAC Consortium, a retrospectively assembled cohort of individuals with no prior cardiovascular diseases (CVD), were used. The predictive value of CAC for all-cause and cause-specific mortality was evaluated using multivariable-adjusted Cox proportional hazards and competing-risks regression. RESULTS Mean BMI was 34.5 (SD 4.4) kg/m2 (22.7% Class II and 10.8% Class III obesity), and 5461 (58.5%) had CAC. Compared with CAC = 0, those with CAC = 1-99, 100-299, and ≥300 Agatston units had higher rates (per 1000 person-years) of all-cause (1.97 vs. 3.5 vs. 5.2 vs. 11.3), CVD (0.4 vs. 1.1 vs. 1.5 vs. 4.2), and coronary heart disease (CHD) mortality (0.2 vs. 0.6 vs. 0.6 vs. 2.5), respectively, after mean follow-up of 10.8 ± 3.0 years. After adjusting for traditional cardiovascular risk factors, CAC ≥ 300 was associated with significantly higher risk of all-cause (hazard ratio [HR]: 2.05; 95% CI: 1.49-2.82), CVD (subdistribution HR: 3.48; 95% CI: 1.81-6.70), and CHD mortality (subdistribution HR: 5.44; 95% CI: 2.02-14.66), compared with CAC = 0. When restricting the sample to individuals with BMI ≥ 35 kg/m2 , CAC ≥ 300 remained significantly associated with the highest risk. CONCLUSIONS Among individuals with obesity, including moderate-severe obesity, CAC strongly predicts all-cause, CVD, and CHD mortality and may serve as an effective cardiovascular risk stratification tool to prioritize the allocation of therapies for weight management.
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Affiliation(s)
- Ellen Boakye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gowtham R Grandhi
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zeina Dardari
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rishav Adhikari
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Garshasb Soroosh
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kunal Jha
- Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Erfan Tasdighi
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John Erhabor
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sant J Kumar
- Department of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Seamus Whelton
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Albert
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai, St. Luke's Hospital, New York, New York, USA
| | - Daniel S Berman
- Departments of Imaging and Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Matthew J Budoff
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Michael D Miedema
- Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - John A Rumberger
- Department of Cardiac Imaging, Princeton Longevity Center, Princeton, New Jersey, USA
| | - Leslee J Shaw
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Michael Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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55
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Kanic V, Suran D. Sex differences in the relationship between body mass index and outcome in myocardial infarction. Am J Med Sci 2023; 366:219-226. [PMID: 37225090 DOI: 10.1016/j.amjms.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 12/24/2022] [Accepted: 04/14/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The data on sex-related differences regarding the body mass index (BMI) in patients with myocardial infarction (MI) are rare and inconclusive. We aimed to assess sex differences in the relationship between BMI and 30-day mortality in men and women with MI. METHODS A single-center retrospective study of 6453 patients with MI who underwent PCI was performed. Patients were divided into five BMI categories and these were compared. The relationship between BMI and 30-day mortality was assessed in men and women. RESULTS An L-shaped relationship between BMI and mortality was observed in men (p=0.003) with the highest mortality rate (9.4%) in normal weight patients and the lowest in patients with obesity grade I (5.3%). In women, similar mortality was found in all BMI categories (p=0.42). After adjustment for potential confounders, the negative association between BMI category and 30-day mortality was found in men, but not in women (p=0.033 and p=0.13, respectively). Overweight men had a 33% lower risk of death within 30 days compared to normal weight patients (OR 0.67,95%CI 0.46-0.96;p=0.03). Other BMI categories in men had a similar mortality risk to the normal weight category. CONCLUSIONS Our results suggest that the relationship between BMI and outcome in patients with MI is different in men and women. We found an L-shaped relationship between BMI and 30-day mortality in men, but no relationship was observed in women. The obesity paradox was not found in women. Sex itself could not explain this differential relationship, and the underlying cause is likely multifactorial.
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Affiliation(s)
- Vojko Kanic
- Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor, Maribor, Slovenia.
| | - David Suran
- Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor, Maribor, Slovenia
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56
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Lu G, Hu R, Dong Z, Wang J, Yang W, Wang C. Bibliometric and Correlation Analysis of Bariatric Surgery Researches in Asia-Pacific from 2000 to 2021. Obes Facts 2023; 16:484-496. [PMID: 37598680 PMCID: PMC10601626 DOI: 10.1159/000533152] [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: 12/12/2022] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Bariatric surgery has grown in popularity over the past two decades, especially in the Asia-Pacific. Correspondingly, researchers' interest in this field has also increased. This study aims to perform a bibliometric analysis of publications from Asia-Pacific represented by the International Federation for the Surgery of Obesity and Metabolic Disorders Asia-Pacific Chapter (IFSO-APC) and investigate the relevant factors that might affect the publications. METHODS The search terms for bariatric surgery were searched in Web of Science focusing on the period 2000-2021. Bibliometric analysis was performed after screening the search results. Univariate and multivariate regression analyses were performed on the number of publications and corresponding indicators obtained from official agencies. RESULTS A total of 9,547 publications in IFSO-APC were retrieved, of which China had the largest number with 2,782 publications. Authors and journals with major contributions were listed. The authors' or affiliations' cooperation networks mainly were limited to domestic. "Bariatric surgery" was the most frequent keyword with 2,063 times and also the largest cluster. "Morbid obesity" was the strongest citation bursts. Multivariate analysis found that the number of publications in each country/region was associated with body mass index ≥25 kg/m2, gross domestic product, and total population. CONCLUSION Generally, Asia-Pacific represented by IFSO-APC scientific publications on bariatric surgery has grown significantly in the last two decades, but cooperation between countries/regions should be strengthened. "Morbid obesity" is the focus and frontier of research in this field.
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Affiliation(s)
- Guanhua Lu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Ruixiang Hu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Zhiyong Dong
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
| | - Jianxue Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou, China
- Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China
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Harrold JA, Hill S, Radu C, Thomas P, Thorp P, Hardman CA, Christiansen P, Halford JCG. Effects of non-nutritive sweetened beverages versus water after a 12-week weight-loss program: A randomized controlled trial. Obesity (Silver Spring) 2023; 31:1996-2008. [PMID: 37475684 DOI: 10.1002/oby.23796] [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: 12/21/2022] [Revised: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The aim of this study was to compare non-nutritive sweetened (NNS) beverages versus water for weight loss after a 12-week behavioral weight-management program. METHODS This is an ongoing, 2-year, parallel-group, open-label, controlled equivalence trial; week-12 data are reported. Adults with BMI of 27 to 35 kg/m2 who regularly drank cold beverages were randomized 1:1 to intention-to-treat water or NNS beverages while undergoing a weekly 12-week group behavioral weight-management program. Weight change to week 12 was the primary end point (equivalence: two-sided p > 0.05); changes in waist and hip circumference, blood pressure, glycemic control markers, fasting lipid profiles, liver function tests, hunger (visual analog scale), sugar and sweetener consumption, and activity levels were secondary end points. RESULTS Overall, 493 participants were randomized (water: n = 246; NNS beverages: n = 247); 24.1% were NNS beverage naïve. Weight change was equivalent with water versus NNS beverages (-5.6 vs. -5.8 kg; difference [90% CI]: -0.2 kg [-0.7 to 0.4]). There were no significant differences between groups for secondary end points except reductions in waist circumference (greater with NNS beverages vs. water), glycated hemoglobin, and consumption of any type of sweetener (both greater with water vs. NNS beverages). CONCLUSIONS Weight loss was equivalent with NNS beverages and water following a 12-week behavioral weight-management program.
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Affiliation(s)
- Joanne A Harrold
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Scott Hill
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Cristina Radu
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Paul Thomas
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Paula Thorp
- Department of Psychology, University of Liverpool, Liverpool, UK
| | | | | | - Jason C G Halford
- Department of Psychology, University of Liverpool, Liverpool, UK
- School of Psychology, University of Leeds, Leeds, UK
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Estébanez B, Amaro-Gahete FJ, Gil-González C, González-Gallego J, Cuevas MJ, Jiménez-Pavón D. Influence of 12-Week Concurrent Training on Exosome Cargo and Its Relationship with Cardiometabolic Health Parameters in Men with Obesity. Nutrients 2023; 15:3069. [PMID: 37447395 DOI: 10.3390/nu15133069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
Exosome release varies depending on the physiological state of the cell, so they could play a fundamental role in obesity, the biggest pandemic in today's societies. The beneficial effects that physical activity has both on weight and cardiovascular parameters may be mediated by exosomes released in response to exercise. Thus, we aimed (I) to study the influence of a 12-week CT intervention on exosome cargo modifications in men with obesity and (II) to determine whether changes in exosomes after the intervention were related to changes in cardiometabolic health parameters in our cohorts. An experimental, controlled design was performed in twelve (nine with valid data) adult male obese patients (mean values: 41.6 years old, 97.6 kg and 32.4 kg/m2) who were randomly divided into a control group (n = 4) and a training group (n = 5), which completed 36 sessions of CT (concurrent training) for 12 weeks. Before and after the training period, cardiometabolic health parameters were evaluated and blood samples to measure exosomes and proteins were drawn. No changes were observed in the levels of any exosomal markers and proteins; however, associations of changes between CD81 and both fat mass and weight, Flot-1 and VO2max, HSP70 and both CRP and left ventricle diastolic diameter or CD14 and leptin were found (all p ≤ 0.05). Although the current CT was not able to clearly modify the exosome cargo, a certain medium to large clinical effect was manifested considering the nature of this study. Moreover, the associations found between the promoted changes in cardiometabolic parameters and exosome-carried proteins could indicate a relationship to be considered for future treatments in patients with obesity.
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Affiliation(s)
- Brisamar Estébanez
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Francisco J Amaro-Gahete
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
| | - Cristina Gil-González
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), 11519 Cádiz, Spain
| | - Javier González-Gallego
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
| | - María J Cuevas
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), 11519 Cádiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
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59
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Lavie CJ, Neeland IJ. Is Metabolically Healthy Obesity Really Healthy for the Heart? JACC Cardiovasc Imaging 2023; 16:902-904. [PMID: 37407122 DOI: 10.1016/j.jcmg.2023.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana, USA.
| | - Ian J Neeland
- Harrington Heart and Vascular Institute, University Hospital Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Zhong P, Tan S, Zhu Z, Bulloch G, Long E, Huang W, He M, Wang W. Metabolomic phenotyping of obesity for profiling cardiovascular and ocular diseases. J Transl Med 2023; 21:384. [PMID: 37308902 DOI: 10.1186/s12967-023-04244-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND We aimed to evaluate the impacts of metabolomic body mass index (metBMI) phenotypes on the risks of cardiovascular and ocular diseases outcomes. METHODS This study included cohorts in UK and Guangzhou, China. By leveraging the serum metabolome and BMI data from UK Biobank, this study developed and validated a metBMI prediction model using a ridge regression model among 89,830 participants based on 249 metabolites. Five obesity phenotypes were obtained by metBMI and actual BMI (actBMI): normal weight (NW, metBMI of 18.5-24.9 kg/m2), overweight (OW, metBMI of 25-29.9 kg/m2), obesity (OB, metBMI ≥ 30 kg/m2), overestimated (OE, metBMI-actBMI > 5 kg/m2), and underestimated (UE, metBMI-actBMI < - 5 kg/m2). Additional participants from the Guangzhou Diabetes Eye Study (GDES) were included for validating the hypothesis. Outcomes included all-cause and cardiovascular (CVD)-cause mortality, as well as incident CVD (coronary heart disease, heart failure, myocardial infarction [MI], and stroke) and age-related eye diseases (age-related macular degeneration [AMD], cataracts, glaucoma, and diabetic retinopathy [DR]). RESULTS In the UKB, although OE group had lower actBMI than NW group, the OE group had a significantly higher risk of all-cause mortality than those in NW prediction group (HR, 1.68; 95% CI 1.16-2.43). Similarly, the OE group had a 1.7-3.6-fold higher risk than their NW counterparts for cardiovascular mortality, heart failure, myocardial infarction, and coronary heart disease (all P < 0.05). In addition, risk of age-related macular denegation (HR, 1.96; 95% CI 1.02-3.77) was significantly higher in OE group. In the contrast, UE and OB groups showed similar risks of mortality and of cardiovascular and age-related eye diseases (all P > 0.05), though the UE group had significantly higher actBMI than OB group. In the GDES cohort, we further confirmed the potential of metabolic BMI (metBMI) fingerprints for risk stratification of cardiovascular diseases using a different metabolomic approach. CONCLUSIONS Gaps of metBMI and actBMI identified novel metabolic subtypes, which exhibit distinctive cardiovascular and ocular risk profiles. The groups carrying obesity-related metabolites were at higher risk of mortality and morbidity than those with normal health metabolites. Metabolomics allowed for leveraging the future of diagnosis and management of 'healthily obese' and 'unhealthily lean' individuals.
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Affiliation(s)
- Pingting Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shaoying Tan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Level 7, 32 Gisborne Street, Melbourne, VIC, 3002, Australia
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Level 7, 32 Gisborne Street, Melbourne, VIC, 3002, Australia
| | - Erping Long
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong, China.
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, China.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Level 7, 32 Gisborne Street, Melbourne, VIC, 3002, Australia.
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
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Yan W, Yan X, Mubarik S. Epidemiological trend and age-period-cohort effects on cardiovascular disease mortality and disability-adjusted life years attributable to dietary risks and high body mass index at the regional and country level across China and Pakistan. Front Nutr 2023; 10:1158769. [PMID: 37346907 PMCID: PMC10280070 DOI: 10.3389/fnut.2023.1158769] [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: 02/04/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023] Open
Abstract
Background Modifiable risk factors are major drivers of cardiovascular disease (CVD). We aimed to determine the epidemiological trend and age-period-cohort effects on CVD burden attributable to dietary risks and high body mass index (BMI) across China and Pakistan from 1990 to 2019. Methods Data on the all-ages and age-specific CVD burden, age-standardized CVD mortality and disability-adjusted life years (DALYs) rates were obtained from the Global Burden of Disease Study 2019. Joinpoint regression analysis was conducted to find temporal trends and age-period-cohort (APC) modeling was used to estimate age, period, and cohort effects on CVD burden. Results Between 1990 and 2019, the all-ages CVD burden attributable to dietary risks and high BMI increased by ~2-3-fold in China and by 3-5-fold in Pakistan. The diet-related CVD age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate significantly decreased in China but increased in Pakistan. Both countries showed a marked increasing trend of CVD ASMR and the age-standardized DALYs rate attributable to high BMI. Taiwan in China showed a remarkable reduction in CVD burden. However, in Pakistan, all regions observed a significantly increasing trend of CVD burden attributable to modifiable risk factors. A higher risk ratio of premature CVD mortality (<70 years) was observed among Chinese attributable to high BMI and among Pakistani attributable to dietary risks. In China, early birth cohorts showed a higher risk ratio and recent birth cohorts experienced a lower risk ratio of CVD burden compared with Pakistan. Conclusion In conclusion, dietary risks and high BMI caused a huge CVD burden across China and Pakistan.
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Affiliation(s)
- Wu Yan
- Department of Information, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xiuzhen Yan
- Department of Information, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei, China
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Parve SD, Sineglazova AV. Cardiac Structure and Function in Young Adults With Various Cardiometabolic Profiles. Cureus 2023; 15:e40524. [PMID: 37333045 PMCID: PMC10275507 DOI: 10.7759/cureus.40524] [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: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background Cardiovascular diseases are a leading cause of mortality worldwide. Cardiometabolic abnormalities result in alterations in the myocardial structure and function. Limited data are available on these changes in young adults with various cardiometabolic risk profiles. The goal was to study the relationship between cardiometabolic risk and echocardiographic changes in young patients of both sexes in a Russian population, using a risk-based cardiometabolic disease staging (CMDS) system. Methods A total of 191 patients were included. The patients were classified into five groups based on the CMDS system. We gathered patient history and performed a physical exam, biochemical blood analysis, and echocardiography. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Results The median age of the participants was 35 (30.0-39.0) years. Elevated systolic and diastolic blood pressure and hypertriglyceridemia were more frequent (p < 0.05) in males than in females. An increase in the end-diastolic volume (EDV) and end-systolic volume (ESV) and a decrease in the ejection fraction were noted from CMDS 0 to 3. The EDV and ESV were associated with most cardiometabolic risk factors and strongly correlated with the visceral fat level, waist circumference, and body mass index. We identified a new subgroup as CMDS 3-overly high in patients with CMDS 3 and an excess level of visceral fat. Conclusion When designing strategies for cardiovascular disease prevention in young adults apart from CMDS parameters, bioimpedance analysis should be considered to assess the level of visceral fat, especially in individuals with CMDS 3 because they are at a higher risk of cardiac chamber enlargements. These results can be used to identify new dominants or phenotypes of heart failure with preserved ejection fraction.
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Affiliation(s)
- Swapnil D Parve
- Primary Care and General Practice, Kazan State Medical University, Kazan, RUS
- Research and Development, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
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Escobar S, Peçanha D, Duque M, Duque A, Crahim V, De Lorenzo A, Tibiriçá E. Evaluation of systemic endothelial-dependent and endothelial-independent microvascular reactivity in metabolically healthy obesity: An observational study. Microvasc Res 2023:104553. [PMID: 37230166 DOI: 10.1016/j.mvr.2023.104553] [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: 01/05/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Metabolically healthy obesity (MHO), a phenotype of obesity considered to be of lower cardiovascular risk, is still a controversial concept. This study aimed to investigate the presence of subclinical systemic microvascular dysfunction in individuals with MHO. METHODS This was a cross-sectional study in which 112 volunteers were allocated into three groups: metabolically healthy normal weight (MHNW), MHO, or metabolically unhealthy obesity (MUO). Obesity was defined as a body mass index (BMI) ≥ 30 kg/m2. MHO was defined as the absence of any component of metabolic syndrome, except waist circumference. Microvascular reactivity was evaluated using cutaneous laser speckle contrast imaging. RESULTS Mean age was 33.2 ± 7.66 years. The median BMI in the MHNW, MHO and MUO groups was 23.6, 32.8, and 35.8 kg/m2, respectively. Baseline microvascular conductance values were lower in the MUO group (0.25 ± 0.08 APU/mmHg) than in MHO (0.30 ± 0.10 APU/mmHg) and MHNW groups (0.33 ± 0.12 APU/mmHg) (P = 0.0008). There were no significant differences regarding endothelial-dependent (acetylcholine stimulation or postocclusive reactive hyperemia) or endothelial-independent (sodium nitroprusside stimulation) microvascular reactivity among the groups. CONCLUSIONS Individuals with MUO had lower baseline systemic microvascular flow than those with MHNW or MHO, but endothelium-dependent or endothelium-independent microvascular reactivity were not changed in any of the groups. The relatively young age of the study population, the low frequency of class III obesity, or the strict definition of MHO (absence of any metabolic syndrome criteria) might account for the lack of difference of microvascular reactivity among MHNW, MHO or MUO.
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Affiliation(s)
- Silas Escobar
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | | | - Maíra Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Alice Duque
- National Institute of Cardiology, Rio de Janeiro, Brazil
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Amani-Beni R, Darouei B, Zefreh H, Sheikhbahaei E, Sadeghi M. Effect of Obesity Duration and BMI Trajectories on Cardiovascular Disease: A Narrative Review. Cardiol Ther 2023; 12:307-326. [PMID: 37154885 DOI: 10.1007/s40119-023-00317-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023] Open
Abstract
Obesity is an important risk factor for cardiovascular diseases (CVDs). It is crucial to understand the impact of its duration due to the more extended exposure period and the higher frequency of overweight/obesity at younger ages. In the last decade, various studies have discovered that the duration of obesity, in addition to its severity, might have an impact. Therefore, this study aimed to summarize the current literature to investigate the effect of body mass index (BMI) trajectories and overweight/obesity duration on cardiovascular outcomes. To retrieve related articles, we searched PubMed, EMBASE, Google Scholar, Web of Science, Scopus, and Cochrane electronic databases. The duration of overweight/obesity is significantly associated with CVDs, especially heart failure and atrial fibrillation. However, there are contradictory results regarding the association between coronary heart disease and stroke with the duration of obesity. Additionally, no association with peripheral vascular disease has yet to be reported. The absence of this association may be brought on by covariates or various follow-up times. Nevertheless, it seems that both stable overweight and remarkably stable obesity increase the risk of CVDs, as does both stable overweight and notably stable obesity. Metrics showing both the severity and the duration of overweight/obesity are more effective than each alone, and it is recommended to be used for assessing the risk of various CVDs. There are few studies in these areas, and studies with more extended follow-up periods, with a wide age range, while adjusting for some specific covariates, are needed.
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Affiliation(s)
- Reza Amani-Beni
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Mushtaq 3rd St, Shahid Rahmani Alley, Isfahan, Iran
| | - Bahar Darouei
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Mushtaq 3rd St, Shahid Rahmani Alley, Isfahan, Iran
| | - Hamidreza Zefreh
- Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Esfahan, Iran
| | - Erfan Sheikhbahaei
- Minimally Invasive Surgery and Obesity Research Center, Alzahra University Hospital, School of Medicine, Isfahan University of Medical Sciences, Esfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Mushtaq 3rd St, Shahid Rahmani Alley, Isfahan, Iran.
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Tanriover C, Copur S, Gaipov A, Ozlusen B, Akcan RE, Kuwabara M, Hornum M, Van Raalte DH, Kanbay M. Metabolically healthy obesity: Misleading phrase or healthy phenotype? Eur J Intern Med 2023; 111:5-20. [PMID: 36890010 DOI: 10.1016/j.ejim.2023.02.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
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Affiliation(s)
- Cem Tanriover
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Abduzhappar Gaipov
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan; Clinical Academic Department of Internal Medicine, CF "University Medical Center", Astana, Kazakhstan
| | - Batu Ozlusen
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Rustu E Akcan
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | | | - Mads Hornum
- Department of Nephrology, Rigshospitalet, Inge Lehmanns Vej 7, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel H Van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Loaction VUMC, Amsterdam, the Netherlands
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul 34010, Turkey.
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Carbone S, Elagizi A, Lavie CJ. Better pharmacotherapy in heart failure with reduced ejection fraction may partly explain the obesity paradox. Eur J Heart Fail 2023; 25:711-713. [PMID: 36974755 PMCID: PMC10330429 DOI: 10.1002/ejhf.2832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023] Open
Affiliation(s)
- Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA
- Division of Cardiology, Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrew Elagizi
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA, USA
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Xie WJ, Li J. Obesity and cancer stem cells: Roles in cancer initiation, progression and therapy resistance. World J Stem Cells 2023; 15:120-135. [PMID: 37181008 PMCID: PMC10173809 DOI: 10.4252/wjsc.v15.i4.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/28/2023] [Accepted: 03/17/2023] [Indexed: 04/26/2023] Open
Abstract
Obesity, the global pandemic since industrialization, is the number one lifestyle-related risk factor for premature death, which increases the incidence and mortality of various diseases and conditions, including cancer. In recent years, the theory of cancer stem cells (CSCs), which have the capacity for self-renewal, metastasis and treatment resistance, has been bolstered by increasing evidence. However, research on how obesity affects CSCs to facilitate cancer initiation, progression and therapy resistance is still in its infancy, although evidence has already begun to accumulate. Regarding the ever-increasing burden of obesity and obesity-related cancer, it is pertinent to summarize evidence about the effects of obesity on CSCs, as elucidating these effects will contribute to the improvement in the management of obesity-related cancers. In this review, we discuss the association between obesity and CSCs, with a particular focus on how obesity promotes cancer initiation, progression and therapy resistance through CSCs and the mechanisms underlying these effects. In addition, the prospect of preventing cancer and targeting the mechanisms linking obesity and CSCs to reduce cancer risk or to improve the survival of patients with cancer is considered.
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Affiliation(s)
- Wen-Jie Xie
- Department of General Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang 621000, Sichuan Province, China
| | - Jian Li
- Department of General Surgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang 621000, Sichuan Province, China
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Neeland IJ, Lavie CJ. Leisure time versus occupational physical activity for cardiometabolic risk. Prog Cardiovasc Dis 2023:S0033-0620(23)00033-6. [PMID: 37054861 DOI: 10.1016/j.pcad.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Affiliation(s)
- Ian J Neeland
- Harrington Heart and Vascular Institute, University Hospital Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, New Orleans, LA, USA
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69
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Ventura HO, Elagizi A, Lavie CJ. Optimal Prevention of Cardiovascular Diseases: The Earlier the Better. J Am Coll Cardiol 2023; 81:1162-1164. [PMID: 36948732 DOI: 10.1016/j.jacc.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Hector O Ventura
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana, USA.
| | - Andrew Elagizi
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana, USA
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Gurevitz C, Assali A, Mohsan J, Gmach SF, Beigel R, Ovdat T, Zwas DR, Kornowski R, Orvin K, Eisen A. The obesity paradox in patients with acute coronary syndromes over 2 decades - the ACSIS registry 2000-2018. Int J Cardiol 2023; 380:48-55. [PMID: 36940822 DOI: 10.1016/j.ijcard.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/05/2023] [Accepted: 03/17/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Obesity is a worldwide epidemic which is associated with major cardiovascular (CV) risk factors. Nevertheless, substantial distant data, mostly published more than a decade ago, have demonstrated an obesity paradox, where obese patients generally have a better short- and long-term prognosis than do their leaner counterparts with the same CV profile. Nonetheless, it is not fully elucidated whether the obesity paradox is still relevant in the contemporary cardiology era among patients with acute coronary syndrome (ACS). We aimed to examine temporal trends in the clinical outcomes of ACS patients by their BMI status. METHODS Data from the ACSIS registry including all patients with calculated BMI data between the years 2002-2018. Patients were stratified by BMI groups to underweight, normal, overweight and obese. Clinical endpoints included 30d major cardiovascular events (MACE), and 1-year mortality. Temporal trends were examined in the late (2010-2018) vs. the early period (2002-2008). Multivariable models examined factors associated with clinical outcomes by BMI status. RESULTS Among the 13,816 patients from the ACSIS registry with available BMI data, 104 were underweight, 3921 were normal weight, 6224 were overweight and 3567 were obese. 1-year mortality was highest among underweight patients (24.8%), as compared to normal weight patients (10.7%) and lowest among overweight and obese patients (7.1% and 7.5% respectively; p for trend <0.001). 30-day MACE rates followed a similar pattern (24.3% for underweight, 13.6% for normal weight, 11.6% for overweight, and 11.7% for obese; p for trend<0.001). Comparing the 2 time-periods, 30-day MACE was significantly lower in the late period in all BMI groups, but unchanged in patients who were underweight. Similarly, 1-year mortality has decreased in normal weight and obese patients but remained similarly high in underweight patients. CONCLUSIONS In ACS patients, during 2-decades, 30-day MACE and 1-year mortality were lower among overweight and obese patients compared to underweight and even normal weight patients. Temporal trends revealed that 30-day MACE and 1-year mortality have decreased among all BMI groups other than the underweight ACS patients, among whom the adverse CV rates were consistently high. Our findings suggest that the obesity paradox is still relevant in ACS patients in the current cardiology era.
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Affiliation(s)
- Chen Gurevitz
- Cardiology division, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Aseel Assali
- Internal medicine division, Sourasky Medical Center, Tel-Aviv, Israel
| | - Jamil Mohsan
- Cardiology department, Hillel Yaffe Medical Center, Hadera, Israel
| | | | - Roy Beigel
- Cardiology department, Sheba Medical Center, Ramat-Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Ovdat
- Cardiology department, Sheba Medical Center, Ramat-Gan, Israel
| | - Donna R Zwas
- Cardiology Department, Hadassah Medical Center, Jerusalem, Israel
| | - Ran Kornowski
- Cardiology division, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Katia Orvin
- Cardiology division, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Eisen
- Cardiology division, Rabin Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kouvari M, M. D’Cunha N, Tsiampalis T, Zec M, Sergi D, Travica N, Marx W, McKune AJ, Panagiotakos DB, Naumovski N. Metabolically Healthy Overweight and Obesity, Transition to Metabolically Unhealthy Status and Cognitive Function: Results from the Framingham Offspring Study. Nutrients 2023; 15:nu15051289. [PMID: 36904288 PMCID: PMC10004783 DOI: 10.3390/nu15051289] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
AIMS To evaluate the association between metabolically healthy overweight/obesity (MHO) status and longitudinal cognitive function while also considering the stability of the condition. METHODS In total, 2892 participants (mean age 60.7 (9.4) years) from Framingham Offspring Study completed health assessments every four years since 1971. Neuropsychological testing was repeated every four years starting from 1999 (Exam 7) to 2014 (Exam 9) (mean follow-up: 12.9 (3.5) years). Standardized neuropsychological tests were constructed into three factor scores (general cognitive performance, memory, processing speed/executive function). Healthy metabolic status was defined as the absence of all NCEP ATP III (2005) criteria (excluding waist circumference). MHO participants who scored positively for one or more of NCEP ATPIII parameters in the follow-up period were defined as unresilient MHO. RESULTS No significant difference on the change in cognitive function over time was observed between MHO and metabolically healthy normal weight (MHN) individuals (all p > 0.05). However, a lower processing speed/executive functioning scale score was observed in unresilient MHO participants compared to resilient MHO participants (β = -0.76; 95% CI = -1.44, -0.08; p = 0.030). CONCLUSIONS Retaining a healthy metabolic status over time represents a more important discriminant in shaping cognitive function compared to body weight alone.
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Affiliation(s)
- Matina Kouvari
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT 2617, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Kallithea, Attica, Greece
| | - Nathan M. D’Cunha
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT 2617, Australia
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Kallithea, Attica, Greece
| | - Manja Zec
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ 85721, USA
| | - Domenico Sergi
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Nikolaj Travica
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine (IMPACT), Deakin University, Barwon Health, Geelong, VIC 3220, Australia
| | - Wolfgang Marx
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine (IMPACT), Deakin University, Barwon Health, Geelong, VIC 3220, Australia
| | - Andrew J. McKune
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT 2617, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2601, Australia
- Discipline of Biokinetics, Exercise, and Leisure Sciences, School of Health Sciences, University of KwaZulu Natal, Durban 4000, South Africa
| | - Demosthenes B. Panagiotakos
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT 2617, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Kallithea, Attica, Greece
| | - Nenad Naumovski
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT 2617, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Kallithea, Attica, Greece
- Correspondence:
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Ahmadi MN, Inan-Eroglu E, Mishra GD, Salis A, Stamatakis E. Associations of changes in physical activity and diet with incident obesity and changes in adiposity: Longitudinal findings from the UK Biobank. Prev Med 2023; 168:107435. [PMID: 36746246 DOI: 10.1016/j.ypmed.2023.107435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
We examined the association of changes in physical activity and diet with obesity development and changes in body fat percentage, body mass index, and waist circumference. 31,344 adults without obesity at baseline (age = 56.0 ± 7.5 years; female = 49.1%) from the UK Biobank were included. Physical activity was categorised based on public health guidelines as: inactive; insufficient; and sufficient. Diet category was assigned based on an established composited score that included consumption of fruits, vegetables, fish, red meat (unprocessed), and processed meat. Diet was categorised as: poor; reasonable; and good. Physical activity and diet changes were categorised based on changes in category: worsened; stable; increased (physical activity)/improved (diet). During a mean follow up of 6.8 (SD = ±2.3) years, 1354 (4.3%) participants developed obesity. Compared to stable physical activity-diet, increasing physical activity was associated with the lowest obesity odds, across diet changes (e.g., OR [95%CI]: diet worsened (0.89 [0.69, 1.15]); diet improved (0.65 [0.48, 0.89])). Increasing physical activity with improved diet was associated with the largest difference in body fat percentage (β:-0.62 [-0.82, -0.41]), body mass index (-0.37 [-0.47, -0.28]), and waist circumference (-1.21 [-1.63, -0.79]). Excluding adults with a history of smoking, or major illness, lowered obesity odds among participants with increased physical activity by an additional 11%-21%. In those who decreased physical activity obesity was attenuated when combined with diet improvement. Improvements in physical activity or diet mutually attenuated the deleterious associations of the other behaviour's deterioration. In most analyses, increases in physical activity conferred consistent positive associations against the development of obesity, across dietary change groups.
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Affiliation(s)
- Matthew N Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
| | - Elif Inan-Eroglu
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Amanda Salis
- The University of Western Australia, Faculty of Science, School of Human Sciences, Crawley, Western Australia, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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73
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Wang JS, Xia PF, Ma MN, Li Y, Geng TT, Zhang YB, Tu ZZ, Jiang L, Zhou LR, Zhang BF, Tong WW, Shan Z, Liu G, Yang K, Pan A. Trends in the Prevalence of Metabolically Healthy Obesity Among US Adults, 1999-2018. JAMA Netw Open 2023; 6:e232145. [PMID: 36892842 PMCID: PMC9999245 DOI: 10.1001/jamanetworkopen.2023.2145] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
IMPORTANCE Improved understanding of trends in the proportion of individuals with metabolically healthy obesity (MHO) may facilitate stratification and management of obesity and inform policy efforts. OBJECTIVES To characterize trends in the prevalence of MHO among US adults with obesity, overall and by sociodemographic subgroups. DESIGN, SETTING, AND PARTICIPANTS This survey study included 20 430 adult participants from 10 National Health and Nutrition Examination Survey (NHANES) cycles between 1999-2000 and 2017-2018. The NHANES is a series of cross-sectional and nationally representative surveys of the US population conducted continuously in 2-year cycles. Data were analyzed from November 2021 to August 2022. EXPOSURES National Health and Nutrition Examination Survey cycles from 1999-2000 to 2017-2018. MAIN OUTCOMES AND MEASURES Metabolically healthy obesity was defined as a body mass index of 30.0 (calculated as weight in kilograms divided by height in meters squared) without any metabolic disorders in blood pressure, fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), or triglycerides based on established cutoffs. Trends in the age-standardized prevalence of MHO were estimated using logistic regression analysis. RESULTS This study included 20 430 participants. Their weighted mean (SE) age was 47.1 (0.2) years; 50.8% were women, and 68.8% self-reported their race and ethnicity as non-Hispanic White. The age-standardized prevalence (95% CI) of MHO increased from 3.2% (2.6%-3.8%) in the 1999-2002 cycles to 6.6% (5.3%-7.9%) in the 2015-2018 cycles (P < .001 for trend). There were 7386 adults with obesity. Their weighted mean (SE) age was 48.0 (0.3) years, and 53.5% were women. The age-standardized proportion (95% CI) of MHO among these 7386 adults increased from 10.6% (8.8%-12.5%) in the 1999-2002 cycles to 15.0% (12.4%-17.6%) in the 2015-2018 cycles (P = .02 for trend). Substantial increases in the proportion of MHO were observed for adults aged 60 years or older, men, non-Hispanic White individuals, and those with higher income, private insurance, or class I obesity. In addition, there were significant decreases in the age-standardized prevalence (95% CI) of elevated triglycerides (from 44.9% [40.9%-48.9%] to 29.0% [25.7%-32.4%]; P < .001 for trend) and reduced HDL-C (from 51.1% [47.6%-54.6%] to 39.6% [36.3%-43.0%]; P = .006 for trend). There was also a significant increase in elevated FPG (from 49.7% [95% CI, 46.3%-53.0%] to 58.0% [54.8%-61.3%]; P < .001 for trend) but no significant change in elevated blood pressure (from 57.3% [53.9%-60.7%] to 54.0% [50.9%-57.1%]; P = .28 for trend). CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that the age-standardized proportion of MHO increased among US adults from 1999 to 2018, but differences in trends existed across sociodemographic subgroups. Effective strategies are needed to improve metabolic health status and prevent obesity-related complications in adults with obesity.
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Affiliation(s)
- Jiang-Shui Wang
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Peng-Fei Xia
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Meng-Nan Ma
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yue Li
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Ting-Ting Geng
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yan-Bo Zhang
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Zhou-Zheng Tu
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Limiao Jiang
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Li-Rong Zhou
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Bing-Fei Zhang
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Wen-Wei Tong
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Zhilei Shan
- Hubei Key Laboratory of Food Nutrition and Safety, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Gang Liu
- Hubei Key Laboratory of Food Nutrition and Safety, Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kun Yang
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - An Pan
- Ministry of Education Key Laboratory of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Abstract
PURPOSE OF REVIEW This review aims to detail the current global research state of metabolically healthy obesogenesis with regard to metabolic factors, disease prevalence, comparisons to unhealthy obesity, and targeted interventions to reverse or delay progression from metabolically healthy to unhealthy obesity. RECENT FINDINGS As a long-term condition with increased risk of cardiovascular, metabolic, and all-cause mortality risks, obesity threatens public health on a national level. The recent discovery of metabolically healthy obesity (MHO), a transitional condition during which obese persons carry comparatively lower health risks, has added to confusion about the true effect of visceral fat and subsequent long-term health risks. In this context, the evaluation of fat loss interventions, such as bariatric surgery, lifestyle changes (diet/exercise), and hormonal therapies require re-evaluation in light of evidence that progression to high-risk stages of obesity relies on metabolic status and that strategies to protect the metabolism may be useful in the prevention of metabolically unhealthy obesity. Typical calorie-based exercise and diet interventions have failed to reduce the prevalence of unhealthy obesity. Holistic lifestyle, psychological, hormonal, and pharmacological interventions for MHO, on the other hand, may at least prevent progression to metabolically unhealthy obesity.
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Affiliation(s)
- Bryan J Mathis
- International Medical Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yuji Hiramatsu
- International Medical Center, University of Tsukuba Hospital, Tsukuba, Ibaraki, 305-8576, Japan
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Echeverri B, Kozak AT, Gildner DJ, Pickett SM. Night eating syndrome subtypes: differences in binge eating and food addiction symptoms. Eat Weight Disord 2023; 28:3. [PMID: 36752994 PMCID: PMC9908657 DOI: 10.1007/s40519-023-01534-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE The purpose of the current study was to examine differences in binge eating and food addiction symptoms between Night Eating Syndrome (NES) latent subtypes: evening hyperphagia with nocturnal ingestions (EHNI), evening hyperphagia-only (EHO), and nocturnal ingestions-only (NIO). It was hypothesized that the EHNI group would report more binge eating behaviors and more food addiction symptoms than both the EHO and NIO groups. Further, it was hypothesized that the EHO and NIO groups would differ with the EHO group reporting more binge eating behaviors and the NIO group reporting more food addiction symptoms. METHODS Participants completed measures online relating to night eating, binge eating, and food addiction. Average age of the final sample was 34.3 (SD = 10.5) and 62.0% were men. Responses to the Night Eating Questionnaire (NEQ; Allison et al., 2008) were used to create an EHNI group (n = 65), an EHO group (n = 32), and a NIO group (n = 69). ANOVAs were conducted to examine between-group differences on disordered eating symptoms. RESULTS Participants in the EHNI group reported more severe binge eating and food addiction symptoms than those in the EHO and NIO groups. However, there were no significant differences in binge eating or food addiction between the EHO and NIO groups. CONCLUSION Individuals who meet both NES core criteria (evening hyperphagia and nocturnal ingestions) are likely at a higher risk for experiencing other, more severe disordered eating pathologies. Implications concerning assessment and future research on NES typology are discussed. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Brenda Echeverri
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Andrea T. Kozak
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Daniel J. Gildner
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
- Department of Psychology, Oakland University, Rochester, MI 48309 USA
| | - Scott M. Pickett
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32310 USA
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76
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Maqbool Z, Khalid W, Atiq HT, Koraqi H, Javaid Z, Alhag SK, Al-Shuraym LA, Bader DMD, Almarzuq M, Afifi M, AL-Farga A. Citrus Waste as Source of Bioactive Compounds: Extraction and Utilization in Health and Food Industry. Molecules 2023; 28:molecules28041636. [PMID: 36838623 PMCID: PMC9960763 DOI: 10.3390/molecules28041636] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/21/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
The current research was conducted to extract the bioactive compounds from citrus waste and assess their role in the development of functional foods to treat different disorders. The scientific name of citrus is Citrus L. and it belongs to the Rutaceae family. It is one of the most important fruit crops that is grown throughout the world. During processing, a large amount of waste is produced from citrus fruits in the form of peel, seeds, and pomace. Every year, the citrus processing industry creates a large amount of waste. The citrus waste is composed of highly bioactive substances and phytochemicals, including essential oils (EOs), ascorbic acid, sugars, carotenoids, flavonoids, dietary fiber, polyphenols, and a range of trace elements. These valuable compounds are used to develop functional foods, including baked products, beverages, meat products, and dairy products. Moreover, these functional foods play an important role in treating various disorders, including anti-aging, anti-mutagenic, antidiabetic, anti-carcinogenic, anti-allergenic, anti-oxidative, anti-inflammatory, neuroprotective, and cardiovascular-protective activity. EOs are complex and contain several naturally occurring bioactive compounds that are frequently used as the best substitutes in the food industry. Citrus essential oils have many uses in the packaging and food safety industries. They can also be used as an alternative preservative to extend the shelf lives of different food products.
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Affiliation(s)
- Zahra Maqbool
- Department of Food Science, Faculty of Life Sciences, Government College University, Faisalabad 38000, Pakistan
| | - Waseem Khalid
- Department of Food Science, Faculty of Life Sciences, Government College University, Faisalabad 38000, Pakistan
- Correspondence:
| | - Hafiz Taimoor Atiq
- Department of Food Science and Technology, Muhammad Nawaz Sharif University of Agriculture, Multan 23546, Pakistan
| | - Hyrije Koraqi
- Faculty of Food Science and Biotechnology, UBT-Higher Education Institution, Rexhep Krasniqi No. 56, 10000 Pristina, Kosovo
| | - Zaryab Javaid
- Department of Pharmacy, University of Central Punjab, Lahore 54590, Pakistan
| | - Sadeq K. Alhag
- Biology Department, College of Science and Arts, King Khalid University, Muhayl Asser 61913, Saudi Arabia
| | - Laila A. Al-Shuraym
- Biology Department, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - D. M. D. Bader
- Chemistry Department, College of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia
| | - Mohammed Almarzuq
- Unit of Scientific Research, Applied College, Qassim University, Buraidah 52571, Saudi Arabia
| | - Mohamed Afifi
- Biochemistry Department, Faculty of Sciences, University of Jeddah, Jeddah 21959, Saudi Arabia
- Department of Biochemistry, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44519, Egypt
- Najla Bint Saud Al Saud Center for Distinguished Research in Biotechnology, Jeddah 21577, Saudi Arabia
| | - Ammar AL-Farga
- Biochemistry Department, Faculty of Sciences, University of Jeddah, Jeddah 21959, Saudi Arabia
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77
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Bianchettin RG, Lavie CJ, Lopez-Jimenez F. Challenges in Cardiovascular Evaluation and Management of Obese Patients: JACC State-of-the-Art Review. J Am Coll Cardiol 2023; 81:490-504. [PMID: 36725178 DOI: 10.1016/j.jacc.2022.11.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 02/01/2023]
Abstract
Many unique clinical challenges accompany the diagnosis and treatment of cardiovascular disease (CVD) in people living with overweight/obesity. Similarly, physicians encounter numerous complicating factors when managing obesity among people with CVD. Diagnostic accuracy in CVD medicine can be hampered by the presence of obesity, and pharmacological treatments or cardiac procedures require careful adjustment to optimize efficacy. The obesity paradox concept remains a source of confusion within the clinical community that may cause important risk factors to go unaddressed, and body mass index is a misleading measure that cannot account for body composition (eg, lean mass). Lifestyle modifications that support weight loss require long-term commitment, but cardiac rehabilitation programs represent a potential opportunity for structured interventions, and bariatric surgery may reduce CVD risk factors in obesity and CVD. This review examines the key issues and considerations for physicians involved in the management of concurrent obesity and CVD.
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Affiliation(s)
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA
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Lavie CJ, Sharma A, Soto JT. Is There an Obesity Paradox in Transcatheter Aortic Valve Replacement? JACC. ASIA 2023; 3:90-92. [PMID: 36873750 PMCID: PMC9982208 DOI: 10.1016/j.jacasi.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Abhishek Sharma
- Structural Heart Disease Program, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jose Tafur Soto
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, Louisiana, USA
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79
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Jhe GB, Lin J, Freizinger M, Richmond T. Adolescents with anorexia nervosa or atypical anorexia nervosa with premorbid overweight/obesity: What should we do about their weight loss? JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:55-58. [PMID: 36121167 DOI: 10.1111/jcap.12394] [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: 03/11/2022] [Revised: 06/25/2022] [Accepted: 09/05/2022] [Indexed: 02/04/2023]
Abstract
Traditionally, anorexia nervosa (AN) was understood to exist exclusively among underweight individuals and weight was used to assess level of severity and course of treatment. Recent trends have found a growing number of individuals presenting with AN or atypical AN (AAN) (i.e., those who remain with weight in a "normal" or "healthy" range despite significant weight loss) have a premorbid history of overweight/obesity. Individuals with AN/AAN and premorbid overweight/obesity represent an especially metabolically vulnerable population as with either AN or AAN, there is marked weight loss. Patients with AAN present a specific challenge as healthcare professionals must identify a clinically significant eating disorder in adolescents of potentially "normal" weights and then must balance their knowledge and training of traditional treatment of AN with obesity treatment and prevention. Currently, there are no evidence-based treatments to guide medical and mental health professionals regarding weight restoration, medical stabilization, and psychological treatment in patients with AN/AAN with a history of overweight/obesity while also addressing risk prevention for obesity.
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Affiliation(s)
- Grace B Jhe
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Jessica Lin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Melissa Freizinger
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Tracy Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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80
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Singh H, Esht V, Shaphe MA, Rathore N, Chahal A, Kashoo FZ. Relationship between body mass index and cardiorespiratory fitness to interpret health risks among sedentary university students from Northern India: A correlation study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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81
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Heidari Almasi M, Barzin M, Mahdavi M, Khalaj A, Ebrahimi D, Valizadeh M, Hosseinpanah F. Comparing Effects of Bariatric Surgery on Body Composition Changes in Metabolically Healthy and Metabolically Unhealthy Severely Obese Patients: Tehran Obesity Treatment Study (TOTS). World J Surg 2023; 47:209-216. [PMID: 36182977 DOI: 10.1007/s00268-022-06769-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Among two popular obesity phenotypes, metabolically healthy severely obese (MHSO) and metabolically unhealthy severely obese (MUSO), it is important to clarify whether or not those with MHSO phenotype would benefit from bariatric surgery in terms of an improvement in body composition parameters. METHODS A prospective cohort was conducted on a total of 4028 participants (1404 MHSO and 2624 MUSO) who underwent bariatric surgery; MHSO was defined as having abnormalities in none or one of these four parameters: systolic blood pressure and/or diastolic blood pressure, triglycerides, fasting plasma glucose, and high-density lipoprotein. Otherwise, the definition of MUSO was met. Body composition analysis was performed at the baseline and 6-, 12-, 24-, and 36-month post-surgery using bioelectrical impedance analyzer. RESULTS Both phenotypes showed a significant decrease in fat mass (FM) and fat-free mass (FFM) and a significant increase in EWL% and TWL% (Ptrend < 0.05). FFM, FM%, and excess weight loss (EWL%) were significantly different between the two phenotypes (Pbetween < 0.05) during the follow-up. Multivariate linear regression demonstrated that compared to MUSO patients, MHSO individuals experienced a greater increase in total weight loss (TWL%) and EWL% at 12- and 24-month and in EWL% at 36-month post-surgery and also a lower decrease in the FFML/WL% after 12 months. CONCLUSION Despite a lower decrease of FFML/WL% and a greater increase in TWL and EWL in MHSO phenotype at some time points, there were no clinically significant differences between the study groups in terms of body composition changes throughout the follow-up period.
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Affiliation(s)
- Minoo Heidari Almasi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-476, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-476, Tehran, Iran.
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-476, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Danial Ebrahimi
- Department of Surgery, Faculty of Medicine, Shiraz University, Shiraz, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-476, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-476, Tehran, Iran.
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82
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Impact of Nutritional Interprofessional Education Experience With NYU Pediatric Dental Alumni. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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83
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Carbone S, daSilva-deAbreu A, Lavie CJ. Weighing in on weight loss in heart failure with reduced ejection fraction. Eur J Heart Fail 2023; 25:128-130. [PMID: 36519663 PMCID: PMC10284063 DOI: 10.1002/ejhf.2753] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of
Humanities & Sciences, Virginia Commonwealth University, Richmond, Virginia,
USA
- Division of Cardiology, Pauley Heart Center, Department of
Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart
and Vascular Institute, Ochsner Clinical School-The University of Queensland School
of Medicine, New Orleans, Louisiana, USA
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85
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Tutor AW, Lavie CJ, Kachur S, Milani RV, Ventura HO. Updates on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis 2022:S0033-0620(22)00134-7. [PMID: 36481212 DOI: 10.1016/j.pcad.2022.11.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/10/2022]
Abstract
The prevalence of obesity has reached pandemic proportions worldwide and certainly in the United States. Obesity is a well-established independent risk factor for development of many cardiovascular diseases (CVD), including heart failure, coronary heart disease, atrial fibrillation, and hypertension. Therefore, it is logical to expect obesity would have a strong correlation with CVD mortality. However, a substantial body of literature demonstrates a paradox with improved prognosis of overweight and obese patients with established CVD compared to lean patients with the identical CVD. Surprisingly, similar data has also shown that cardiovascular fitness, rather than weight loss alone, influences the relationship between obesity and mortality in those with established CVD. The impact of fitness, exercise, physical activity (PA), and weight loss and their relationship to the obesity paradox are all reviewed here.
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Affiliation(s)
- Austin W Tutor
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA.
| | - Sergey Kachur
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA; Ascension Sacred Heart Regional Heart and Vascular Institute, Pensacola, FL, USA; Department of Medicine, University of Central Florida School of Medicine, Orlando, FL, USA
| | - Richard V Milani
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
| | - Hector O Ventura
- John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
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Laukkanen JA, Kunutsor SK, Hernesniemi J, Immonen J, Eskola M, Zaccardi F, Niemelä M, Mäkikallio T, Hagnäs M, Piuhola J, Juvonen J, Sia J, Rummukainen J, Kervinen K, Karvanen J, Nikus K. Underweight and obesity are related to higher mortality in patients undergoing coronary angiography: The KARDIO invasive cardiology register study. Catheter Cardiovasc Interv 2022; 100:1242-1251. [PMID: 36378689 PMCID: PMC10098486 DOI: 10.1002/ccd.30463] [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: 07/22/2022] [Revised: 09/10/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND In patients with some cardiovascular disease conditions, slightly elevated body mass index (BMI) is associated with a lower mortality risk (termed "obesity paradox"). It is uncertain, however, if this obesity paradox exists in patients who have had invasive cardiology procedures. We evaluated the association between BMI and mortality in patients who underwent coronary angiography. METHODS We utilised the KARDIO registry, which comprised data on demographics, prevalent diseases, risk factors, coronary angiographies, and interventions on 42,636 patients. BMI was categorised based on WHO cut-offs or transformed using P-splines. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for all-cause mortality. RESULTS During a median follow-up of 4.9 years, 4688 all-cause deaths occurred. BMI was nonlinearly associated with mortality risk: compared to normal weight category (18.5-25 kg/m2 ), the age-adjusted HRs (95% CIs) for all-cause mortality were 1.90 (1.49, 2.43), 0.96 (0.92, 1.01), 1.04 (0.99, 1.09), 1.08 (0.96, 1.20), and 1.45 (1.22, 1.72) for underweight (<18.5 kg/m2 ), preobesity (25 to <30 kg/m2 ), obesity class I (30 to <35 kg/m2 ), obesity class II (35 to <40 kg/m2 ), and obesity class III (>40 kg/m2 ), respectively. The corresponding multivariable adjusted HRs (95% CIs) were 2.00 (1.55, 2.58), 0.92 (0.88, 0.97) 1.01 (0.95, 1.06), 1.10 (0.98, 1.23), and 1.49 (1.26, 1,78), respectively. CONCLUSIONS In patients undergoing coronary angiography, underweight and obesity class III are associated with increased mortality risk, and the lowest mortality was observed in the preobesity class. It appears the obesity paradox may be present in patients who undergo invasive coronary procedures.
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Affiliation(s)
- Jari A. Laukkanen
- School of MedicineInstitute of Clinical Medicine, University of Eastern FinlandKuopioFinland
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
| | - Setor K. Kunutsor
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
- Leicester Real World Evidence Unit, Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
- Translational Health Sciences, Bristol Medical SchoolUniversity of Bristol, Learning & Research Building (Level 1), Southmead HospitalBristolUK
| | - Jussi Hernesniemi
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Jaakko Immonen
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
| | - Markku Eskola
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
| | - Francesco Zaccardi
- Central Finland Health Care District, Department of MedicineJyväskyläFinland
- Leicester Real World Evidence Unit, Diabetes Research CentreUniversity of Leicester, Leicester General HospitalLeicesterUK
| | - Matti Niemelä
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Timo Mäkikallio
- Department of MedicineSouth‐Karelia Central HospitalLappeenrantaFinland
| | - Magnus Hagnäs
- Lapland Health Care District, Department of Internal MedicineRovaniemiFinland
| | - Jarkko Piuhola
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Jukka Juvonen
- Department of Internal MedicineKainuu Central HospitalKajaaniFinland
| | - Jussi Sia
- Department of CardiologyKokkola Central HospitalKokkolaFinland
| | - Juha Rummukainen
- Department of Internal MedicineSatakunta Central HospitalPoriFinland
| | - Kari Kervinen
- Division of Cardiology, Department of Internal MedicineOulu University HospitalOuluFinland
| | - Juha Karvanen
- Department of Mathematics and StatisticsUniversity of JyvaskylaJyväskyläFinland
| | - Kjell Nikus
- Heart Center, Department of CardiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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87
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Keller K, Geyer M, Hobohm L, Tamm AR, Kreidel F, Ruf TF, Hell M, Schmitt VH, Bachmann K, Born S, Schulz E, Münzel T, von Bardeleben RS. Survival benefit of overweight patients undergoing MitraClip® procedure in comparison to normal-weight patients. Clin Cardiol 2022; 45:1236-1245. [PMID: 36070481 DOI: 10.1002/clc.23897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/06/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The number of MitraClip® implantations increased significantly in recent years. Data regarding the impact of weight class on survival are sparse. HYPOTHESIS We hypothesized that weight class influences survival of patients treated with MitraClip® implantation. METHODS We investigated in-hospital, 1-year, 3-year, and long-term survival of patients successfully treated with isolated MitraClip® implantation for mitral valve regurgitation (MR) (June 2010-March 2018). Patients were categorized by weight classes, and the impact of weight classes on survival was analyzed. RESULTS Of 617 patients (aged 79.2 years; 47.3% females) treated with MitraClip® implantation (June 2010-March 2018), 12 patients were underweight (2.2%), 220 normal weight (40.1%), 237 overweight (43.2%), and 64 obesity class I (11.7%), 12 class II (2.2%), and 4 class III (0.7%). Preprocedural Logistic EuroScore (21.1 points [IQR 14.0-37.1]; 26.0 [18.5-38.5]; 26.0 [18.4-39.9]; 24.8 [16.8-33.8]; 33.0 [25.9-49.2]; 31.6 [13.1-47.6]; p = .291) was comparable between groups. Weight class had no impact on in-hospital death (0.0%; 4.1%; 1.5%; 0.0%; 7.7%; 0.0%; p = .189), 1-year survival (75.0%; 72.0%; 76.9%; 75.0%; 75.0%; 33.3%; p = .542), and 3-year survival (40.0%; 36.8%; 38.2%; 48.6%; 20.0%; 33.3%; p = .661). Compared to normal weight, underweight (hazard ratio [HR]: 1.35 [95% confidence interval [CI]: 0.65-2.79], p = .419), obesity-class I (HR: 0.93 [95% CI: 0.65-1.34], p = .705), class II (HR: 0.39 [95% CI: 0.12-1.24], p = .112), and class III (HR: 1.28 [95% CI: 0.32-5.21], p = .726) did not affect long-term survival. In contrast, overweight was associated with better survival (HR: 1.32 [95% CI: 1.04-1.68], p = .023). CONCLUSION Overweight affected the long-term survival of patients undergoing MitraClip® implantation beneficially compared to normal weight.
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Affiliation(s)
- Karsten Keller
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Medical Clinic VII: Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Geyer
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lukas Hobohm
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander R Tamm
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix Kreidel
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tobias F Ruf
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michaela Hell
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Volker H Schmitt
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhein Main, Mainz, Germany
| | - Kevin Bachmann
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sonja Born
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Eberhard Schulz
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhein Main, Mainz, Germany
| | - Ralph S von Bardeleben
- Department of Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhein Main, Mainz, Germany
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88
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Impact of body mass index on in-hospital mortality for six acute cardiovascular diseases in Japan. Sci Rep 2022; 12:18934. [PMID: 36344547 PMCID: PMC9640599 DOI: 10.1038/s41598-022-23354-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
Body mass index (BMI) distribution and its impact on cardiovascular disease (CVD) vary between Asian and western populations. The study aimed to reveal time-related trends in the prevalence of obesity and underweight and safe ranges of BMI in Japanese patients with CVD. We analyzed 5,020,464 records from the national Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination dataset over time (2012-2019) and evaluated BMI trends and the impact on in-hospital mortality for six acute CVDs: acute heart failure (AHF), acute myocardial infarction (AMI), acute aortic dissection (AAD), ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Patients were categorized into five groups using the WHO Asian-BMI criteria: underweight (< 18.5 kg/m2), normal (18.5-22.9 kg/m2), overweight at risk (23.0-24.9 kg/m2), obese I (25.0-29.9 kg/m2), and obese II (≥ 30.0 kg/m2). Age was significantly and inversely related to high BMI for all diseases (P < 0.001). The proportion of BMI categories significantly altered over time; annual BMI trends showed a significant and gradual increase, except AAD. In adjusted mixed models, underweight was significantly associated with a high risk of in-hospital mortality in all CVD patients (AHF, OR 1.41, 95% CI 1.35-1.48, P < 0.001; AMI, OR 1.27, 95% CI 1.20-1.35, P < 0.001; AAD, OR 1.23, 95% CI 1.16-1.32, P < 0.001; IS, OR 1.45, 95% CI 1.41-1.50, P < 0.001; ICH, OR 1.18, 95% CI 1.13-1.22, P < 0.001; SAH, OR 1.17, 95% CI 1.10-1.26, P < 0.001). Moreover, obese I and II groups were significantly associated with a higher incidence of in-hospital mortality, except AHF and IS. Age was associated with in-hospital mortality for all BMI categories in six CVD patients. BMI increased annually in patients with six types of CVDs. Although underweight BMI was associated with high mortality rates, the impact of obesity on in-hospital mortality differs among CVD types.
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89
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Jahromi MK, Ebadinejad A, Barzin M, Mahdavi M, Niroomand M, Khalili D, Valizadeh M, Azizi F, Hosseinpanah F. Association of cumulative excess weight and waist circumference exposure with transition from metabolically healthy obesity to metabolically unhealthy. Nutr Metab Cardiovasc Dis 2022; 32:2544-2552. [PMID: 36163212 DOI: 10.1016/j.numecd.2022.07.014] [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: 03/19/2022] [Revised: 07/02/2022] [Accepted: 07/21/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND AIMS The association between obesity severity and duration with the transition from metabolically healthy obese/overweight (MHO) phenotype to metabolically unhealthy obese (MUO) phenotype is not well understood. METHODS AND RESULTS This study includes the Tehran Lipid and Glucose Study participants who were initially classed as MHO. Cumulative excess weight (CEW) and cumulative excess waist circumference (CEWC) scores, which represent the accumulation of body mass index and waist circumference deviations from expected values over time (kg/m2 ∗ y and cm ∗ y, respectively), were calculated until the transition from MHO to MUO or the end of follow-up. The sex-stratified association of CEW and CWEC with the transition from MHO to MUO was investigated by time-dependent Cox models, adjusting for confounders. Out of 2525 participants, 1732 (68.5%) were women. During 15 years of follow-up, 1886 (74.6%) participants transitioned from MHO to MUO. A significant association was found between CEW and CEWC quartiles with the development of MUO among women participants (fully adjusted hazard ratios in the fourth quartile of CEW and CEWC [95% (CI)]:1.65 [1.37-1.98] and [95% CI]: 1.83 [1.53-2.19]). There was no significant association between CEW and CEWC with the MHO transition to MUO among men participants. CONCLUSION Over 15 years of follow-up in TLGS, general and central obesity accumulation was associated with the increased transition from MHO to MUO among women participants. More research with a larger sample size is needed to confirm and explain why the results are different for men and women.
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Affiliation(s)
- Mitra Kazemi Jahromi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Ebadinejad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahtab Niroomand
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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90
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Alhuneafat L, Jabri A, Abu Omar Y, Margaria B, Al-abdouh A, Mhanna M, Shahrori Z, Hammad N, Rayyan A, Nasser F, Kondapaneni M, Siraj A. Relationship Between Body Mass Index and Outcomes in Acute Myocardial Infarction. J Clin Med Res 2022; 14:458-465. [PMID: 36578372 PMCID: PMC9765317 DOI: 10.14740/jocmr4818] [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: 09/01/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022] Open
Abstract
Background The prevalence of obesity in the United States is high. Obesity is one of the leading risk factors in the development of acute myocardial infarction (AMI). Nevertheless, how obesity impacts AMI in-hospital outcomes remains controversial. Methods Using National Inpatient Sample (NIS) database, we identified patients diagnosed with AMI from the year 2015 to 2018. We divided these patients into five subgroups based on their body mass index (BMI). We compared outcomes such as mortality, length of inpatient stay, and inpatient complications between our subgroups. Statistical analysis was done using the program STATA. Our nationally representative analysis included 561,535 patients who had an AMI event across various weight classes. Results Most of our sample was obese (BMI > 30 kg/m2) and male. Obese patients were significantly younger than the rest. Length of stay (LOS) for AMI was highest for those with a BMI of less than 24 kg/m2. In-hospital mortality is highest for those with a BMI of < 30 kg/m2 and lowest for those with a BMI of 30 - 40 kg/m2. Inpatient complications are highest in the lower BMI population (BMI < 24 kg/m2). Conclusion The current analysis of a nationally representative sample showed the clinical implications of BMI in patients with AMI. Patients with a BMI of 30 - 40 kg/m2 had more favorable LOS, inpatient complications, and in-hospital mortality when compared to those with an ideal body weight. Hence, this supports and expands on the concept of the "obesity paradox". Further studies are needed to further investigate the possible mechanism behind this.
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Affiliation(s)
- Laith Alhuneafat
- Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA
| | - Ahmad Jabri
- Heart and Vascular Center, MetroHealth Medical Center, Cleveland, OH, USA
| | - Yazan Abu Omar
- Department of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Bryan Margaria
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA
| | - Ahmad Al-abdouh
- Division of hospital medicine, University of Kentucky, Lexington, KY, USA
| | - Mohammed Mhanna
- Department of Internal Medicine, University of Toledo, Toledo, OH, USA
| | - Zaid Shahrori
- Department of Medicine, Hashemite University Amman, Jordan
| | - Nour Hammad
- Department of Nephrology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Abdallah Rayyan
- Department of Medicine, University of Jordan School of Medicine, Amman, Jordan
| | - Farhan Nasser
- Heart and Vascular Center, MetroHealth Medical Center, Cleveland, OH, USA
| | - Meera Kondapaneni
- Heart and Vascular Center, MetroHealth Medical Center, Cleveland, OH, USA
| | - Aisha Siraj
- Heart and Vascular Center, MetroHealth Medical Center, Cleveland, OH, USA
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91
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Fitero A, Bungau SG, Tit DM, Endres L, Khan SA, Bungau AF, Romanul I, Vesa CM, Radu AF, Tarce AG, Bogdan MA, Nechifor AC, Negrut N. Comorbidities, Associated Diseases, and Risk Assessment in COVID-19-A Systematic Review. Int J Clin Pract 2022; 2022:1571826. [PMID: 36406478 PMCID: PMC9640235 DOI: 10.1155/2022/1571826] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
It is considered that COVID-19's pandemic expansion is responsible for the particular increase in deaths, especially among the population with comorbidities. The health system is often overwhelmed by the large number of cases of patients addressing it, by the regional limitation of funds, and by the gravity of cases at subjects suffering from this pathology. Several associated conditions including diabetes, cardiovascular illnesses, obesity, persistent lung condition, neurodegenerative diseases, etc., increase the mortality risk and hospitalization of subjects suffering from COVID-19. The rapid identification of patients with increased risk of death from the SARS-CoV-2 virus, the stratification in accordance with the risk and the allocation of human, financial, and logistical resources in proportion must be a priority for health systems worldwide.
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Affiliation(s)
- Andreea Fitero
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Delia Mirela Tit
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Laura Endres
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Shamim Ahmad Khan
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | | | - Ioana Romanul
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Cosmin Mihai Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | - Andrei-Flavius Radu
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
| | | | - Mihaela Alexandra Bogdan
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Aurelia Cristina Nechifor
- Analytical Chemistry and Environmental Engineering Department, Polytechnic University of Bucharest, Bucharest 011061, Romania
| | - Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410073, Romania
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Pan J, Wang Z, Dong C, Yang B, Tang L, Jia P, Yang S, Zeng H. Association between obese phenotypes and risk of carotid artery plaque among chinese male railway drivers. BMC Public Health 2022; 22:1859. [PMID: 36199053 PMCID: PMC9533504 DOI: 10.1186/s12889-022-14253-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has the world's highest rail transportation network density, and the prevalence of obesity among railway workers in China is more than twice that of adults in the world. Carotid artery plaque (CAP) is a simple and noninvasive predictor of early atherosclerosis, while the association between different obese phenotypes and CAP risk among Chinese male railway drivers is unclear. METHODS This cross-sectional study was performed among 8,645 Chinese male railway drivers. Obese phenotypes were assessed based on the obesity status (the body mass index ≥ 28 kg/m2 as obesity vs. < 28 kg/m2 as non-obesity) and metabolic status (metabolically healthy vs. metabolically unhealthy). Metabolically unhealthy was defined as the presence of at least one dysfunction, including elevated blood pressure, elevated fasting blood glucose, elevated triglyceride, and reduced high-density-lipoprotein cholesterol. Four obese phenotypes were defined based on the body mass index and metabolic status, i.e., metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), and metabolically unhealthy non-obesity (MUNO). Multivariable logistic regression was employed to estimate the association between different obese phenotypes and the risk of CAP. Subgroup analysis was performed to examine the variation of the association by age, circadian rhythm disorders, and history of smoking and drinking. RESULTS The prevalence of CAP among male railway drivers in MHO, MUO, MUNO, and MHNO was 8.75%, 18.67%, 17.82%, and 5.36%, respectively. Compared to those with MHNO, an increased risk for CAP was observed among those with MHO (OR = 2.18, 95% CI: 0.82, 5.10), MUO (OR = 1.78, 95% CI:1.44, 2.21), and MUNO (OR = 2.20, 95% CI: 1.67, 2.89). The subgroup analysis showed that both of the metabolically unhealthy groups (MUNO and MUO) aged < 45 years were prone to a higher risk of CAP (for the MUNO group, OR = 4.27, 95% CI:2.71, 7.10; for the MUO group, OR = 4.00, 95%CI: 2.26, 7.17). CONCLUSION The obese phenotypes are associated with CAP risk in male railway drivers, especially those with metabolically unhealthy conditions aged < 45 years.
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Affiliation(s)
- Jia Pan
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China
| | - Zihang Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chaohui Dong
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China
| | - Bo Yang
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China
| | - Lei Tang
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China
| | - Peng Jia
- School of Resources and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Health Epidemiology (ISLE), Wuhan University, Wuhan, China
| | - Shujuan Yang
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China.
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
- International Institute of Spatial Health Epidemiology (ISLE), Wuhan University, Wuhan, China.
| | - Honglian Zeng
- Department of Health Management Center, Affiliated Hospital of Chengdu University , Chengdu, Sichuan, China.
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93
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Wang J, Xue D, Shi B, Xia L, Chen W, Liu L, Liu J, Wang H, Ye F. Sleep duration and metabolic body size phenotypes among Chinese young workers. Front Public Health 2022; 10:1017056. [PMID: 36276399 PMCID: PMC9580563 DOI: 10.3389/fpubh.2022.1017056] [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: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023] Open
Abstract
The evidence linking sleep duration and metabolic body size phenotypes is limited, especially in young adulthood. In this study, we aimed to examine the association between sleep duration and metabolic body size phenotypes among Chinese young workers and investigate whether discrepancies exist among shift and non-shift workers. A cross-sectional study was performed between 2018 and 2019 in Wuhan, China and 7,376 young adults aged 20-35 years were included. Self-reported sleep duration was coded into four groups: <7, 7-8, 8-9, and ≥9 h per day. Participants were classified into four metabolic body size phenotypes according to their body mass index and metabolic health status: metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy overweight/obesity (MHO), and metabolically unhealthy overweight/obesity (MUO). Multinomial logistic regression models were used to explore the associations between sleep duration and metabolic body phenotypes. Compared with those who slept 7-8 h each night, those with sleep duration <7 h per day had higher odds of MHO (OR 1.27, 95% CI: 1.02-1.56) and MUO (OR 1.22, 95% CI: 1.03-1.43), irrespective of multiple confounders. Stratification analyses by shift work showed that the association between short nighttime sleep and increased odds of MUO was only observed in shift workers (OR 1.26, 95% CI 1.03-1.54). Sleep duration is independently associated with metabolic body size phenotypes among Chinese young adults, while shift work could possibly modulate the association. These results may provide evidence for advocating adequate sleep toward favorable metabolic body size phenotypes in young workers.
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Affiliation(s)
- Jiangshui Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Xue
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Shi
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Lu Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junling Liu
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Huaiji Wang
- Wuhan Centers for Disease Prevention and Control, Wuhan, China,Huaiji Wang
| | - Fang Ye
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, Wuhan, China,State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Fang Ye
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94
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Haar M, Hercman R. Awkward Topics. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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95
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Souza FRM, Silva GMM, Cadavid COM, Lisboa LDS, Silva MMCL, Paiva WS, Ferreira MJP, de Paula Oliveira R, Rocha HAO. Antioxidant Baccharis trimera Leaf Extract Suppresses Lipid Accumulation in C. elegans Dependent on Transcription Factor NHR-49. Antioxidants (Basel) 2022; 11:antiox11101913. [PMID: 36290635 PMCID: PMC9598929 DOI: 10.3390/antiox11101913] [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: 08/12/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Obesity is a global public health problem that is associated with oxidative stress. One of the strategies for the treatment of obesity is the use of drugs; however, these are expensive and have numerous side effects. Therefore, the search for new alternatives is necessary. Baccharis trimera is used in Brazilian folk medicine for the treatment of obesity. Here, B. trimera leaf extract (BT) showed antioxidant activity in seven in vitro tests, and it was not toxic to 3T3 murine fibroblasts or Caenorhabditis elegans. Furthermore, BT reduces the intracellular amount of reactive oxygen species and increases C. elegans survival. Moreover, these effects were not dependent on transcription factors. The inhibition of fat accumulation by BT in the C. elegans model was also investigated. BT reduced lipid accumulation in animals fed diets without or with high amount of glucose. Furthermore, it was observed using RNA interference (iRNA) that BT depends on the transcription factor NHR-49 to exert its effect. Phytochemical analysis of BT revealed rutin, hyperoside, and 5-caffeoylquinic acid as the main BT components. Thus, these data demonstrate that BT has antioxidant and anti-obesity effects. However, further studies should be conducted to understand the mechanisms involved in its action.
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Affiliation(s)
- Flávia Roberta Monteiro Souza
- Laboratório de Biotecnologia de Polímeros Naturais (BIOPOL), Programa de Pós-graduação em Bioquímica e Biologia Molecular, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Giovanna Melo Martins Silva
- Laboratório de Genética Bioquímica (LGB), Programa de Pós-graduação em Biotecnologia, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Cesar Orlando Muñoz Cadavid
- Laboratório de Genética Bioquímica (LGB), Programa de Pós-graduação em Biotecnologia, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Lucas dos Santos Lisboa
- Laboratório de Biotecnologia de Polímeros Naturais (BIOPOL), Programa de Pós-graduação em Bioquímica e Biologia Molecular, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Maylla Maria Correia Leite Silva
- Laboratório de Biotecnologia de Polímeros Naturais (BIOPOL), Programa de Pós-graduação em Bioquímica e Biologia Molecular, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Weslley Souza Paiva
- Laboratório de Biotecnologia de Polímeros Naturais (BIOPOL), Programa de Pós-graduação em Bioquímica e Biologia Molecular, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Marcelo José Pena Ferreira
- Laboratório de Fitoquímica, Departamento de Botânica, Instituto de Biociências, Universidade de São Paulo—USP, Rua do Matão, 277, São Paulo 05508-090, Brazil
| | - Riva de Paula Oliveira
- Laboratório de Genética Bioquímica (LGB), Programa de Pós-graduação em Biotecnologia, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
| | - Hugo Alexandre Oliveira Rocha
- Laboratório de Biotecnologia de Polímeros Naturais (BIOPOL), Programa de Pós-graduação em Bioquímica e Biologia Molecular, Centro de Biociências, Federal University of Rio Grande do Norte—UFRN, Natal 59078-970, Brazil
- Correspondence: ; Tel.: +55-84-99999-9561
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96
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Suppressive Effect of Fraxetin on Adipogenesis and Reactive Oxygen Species Production in 3T3-L1 Cells by Regulating MAPK Signaling Pathways. Antioxidants (Basel) 2022; 11:antiox11101893. [PMID: 36290616 PMCID: PMC9598290 DOI: 10.3390/antiox11101893] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022] Open
Abstract
Recent studies have identified obesity as one of the world’s most serious chronic disorders. Adipogenesis, in which preadipocytes are differentiated into mature adipocytes, has a decisive role in establishing the number of adipocytes and determining the lipid storage capacity of adipose tissue and fat mass in adults. Fat accumulation in obesity is implicated with elevated oxidative stress in adipocytes induced by reactive oxygen species (ROS). Adipogenesis regulation by inhibiting adipogenic differentiation and ROS production has been selected as the strategy to treat obesity. The conventional anti-obesity drugs allowed by the U.S. Food and Drug Administration have severe adverse effects. Therefore, various natural products have been developed as a solution for obesity, suppressing adipogenic differentiation. Fraxetin is a major component extracted from the stem barks of Fraxinus rhynchophylla, with various bioactivities, including anti-inflammatory, anticancer, antioxidant, and antibacterial functions. However, the effect of fraxetin on adipogenesis is still not clearly understood. We studied the pharmacological functions of fraxetin in suppressing lipid accumulation and its underlying molecular mechanisms involving 3T3-L1 preadipocytes. Moreover, increased ROS production induced by a mixture of insulin, dexamethasone, and 3-isobutylmethylxanthine (MDI) in 3T3-L1 was attenuated by fraxetin during adipogenesis. These effects were regulated by mitogen-activated protein kinase (MAPK) signaling pathways. Therefore, our findings imply that fraxetin possesses inhibitory roles in adipogenesis and can be a potential anti-obesity drug.
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97
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You Y, Chen Y, Yin J, Zhang Z, Zhang K, Zhou J, Jin S. Relationship between leisure-time physical activity and depressive symptoms under different levels of dietary inflammatory index. Front Nutr 2022; 9:983511. [PMID: 36159493 PMCID: PMC9490084 DOI: 10.3389/fnut.2022.983511] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Depressive symptoms are major public health problems. Leisure-time Physical activity (LPA) and dietary inflammatory preference are emerging factors that tends to affect the mental health status. There is limited evidence regarding the joint influence of LPA and dietary status on the prevalence of depression. This study was a cross-sectional study, which used a nationwide represented sample from the National Health and Nutrition Examination Survey (NHANES) to assess the relationship among LPA, diet status and depression. Depression and LPA status was reported by the 9-item Patient Health Questionnaire (PHQ-9) and Physical Activity Questionnaire (PAQ), respectively. To assess dietary inflammatory preferences, dietary inflammatory index (DII) was applied based on a 24-h dietary recall interview. A total of 11,078 subjects was included in this study and weighted participants were 89,682,020. Weighted multivariable linear regression showed that DII was negatively associated with LPA after full adjustment, with β (95% CI): −0.487 (−0.647, −0.327). Weighted multivariable logistic regression showed that LPA was significantly associated with depressive symptoms after full adjustment, with odds ratios OR (95% CIs): 0.986 (0.977, 0.995). By DII stratification analysis, this phenomenon was also existed in groups with anti-inflammatory diet. Mediation effect analysis was further performed, which showed that DII significantly mediating the association between LPA and depression with proportion mediated as 3.94%. Our findings indicated the mediating role of DII in the association between LPA condition and incident depression. More well-designed studies are still needed to validate the causal relationship.
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Affiliation(s)
- Yanwei You
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zheng Zhang
- School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Kening Zhang
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Jing Zhou
- Catering Service Center, Tsinghua University, Beijing, China
- *Correspondence: Jing Zhou
| | - Shuai Jin
- College of Big Health, Guizhou Medical University, Guiyang, China
- Shuai Jin
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98
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Bays HE, Golden A, Tondt J. Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 3:100034. [PMID: 37990730 PMCID: PMC10661978 DOI: 10.1016/j.obpill.2022.100034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of 30 common obesity myths, misunderstandings, and/or oversimplifications. Methods The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS discusses 30 common obesity myths, misunderstandings, and/or oversimplifications, utilizing referenced scientific publications such as the integrative use of other published OMA CPSs to help explain the applicable physiology/pathophysiology. Conclusions This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on 30 common obesity myths, misunderstandings, and/or oversimplifications is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of the underlying science may assist the obesity medicine clinician improve the care of patients with obesity.
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Affiliation(s)
- Harold Edward Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288, Illinois Avenue, Louisville, KY, 40213, USA
| | - Angela Golden
- NP Obesity Treatment Clinic, Flagstaff, AZ, 86001, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Penn State Health, Penn State College of Medicine, 700 HMC Crescent Rd Hershey, PA, 17033, USA
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99
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Liu J, Zhang Y, Lavie CJ, Moran AE. Trends in Metabolic Phenotypes According to Body Mass Index Among US Adults, 1999-2018. Mayo Clin Proc 2022; 97:1664-1679. [PMID: 35691704 DOI: 10.1016/j.mayocp.2022.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine the prevalence, distribution, and temporal trends of metabolic phenotypes that are jointly determined by obesity and metabolic health status among US adults, overall and in key population subgroups. PARTICIPANTS AND METHODS A nationally representative sample of civilian, noninstitutionalized US adults aged 20 years and older from the National Health and Nutrition Examination Survey between 1999-2000 and 2017-2018 were included. Metabolic phenotypes were characterized jointly by body mass index and metabolic health: metabolically healthy underweight, normal weight, overweight, and obese (MH-OB); and metabolically unhealthy underweight, normal weight, overweight, and obese (MU-OB). Metabolic health was defined using the 2009 joint scientific statement for metabolic syndrome from the International Diabetes Federation Task Force on Epidemiology and Prevention, National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity as having 2 or less components (primary analysis) or no components (secondary analysis) of the following: waist circumference of 102 cm or greater in men and 88 cm or greater in women, fasting plasma glucose level of 100 mg/dL or greater, blood pressure of 130/85 mm Hg or greater, triglyceride level of 150 mg/dL or greater, and high-density lipoprotein cholesterol level of less than 40 mg/dL in men and less than 50 mg/dL in women. RESULTS Of 19,941 adults, the mean age was 46.9 years; 10,005 (50.6%) were female. From 1999 to 2018, the prevalence in primary analysis declined from 33.2% (465465 of 1646) to 25.1% (454454 of 2058) (difference, -8.09%; 95% CI, -12.5% to -3.70%) for metabolically healthy normal weight, whereas it increased from 9.92% (178178 of 1646) to 14.1% (277277 of 2058) (difference, 4.17%; 95% CI, 1.13% to 7.21%) for MH-OB (both P<.001 for trend). The prevalence of metabolically healthy underweight and overweight remained stable at about 1.62% (298298 of 19,94119,941) (95% CI, 1.38% to 1.89%; P=.34 for trend) and 22.2% (4,275 of 19,941) (95% CI, 21.4% to 23.0%; P=.14 for trend), respectively. The prevalence declined from 3.77% (72 of 1646) to 2.10% (68 of 2058) (difference, -1.67%; 95% CI, -3.22% to -0.12%; P=.006 for trend) for metabolically unhealthy normal weight, whereas it increased from 19.0% (343 of 1646) to 26.4% (574 of 2058) (difference, 7.41%; 95% CI, 2.67% to 12.2%; P<.001 for trend) for MU-OB. The prevalence of metabolically unhealthy underweight and overweight remained stable at 0.06% (11 of 19,941) (95% CI, 0.03% to 0.15%; P=.84 for trend) and 11.2% (2528 of 19,941) (95% CI, 10.6% to 11.8%; P=.29 for trend), respectively. Persistent differences in the prevalence of metabolic phenotypes were identified across multiple sociodemographic subgroups. For example, the prevalence of MH-OB increased from 7.58% (53 of 754) to 12.0% (79 of 694) (P<.001 for trend) for non-Hispanic Whites and 12.2% (60 of 567) to 18.4% (76 of 493) for Hispanics (P=.01 for trend) and remained stable at 22.6% (756 of 3,825) for non-Hispanic Blacks (P=.62 for trend and P=.05 for interaction). Results in secondary analyses revealed similar patterns. CONCLUSION From 1999 to 2018, US adults experienced major increases in the prevalence of both MH-OB and MU-OB, largely due to decreases in MH-N. The prevalence of MU-OB increased across all subgroups, with higher values observed in older adults and those with lower education and income levels.
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Affiliation(s)
- Junxiu Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Yiyi Zhang
- Division of General Medicine, Columbia University Irving Medical Center, New York, NY
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA
| | - Andrew E Moran
- Division of General Medicine, Columbia University Irving Medical Center, New York, NY
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100
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Gherbesi E, Cuspidi C, Faggiano A, Sala C, Carugo S, Tadic M. Bariatric Surgery and Myocardial Mechanics: A Meta-Analysis of Speckle Tracking Echocardiographic Studies. J Clin Med 2022; 11:jcm11164655. [PMID: 36012899 PMCID: PMC9410478 DOI: 10.3390/jcm11164655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 11/18/2022] Open
Abstract
Aim: Current evidence on the effects of bariatric surgery on cardiac mechanics in patients with obesity is based on a few single studies. We investigated this issue through a meta-analysis of speckle tracking echocardiography (STE) studies that reported data on changes in left ventricular (LV) mechanics as assessed by global longitudinal strain (GLS). Methods: The PubMed, OVID-MEDLINE and Cochrane library databases were systematically analysed to search English-language articles published from inception to 31 May 2022. Studies were identified by using Me-SH terms and crossing the following terms: “obesity”, “bariatric surgery”, “left ventricular mechanics”, “left ventricular hypertrophy”, “systolic dysfunction”, “global longitudinal strain”, “echocardiography” and “STE echocardiography”. Results: The meta-analysis, including a total of 512 patients with obesity from 13 studies (follow-up 1−23 months), showed a significant GLS improvement after bariatric procedures, with standard mean difference (SMD) being 0.50 ± 0.08, CI: 0.34/0.65, p < 0.0001. Corresponding SMD value for LV ejection fraction (LVEF) was 0.15 ± 0.09, CI: −0.04/0.34, p = 0.11. A sensitivity analysis restricted to 11 studies with follow-up ≥ 6 months confirmed that GLS (SMD: 0.47 ± 0.08, CI: 0.30/0.63, p < 0.0001) but not LVEF (SMD: 0.14 ± 0.11, CI: −0.08/0.37, p = 0.21) improved after surgery. Conclusions: Our meta-analysis adds a new piece of information on the beneficial effects of bariatric surgery on LV systolic function and, more importantly, suggests that the assessment of myocardial strain should be routinely implemented for a comprehensive evaluation of cardiac functional changes associated with bariatric procedures.
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Affiliation(s)
- Elisa Gherbesi
- Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, 20122 Milan, Italy
| | - Cesare Cuspidi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Andrea Faggiano
- Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, 20122 Milan, Italy
| | - Carla Sala
- Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, 20122 Milan, Italy
| | - Stefano Carugo
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Marijana Tadic
- Department of Cardiology, University Clinical Hospital Centre “Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-658107085
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