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Mitchell ES, Fabry A, Ho AS, May CN, Baldwin M, Blanco P, Smith K, Michaelides A, Shokoohi M, West M, Gotera K, El Massad O, Zhou A. The Impact of a Digital Weight Loss Intervention on Health Care Resource Utilization and Costs Compared Between Users and Nonusers With Overweight and Obesity: Retrospective Analysis Study. JMIR Mhealth Uhealth 2023; 11:e47473. [PMID: 37616049 PMCID: PMC10485704 DOI: 10.2196/47473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The Noom Weight program is a smartphone-based weight management program that uses cognitive behavioral therapy techniques to motivate users to achieve weight loss through a comprehensive lifestyle intervention. OBJECTIVE This retrospective database analysis aimed to evaluate the impact of Noom Weight use on health care resource utilization (HRU) and health care costs among individuals with overweight and obesity. METHODS Electronic health record data, insurance claims data, and Noom Weight program data were used to conduct the analysis. The study included 43,047 Noom Weight users and 14,555 non-Noom Weight users aged between 18 and 80 years with a BMI of ≥25 kg/m² and residing in the United States. The index date was defined as the first day of a 3-month treatment window during which Noom Weight was used at least once per week on average. Inverse probability treatment weighting was used to balance sociodemographic covariates between the 2 cohorts. HRU and costs for inpatient visits, outpatient visits, telehealth visits, surgeries, and prescriptions were analyzed. RESULTS Within 12 months after the index date, Noom Weight users had less inpatient costs (mean difference [MD] -US $20.10, 95% CI -US $30.08 to -US $10.12), less outpatient costs (MD -US $124.33, 95% CI -US $159.76 to -US $88.89), less overall prescription costs (MD -US $313.82, 95% CI -US $565.42 to -US $62.21), and less overall health care costs (MD -US $450.39, 95% CI -US $706.28 to -US $194.50) per user than non-Noom Weight users. In terms of HRU, Noom Weight users had fewer inpatient visits (MD -0.03, 95% CI -0.04 to -0.03), fewer outpatient visits (MD -0.78, 95% CI -0.93 to -0.62), fewer surgeries (MD -0.01, 95% CI -0.01 to 0.00), and fewer prescriptions (MD -1.39, 95% CI -1.76 to -1.03) per user than non-Noom Weight users. Among a subset of individuals with 24-month follow-up data, Noom Weight users incurred lower overall prescription costs (MD -US $1139.52, 95% CI -US $1972.21 to -US $306.83) and lower overall health care costs (MD -US $1219.06, 95% CI -US $2061.56 to -US $376.55) per user than non-Noom Weight users. The key differences were associated with reduced prescription use. CONCLUSIONS Noom Weight use is associated with lower HRU and costs than non-Noom Weight use, with potential cost savings of up to US $1219.06 per user at 24 months after the index date. These findings suggest that Noom Weight could be a cost-effective weight management program for individuals with overweight and obesity. This study provides valuable evidence for health care providers and payers in evaluating the potential benefits of digital weight loss interventions such as Noom Weight.
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Affiliation(s)
| | - Alexander Fabry
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Annabell Suh Ho
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Christine N May
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Matthew Baldwin
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Paige Blanco
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Kyle Smith
- Academic Research, Noom, Inc, New York City, NY, United States
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Alnajjar LI, Alzaben MA, Alghamdi AA, Alomani M, Abbas MS, Altammami RF, Alabdullatif SA, Rokan AKB, Youssef AM, Alhubaishi AA. The remission rate, metabolic changes, and quality of life assessment among patients with type 2 diabetes post-bariatric surgery in Riyadh, Saudi Arabia: A cross-sectional study. Saudi Med J 2023; 44:694-702. [PMID: 37463701 PMCID: PMC10370379 DOI: 10.15537/smj.2023.44.7.20230080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES To assess the remission rate, metabolic changes, and quality of life after bariatric surgery among Saudi patients with type 2 diabetes (T2DM). METHODS This cross-sectional study was conducted in 2 main centers in the Riyadh, Saudi Arabia. The study included patients with T2DM who underwent either laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) surgery from 2014 to 2018. The remission rate was defined based on the American Diabetes Association (ADA) and the International Diabetes Federation (IDF) criteria. Quality of life was assessed using the World Health Organization Quality of Life (WHOQOL)-BREF. RESULTS A total of 232 patients were included with a mean age of 44.3 ± 10.3 years. 93.4% of the patients had LSG, while only 6.6% had RYGB surgery. Among patients who underwent either LSG or RYGB surgery, there was a significant improvement in metabolic and glycemic markers compared to the baseline. According to the ADA criteria, 48.5% of the patients had complete remission, while 18.9% had partial remission. Overall, 7% of the patients met the IDF optimization criteria, while 5.7% met the IDF improvement criteria. The mean score for all the QOL domains exceeded 63 ± 13, with the environmental and physical health domains having the highest scores. CONCLUSION Among Saudi patients, bariatric surgery was associated with high remission rates and a better quality of life.
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Affiliation(s)
- Lina I. Alnajjar
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Mohammed A. Alzaben
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Atheer A. Alghamdi
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Munirah.O. Alomani
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Maha S. Abbas
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Rahaf F. Altammami
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Sara A. Alabdullatif
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Aljawharah K. Bin Rokan
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Amira M. Youssef
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Alaa A. Alhubaishi
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
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Kim BI, Anastasio AT, Wixted CM, DeOrio JK, Nunley JA, Easley ME, Adams SB. Total Ankle Arthroplasty: Does Obesity Matter? Foot Ankle Int 2023; 44:587-595. [PMID: 37345836 DOI: 10.1177/10711007231171084] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND There is limited data evaluating the effect of obesity on outcomes following total ankle arthroplasty (TAA), especially in adequate sample sizes to detect impacts on patient-reported outcomes (PROs). The purpose of this study was to assess the effect of obesity on complication rates and PROs. METHODS This was a single-institution, retrospective study of 1093 primary TAA performed between 2001 and 2020. Minimum follow-up was 2 years. Patients were stratified by body mass index (BMI) into control (BMI = 18.5-29.9; n = 615), obesity class I (BMI = 30.0-34.9; n = 285), and obesity class II (BMI > 35.0; n = 193) groups. Patient information, intraoperative variables, postoperative complications, and PRO measures were compared between groups using univariable statistics. Multivariable Cox regression was performed to assess risk for implant failure. Mean follow-up was 5.6 years (SD: 3.1). RESULTS Compared to control and class I, class II patients had the lowest mean age (P = .001), highest mean ASA score (P < .001), and greatest proportion of female sex (P < .001) and Black/African American race (P = .005). There were no statistically significant differences in postoperative complications (infection, implant failure, or impingement) across the BMI classes (P > .05).Preoperatively, class II had lower (worse) mean scores for Foot and Ankle Outcome Score pain and ADL subscales than controls (post hoc pairwise P < .001 for both). At final follow-up, both class II and class I had lower (worse) mean Short Musculoskeletal Function Assessment (post hoc pairwise P < .001 and P = .030, respectively) and 36-Item Short Form Health Survey scores (post hoc pairwise P < .001 and P = .005, respectively) than controls. CONCLUSION At midterm follow-up, obesity was not associated with increased rates of complications after TAA. Patients with obesity reported worse musculoskeletal function and overall quality of life after TAA but there was no differential improvement in PROs across BMI classes. To our knowledge, this is the largest single-institution study to date examining the effect of obesity on outcomes after primary TAA. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Billy I Kim
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
| | | | - Colleen M Wixted
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
| | - James K DeOrio
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
| | - James A Nunley
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
| | - Mark E Easley
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
| | - Samuel B Adams
- Duke University Department of Orthopaedic Surgery, Durham, NC, USA
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Fares AB, Scanaliato JP, Green CK, Dunn JC, Gordon M, Parnes N. The Effect of the Overweight Condition on Arthroscopic Rotator Cuff Repair Outcomes. Orthopedics 2023; 46:242-249. [PMID: 36719410 DOI: 10.3928/01477447-20230125-07] [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] [Indexed: 02/01/2023]
Abstract
This study sought to investigate the influence of a preexisting overweight condition (body mass index [BMI], 25-29.9 kg/m2) on functional outcomes after arthroscopic rotator cuff repair surgery. A retrospective review was performed examining the outcomes of arthroscopic rotator cuff repair in a normal-weight (BMI, 18.5-24.9 kg/m2) and an overweight (BMI, 25-29.9 kg/m2) population. Functional outcomes were assessed to include the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation score, and the visual analog scale (VAS) pain score, as well as range of motion in forward flexion, external rotation, and internal rotation. A total of 52 normal-weight patients (mean BMI, 23.7±2.1 kg/m2) and 57 overweight patients (mean BMI, 28.4±1.4 kg/m2) were included. Both groups demonstrated statistically and clinically significant improvements in VAS score, Single Assessment Numeric Evaluation score, and ASES score at final follow-up (P<.0001), with no difference in range of motion (P>.05). Overall, when comparing outcomes between the groups, there were significantly better outcomes in the normal-weight group's VAS scores (mean, 0.56±0.96 vs 1.3±1.7; P=.0064), ASES scores (mean, 96.1±5.8 vs 92.4±9.7; P=.0187), and internal rotation (mean thoracic vertebrae, 9.2±3.0 vs 10.4±2.6; P=.0289). However, these differences did not reach clinical significance regarding the threshold of patients meeting standard minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state for rotator cuff repairs. Over-weight patients have improved outcomes after arthroscopic rotator cuff repair surgery with noninferior clinical results when compared with normal-weight patients. More data regarding outcomes of overweight patients will help physicians make better-informed decisions when considering rotator cuff repair. [Orthopedics. 2023;46(4):242-249.].
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Pokharel A, Acharya I, Akhiwu TO, Haas CJ. Dry Beriberi Post Roux-en-Y Gastric Bypass Surgery. J Community Hosp Intern Med Perspect 2023; 13:58-64. [PMID: 37868250 PMCID: PMC10589022 DOI: 10.55729/2000-9666.1210] [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: 03/14/2023] [Revised: 04/07/2023] [Accepted: 04/21/2023] [Indexed: 10/24/2023] Open
Abstract
Bariatric surgery is an effective strategy for achieving substantial weight loss, prolonging survival, and improving the comorbidities associated with obesity. Nutritional deficiency is a commonly recognized post-procedural complication. Here, we present a case of a patient with paresthesia, lower extremity weakness, and altered mental status one year following Roux-en-Y gastric bypass, who was found to have multiple vitamin and micronutrient deficiencies and was diagnosed with beriberi in the setting of profound thiamine deficiency.
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Affiliation(s)
- Ashik Pokharel
- Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA
| | - Indira Acharya
- Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA
| | - Ted O Akhiwu
- Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA
| | - Christopher J Haas
- Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA
- Georgetown University School of Medicine, Washington, D.C, USA
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Gómez Lumbreras A, Tan MS, Villa-Zapata L, Ilham S, Earl JC, Malone DC. Cost-effectiveness analysis of five anti-obesity medications from a US payer's perspective. Nutr Metab Cardiovasc Dis 2023; 33:1268-1276. [PMID: 37088648 DOI: 10.1016/j.numecd.2023.03.012] [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: 10/18/2022] [Revised: 02/06/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND AND AIMS To determine the cost-effectiveness of anti-obesity medications (AOM): tirzepatide, semaglutide, liraglutide, phentermine plus topiramate (PpT), and naltrexone plus bupropion (NpB). METHODS AND RESULTS From a U.S. perspective we developed a Markov model to simulate weight change over a 40-year time horizon using results from clinical studies. According to the body mass index (BMI), cardiovascular diseases, diabetes and mortality risk were the health states considered in the model, being mutually exclusive. Costs of AOM, adverse events, cardiovascular events, and diabetes were included. We applied a 3% per-year discount rate and calculated the incremental cost-effectiveness ratios (ICERs) of cost per quality-adjusted life-year (QALY) gained. Probabilistic sensitivity analyses incorporated uncertainty in input parameters. A deterministic analysis was conducted to determine the robustness of the model. The model included a cohort of 78.2% females with a mean age of 45 years and BMI of 37.1 (SD 4.9) for females and 36.8 (SD 4.9) for males. NpB and PpT were the least costly medications and, all medications differed no more than 0.5 QALYs. Tirzepatide ICER was $355,616 per QALY. Liraglutide and semaglutide options were dominated by PpT. CONCLUSION Compared to other AOM, PpT was lowest cost treatment with nearly identical QALYs with other agents.
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Affiliation(s)
- Ainhoa Gómez Lumbreras
- Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA.
| | - Malinda S Tan
- Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA.
| | - Lorenzo Villa-Zapata
- Department of Pharmacy Practice, College of Pharmacy. Mercer University, Atlanta, GA, USA.
| | - Sabrina Ilham
- Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA.
| | - Jacob C Earl
- Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA.
| | - Daniel C Malone
- Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA.
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Ramezankhani A, Azizi F, Hasheminia M, Hadaegh F. The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort. BMC Public Health 2023; 23:903. [PMID: 37202748 DOI: 10.1186/s12889-023-15851-0] [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: 11/21/2022] [Accepted: 05/09/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Few studies have examined the effect of obesity indices on total number of hospitalizations. We examined the associations between body mass index (BMI) and waist circumference (WC) and rate of all-cause hospitalizations among Iranian adult participated in the Tehran Lipid and Glucose Study cohort. METHODS This study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median of 18 years. Participants were categorized into three groups according to their baseline BMI: normal weight, overweight and obese. In addition, they were classified according to WC in two categories: normal WC and high WC. Negative Binomial regression model was used to estimate the incidence rate ratios (IRRs) and 95% confidence interval (95% CI) of all-cause hospitalizations in relation to obesity indices. RESULTS The overall crude rate of all-cause hospitalizations were 77.6 (95% CI, 73.9-81.2) and 76.9 (73.4-80.3) per 1000 person-year in men and women, respectively. The covariate adjusted rate of all-cause hospitalizations was 27% higher in obese men than normal weight men (IRR (95% CI): 1.27 (1.11-1.42)). Among women, overweight and obese individuals had 17% (1.17 (1.03-1.31)) and 40% (1.40 (1.23-1.56)) higher rate of hospitalization compared to normal weight women. Having high WC was associated with 18% (1.18 (1.08-1.29)) and 30% (1.30 (1.18-1.41)) higher rate of all-cause hospitalization in men and women, respectively. CONCLUSIONS Obesity and high WC were associated with increased hospitalization rates during long-term follow-up. Our findings suggests that successful obesity prevention programs may decrease the number of hospitalizations, particularly, in women.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Floor 3th, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Floor 3th, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Floor 3th, Number 24, Yemen Street, Shahid Chamran Highway, P.O. Box: 19395-4763, Tehran, Iran.
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Atlas SJ, Kim K, Nhan E, Touchette DR, Moradi A, Agboola F, Rind DM, Beaudoin FL, Pearson SD. Medications for obesity management: Effectiveness and value. J Manag Care Spec Pharm 2023; 29:569-575. [PMID: 37121254 PMCID: PMC10387935 DOI: 10.18553/jmcp.2023.29.5.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Steven J Atlas
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kibum Kim
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago
| | - Emily Nhan
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Daniel R Touchette
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago
| | - Ashton Moradi
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Foluso Agboola
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - David M Rind
- Institute for Clinical and Economic Review (ICER), Boston, MA
| | - Francesca L Beaudoin
- Institute for Clinical and Economic Review (ICER), Boston, MA
- Department of Epidemiology, Brown University, Providence, RI
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Green L, Taddei-Allen P. Shifting paradigms: Reframing coverage of antiobesity medications for plan sponsors. J Manag Care Spec Pharm 2023; 29:564-568. [PMID: 37121250 PMCID: PMC10387974 DOI: 10.18553/jmcp.2023.29.5.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
| | - Patty Taddei-Allen
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1460] [Impact Index Per Article: 1460.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Ban OH, Lee M, Bang WY, Nam EH, Jeon HJ, Shin M, Yang J, Jung YH. Bifidobacterium lactis IDCC 4301 Exerts Anti-Obesity Effects in High-Fat Diet-Fed Mice Model by Regulating Lipid Metabolism. Mol Nutr Food Res 2023; 67:e2200385. [PMID: 36517937 DOI: 10.1002/mnfr.202200385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
SCOPE Chronic hypernutrition promotes lipid accumulation in the body and excessive lipid accumulation leads to obesity. An increase in the number and size of adipocytes, a characteristic of obesity is closely associated with adipose dysfunction. Recent in vitro and in vivo studies have shown that probiotics may prevent this dysfunction by regulating lipid metabolism. However, the mechanisms of action of probiotics in obesity are not fully understood and their usage for treating obesity remains limited. METHODS AND RESULTS Bifidobacterium lactis IDCC 4301 is selected for its anti-obesity potential after evaluating inhibitory activity of pancreatic lipase and cholesterol reducing activity. Next, this study investigates the roles of B. lactis IDCC 4301 on lipid metabolism in 3T3-L1 preadipocytes and high-fat diet (HFD)-fed mice. B. lactis IDCC 4301 inhibits cell differentiation and lipid accumulation by suppressing the expression of adipogenic enzymes in 3T3-L1 cells. Moreover, the administration of B. lactis IDCC 4301 decreases body and adipose tissue weight, improves serum lipid levels, and downregulates adipogenic mRNA expression in HFD-fed mice. Additionally, metabolomic analysis suggests that 2-ketobutyrate should be a possible target compound against obesity. CONCLUSIONS B. lactis IDCC 4301 may be used as an alternative treatment for obesity.
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Affiliation(s)
- O-Hyun Ban
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea.,School of Food Science and Biotechnology, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Minjee Lee
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Won Yeong Bang
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Eoun Ho Nam
- Department of Microbiology, College of Medicine, Inha University, Incheon, 22212, Republic of Korea
| | - Hyeon Ji Jeon
- School of Food Science and Biotechnology, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Minhye Shin
- Department of Microbiology, College of Medicine, Inha University, Incheon, 22212, Republic of Korea
| | - Jungwoo Yang
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Young Hoon Jung
- School of Food Science and Biotechnology, Kyungpook National University, Daegu, 41566, Republic of Korea
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Garvey WT, Cheng M, Ramasamy A, Smolarz BG, Park S, Kumar N, Kim N, DerSarkissian M, Bhak RH, Duh MS, Wu M, Hansen S, Young-Xu Y. Clinical and Cost Benefits of Anti-Obesity Medication for US Veterans Participating in the MOVE! Weight Management Program. Popul Health Manag 2023; 26:72-82. [PMID: 36735596 DOI: 10.1089/pop.2022.0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Abstract This study investigated the clinical and economic impact of anti-obesity medications (AOMs; orlistat, liraglutide, phentermine/topiramate extended-release [ER], naltrexone ER/bupropion ER) among United States Veterans with obesity participating in Motivating Overweight/Obese Veterans Everywhere! (MOVE!), a government-initiated weight management program. The study population was identified from electronic medical records of the Veterans Health Administration (2010-2020). Clinical indices of obesity and health care resource utilization and costs were evaluated at 6, 12, and 24 months after the initial dispensing of an AOM in the AOM+MOVE! cohort (N = 3732, mean age 57 years, 79% male) or on the corresponding date of an inpatient or outpatient encounter in the MOVE! cohort (N = 7883, mean age 58 years, 81% male). At 6 months postindex, the AOM+MOVE! cohort had better cardiometabolic indices (eg, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, hemoglobin A1c) than the MOVE! cohort, with the trends persisting at 12 and 24 months. The AOM+MOVE! cohort was significantly more likely than the MOVE! cohort to have weight decreases of 5%-10%, 10%-15%, and >15% and lower body mass index at 6, 12, and 24 months. The AOM+MOVE! cohort also had fewer inpatient and emergency department visits than the MOVE! cohort, which was associated with lower mean total medical costs including inpatient costs. These results suggest that combining AOM treatment with the MOVE! program could yield long-term cost savings for the Veterans Affairs network and meaningful clinical improvements for Veterans with obesity.
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Affiliation(s)
- W Timothy Garvey
- UAB Diabetes Research Center, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mu Cheng
- Analysis Group, Inc., Boston, Massachusetts, USA
| | | | | | - Suna Park
- Analysis Group, Inc., Boston, Massachusetts, USA
| | - Neela Kumar
- Novo Nordisk, Inc., Plainsboro, New Jersey, USA
| | - Nina Kim
- Novo Nordisk, Inc., Plainsboro, New Jersey, USA
| | | | | | | | - Melody Wu
- Analysis Group, Inc., Boston, Massachusetts, USA
| | | | - Yinong Young-Xu
- Clinical Epidemiology Program, White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA
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Eichen DM, Sim DJEK, Appleton-Knapp SL, Strong DR, Boutelle KN. Adults with overweight or obesity use less efficient memory strategies compared to adults with healthy weight on a verbal list learning task modified with food words. Appetite 2023; 181:106402. [PMID: 36460122 PMCID: PMC9836657 DOI: 10.1016/j.appet.2022.106402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 11/30/2022]
Abstract
Several studies suggest poorer episodic memory among adults with overweight (OW) relative to those with healthy weight (HW); however, few have used food stimuli. To understand the salience of food-related items when assessing memory, we adapted an episodic memory task, by replacing some non-food words with snack foods. Participants were 96 weight-loss seeking adults with OW compared to 48 adults with HW from the community matched on age, gender, ethnicity, and education. Overall memory ability was similar, although a trend showed the adults with HW performed better than adults with OW on immediate recall (d = 0.32, p = 0.07). However, there were clear differences in the use of learning strategies. Adults with HW utilized sematic clustering more effectively than adults with OW during all test phases (ds = 0.44-0.62; ps ≤ 0.01). Adults with HW also utilized serial clustering more effectively (d = 0.51; p < 0.01). Adults with HW showed better semantic clustering for both food and non-food words during immediate and short delay recall (ds = 0.42-0.78; ps ≤ 0.01) but semantic clustering was only better for the non-food category at long delay (d = 0.55; p < 0.01). These results show that adults with OW utilized less efficient learning strategies throughout the task and food-related content may impact learning. Clinically, these findings may suggest that weight-loss treatments should consider incorporating the teaching of learning and memory strategies to help increase utilization of new skills.
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Affiliation(s)
- Dawn M. Eichen
- University of California San Diego, Department of Pediatrics, San Diego, CA, USA,Corresponding author. University of California, San Diego, 9500 Gilman Drive #0874, La Jolla, CA, 92093, USA., (D.M. Eichen)
| | - Dong-Jin E. Kang Sim
- University of California San Diego, Department of Pediatrics, San Diego, CA, USA
| | | | - David R. Strong
- University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA
| | - Kerri N. Boutelle
- University of California San Diego, Department of Pediatrics, San Diego, CA, USA,University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA,University of California San Diego, Department of Psychiatry, San Diego, CA, USA
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Kim N, Estrada J, Chow I, Ruseva A, Ramasamy A, Burudpakdee C, Blanchette CM. The Relative Value of Anti-Obesity Medications Compared to Similar Therapies. Clinicoecon Outcomes Res 2023; 15:51-62. [PMID: 36726966 PMCID: PMC9886521 DOI: 10.2147/ceor.s392276] [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: 10/07/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023]
Abstract
Purpose To demonstrate a need for improved health insurance coverage for anti-obesity medications (AOMs) by comparing clinical and economic benefits of obesity treatments to covered medications for selected therapeutic areas. Methods Using a grey literature search, we identified and prioritized therapeutic areas and treatment analogues for comparison to obesity. A targeted literature review identified clinical and economic outcomes research across the therapeutic area analogues. Associated comorbidities, clinical evidence, indirect costs (ie, absenteeism and productivity loss), and direct medical costs were evaluated to determine the relative value of treating obesity. Results Four therapeutic areas/treatment analogues were selected for comparison to obesity: smoking cessation (varenicline), daytime sleepiness (modafinil), migraines (erenumab), and fibromyalgia (pregabalin). Obesity was associated with 17 comorbidities, more than migraine (9), smoking (8), daytime sleepiness (5), and fibromyalgia (2). Economic burden was greatest for obesity, followed by smoking, with yearly indirect and direct medical costs totaling $676 and $345 billion, respectively. AOMs resulted in cost savings of $2586 in direct medical costs per patient per year (PPPY), greater than that for varenicline at $930 PPPY, modafinil at $1045 PPPY, and erenumab at $468 PPPY; pregabalin utilization increased costs by $924 PPPY. AOMs were covered by 10-16% of United States health insurance plans, compared to 45-59% for the four comparators. Conclusion Compared to four therapeutic analogues, obesity represented the highest economic burden and was associated with more comorbidities. AOMs provide greater cost savings compared to selected analogues. However, AOMs have limited formulary coverage. Improved coverage of AOMs may increase access to these treatments and may help address the clinical and economic burden associated with obesity and its comorbidities.
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Affiliation(s)
- Nina Kim
- Novo Nordisk, Inc, Plainsboro, NJ, USA
| | | | | | - Aleksandrina Ruseva
- Novo Nordisk, Inc, Plainsboro, NJ, USA,Correspondence: Aleksandrina Ruseva, Novo Nordisk, Inc, 800 Scudders Mill Road, Plainsboro, NJ, 08536, USA, Tel +1 609-598-8146, Email
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Vesikansa A, Mehtälä J, Mutanen K, Lundqvist A, Laatikainen T, Ylisaukko-oja T, Saukkonen T, Pietiläinen KH. The association between body mass index groups and metabolic comorbidities with healthcare and medication costs: a nationwide biobank and registry study in Finland. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2023; 11:2166313. [PMID: 36684852 PMCID: PMC9858397 DOI: 10.1080/20016689.2023.2166313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The increasing prevalence of obesity imposes a significant cost burden on individuals and societies worldwide. OBJECTIVE In this nationally representative study, the association between body mass index (BMI) groups and the number of metabolic comorbidities (MetC) with total direct costs was investigated in the Finnish population. STUDY DESIGN, SETTING, AND PARTICIPANTS The study cohort included 5,587 adults with BMI ≥18.5 kg/m2 who participated in the cross-sectional FinHealth 2017 health examination survey conducted by the Finnish Institute for Health and Welfare. Data on healthcare resource utilization (HCRU) and drug purchases were collected from national healthcare and drug registers. MAIN OUTCOME MEASURE The primary outcome was total direct costs (costs of primary and secondary HCRU and prescription medications). RESULTS Class I (BMI 30.0-34.9 kg/m2) and class II - III (BMI ≥35.0 kg/m2) obesity were associated with 43% and 40% higher age- and sex-adjusted direct costs, respectively, compared with normal weight, mainly driven by a steeply increased comorbidity in the higher BMI groups. In all BMI groups combined, individuals with ≥2 MetCs comprised 39% of the total study population and 60% of the total costs. CONCLUSION To manage the cost burden of obesity, treatment should be given equal consideration as other chronic diseases, and BMIs ≥30.0 kg/m2 should be considered in treatment decisions.
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Affiliation(s)
| | | | | | | | - Tiina Laatikainen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social andHealth Services (Siun Sote), Joensuu, Finland
| | - Tero Ylisaukko-oja
- MedEngine Oy, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki,Helsinki, Finland & Obesity Center, Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Osińska M, Towpik I, Sanchak Y, Franek E, Śliwczyński A, Walicka M. Cost of Surgical Treatment of Obesity and Its Impact on Healthcare Expense-Nationwide Data from a Polish Registry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1118. [PMID: 36673873 PMCID: PMC9859611 DOI: 10.3390/ijerph20021118] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Weight loss surgery is linked to health benefits and may reduce the cost to the public healthcare systems. The aim of this study was to assess the cost and cost-structure in the one-year periods before and after a bariatric surgery in the Polish nationwide registry. The study included 2390 obese adults which underwent surgical treatment for obesity in 2017. The cost structure and the total costs per patient for one year before bariatric surgery, preoperatively, and for one year after surgery were analyzed. The total cost of the postoperative period was about PLN 3 million lower than during the preoperative period. After bariatric surgery, a reduction of approximately 59% in costs associated with hospital treatment was observed. The costs of outpatient specialist services, hospital treatment, psychiatric care, and addiction treatment also significantly decreased. There was a negative correlation between the changes in the cost of treatment of patients undergoing obesity surgery and their age. The health care cost during the period of one year after bariatric surgery is lower than in the year preceding the surgery (a greater cost difference is observed in younger people). This is mainly influenced by the reduction in costs associated with hospital treatment.
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Affiliation(s)
- Magdalena Osińska
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
| | - Iwona Towpik
- Department of Internal Diseases, Diabetology, and Endocrinology, Collegium Medicum, University of Zielona Góra, 28 Zyty Str., 65-046 Zielona Góra, Poland
| | - Yaroslav Sanchak
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
- Department of Human Epigenetics, Mossakowski Medical Research Institute, 5 Pawińskiego Str., 02-106 Warsaw, Poland
| | - Andrzej Śliwczyński
- Faculty of Medicine, Lazarski University, 43 Świeradowska Str., 02-662 Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
- Department of Human Epigenetics, Mossakowski Medical Research Institute, 5 Pawińskiego Str., 02-106 Warsaw, Poland
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Galvain T, Bosut MP, Jamous N, Ben Mansour N. Cost-Effectiveness of Bariatric Surgery in Tunisia. Diabetes Metab Syndr Obes 2023; 16:935-945. [PMID: 37033399 PMCID: PMC10075262 DOI: 10.2147/dmso.s385110] [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: 08/05/2022] [Accepted: 03/10/2023] [Indexed: 04/04/2023] Open
Abstract
PURPOSE Obesity is a growing global issue with evidence linking it to an increase in loss of disease-free years, reduced quality of life, increased mortality, and additional economic burden. This study sought to establish the cost-effectiveness of gastric bypass and sleeve gastrectomy, compared to conventional therapy in patients with obesity, from a Tunisian healthcare payor perspective. PATIENTS AND METHODS A Markov model compared lifetime costs and outcomes of bariatric surgery with conventional treatment among patients with body mass index (BMI) ≥ 40 kg/m2, BMI ≥ 35 kg/m2 with obesity-related co-morbidities (Group 1), or BMI ≥ 35 kg/m2 with type 2 diabetes mellitus (T2DM) (Group 2). Inputs were sourced from the Tunisian Health Examination Survey, local clinician data and literature sources. Health states were associated with different cost and utility decrements. Changes in body mass index, systolic blood pressure, lipid ratio and diabetes remission rates were modelled on a yearly basis. The incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs) and net monetary benefit (NMB) were key outcomes. Sensitivity and scenario analyses were performed to test the model's robustness. RESULTS The model showed that the benefits of bariatric surgery were favorable compared to conventional treatment, with an ICER of 1844 TND/QALY in Group 1 patients and 2413 TND/QALY in Group 2 patients. Bariatric surgery resulted in a QALY gain of 3.26 per patient in Group 1 and a gain of 1.77 per patient in Group 2. At a willingness to pay threshold of 31,379 TND/QALY, the incremental NMB was 96,251 TND and 51,123 TND for Group 1 and Group 2, respectively. CONCLUSION From the Tunisian healthcare payor perspective, bariatric surgery is cost-effective for patients with obesity and those with T2DM and obesity-related comorbidities. These findings may have impact on future decision-making on funding and reimbursement of bariatric surgery in Tunisia.
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Affiliation(s)
- Thibaut Galvain
- Health Economics and Market Access, Johnson & Johnson Medical NV, Diegem, Belgium
- Correspondence: Thibaut Galvain, Health Economics and Market Access, Johnson & Johnson Medical NV, Leonardo da Vincilaan 15, Diegem, Belgium, Tel +33648649800, Email
| | - Melek Pinar Bosut
- Health Economics and Market Access, Johnson & Johnson Medical NV, Diegem, Belgium
| | - Nadine Jamous
- Health Economics and Market Access, Johnson & Johnson Medical NV, Diegem, Belgium
| | - Nadia Ben Mansour
- National Institute of Health, Tunis, Tunisia
- Faculty of Medicine, Université de Tunis El Manar, Tunis, Tunisia
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Ragland TJ, Heiston EM, Ballantyne A, Stewart NR, La Salvia S, Musante L, Luse MA, Isakson BE, Erdbrügger U, Malin SK. Extracellular vesicles and insulin-mediated vascular function in metabolic syndrome. Physiol Rep 2023; 11:e15530. [PMID: 36597186 PMCID: PMC9810789 DOI: 10.14814/phy2.15530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 01/05/2023] Open
Abstract
Metabolic Syndrome (MetS) raises cardiovascular disease risk. Extracellular vesicles (EVs) have emerged as important mediators of insulin sensitivity, although few studies on vascular function exist in humans. We determined the effect of insulin on EVs in relation to vascular function. Adults with MetS (n = 51, n = 9 M, 54.8 ± 1.0 years, 36.4 ± 0.7 kg/m2 , ATPIII: 3.5 ± 0.1 a.u., VO2 max: 22.1 ± 0.6 ml/kg/min) were enrolled in this cross-sectional study. Peripheral insulin sensitivity (M-value) was determined during a euglycemic clamp (40 mU/m2 /min, 90 mg/dl), and blood was collected for EVs (CD105+, CD45+, CD41+, TX+, and CD31+; spectral flow cytometry), inflammation, insulin, and substrates. Central hemodynamics (applanation tonometry) was determined at 0 and 120 min via aortic waveforms. Pressure myography was used to assess insulin-induced arterial vasodilation from mouse 3rd order mesenteric arteries (100-200 μm in diameter) at 0.2, 2 and 20 nM of insulin with EVs from healthy and MetS adults. Adults with MetS had low peripheral insulin sensitivity (2.6 ± 0.2 mg/kg/min) and high HOMA-IR (4.7 ± 0.4 a.u.) plus Adipose-IR (13.0 ± 1.3 a.u.). Insulin decreased total/particle counts (p < 0.001), CD45+ EVs (p = 0.002), AIx75 (p = 0.005) and Pb (p = 0.04), FFA (p < 0.001), total adiponectin (p = 0.006), ICAM (p = 0.002), and VCAM (p = 0.03). Higher M-value related to lower fasted total EVs (r = -0.40, p = 0.004) while higher Adipose-IR associated with higher fasted EVs (r = 0.42, p = 0.004) independent of VAT. Fasting CD105+ and CD45+ derived total EVs correlated with fasting AIx75 (r = 0.29, p < 0.05) and Pb (r = 0.30, p < 0.05). EVs from MetS participants blunted insulin-induced vasodilation in mesenteric arteries compared with increases from healthy controls across insulin doses (all p < 0.005). These data highlight EVs as potentially novel mediators of vascular insulin sensitivity and disease risk.
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Affiliation(s)
- Tristan J. Ragland
- Department of Kinesiology & HealthRutgers UniversityNew BrunswickNew JerseyUSA
| | - Emily M. Heiston
- Department of Internal Medicine, Pauley Heart CenterVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Anna Ballantyne
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Nathan R. Stewart
- Department of Kinesiology & HealthRutgers UniversityNew BrunswickNew JerseyUSA
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | | | - Luca Musante
- School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Melissa A. Luse
- Robert M Berne Cardiovascular Research CenterUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
| | - Brant E. Isakson
- Robert M Berne Cardiovascular Research CenterUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
- Department of Molecular Physiology and BiophysicsUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
| | - Uta Erdbrügger
- Division of Nephrology, Department of MedicineUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Steven K. Malin
- Department of Kinesiology & HealthRutgers UniversityNew BrunswickNew JerseyUSA
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
- Division of Endocrinology, Metabolism & NutritionDepartment of MedicineNew BrunswickNew JerseyUSA
- The New Jersey Institute for Food, Nutrition and HealthRutgers UniversityNew BrunswickNew JerseyUSA
- Institute of Translational Medicine and ScienceRutgers UniversityNew BrunswickNew JerseyUSA
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Cho E, Kim JY, Cho B, Lee JS, Yoon YC, Shin YC, Kim H, Gil S, Kim S. Efficacy of fermented grain using Bacillus coagulans in reducing visceral fat among people with obesity: a randomized controlled trial. Front Nutr 2023; 10:1148512. [PMID: 37139448 PMCID: PMC10149940 DOI: 10.3389/fnut.2023.1148512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/03/2023] [Indexed: 05/05/2023] Open
Abstract
Background Obesity is a socioeconomic problem, and visceral obesity, in particular, is related to cardiovascular diseases or metabolic syndrome. Fermented grains and various microorganisms are known to help with anti-obesity effects and weight management. Studies on the relationship between Bacillus coagulans and anti-obesity effects are not well known, and studies on the application of fermented grains and microorganisms to the human body are also insufficient. Objectives This study aimed to evaluate the efficacy of Curezyme-LAC, an ingredient mixed with six-grain types fermented by B. coagulans, in reducing fat mass in adults with obesity. Methods In this randomized double-blinded placebo-controlled study, 100 participants [aged 40-65 years; body mass index (BMI) ≥ 25 to ≤ 33 kg/m2) were randomly allocated to two groups: 4 g/day Curezyme-LAC administered as a granulated powder or placebo (steamed grain powder mixture). Results After 12 weeks, visceral adipose tissue decreased significantly in the Curezyme-LAC group compared with that in the placebo group (mean ± standard error, SE of -9.3 cm2 ± 5.1) vs. (6.8 cm2 ± 3.4; p = 0.008). Compared to the placebo group, the Curezyme-LAC group also showed significant reductions in total fat mass (-0.43 ± 0.24 kg vs. 0.31 ± 0.19 kg, p = 0.011), body weight (-0.4 ± 0.3 kg vs. 0.3 ± 0.2 kg, p = 0.021), BMI (-0.14 ± 0.12 vs. 0.10 ± 0.07, p = 0.028), and waist circumference (-0.6 ± 0.2 cm vs. -0.1 ± 0.2 cm, p = 0.018) without a change in dietary intake and physical activity. Conclusion Curezyme-LAC supplementation for 12 weeks may benefit individuals with obesity by reducing visceral fat mass.
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Affiliation(s)
- Eunbyul Cho
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Ju Young Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- *Correspondence: Ju Young Kim,
| | - Belong Cho
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Belong Cho,
| | | | | | | | - Hyerim Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Siye Gil
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Sohye Kim
- Nutrition Care Services, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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Zhao SQ, Zhao LP, Xu XP, You H. Individual-Level Health Care Costs Attributable to Noncommunicable Diseases: A Longitudinal Study Based on the Older Adults in China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231214469. [PMID: 38044620 PMCID: PMC10697053 DOI: 10.1177/00469580231214469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023]
Abstract
Noncommunicable chronic diseases among the elderly population represent a significant economic burden in China. However, previous disease-related health cost studies lacked representation of older adults and comparability of the burden of multiple chronic diseases. The objective of this study was to determine the fraction of health care costs attributable to the 6 most prevalent chronic diseases and comorbidities in the sample of older adults. This study employed data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with 3 waves in 2011, 2014, and 2018, and included 18 349 observations in total. Outpatient costs, inpatient costs, and total health care costs were included in this study. Based on a 2-part random effects model, the effect of chronic disease on health service utilization was first explored by constructing a dummy variable for whether or not to utilize health care, followed by estimation of attributable costs in the population with health care utilization. Among the older adults in the sample, hypertension, heart disease, cataracts, arthritis, stroke or Cerebrovascular disease (CVD) and chronic lung disease are the 6 most prevalent chronic conditions. The costs attributable to the 6 chronic diseases mentioned above were 36.00% of outpatient costs, 55.92% of inpatient costs, and 45.05% of total health care costs for older adults. Of these, heart disease, stroke or CVD, and chronic lung disease accounted for 22.11%, 13.24%, and 10.56% of total health care costs, respectively. Moreover, the proportion of health care costs attributable to chronic diseases was higher for older adults who were male, lived in urban areas, and had a lower level of education. The proportion of health care costs attributable to chronic diseases is substantial among older adults in China. Health care costs associated with chronic diseases can be decreased with well-targeted interventions and comprehensive access to health services.
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Affiliation(s)
| | | | | | - Hua You
- Nanjing Medical University, Nanjing, China
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71
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Leung T, Jerome GJ. Self-Monitoring Physical Activity, Diet, and Weight Among Adults Who Are Legally Blind: Exploratory Investigation. JMIR Rehabil Assist Technol 2022; 9:e42923. [PMID: 36508250 PMCID: PMC9793293 DOI: 10.2196/42923] [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: 09/23/2022] [Revised: 11/02/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Obesity is a global pandemic. Lifestyle approaches have been shown effective for weight loss and weight loss maintenance. Central to these evidence-based approaches are increased physical activity, decreased caloric intake, regular self-weighing, and the tracking of these behaviors. OBJECTIVE This exploratory descriptive study surveyed adults who are legally blind to identify strategies related to tracking physical activity, diet, and weight. These health behaviors are essential components to evidence-based weight loss programs. We also identified areas where we can better support adults who are legally blind in their independent efforts to change these behaviors and improve their health. METHODS Participants (≥18 years of age) who self-identified as being legally blind were recruited using email announcements in low vision advocacy groups. They completed an interviewer-administered survey on the telephone and an in-person visit for standardized assessment of height and weight. RESULTS The participants (N=18) had an average age of 31.2 (SD 13.4) years; 50% (9/18) had normal weight (BMI 18.5 to <25); 44% (8/18) were female; 44% (8/18) were Black; and 39% (7/18) were Non-Hispanic White. Most participants (16/18, 89%) used their smartphone to access the internet daily, and 67% (12/18) had at least 150 mins of exercise per week. Although 78% (14/18) of the participants indicated tracking their weight, only 61% (11/18) could indicate how they tracked their weight, and 22% (4/18) indicated they tracked it mentally. Providing individuals with a talking scale was the most consistent recommendation (12/18, 67%) to facilitate independence in managing weight through lifestyle changes. Even though 50% (9/18) of the participants indicated using an app or electronic notes to track some portion of their diet, participants reported challenges with determining portion size and corresponding calorie counts. Most participants (17/18, 94%) reported using apps, electronic notes, smartphones, or wearable devices to track their physical activity. Although strategies such as using wearables and smartphones could provide measurements (eg, step counts) as well as recording data, they also pose financial and technology literacy barriers. CONCLUSIONS Technology-based solutions were identified for tracking weight, diet, and physical activity for weight management. These strategies have financial and technology literacy barriers. A range of strategies for adopting and tracking health behaviors will be needed to assist individuals with varying skills and life experiences.
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Affiliation(s)
| | - Gerald J Jerome
- Department of Kinesiology, Towson University, Towson, MD, United States
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De la Rosa A, Ghusn W, Sacoto D, Campos A, Cifuentes L, Feris F, Busebee B, Calderon G, Acosta A, Hurtado MD. A comparison between weight loss outcomes with anti-obesity medications before and during Covid-19 pandemic at a tertiary weight management center. OBESITY PILLARS (ONLINE) 2022; 4:100046. [PMID: 37990666 PMCID: PMC9714128 DOI: 10.1016/j.obpill.2022.100046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
Background /Objectives: Obesity is a risk factor for COVID-19 infection severity and mortality. Anti-obesity medications (AOM) are effective for weight loss. However, weight loss outcomes with AOM during the COVID-19 pandemic are yet to be described. Subjects /Methods: Between January 1, 2016, and June 30, 2021, a total of 966 patients were prescribed long-term FDA-approved AOMs at the Mayo Clinic. From these patients, 711 patients did not meet inclusion criteria. A total of 255 patients were included. Interventions/methods We performed a retrospective systematic review of electronic medical records and included patients who started a long-term FDA-approved AOM. We excluded patients with history of bariatric procedure, AOM prescription with lorcaserin, orlistat, semaglutide (approved for weight loss after the pandemic), or phentermine (short-term AOM), those taking ≥2 AOMs, <3 months of prescribed AOM, and/or pregnancy. Analysis was divided by 1)preCOVID-19: those who started an AOM before COVID-19 restrictions, 2)COVID-19: those who started an AOM during first quarter of 2020 after the establishment of COVID-19 restrictions. Our primary endpoint was the total body weight loss percentage (%TBWL) at 3, 6, and 12 months after AOM initiation. Results There was a statistical difference in TBWL% between the preCOVID-19 and COVID-19 group: 5.3 ± 3.5% vs 4 ± 3.0% (95% CI -2.4 to -0.2; p = 0.02) and 9.7 ± 7.2% vs 6.2 ± 4.7% (95% CI -5.7 to -1.3; p = 0.002) at 3 and 12 months, respectively. At 6 months, the TBWL% was 7.1 for the preCOVID-19 group compared to 6.2% for the COVID-19 (95% CI -2.5 to 0.7; p = 0.25). Conclusion With the possible exception of liraglutide, this study shows that weight loss outcomes to AOMs were inferior when prescribed during the routine clinical practice throughout COVID-19 pandemic, compared to the outcomes observed prior to the COVID-19 pandemic.
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Affiliation(s)
- Alan De la Rosa
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Wissam Ghusn
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Daniel Sacoto
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alejandro Campos
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Lizeth Cifuentes
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Fauzi Feris
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bradley Busebee
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gerardo Calderon
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andres Acosta
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Maria D. Hurtado
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism & Nutrition, Mayo Clinic, Jacksonville, FL, USA
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Okobi OE, Izundu IC, Evbayekha EO, Egberuare EO, Segun EO, Abdulgaffar RA, Oyelade BO, Onyema JJ, Peresuodei TS, Abu-Undiyaundeye SU. Obesity in the Pediatric Population of the National (Nationwide) Inpatient Sample (NIS), USA. Cureus 2022; 14:e33111. [PMID: 36721619 PMCID: PMC9884308 DOI: 10.7759/cureus.33111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The incidence of childhood obesity has received a lot of attention lately, especially in the United States. The increased prevalence of pediatric obesity and its association with comorbidities has piqued the attention of more scientists in the epidemic's patterns. Our research examined the National (Nationwide) Inpatient Sample (NIS) data set for hospitalized persons aged 18 years or younger with primary or secondary obesity between 2016 and 2019 to investigate the prevalence, risk factors, and related diseases. METHODS We retrospectively examined individuals with primary or secondary obesity from 2016 to 2019 using the NIS database. To extract the weighted samples, we utilized the International Classification of Diseases (ICD)-10 diagnostic codes E66, E660, E6601, E6609, E662, E668, and E669. Individuals with drug-related obesity or obesity caused by a recognized pathologic disease unrelated to high-calorie intake were excluded. First, we queried the total population, then separated them by age category and picked our population of interest, i.e., those aged 18 and under. The NIS is a deidentified database available to the public. It collects data on around 8 million hospitalizations annually, accounting for roughly 20% of all admissions in the United States. Results: The findings show that between 2016 and 2019, prevalence rates of childhood obesity were still on the rise and plateaued in 2019. There were 28,484,087 study subjects in this weighted sample between 2016 and 2019. Of these, 13.9% (3,946,889) were diagnosed with obesity. The sample population for those 18 years of age or under was 62,669 (1.5%) children with obesity with a mean age of 14 (SD = 4). Also, there was a 64.2% female preponderance. The obtained yearly showed a steady and significant rise from 2016 to 2018 (24% vs. 26%), with a slight decline in 2019 (25%; p < 0.001). Even though the white population had the highest overall prevalence of childhood obesity (40.9%), the Hispanic and black people had a higher prevalence per population, with a 0.5% and 0.33% prevalence, respectively, compared to 0.14% in the white population (p < 0.0001). When geographical regions were considered, south had the highest rate (36.40%), followed by the west (24.71%) and the midwest (23.56%). The analysis also showed that people with lower median household income (0-25th percentile) had the highest rate of childhood obesity (38.17%) compared to higher-income earners (13.19%). CONCLUSION In our finding, obesity in the pediatric population is still increasing, continuing on its previously recorded trajectory. Various recommendations from health policymakers have bolstered efforts to tackle this escalating pandemic. However, additional information on the compliance, use, and adherence to these policies by healthcare professionals and members of the public, as well as the consequence of utilization or compliance to these guidelines, is needed. Nevertheless, given the continuous growth of childhood obesity, despite the avalanche of these recommendations, the issue of compliance arises, or other essential risk factors might have been overlooked. Additional studies may be needed to unmask this looming phenomenon.
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Affiliation(s)
- Okelue E Okobi
- Family Medicine, Arizona State University, Tempe, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Ijeoma C Izundu
- Pediatrics and Child Health, iheed, Royal College of Physicians of Ireland (RCPI), Dublin, IRL
- Post-Anaesthetic Care Unit, Markham Stouffville Hospital, Markham, CAN
| | | | | | - Esther O Segun
- School of Biological Sciences & Applied Chemistry, Seneca College, Toronto , CAN
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Adipose Tissue Dysfunction in Obesity: Role of Mineralocorticoid Receptor. Nutrients 2022; 14:nu14224735. [PMID: 36432422 PMCID: PMC9699173 DOI: 10.3390/nu14224735] [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: 10/16/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
The mineralocorticoid receptor (MR) acts as an essential regulator of blood pressure, volume status, and electrolyte balance. However, in recent decades, a growing body of evidence has suggested that MR may also have a role in mediating pro-inflammatory, pro-oxidative, and pro-fibrotic changes in several target organs, including the adipose tissue. The finding that MR is overexpressed in the adipose tissue of patients with obesity has led to the hypothesis that this receptor can contribute to adipokine dysregulation and low-grade chronic inflammation, alterations that are linked to the development of obesity-related metabolic and cardiovascular complications. Moreover, several studies in animal models have investigated the role of MR antagonists (MRAs) in preventing the metabolic alterations observed in obesity. In the present review we will focus on the potential mechanisms by which MR activation can contribute to adipose tissue dysfunction in obesity and on the possible beneficial effects of MRAs in this setting.
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75
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Wronski ML, Plessow F, Kerem L, Asanza E, O'Donoghue ML, Stanford FC, Bredella MA, Torriani M, Soukas AA, Kheterpal A, Eddy KT, Holmes TM, Deckersbach T, Vangel M, Holsen LM, Lawson EA. A randomized, double-blind, placebo-controlled clinical trial of 8-week intranasal oxytocin administration in adults with obesity: Rationale, study design, and methods. Contemp Clin Trials 2022; 122:106909. [PMID: 36087842 PMCID: PMC10329413 DOI: 10.1016/j.cct.2022.106909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Obesity affects more than one-third of adults in the U.S., and effective treatment options are urgently needed. Oxytocin administration induces weight loss in animal models of obesity via effects on caloric intake, energy expenditure, and fat metabolism. We study intranasal oxytocin, an investigational drug shown to reduce caloric intake in humans, as a potential novel treatment for obesity. METHODS We report the rationale, design, methods, and biostatistical analysis plan of a randomized, double-blind, placebo-controlled clinical trial of intranasal oxytocin for weight loss (primary endpoint) in adults with obesity. Participants (aged 18-45 years) were randomly allocated (1:1) to oxytocin (four times daily over eight weeks) versus placebo. Randomization was stratified by biological sex and BMI (30 to <35, 35 to <40, ≥40 kg/m2). We investigate the efficacy, safety, and mechanisms of oxytocin administration in reducing body weight. Secondary endpoints include changes in resting energy expenditure, body composition, caloric intake, metabolic profile, and brain activation via functional magnetic resonance imaging in response to food images and during an impulse control task. Safety and tolerability (e.g., review of adverse events, vital signs, electrocardiogram, comprehensive metabolic panel) are assessed throughout the study and six weeks after treatment completion. RESULTS Sixty-one male and female participants aged 18-45 years were randomized (mean age 34 years, mean BMI 37 kg/m2). The study sample is diverse with 38% identifying as non-White and 20% Hispanic. CONCLUSION Investigating intranasal oxytocin's efficacy, safety, and mechanisms as an anti-obesity medication will advance the search for optimal treatment strategies for obesity and its associated severe sequelae.
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Affiliation(s)
- Marie-Louis Wronski
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Liya Kerem
- Division of Pediatric Endocrinology, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elisa Asanza
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michelle L O'Donoghue
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Fatima C Stanford
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Pediatric Endocrinology, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexander A Soukas
- Center for Genomic Medicine, Diabetes Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Arvin Kheterpal
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tara M Holmes
- Translational and Clinical Research Centers, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Diploma Hochschule/University of Applied Sciences, Bad Sooden-Allendorf, Germany
| | - Mark Vangel
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Laura M Holsen
- Division of Women's Health, Department of Medicine and Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Towards Cost-Effective Care for Severe Obesity. Obes Surg 2022; 32:4096-4097. [PMID: 36243898 DOI: 10.1007/s11695-022-06316-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022]
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Watkins S, Toliver JC, Kim N, Whitmire S, Garvey WT. Economic outcomes of antiobesity medication use among adults in the United States: A retrospective cohort study. J Manag Care Spec Pharm 2022; 28:1066-1079. [DOI: 10.18553/jmcp.2022.22116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Nina Kim
- Novo Nordisk Inc, Plainsboro, NJ
| | | | - W. Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham
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Hill M, Obeng-Gyasi E. The Association of Cytomegalovirus IgM and Allostatic Load. Diseases 2022; 10:diseases10040070. [PMID: 36278569 PMCID: PMC9590072 DOI: 10.3390/diseases10040070] [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: 08/30/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cytomegalovirus (CMV) is a deoxyribonucleic acid virus that affects a significant proportion of the worldwide population; after primary infection, it goes into a latent state and can be reactivated, primarily after a reduction in host immune defenses. Methods: This study evaluated the association of acute cytomegalovirus infection (CMV IgM) and Allostatic Load (AL) by sociodemographic factors using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2004 among participants (aged 20–49 years). CMV infection was determined by the level of CMV IgM antibody in serum samples. AL was assessed as a combination of 10 biomarkers from the cardiovascular, inflammatory, and metabolic systems. The evaluation of the association between CMV infection and AL included descriptive statistics and logistic regression models, which were adjusted for demographic and behavioral covariates. Results: AL was more elevated among those who were older, male, those with lower education, those performing limited physical activity, and smokers. CMV was more elevated in females than males among those who consumed alcohol and cigarette smokers. In Pearson’s correlation analysis, there was a slight positive correlation between CMV IgM and AL, with triglycerides and Body Mass Index (BMI) the most strongly correlated with AL. Binary logistic regression showed no significant relationship between high AL and positive CMV IgM but did show a significant relationship between high AL and age (OR = 1.0592, 95% CI 1.0215–1.0983, p = 0.00715). The findings of this study provide insight into the relationship between CMV and AL and provide awareness of factors that affect their relationship.
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Affiliation(s)
- Matthew Hill
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
- Correspondence: ; Tel.: +1-336-285-3132
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Rego de Figueiredo I, Carvalho Vasques M, Cunha N, Martins D, Silva-Nunes J. Quality of Life in Obese Patients from a Multidisciplinary Bariatric Consultation: A Cross-Sectional Study Comparing to a Non-Bariatric Population and to the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12029. [PMID: 36231331 PMCID: PMC9564586 DOI: 10.3390/ijerph191912029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Obesity is a chronic disease defined by a body mass index of ≥30 kg/m2, which can result in a decrease in quality of life (QoL). Our study aim was to assess the QoL of an obese population of bariatric surgery (BS) candidates, and to compare it to both that of a non-bariatric obese population (C) and that of the general population. This was a cross-sectional study using: (1) the EQ-5D-3L instrument: comparing BS with the C population and with the Portuguese general population; and (2) the Bariatric Quality of Life (BQL) Index: comparing the two groups of obese patients. We included 228 BS and 68 C obese patients. BS patients had higher BMI (44 ± 6 kg/m2 vs. 41 ± 6.5 kg/m2; p < 0.001), higher waist circumference (130 ± 13 cm vs. 123 ± 17 cm; p = 0.03), and higher total body fat mass (49.9 ± 6.7% vs. 45 ± 6.7%; p < 0.001). QoL as evaluated by EQ-5D-3L was similar, but the BQL index showed lower QoL in BS patients (40.9 ± 8.9 vs. 44.2 ± 11.2; p = 0.01). Compared to the Portuguese general population, BS patients had lower QoL (VAS: 55 ± 19 vs. 74.9; p < 0.001; index: 0.33 ± 0.2 vs. 0.76; p < 0.001). Despite higher adiposity in the BS group, QoL was similar between the groups by EQ-5D-3L. Nevertheless, there was a decrease in the QoL for the BS patients as determined using the BQL, a tool with higher sensitivity to bariatric patients.
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Affiliation(s)
- Inês Rego de Figueiredo
- Multidisciplinary Unit for Bariatric and Metabolic Surgery, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- Transplantation Unit, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- NOVA Medical School/Faculdade de Ciencias Medicas, New University of Lisbon/Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Miguel Carvalho Vasques
- Multidisciplinary Unit for Bariatric and Metabolic Surgery, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- NOVA Medical School/Faculdade de Ciencias Medicas, New University of Lisbon/Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
| | - Nelson Cunha
- Multidisciplinary Unit for Bariatric and Metabolic Surgery, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
| | - Diana Martins
- Multidisciplinary Unit for Bariatric and Metabolic Surgery, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- NOVA Medical School/Faculdade de Ciencias Medicas, New University of Lisbon/Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
| | - José Silva-Nunes
- Multidisciplinary Unit for Bariatric and Metabolic Surgery, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- NOVA Medical School/Faculdade de Ciencias Medicas, New University of Lisbon/Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Lisboa Central, 1069-166 Lisbon, Portugal
- Health and Technology Research Center, Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096 Lisbon, Portugal
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Zare H, Gilmore DR, Meyerson NS, Thorpe RJ. Income Inequality, Race/Ethnicity, and Obesity in U.S. Men 20 Years and Older: 1999 to 2016. Am J Mens Health 2022; 16:15579883221123852. [PMID: 36305637 PMCID: PMC9619283 DOI: 10.1177/15579883221123852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/11/2022] [Accepted: 08/12/2022] [Indexed: 01/24/2023] Open
Abstract
Obesity is a significant public health problem globally and within the United States. It varies by multiple factors, including but not limited to income. The literature indicates little evidence of the association between income and obesity. We examined the association between income and obesity in U.S. adult men ages 20 years and older and tested racial and ethnic differences. We used data from the 1999 to 2016 National Health and Nutrition Examination Surveys for analyses. Obesity was determined using body mass index ≥30 kg/m2. We used poverty income ratio (PIR) as a proxy for income and calculated the Gini coefficient (GC) to measure income inequality. We then categorized low-, medium-, and high PIR to examine the relationship between income inequality and obesity. We used Modified Poisson regression in a sample of 17,238 adult men, including 9,511 White Non-Hispanic White (NHW), 4,166 Non-Hispanic Black (NHB), and 3,561 Mexican Americans (MA). We controlled the models for age category, racial and ethnic groups, marital status, education, health behaviors, health insurance coverage, self-reported health, comorbidity, and household structure. Results of our adjusted models suggested a positive and significant association between PIR and obesity among NHWs and NHBs in medium and high PIR; this association was not significant in MAs. Results of our analyses using GC in obese men indicate that compared with NHWs (GC: 0.306, SE: 0.004), MAs (GC: 0.368, SE: 0.005), and NHBs (GC: 0.328, SE: 0.005) had experienced higher-income inequality. In treating obesity, policymakers should consider race/ethnicity strategies to reduce inequality in income.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- The School of Business, University of Maryland Global Campus, Adelphi, MD, USA
| | - Danielle R. Gilmore
- Trachtenberg School of Public Policy & Administration, The George Washington University, Washington, DC, USA
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas S. Meyerson
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J. Thorpe
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Muacevic A, Adler JR, Adetokunbo S, Omokhodion O, Fasokun M, Akingbule AS, Martins C, Fakorede M, Ogundipe T, Filani O. Increasing Pre-pregnancy Body Mass Index and Pregnancy Outcomes in the United States. Cureus 2022; 14:e28695. [PMID: 36196279 PMCID: PMC9525097 DOI: 10.7759/cureus.28695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION As many Americans are becoming overweight or obese, increased body mass index (BMI) is fast becoming normalized. There is a need for more research that highlights the association between pre-pregnancy obesity and adverse pregnancy outcomes. AIM To determine the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes. METHODS We utilized the United States Vital Statistics records to collate data on all childbirths in the United States between 2015 and 2019. We determined the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes using multivariate analysis. Neonatal outcomes measures include the five-minute Apgar score, neonatal unit admission, neonates receiving assisted ventilation > six hours, neonatal antibiotics use, and neonatal seizures. Maternal outcomes include cesarean section rate, mothers requiring blood transfusion, unplanned hysterectomy, and intensive care unit admission. In addition, we controlled for maternal parameters such as race/ethnicity, age, insurance type, and pre-existing conditions such as chronic hypertension and prediabetes. Other covariates include paternal race, age and education level, gestational diabetes mellitus, induction of labor, weight gain during pregnancy, gestational age at delivery, and delivery weight. RESULTS We studied 15,627,572 deliveries in the US Vital Statistics records between 2015 and 2019. Among these women, 3.36% were underweight, 43.19% were with a normal BMI, 26.34% were overweight, 14.73% were in the obese class I, 7.23% were in the obese class II, and 5.14% were in the obese class III. Increasing pre-pregnancy BMI was associated with significant adverse outcomes across all measures of maternal and neonatal outcomes. CONCLUSION A strong association exists between increasing pre-pregnancy BMI and adverse maternal and neonatal outcomes. The higher risk of adverse pregnancy outcomes among overweight and obese women remained even after controlling for other traditional risk factors of adverse maternal and neonatal outcomes.
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Feingold CL, Smiley A. Healthy Sleep Every Day Keeps the Doctor Away. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10740. [PMID: 36078455 PMCID: PMC9518120 DOI: 10.3390/ijerph191710740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
When one considers the big picture of their health, sufficient sleep may often go overlooked as a keystone element in this picture. Insufficient sleep in either quality or duration is a growing problem for our modern society. It is essential to look at what this means for our health because insufficient sleep increases our risks of innumerable lifechanging diseases. Beyond increasing the risk of developing these diseases, it also makes the symptoms and pathogenesis of many diseases worse. Additionally, consistent quality sleep can not only improve our physical health but has also been shown to improve mental health and overall quality of life. Substandard sleep health could be a root cause for numerous issues individuals may be facing in their lives. It is essential that physicians take the time to learn about how to educate their patients on sleep health and try to work with them on an individual level to help motivate lifestyle changes. Facilitating access to sleep education for their patients is one way in which physicians can help provide patients with the tools to improve their sleep health. Throughout this paper, we will review the mechanisms behind the relationship between insufficient sleep health and chronic disease and what the science says about how inadequate sleep health negatively impacts the overall health and the quality of our lives. We will also explain the lifechanging effects of sufficient sleep and how we can help patients get there.
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Affiliation(s)
| | - Abbas Smiley
- Westchester Medical Center, New York Medical College, New York, NY 10595, USA
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83
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Negi A, Asokkumar R, Ravi R, Lopez-Nava G, Bautista-Castaño I. Nutritional Management and Role of Multidisciplinary Follow-Up after Endoscopic Bariatric Treatment for Obesity. Nutrients 2022; 14:3450. [PMID: 36014956 PMCID: PMC9416269 DOI: 10.3390/nu14163450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/26/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
The prevalence of obesity has risen exponentially, and patients living with obesity suffer from its debilitating consequences. The treatment options for obesity have expanded significantly and include lifestyle changes, pharmacotherapy, endoscopic bariatric therapies (EBTs), and bariatric surgery. Endoscopic bariatric therapies comprise volume-reducing procedures such as endoscopic gastroplasty and gastric space-occupying devices such as intragastric balloons. Because of its minimally invasive nature and ease of delivery, EBTs are increasingly being adopted as a treatment option for obesity in several centers. These procedures mainly achieve weight loss by inducing early satiety and reducing meal volume. While the technical aspects of EBTs have been well explained, the nutritional management surrounding EBTs and the effectiveness of multidisciplinary team for maximizing weight loss is less described. There is considerable variation in post-EBT care between studies and centers. In this paper, we review the existing literature and share our experience on nutrition and the role of multidisciplinary management of obesity following EBT.
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Affiliation(s)
- Anuradha Negi
- Department of Endocrinology, Raffles Hospital Specialist Center, 585 North Bridge Road, Singapore 188770, Singapore
| | - Ravishankar Asokkumar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169856, Singapore
- Duke-NUS Graduate Medical School, Singapore 637551, Singapore
| | - Rajesh Ravi
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169856, Singapore
| | - Gontrand Lopez-Nava
- Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, 28050 Madrid, Spain
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84
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Cain-Shields L, Glover L, Joseph JJ, Bertoni AG, Sims M. Goal-striving stress and repeated measures of adiposity in the Jackson heart study. Stress Health 2022; 38:443-452. [PMID: 34643027 PMCID: PMC9023066 DOI: 10.1002/smi.3105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022]
Abstract
Psychosocial stressors are determinants of increases in adiposity. Both psychosocial stressors and adiposity are higher among African Americans (AAs). Therefore, clarifying the stress-obesity link in AAs is important. The stress associated with goal striving is particularly relevant to AAs because opportunity for upward mobility is not always equal. Goal-striving stress (GSS) has not been assessed with adiposity, a potential result of GSS. Therefore, the objective of this study was to determine whether GSS would be associated with repeated measures of adiposity [body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHR)] in AAs. Linear mixed models were used to assess the relationship between GSS with repeated measures of adiposity across three exam periods among 2902 AAs, and sex was assessed as a moderator. Models were adjusted for demographics, health behaviours, morbidities, and daily discrimination. GSS was positively associated with repeated measures of adiposity in women but not men: WC [estimate (standard error) p-value] [0.003 (0.001) p < 0.01] and WHR [0.003 (0.0007) p < 0.01]. This suggests that high stress due to goal striving may contribute to greater increases in adiposity in AA women over time. Community-based interventions should continue to consider focused support group models as viable options for goal-striving related stress reduction.
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Affiliation(s)
- Loretta Cain-Shields
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - LáShauntá Glover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joshua J. Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Alain G. Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
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85
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Bajaj SS, Jain B, Kyle TK, Gallagher C, Stanford FC, Srivastava G. Overcoming congressional inertia on obesity requires better literacy in obesity science. Obesity (Silver Spring) 2022; 30:799-801. [PMID: 35244978 PMCID: PMC8957554 DOI: 10.1002/oby.23405] [Citation(s) in RCA: 2] [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: 12/28/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 12/21/2022]
Abstract
Obesity-focused health policies, including the landmark Treat and Reduce Obesity Act, have stalled at the federal level over the past decade. Congressional inaction on obesity reflects both misconceptions of obesity as a lifestyle choice and limited awareness for the burden obesity imposes on our health care system. Given these challenges, we argue that health professionals must bolster their efforts to partner with public figures with obesity and to directly educate the public. These strategies may help destigmatize obesity and build awareness of obesity as a disease. Furthermore, we suggest that these strategies may empower patients to flex their unrealized political muscle and demand more from their elected leaders. A bold, multilevel approach that elicits a public demand for change can propel obesity policy into the 21st century.
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Affiliation(s)
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA, 02139
| | | | | | - Fatima Cody Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, 50 Staniford Street, Boston, MA 02114
| | - Gitanjali Srivastava
- Vanderbilt University Medical Center, Vanderbilt Weight Loss Center, Department of Medicine-Division of Diabetes, Endocrinology & Metabolism; Department of Pediatrics; Department of Surgery, Nashville, TN 37204
- Vanderbilt University School of Medicine, Nashville, TN 37204
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Czaja-Stolc S, Potrykus M, Stankiewicz M, Kaska Ł, Małgorzewicz S. Pro-Inflammatory Profile of Adipokines in Obesity Contributes to Pathogenesis, Nutritional Disorders, and Cardiovascular Risk in Chronic Kidney Disease. Nutrients 2022; 14:nu14071457. [PMID: 35406070 PMCID: PMC9002635 DOI: 10.3390/nu14071457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 01/27/2023] Open
Abstract
Obesity is a disease which leads to the development of many other disorders. Excessive accumulation of lipids in adipose tissue (AT) leads to metabolic changes, including hypertrophy of adipocytes, macrophage migration, changes in the composition of immune cells, and impaired secretion of adipokines. Adipokines are cytokines produced by AT and greatly influence human health. Obesity and the pro-inflammatory profile of adipokines lead to the development of chronic kidney disease (CKD) through different mechanisms. In obesity and adipokine profile, there are gender differences that characterize the male gender as more susceptible to metabolic disorders accompanying obesity, including impaired renal function. The relationship between impaired adipokine secretion and renal disease is two-sided. In the developed CKD, the concentration of adipokines in the serum is additionally disturbed due to their insufficient excretion by the excretory system caused by renal pathology. Increased levels of adipokines affect the nutritional status and cardiovascular risk (CVR) of patients with CKD. This article aims to systematize the current knowledge on the influence of obesity, AT, and adipokine secretion disorders on the pathogenesis of CKD and their influence on nutritional status and CVR in patients with CKD.
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Affiliation(s)
- Sylwia Czaja-Stolc
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.S.); (S.M.)
- Correspondence: ; Tel.: +48-(58)-349-27-24
| | - Marta Potrykus
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.P.); (Ł.K.)
| | - Marta Stankiewicz
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.S.); (S.M.)
| | - Łukasz Kaska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.P.); (Ł.K.)
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland; (M.S.); (S.M.)
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Spanggaard M, Bøgelund M, Dirksen C, Jørgensen NB, Madsbad S, Panton UH, Pedersen MH, Reitzel SB, Johansen P. The substantial costs to society associated with obesity - a Danish register-based study based on 2002-2018 data. Expert Rev Pharmacoecon Outcomes Res 2022; 22:823-833. [PMID: 35297718 DOI: 10.1080/14737167.2022.2053676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Danish national health registers were used to investigate the economic burden of obesity, associated costs of comorbidities and a breakdown into direct and indirect costs. METHODS The study population comprised all Danish adult citizens registered with a hospital diagnosis of obesity in the Danish National Patient Register between 2002 and 2018. Cases were matched with five controls via the Danish Civil Registration System. We estimated the difference in total healthcare costs and indirect costs between cases and controls and the difference in healthcare resource utilization. In a sub-analysis, we estimated total healthcare costs for persons who had been registered with one or more of 11 predefined comorbidities. RESULTS People with obesity experienced a statistically significant twofold increase in average direct healthcare costs per year (EUR 5,934), compared with controls (EUR 2,788) and had statistically significantly higher indirect costs compared to controls. Total healthcare costs for people with obesity and one or more of the 11 comorbidities were 91.7%-342.8% higher than total healthcare costs of the population with obesity but none of the 11 comorbidities. CONCLUSION Obesity was associated with an increase in both direct and indirect costs. The presence of comorbidities was associated with additional healthcare costs. KEY POINTS Obesity is associated with an increase in direct and indirect costs in Denmark.Comorbidities are associated with additional healthcare costs.
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Affiliation(s)
| | | | - Carsten Dirksen
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Steen Madsbad
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | - Ulrik Haagen Panton
- Novo Nordisk North West Europe Pharmaceuticals A/S, Crowne Plaza Copenhagen Towers, Copenhagen, Denmark
| | | | | | - Pierre Johansen
- Novo Nordisk North West Europe Pharmaceuticals A/S, Crowne Plaza Copenhagen Towers, Copenhagen, Denmark
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88
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Vrdoljak J, Kumric M, Vilovic M, Martinovic D, Rogosic V, Borovac JA, Ticinovic Kurir T, Bozic J. Can Fasting Curb the Metabolic Syndrome Epidemic? Nutrients 2022; 14:nu14030456. [PMID: 35276815 PMCID: PMC8838760 DOI: 10.3390/nu14030456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
Metabolic syndrome (MetS) represents a cluster of metabolic abnormalities that includes hypertension, central obesity, insulin resistance, and atherogenic dyslipidemia. Due to the high prevalence (around 1/3 of the world population) economic burden of MetS, there is a need for new dietary, lifestyle, and therapeutic options. Recently, fasting emerged as a dietary method proposed for controlling metabolic risk factors. Intermittent fasting (IF), or time-restricted feeding (TRF), describes an array of feeding patterns in which calorie intake is restricted to a specific time period. Hence, this review aimed to elucidate the latest data on MetS and explore the viability of simple management options, such as IF and TRF. Preclinical studies have shown how IF/TRF exerts beneficial effects on the gut microbiota, glucose and insulin metabolism, weight and visceral fat, and lipid metabolism. However, the results obtained from human studies are somewhat conflicting, as weight loss was achieved in all studies, whereas in some studies, there was no significant effect on insulin resistance, cholesterol/lipid metabolism, or blood pressure. Nevertheless, as only very few human studies were performed, there is a need for more randomized control trials on larger cohorts of patients with MetS to gather higher-yield evidence to clarify whether IF/TRF are suitable dietary patterns for this population.
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Affiliation(s)
- Josip Vrdoljak
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
| | - Veljko Rogosic
- Department of Ophthalmology, University of Split School of Medicine, 21000 Split, Croatia;
- Department of Ophthalmology, University Hospital of Split, 21000 Split, Croatia
| | - Josip A. Borovac
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
- Department of Health Studies, University of Split, 21000 Split, Croatia
- Department of Cardiology, University Hospital of Split, 21000 Split, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Split, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.V.); (M.K.); (M.V.); (D.M.); (J.A.B.); (T.T.K.)
- Correspondence:
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Rautenberg EK, Hamzaoui Y, Coletta DK. Mini-review: Mitochondrial DNA methylation in type 2 diabetes and obesity. Front Endocrinol (Lausanne) 2022; 13:968268. [PMID: 36093112 PMCID: PMC9453027 DOI: 10.3389/fendo.2022.968268] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Type 2 diabetes (T2D) and obesity are two of the most challenging public health problems of our time. Therefore, understanding the molecular mechanisms that contribute to these complex metabolic disorders is essential. An underlying pathophysiological condition of T2D and obesity is insulin resistance (IR), a reduced biological response to insulin in peripheral tissues such as the liver, adipose tissue, and skeletal muscle. Many factors contribute to IR, including lifestyle variables such as a high-fat diet and physical inactivity, genetics, and impaired mitochondrial function. It is well established that impaired mitochondria structure and function occur in insulin-resistant skeletal muscle volunteers with T2D or obesity. Therefore, it could be hypothesized that the mitochondrial abnormalities are due to epigenetic regulation of mitochondrial and nuclear-encoded genes that code for mitochondrial structure and function. In this review, we describe the normal function and structure of mitochondria and highlight some of the key studies that demonstrate mitochondrial abnormalities in skeletal muscle of volunteers with T2D and obesity. Additionally, we describe epigenetic modifications in the context of IR and mitochondrial abnormalities, emphasizing mitochondria DNA (mtDNA) methylation, an emerging area of research.
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Affiliation(s)
- Emma K. Rautenberg
- Department of Physiology, The University of Arizona College of Medicine, Tucson, AZ, United States
| | - Yassin Hamzaoui
- Department of Physiology, The University of Arizona College of Medicine, Tucson, AZ, United States
| | - Dawn K. Coletta
- Department of Physiology, The University of Arizona College of Medicine, Tucson, AZ, United States
- Department of Medicine, Division of Endocrinology, The University of Arizona College of Medicine, Tucson, AZ, United States
- Center for Disparities in Diabetes, Obesity and Metabolism, The University of Arizona, Tucson, AZ, United States
- *Correspondence: Dawn K. Coletta,
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90
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Goldstein SP, Zhang F, Klasnja P, Hoover A, Wing RR, Thomas JG. Optimizing a Just-in-Time Adaptive Intervention to Improve Dietary Adherence in Behavioral Obesity Treatment: Protocol for a Microrandomized Trial. JMIR Res Protoc 2021; 10:e33568. [PMID: 34874892 PMCID: PMC8691411 DOI: 10.2196/33568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/28/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Behavioral obesity treatment (BOT) is a gold standard approach to weight loss and reduces the risk of cardiovascular disease. However, frequent lapses from the recommended diet stymie weight loss and prevent individuals from actualizing the health benefits of BOT. There is a need for innovative treatment solutions to improve adherence to the prescribed diet in BOT. OBJECTIVE The aim of this study is to optimize a smartphone-based just-in-time adaptive intervention (JITAI) that uses daily surveys to assess triggers for dietary lapses and deliver interventions when the risk of lapse is high. A microrandomized trial design will evaluate the efficacy of any interventions (ie, theory-driven or a generic alert to risk) on the proximal outcome of lapses during BOT, compare the effects of theory-driven interventions with generic risk alerts on the proximal outcome of lapse, and examine contextual moderators of interventions. METHODS Adults with overweight or obesity and cardiovascular disease risk (n=159) will participate in a 6-month web-based BOT while using the JITAI to prevent dietary lapses. Each time the JITAI detects elevated lapse risk, the participant will be randomized to no intervention, a generic risk alert, or 1 of 4 theory-driven interventions (ie, enhanced education, building self-efficacy, fostering motivation, and improving self-regulation). The primary outcome will be the occurrence of lapse in the 2.5 hours following randomization. Contextual moderators of intervention efficacy will also be explored (eg, location and time of day). The data will inform an optimized JITAI that selects the theory-driven approach most likely to prevent lapses in a given moment. RESULTS The recruitment for the microrandomized trial began on April 19, 2021, and is ongoing. CONCLUSIONS This study will optimize a JITAI for dietary lapses so that it empirically tailors the provision of evidence-based intervention to the individual and context. The finalized JITAI will be evaluated for efficacy in a future randomized controlled trial of distal health outcomes (eg, weight loss). TRIAL REGISTRATION ClinicalTrials.gov NCT04784585; http://clinicaltrials.gov/ct2/show/NCT04784585. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/33568.
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Affiliation(s)
- Stephanie P Goldstein
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Fengqing Zhang
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Predrag Klasnja
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Adam Hoover
- Holcombe Department of Electrical and Computer Engineering, Clemson University, Clemson, SC, United States
| | - Rena R Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - John Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
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Weir MR, Chen YW, He J, Bookhart B, Campbell A, Ashton V. Healthcare Resource Utilization and Costs of Rivaroxaban Versus Warfarin Among Nonvalvular Atrial Fibrillation Patients with Obesity and Diabetes. Diabetes Ther 2021; 12:3167-3186. [PMID: 34699020 PMCID: PMC8586051 DOI: 10.1007/s13300-021-01161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Nonvalvular atrial fibrillation (NVAF) is associated with a substantial economic burden, particularly in patients with comorbid conditions. This study compared healthcare resource utilization (HRU) and costs of rivaroxaban and warfarin in patients with NVAF, obesity, and diabetes. METHODS A de-identified healthcare claims database was used to identify adult patients newly initiating rivaroxaban or warfarin and having at least one medical claim with a diagnosis of AF, obesity determined by validated algorithm, and at least one claim with a diagnosis of diabetes or for antidiabetic medication from December 2011 to March 2020. Propensity score matching was used to balance the treatment cohorts on the basis of demographics and baseline characteristics. All-cause and NVAF-related HRU rates and costs were compared between treatments using rate ratios, and mean cost differences were calculated on a per patient per year (PPPY) basis. RESULTS A total of 9999 matched pairs of patients with NVAF, obesity, and diabetes were identified in the rivaroxaban and warfarin cohorts. Rate ratios of all-cause HRU were significantly reduced with rivaroxaban versus warfarin in all healthcare settings evaluated, except emergency room visits. The greatest impact was on physician office visits followed by hospital outpatient and inpatient visits. NVAF-related HRU was significantly lower for rivaroxaban versus warfarin in all care settings. Consistent with these findings, the length of hospital stay was significantly reduced by approximately 4 days among all patients for both all-cause and NVAF-related hospitalizations in the rivaroxaban cohort compared with the warfarin cohort. Rivaroxaban was associated with reductions in all-cause total healthcare costs by more than $5000 PPPY and NVAF-related medical costs by approximately $1100 PPPY. CONCLUSION In comparison with warfarin, rivaroxaban reduced HRU and costs, particularly hospital inpatient and outpatient visits and physician office visits, in patients with NVAF and comorbidities of obesity and diabetes.
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Affiliation(s)
- Matthew R Weir
- University of Maryland School of Medicine, 22 S. Greene St., Room N3W143, Baltimore, MD, 21201, USA.
| | - Yen-Wen Chen
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Jinghua He
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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Attitudes, Perceptions, and Practices in Managing Obesity Among Endocrinologists. Endocr Pract 2021; 28:179-184. [PMID: 34748965 DOI: 10.1016/j.eprac.2021.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Obesity is globally recognized as a critically important disease by professional medical organizations in addition to the World Health Organization and American Medical Association, but the health care systems, medical teams, and the public have been slow to embrace this concept. METHODS American Association of Clinical Endocrinology (AACE) staff drafted the survey, and two endocrinologists independently reviewed the survey questions and modified the survey instrument. The survey included inquiries related to practice and patient demographics, awareness of obesity, treatment of obesity, barriers to improving obesity outcomes, digital health, cognitive behavioral therapy, lifestyle medicine, anti-obesity medications, weight stigma, and social determinants of health. The survey was emailed to 493 endocrinologists, with 305 completing the study (62%). RESULTS Ninety-eight percent of the responders agree that obesity is a disease, while 2% neither agree nor disagree. 53% of respondents are familiar with the term "adiposity-based chronic disease." 13% of the respondents are certified by the American Board of Obesity Medicine (ABOM). 57% of the respondents use published obesity guidelines as a resource for treating patients with obesity. Most endocrinologists recommend dietary and lifestyle changes, but fewer prescribe anti-obesity medication (AOM) or recommend bariatric surgery. ABOM-certified endocrinologists are more likely to use a multidisciplinary approach. CONCLUSION Self-reported knowledge and practices in the management of obesity highlight the importance of a multimodal approach to obesity and foster collaboration among healthcare professionals. It is necessary to raise awareness about obesity among clinicians, identify knowledge gaps and create educational tools to address those gaps.
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Zhang S, Wu P, Tian Y, Liu B, Huang L, Liu Z, Lin N, Xu N, Ruan Y, Zhang Z, Wang M, Cui Z, Zhou H, Xie L, Chen H, Sun J. Gut Microbiota Serves a Predictable Outcome of Short-Term Low-Carbohydrate Diet (LCD) Intervention for Patients with Obesity. Microbiol Spectr 2021; 9:e0022321. [PMID: 34523948 PMCID: PMC8557869 DOI: 10.1128/spectrum.00223-21] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/15/2021] [Indexed: 12/25/2022] Open
Abstract
To date, much progress has been made in dietary therapy for obese patients. A low-carbohydrate diet (LCD) has reached a revival in its clinical use during the past decade with undefined mechanisms and debatable efficacy. The gut microbiota has been suggested to promote energy harvesting. Here, we propose that the gut microbiota contributes to the inconsistent outcome under an LCD. To test this hypothesis, patients with obesity or patients who were overweight were randomly assigned to a normal diet (ND) or an LCD group with ad libitum energy intake for 12 weeks. Using matched sampling, the microbiome profile at baseline and end stage was examined. The relative abundance of butyrate-producing bacteria, including Porphyromonadaceae Parabacteroides and Ruminococcaceae Oscillospira, was markedly increased after LCD intervention for 12 weeks. Moreover, within the LCD group, participants with a higher relative abundance of Bacteroidaceae Bacteroides at baseline exhibited a better response to LCD intervention and achieved greater weight loss outcomes. Nevertheless, the adoption of an artificial neural network (ANN)-based prediction model greatly surpasses a general linear model in predicting weight loss outcomes after LCD intervention. Therefore, the gut microbiota served as a positive outcome predictor and has the potential to predict weight loss outcomes after short-term LCD intervention. Gut microbiota may help to guide the clinical application of short-term LCD intervention to develop effective weight loss strategies. (This study has been registered at the China Clinical Trial Registry under approval no. ChiCTR1800015156). IMPORTANCE Obesity and its related complications pose a serious threat to human health. Short-term low-carbohydrate diet (LCD) intervention without calorie restriction has a significant weight loss effect for overweight/obese people. Furthermore, the relative abundance of Bacteroidaceae Bacteroides is a positive outcome predictor of individual weight loss after short-term LCD intervention. Moreover, leveraging on these distinct gut microbial structures at baseline, we have established a prediction model based on the artificial neural network (ANN) algorithm that could be used to estimate weight loss potential before each clinical trial (with Chinese patent number 2021104655623). This will help to guide the clinical application of short-term LCD intervention to improve weight loss strategies.
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Affiliation(s)
- Susu Zhang
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Peili Wu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ye Tian
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Bingdong Liu
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liujing Huang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Zhihong Liu
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Nie Lin
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Endocrinology and Metabolism, Shantou Central Hospital, Shantou, China
| | - Ningning Xu
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuting Ruan
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhen Zhang
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ming Wang
- Nephrology Center of Integrated Traditional Chinese and Western Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zongbing Cui
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - HongWei Zhou
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Liwei Xie
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
- School of Public Health, Xinxiang Medical University, Xinxiang, China
| | - Hong Chen
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jia Sun
- Department of Endocrinology and Metabolism, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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