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In Vitro Anti-Obesity Effect of Shenheling Extract (SHLE) Fermented with Lactobacillus fermentum grx08. Foods 2022; 11:foods11091221. [PMID: 35563944 PMCID: PMC9104015 DOI: 10.3390/foods11091221] [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: 02/16/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/24/2022] Open
Abstract
Obesity is a common global problem. There are many fat-reducing herbal prescriptions in traditional Chinese medicine that have been proven to be safe and functional during long-term application. Microbial fermentation can improve the efficacy of herbal medicine and improve the unsavory flavor. In this study, Shenheling extract (SHLE) composed of six medicine food homology materials was used as the research object. The purpose of this study was to evaluate the effects of Lactobacillusfermentum grx08 fermentation on the antiobesity efficacy and flavor of SHLE. We found that L. fermentum grx08 grew well in SHLE. After 72 h of fermentation, the total polysaccharides, total flavonoids, total polyphenols and total saponins of SHLE decreased, but the lipase inhibitory activity and total antioxidant capacity (FRAP) were significantly increased (p < 0.01). There were no significant differences in the α-glucosidase inhibition rate and DPPH· clearance rate before or after fermentation (p > 0.05). In addition, the fermentation reduces the unpleasant flavors of SHLE such as bitterness and grassy and cassia flavors. This study demonstrates that SHLE fermented by L. fermentum grx08 improved some anti-obesity functions and improved the unpleasant flavor.
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202
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Remodeling and Fibrosis of the Cardiac Muscle in the Course of Obesity-Pathogenesis and Involvement of the Extracellular Matrix. Int J Mol Sci 2022; 23:ijms23084195. [PMID: 35457013 PMCID: PMC9032681 DOI: 10.3390/ijms23084195] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/09/2022] [Indexed: 12/16/2022] Open
Abstract
Obesity is a growing epidemiological problem, as two-thirds of the adult population are carrying excess weight. It is a risk factor for the development of cardiovascular diseases (hypertension, ischemic heart disease, myocardial infarct, and atrial fibrillation). It has also been shown that chronic obesity in people may be a cause for the development of heart failure with preserved ejection fraction (HFpEF), whose components include cellular hypertrophy, left ventricular diastolic dysfunction, and increased extracellular collagen deposition. Several animal models with induced obesity, via the administration of a high-fat diet, also developed increased heart fibrosis as a result of extracellular collagen accumulation. Excessive collagen deposition in the extracellular matrix (ECM) in the course of obesity may increase the stiffness of the myocardium and thereby deteriorate the heart diastolic function and facilitate the occurrence of HFpEF. In this review, we include a rationale for that process, including a discussion about possible putative factors (such as increased renin–angiotensin–aldosterone activity, sympathetic overdrive, hemodynamic alterations, hypoadiponectinemia, hyperleptinemia, and concomitant heart diseases). To address the topic clearly, we include a description of the fundamentals of ECM turnover, as well as a summary of studies assessing collagen deposition in obese individuals.
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203
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Stapel B, Jelinic M, Drummond GR, Hartung D, Kahl KG. Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression. Front Psychiatry 2022; 13:831358. [PMID: 35444568 PMCID: PMC9013771 DOI: 10.3389/fpsyt.2022.831358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus-pituitary-adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.
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Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Maria Jelinic
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Grant R. Drummond
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Dagmar Hartung
- Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Hanover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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204
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Nobarani S, Alaei-Shahmiri F, Aghili R, Malek M, Poustchi H, Lahouti M, Khamseh ME. Visceral Adipose Tissue and Non-alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes. Dig Dis Sci 2022; 67:1389-1398. [PMID: 33788095 DOI: 10.1007/s10620-021-06953-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
AIM To explore the association of visceral adipose tissue (VAT) area and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS This was a cross-sectional study comprising 100 patients with T2DM and 100 non-T2DM individuals, matched for age, sex, and body mass index (BMI). Transient elastography was used to assess hepatic steatosis and liver stiffness measurements (LSM). Controlled attenuation parameter (CAP) was used to quantify hepatic steatosis. To distinguish grades of hepatic steatosis, cutoff values were as follows: S1 ≥ 302, S2 ≥ 331, and S3 ≥ 337 dB/m. Moreover, VAT area was measured by dual-energy X-ray absorptiometry in accordance with validated protocols. RESULTS CAP score was significantly higher in participants with T2DM (294.61 ± 3.82 vs. 269.86 ± 3.86 dB/ m; P < 0.001). Furthermore, 42% of participants with T2DM had hepatic steatosis (S > S1: 302 dB/m), while this figure was 26% in non-T2DM group (P < 0.003). The mean liver stiffness measurement was also significantly higher in patients with T2DM (5.53 vs. 4.79 kPa; P < 0.001). VAT area was greater in patients with T2DM compared to non-T2DM individuals: 163.79 ± 47.98 cm2 versus 147.49 ± 39.09 cm2, P = 0.009. However, total and truncal fat mass were not different between the two groups. Age, BMI, waist circumference, ALT, CAP, and LSM were significantly associated with VAT area. BMI and VAT area were the important determinants of steatosis in both groups of participants with and without T2DM. Moreover, the VAT area was associated with the severity of hepatic steatosis and liver stiffness, independent of anthropometric measures of obesity. CONCLUSION VAT area is a major determinant of the severity of hepatic steatosis and liver stiffness in patient with T2DM.
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Affiliation(s)
- Sohrab Nobarani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Fariba Alaei-Shahmiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Lahouti
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran
| | - Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, No. 10, Firoozeh St., South Vali-asr Ave., Vali-Asr Sq., Tehran, Iran.
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Wang P, Zeng G, Yan Y, Zhang SY, Dong Y, Zhang Y, Zhang X, Liu H, Zhang Z, Jiang C, Pang Y. Disruption of adipocyte HIF-1α improves atherosclerosis through the inhibition of ceramide generation. Acta Pharm Sin B 2022; 12:1899-1912. [PMID: 35847503 PMCID: PMC9279628 DOI: 10.1016/j.apsb.2021.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/05/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022] Open
Abstract
Atherosclerosis is a chronic multifactorial cardiovascular disease. Western diets have been reported to affect atherosclerosis through regulating adipose function. In high cholesterol diet-fed ApoE–/– mice, adipocyte HIF-1α deficiency or direct inhibition of HIF-1α by the selective pharmacological HIF-1α inhibitor PX-478 alleviates high cholesterol diet-induced atherosclerosis by reducing adipose ceramide generation, which lowers cholesterol levels and reduces inflammatory responses, resulting in improved dyslipidemia and atherogenesis. Smpd3, the gene encoding neutral sphingomyelinase, is identified as a new target gene directly regulated by HIF-1α that is involved in ceramide generation. Injection of lentivirus-SMPD3 in epididymal adipose tissue reverses the decrease in ceramides in adipocytes and eliminates the improvements on atherosclerosis in the adipocyte HIF-1α-deficient mice. Therefore, HIF-1α inhibition may constitute a novel approach to slow atherosclerotic progression.
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206
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Miao R, Fang X, Wei J, Wu H, Wang X, Tian J. Akt: A Potential Drug Target for Metabolic Syndrome. Front Physiol 2022; 13:822333. [PMID: 35330934 PMCID: PMC8940245 DOI: 10.3389/fphys.2022.822333] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/07/2022] [Indexed: 12/21/2022] Open
Abstract
The serine/threonine kinase Akt, also known as protein kinase B (PKB), is one of the key factors regulating glucose and lipid energy metabolism, and is the core focus of current research on diabetes and metabolic diseases. Akt is mostly expressed in key metabolism-related organs and it is activated in response to various stimuli, including cell stress, cell movement, and various hormones and drugs that affect cell metabolism. Genetic and pharmacological studies have shown that Akt is necessary to maintain the steady state of glucose and lipid metabolism and a variety of cellular responses. Existing evidence shows that metabolic syndrome is related to insulin resistance and lipid metabolism disorders. Based on a large number of studies on Akt-related pathways and reactions, we believe that Akt can be used as a potential drug target to effectively treat metabolic syndrome.
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Affiliation(s)
- Runyu Miao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate College, Beijing University of Chinese Medicine, Beijing, China
| | - Xinyi Fang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate College, Beijing University of Chinese Medicine, Beijing, China
| | - Jiahua Wei
- Graduate College, Changchun University of Chinese Medicine, Changchun, China
| | - Haoran Wu
- Graduate College, Beijing University of Chinese Medicine, Beijing, China
| | - Xinmiao Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiaxing Tian
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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207
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Horn DB, Almandoz JP, Look M. What is clinically relevant weight loss for your patients and how can it be achieved? A narrative review. Postgrad Med 2022; 134:359-375. [PMID: 35315311 DOI: 10.1080/00325481.2022.2051366] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Obesity is a chronic disease with increasing prevalence. It affects quality of life and renders those affected at increased risk of mortality. For people living with obesity, weight loss is one of the most important strategies to improve health outcomes and prevent or reverse obesity-related complications. In line with newly released clinical practice guidelines, weight loss targets for people living with obesity should be defined individually based on their clinical profile, and progress measured in the context of improvements in health outcomes, rather than weight loss alone. We outline current treatment options for clinically meaningful weight loss and briefly discuss pharmacological agents and devices under development. Numerous studies have shown that weight loss of ≥5% results in significant improvements in cardiometabolic risk factors associated with obesity; this degree of weight loss is also required for the approval of novel anti-obesity medications by the US Food and Drug Administration. However, some obesity-related comorbidities and complications, such as non-alcoholic steatohepatitis, obstructive sleep apnea, gastroesophageal reflux disease and remission of type 2 diabetes, require a greater magnitude of weight loss to achieve clinically meaningful improvements. In this review, we assessed the available literature describing the effect of categorical weight losses of ≥5%, ≥10%, and ≥15% on obesity-related comorbidities and complications, and challenge the concept of clinically meaningful weight loss to go beyond percentage change in total body weight. We discuss weight-loss interventions including lifestyle interventions and therapeutic options including devices, and pharmacological and surgical approaches as assessed from the available literature.
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Affiliation(s)
- Deborah B Horn
- University of Texas McGovern Medical School, Center for Obesity Medicine and Metabolic Performance, Bellaire, TX, USA
| | - Jaime P Almandoz
- Department of Internal Medicine, Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michelle Look
- San Diego Sports Medicine & Family Health Center, San Diego, CA, USA
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208
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Peripheral Aβ acts as a negative modulator of insulin secretion. Proc Natl Acad Sci U S A 2022; 119:e2117723119. [PMID: 35290109 PMCID: PMC8944757 DOI: 10.1073/pnas.2117723119] [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] [Indexed: 11/18/2022] Open
Abstract
The cerebral accumulation of amyloid β (Aβ) is a hallmark of Alzheimer’s disease (AD). While type 2 diabetes mellitus is known to be a risk factor for AD, the underlying mechanisms remain unclear. In the present study, we demonstrate that plasma Aβ is produced from glucose- and insulin-susceptible peripheral tissues, such as the pancreas, adipose tissues, skeletal muscles, and liver, to inhibit insulin secretion from islet β-cells. Our findings suggest a physiological role of peripheral Aβ in glucose and insulin metabolism and a possible mechanism linking diabetes to AD. In addition, although plasma Aβ levels are currently used as a diagnostic biomarker of AD, our data suggest they should be used with caution. Type 2 diabetes mellitus is known to be a risk factor for Alzheimer’s disease (AD), but the underlying mechanisms remain unclear. In AD, the cerebral accumulation of amyloid β (Aβ) triggers a pathological cascade leading to neurodegeneration. Plasma Aβ levels are thought to reflect the brain amyloid pathology and currently used as a diagnostic biomarker of AD. However, amyloid precursor protein and Aβ-generating enzymes, β- and γ-secretases, are widely expressed in various peripheral tissues. Previous reports have shown that glucose and insulin loading cause a transient increase of plasma Aβ in mice and humans. These findings led us to speculate that plasma Aβ is produced from glucose- and insulin-susceptible peripheral tissues to play a role in glucose and insulin metabolism. To test this hypothesis, we investigated the effects of glucose and insulin on Aβ secretion and the effect of Aβ on insulin secretion in vivo, ex vivo, and in vitro. Aβ was found to be secreted from β-cells of the pancreas along with insulin upon glucose stimulation. Upon insulin stimulation, Aβ was secreted from cells of insulin-targeted organs, such as adipose tissues, skeletal muscles, and the liver, along with their organokines. Furthermore, Aβ inhibited the glucose-triggered insulin secretion from β-cells, slowing down glucose clearance from the blood. These results suggest that peripheral Aβ acts as a negative modulator of insulin secretion. Our findings provide a possible mechanism linking diabetes to AD and call attention to how plasma Aβ levels are used in AD diagnosis.
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209
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Abstract
Interest in epicardial adipose tissue (EAT) is growing rapidly, and research in this area appeals to a broad, multidisciplinary audience. EAT is unique in its anatomy and unobstructed proximity to the heart and has a transcriptome and secretome very different from that of other fat depots. EAT has physiological and pathological properties that vary depending on its location. It can be highly protective for the adjacent myocardium through dynamic brown fat-like thermogenic function and harmful via paracrine or vasocrine secretion of pro-inflammatory and profibrotic cytokines. EAT is a modifiable risk factor that can be assessed with traditional and novel imaging techniques. Coronary and left atrial EAT are involved in the pathogenesis of coronary artery disease and atrial fibrillation, respectively, and it also contributes to the development and progression of heart failure. In addition, EAT might have a role in coronavirus disease 2019 (COVID-19)-related cardiac syndrome. EAT is a reliable potential therapeutic target for drugs with cardiovascular benefits such as glucagon-like peptide 1 receptor agonists and sodium–glucose co-transporter 2 inhibitors. This Review provides a comprehensive and up-to-date overview of the role of EAT in cardiovascular disease and highlights the translational nature of EAT research and its applications in contemporary cardiology. In this Review, Iacobellis provides a comprehensive overview of the role of epicardial adipose tissue (EAT) in cardiovascular disease, including coronary artery disease, heart failure and atrial fibrillation, discusses imaging techniques for EAT assessment and highlights the therapeutic potential of targeting EAT in cardiovascular disease. Epicardial adipose tissue (EAT) has anatomical and functional interactions with the heart owing to the shared circulation and the absence of muscle fascia separating the two organs. EAT can be clinically measured with cardiac imaging techniques that can help to predict and stratify cardiovascular risk. Regional distribution of EAT is important because pericoronary EAT and left atrial EAT differently affect the risk of coronary artery diseases and atrial fibrillation, respectively. EAT has a role in the development of several cardiovascular diseases through complex mechanisms, including gene expression profile, pro-inflammatory and profibrotic proteome, neuromodulation, and glucose and lipid metabolism. EAT could be a potential therapeutic target for novel cardiometabolic medications that modulate adipose tissue such as glucagon-like peptide 1 receptor agonists and sodium–glucose co-transporter 2 inhibitors. EAT might be a reservoir of severe acute respiratory syndrome coronavirus 2 and an amplifier of coronavirus disease 2019 (COVID-19)-related cardiac syndrome.
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Affiliation(s)
- Gianluca Iacobellis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami, Miami, FL, USA.
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210
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Nitsche LJ, Mukherjee S, Cheruvu K, Krabak C, Rachala R, Ratnakaram K, Sharma P, Singh M, Yendamuri S. Exploring the Impact of the Obesity Paradox on Lung Cancer and Other Malignancies. Cancers (Basel) 2022; 14:cancers14061440. [PMID: 35326592 PMCID: PMC8946288 DOI: 10.3390/cancers14061440] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Studies have shown that obesity is associated with many adverse health effects, including worse cancer outcomes. Many studies paradoxically suggest a survival benefit for obesity in treatment outcomes of cancers such as non-small-cell lung cancer. This relationship is not seen in animal models. We hypothesize that this relationship is secondary to suboptimal quantification of adiposity, enhanced immunotherapy response, and variables such as sex, medications, and smoking status. There are many ways to measure and classify adiposity, but the ability to distinguish abdominal obesity is likely key in predicting accurate prognosis. There are many ways obesity impacts cancer treatment course from diagnosis to survivorship. In this paper, we aim to analyze the factors contributing to the obesity paradox and its effect on lung cancer. This can aid the treatment and prognosis of lung cancer and may support further research into obesity-specific impacts on this malignancy. Abstract There is a paradoxical relationship between obesity, as measured by BMI, and many types of cancer, including non-small-cell lung cancer. Obese non-small-cell lung cancer patients have been shown to fare better than their non-obese counterparts. To analyze the multifaceted effects of obesity on oncologic outcomes, we reviewed the literature on the obesity paradox, methods to measure adiposity, the obesity-related derangements in immunology and metabolism, and the oncologic impact of confounding variables such as gender, smoking, and concomitant medications such as statins and metformin. We analyzed how these aspects may contribute to the obesity paradox and cancer outcomes with a focus on lung cancer. We concluded that the use of BMI to measure adiposity is limited and should be replaced by a method that can differentiate abdominal obesity. We also concluded that the concomitant metabolic and immunologic derangements caused by obesity contribute to the obesity paradox. Medications, gender, and smoking are additional variables that impact oncologic outcomes, and further research needs to be performed to solidify the mechanisms.
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Affiliation(s)
- Lindsay Joyce Nitsche
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Sarbajit Mukherjee
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA;
| | - Kareena Cheruvu
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Cathleen Krabak
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Rohit Rachala
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Kalyan Ratnakaram
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Priyanka Sharma
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Maddy Singh
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
| | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263, USA; (L.J.N.); (K.C.); (C.K.); (R.R.); (K.R.); (P.S.); (M.S.)
- Correspondence: ; Tel.: +1-716-8458675
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Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat. Curr Atheroscler Rep 2022; 24:185-195. [PMID: 35235165 DOI: 10.1007/s11883-022-00996-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Despite its prevalence and well-documented impact on population health, obesity has not emerged as a strong independent risk factor for cardiovascular disease after control for intermediate risk factors. The purpose of this brief narrative review is to highlight results from imaging studies that have not only documented the remarkable heterogeneity of body fat topography but also the importance of visceral adiposity as a key body fat depot associated with cardiovascular disease risk and type 2 diabetes. RECENT FINDINGS Simple tools are also discussed in order to refine cardiometabolic risk assessment in persons with overweight/obesity. It is proposed that four lifestyle vital signs should be considered in clinical practice to improve discrimination of health risk in individuals with overweight/obesity: waist circumference as a simple marker of abdominal adiposity, cardiorespiratory fitness, overall diet quality, and level of reported physical activity. Heterogeneity of obesity is proposed as an example of a condition that would benefit from a precision lifestyle medicine approach.
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212
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Zhong P, Zeng H, Huang M, Fu W, Chen Z. Efficacy and safety of once-weekly semaglutide in adults with overweight or obesity: a meta-analysis. Endocrine 2022; 75:718-724. [PMID: 34981419 DOI: 10.1007/s12020-021-02945-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/10/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE This meta-analysis aimed to assess the efficacy and safety of once-weekly semaglutide among adults with overweight or obesity. METHODS We searched multiple electronic databases for randomized controlled trials that compared once-weekly semaglutide versus placebo in adults with overweight or obesity. The primary outcomes were the percentage change and absolute change in body weight. Secondary outcomes included achievement of categorical weight loss targets (at least 5, 10, 15, or 20%), cardiometabolic risk profiles, and health-related quality of life. RESULTS This meta-analysis included a total of four trials with 3447 patients. Once-weekly semaglutide was superior to placebo in terms of the percentage change and absolute change in body weight. Compared with placebo, once-weekly semaglutide also led to significant increases in the proportions of achievement of categorical weight reduction targets. Moreover, once-weekly semaglutide induced superior reductions in waist circumference and body-mass index compared with placebo. Furthermore, the effect on improving other cardiometabolic risk factors and health-related quality of life was more pronounced for once-weekly semaglutide relative to placebo. CONCLUSION Among adults with overweight or obesity, once-weekly semaglutide could result in clinically meaningful weight loss, which was a promising therapy for treating overweight or obesity.
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Affiliation(s)
- Ping Zhong
- Department of Acupuncture and Moxibustion, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hai Zeng
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Miaochun Huang
- Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Wenbin Fu
- Department of Acupuncture and Moxibustion, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Zhixia Chen
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
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213
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Fitch AK, Bays HE. Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100004. [PMID: 37990702 PMCID: PMC10661988 DOI: 10.1016/j.obpill.2021.100004] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2023]
Abstract
Background The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding definition, diagnosis, bias, standard operating procedures (SOPs) and telehealth is intended to provide clinicians an overview of obesity medicine and provide basic organizational tools towards establishing, directing, managing, and maintaining an obesity medical practice. Methods This CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by Obesity Medicine Association leadership. Results OMA has defined obesity as: "A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences." While body mass index may be sufficiently diagnostic for populations and many patients, accurate diagnosis of adiposity in an individual may require anthropometric assessments beyond body weight alone (e.g., waist circumference, percent body fat, and android/visceral fat). Obesity complications can be categorized as "sick fat disease" (adiposopathy) and/or "fat mass disease." Obesity complications predominantly of fat mass origins include sleep apnea and orthopedic conditions. Obesity complications due to adiposopathic endocrinopathies and/or immunopathies include cardiovascular disease, cancer, elevated blood sugar, elevated blood pressure, dyslipidemia, fatty liver, and alterations in sex hormones in both males (i.e., hypogonadism) and females (i.e., polycystic ovary syndrome). Obesity treatment begins with proactive steps to avoid weight bias, including patient-appropriate language, office equipment, and supplies. To help manage obesity and its complications, this CPS provides a practical template for an obesity medicine practice, creation of standard operating procedures, and incorporation of the OMA "ADAPT" method in telehealth (Assessment, Diagnosis, Advice, Prognosis, and Treatment). Conclusions The OMA CPS regarding "Obesity Definition, Diagnosis, Bias, Standard Operating Procedures (SOPs), and Telehealth" is one in a series of OMA CPSs designed to assist clinicians care for patients with the disease of obesity.
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Affiliation(s)
- Angela K. Fitch
- Massachusetts General Hospital Weight Center, Harvard Medical School, 50 Staniford Street Suite 430, Boston, MA, 02114, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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Burridge K, Christensen SM, Golden A, Ingersoll AB, Tondt J, Bays HE. Obesity history, physical exam, laboratory, body composition, and energy expenditure: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100007. [PMID: 37990700 PMCID: PMC10661987 DOI: 10.1016/j.obpill.2021.100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is intended to provide clinicians an overview of the clinical and diagnostic evaluation of patients with pre-obesity/obesity. Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of medical, dietary, and physical activity history as well as physical exams, with a focus on specific aspects unique to managing patients with pre-obesity or obesity. Patients with pre-obesity/obesity benefit from the same preventive care and general laboratory testing as those without an increase in body fat. In addition, patients with pre-obesity/obesity may benefit from adiposity-specific diagnostic testing - both generally and individually - according to patient presentation and clinical judgment. Body composition testing, such as dual energy x-ray absorptiometry, bioelectrical impedance, and other measures, each have their own advantages and disadvantages. Some patients in clinical research, and perhaps even clinical practice, may benefit from an assessment of energy expenditure. This can be achieved by several methods including direct calorimetry, indirect calorimetry, doubly labeled water, or estimated by equations. Finally, a unifying theme regarding the etiology of pre-obesity/obesity and effectiveness of treatments of obesity centers on the role of biologic and behavior efficiencies and inefficiencies, with efficiencies more often associated with increases in fat mass and inefficiencies more often associated with decreases in fat mass. Conclusion The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity.
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Affiliation(s)
- Karlijn Burridge
- Gaining Health, 528 Pennsylvania Ave #708 Glen Ellyn, IL 60137, USA
| | - Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St., Suite 100B, Seattle, WA, 98125, USA
| | - Angela Golden
- NP Obesity Treatment Clinic and NP from Home, LLC, PO Box 25959, Munds Park, AZ, 86017, USA
| | - Amy B. Ingersoll
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- University of Louisville School of Medicine, USA
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215
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Chaudhari UK, Newcomb JD, Jen KLC, Hansen BC. Iron deficiency, but not anemia, is identified in naturally occurring obesity and insulin resistance in male nonhuman primates. J Med Primatol 2022; 51:165-171. [PMID: 35229310 DOI: 10.1111/jmp.12572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/01/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To understand the development of iron deficiency in obesity and its long-term impact on the profile of anemia in spontaneously obese nonhuman primates. METHODS The study included 69 adult male nonhuman primates, (NHPs, Macaca mulatta, rhesus monkeys), ranging from normal to obese, and type 2 diabetes (T2D) as defined for humans. RESULTS Iron deficiency was present in 31.9% and mild anemia in 13% of the rhesus monkey in the colony. Serum iron levels were significantly lower in obese (p < .01) and T2D (p < .01)) compared with normal NHP. Obese NHPs also had significantly higher hemoglobin (p < .05), and red blood cell count (p < .05) than normal weight NHPs, thus not related to anemia. CONCLUSIONS Iron deficiency with increased hemoglobin and red blood cells was significantly associated with increased adiposity, insulin resistance, and diabetes. Iron deficiency does not cause and is not related to anemia in obese and T2D NHPs.
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Affiliation(s)
- Uddhav K Chaudhari
- Department of Internal Medicine, Obesity Diabetes and Aging Research Center, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.,ICMR-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), Mumbai, India
| | - Jennifer D Newcomb
- Department of Internal Medicine, Obesity Diabetes and Aging Research Center, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - K-L Catherine Jen
- Department of Nutrition and Food Science, Wayne State University, Detroit, Michigan, USA
| | - Barbara C Hansen
- Department of Internal Medicine, Obesity Diabetes and Aging Research Center, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
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216
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Henriksson P, Sandborg J, Henström M, Delisle Nyström C, Ek E, Ortega FB, Löf M. Body composition, physical fitness and cardiovascular risk factors in 9-year-old children. Sci Rep 2022; 12:2665. [PMID: 35177687 PMCID: PMC8854391 DOI: 10.1038/s41598-022-06578-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/01/2022] [Indexed: 12/24/2022] Open
Abstract
The independent associations of body composition and physical fitness components with cardiovascular disease (CVD) risk factors in childhood are not fully understood. Thus, this cross-sectional study examined the independent associations of body composition and physical fitness with CVD risk factors in Swedish 9-year-old children (n = 411). Unadjusted linear regression analyses showed that body mass index (BMI), % fat mass and fat mass index were all positively associated with systolic and diastolic blood pressure, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Metabolic Syndrome (MetS) score (all β ≥ 0.229, P ≤ 0.001). These associations were virtually unaffected by adjustments for basic covariates (child's age and sex, maternal educational level and maternal BMI), fat-free mass and physical fitness. Fat-free mass index had generally weak associations with CVD risk factors and no associations were statistically significant after adjustments (all P > 0.27). Greater cardiorespiratory fitness and motor fitness were associated with lower HOMA-IR and MetS score in unadjusted models (all β ≤ - 0.158, P ≤ 0.039) but not after adjustments for basic covariates and body composition. These findings indicate that cardiovascular health promotion in childhood may focus on the maintenance of a healthy fat mass.
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Affiliation(s)
- Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 58183, Sweden.
| | - Johanna Sandborg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 58183, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | | | - Evelina Ek
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 58183, Sweden
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
- PROFITH (PROmoting FITness and Health Through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, 58183, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
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217
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Lu Z, Jiang Z, Tang J, Lin C, Zhang H. Functions and origins of cardiac fat. FEBS J 2022; 290:1705-1718. [PMID: 35114069 DOI: 10.1111/febs.16388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/06/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
Abstract
Triglyceride droplets can be stored within cardiac adipocytes (CAs) and cardiomyocytes in the heart. Cardiac adipocytes reside in three distinct regions: pericardial, epicardial, and intramyocardial adipose tissues. In healthy individuals, cardiac adipose tissues modulate cardiovascular functions and energy partitioning, which are, thus, protective. However, ectopic deposition of cardiac adipose tissues turns them into adverse lipotoxic, prothrombotic, and pro-inflammatory tissues with local and systemic contribution to the development of cardiovascular disorders. Accumulation of triglyceride droplets in cardiomyocytes may lead to lipotoxic injury of cardiomyocytes and contribute to the development of cardiac hypertrophy and dysfunction. Here, we summarize the roles of CAs and myocardial triglyceride droplets under physiological and pathological conditions and review the cellular sources of CAs in heart development and diseases. Understanding the functions and cellular origins of cardiac fat will provide clues for future studies on pathophysiological processes and treatment of cardiovascular diseases.
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Affiliation(s)
- Zhengkai Lu
- School of Life Science and Technology ShanghaiTech University China
- University of Chinese Academy of Sciences Beijing China
| | - Zhen Jiang
- School of Life Science and Technology ShanghaiTech University China
| | - Juan Tang
- Institute for Regenerative Medicine Shanghai East Hospital Frontier Science Center for Stem Cell Research School of Life Science and Technology Tongji University Shanghai China
| | - Chao‐Po Lin
- School of Life Science and Technology ShanghaiTech University China
| | - Hui Zhang
- School of Life Science and Technology ShanghaiTech University China
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218
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Carbone F, Meessen J, Magnoni M, Andreini D, Maggioni AP, Latini R, Montecucco F. Osteopontin as Candidate Biomarker of Coronary Disease despite Low Cardiovascular Risk: Insights from CAPIRE Study. Cells 2022; 11:669. [PMID: 35203321 PMCID: PMC8870389 DOI: 10.3390/cells11040669] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Stratification according high cardiovascular (CV) risk categories, still represents a clinical challenge. In this analysis of the CAPIRE study (NCT02157662), we investigate whether inflammation could fit between CV risk factors (RFs) and the presence of coronary artery disease (CAD). In total, 544 patients were included and categorized according with the presence of CAD and CV risk factor burden (low/multiple). The primary endpoint was to verify any independent association of neutrophil-related biomarkers with CAD across CV risk categories. The highest values of osteopontin (OPN) were detected in the low RF group and associated with CAD (23.2 vs. 19.4 ng/mL; p = 0.001), although no correlation with plaque extent and/or composition were observed. Conversely, myeloperoxidase (MPO) and resistin did not differ by CAD presence. Again, OPN was identified as independent variable associated with CAD but only in the low RF group (adjOR 8.42 [95% CI 8.42-46.83]; p-value = 0.015). As an ancillary finding, a correlation linked OPN with the neutrophil degranulation biomarker MPO (r = 0.085; p = 0.048) and resistin (r = 0.177; p = 3.4 × 10-5). In the present study, OPN further strengthens its role as biomarker of CAD, potentially bridging subclinical CV risk with development of atherosclerosis.
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Affiliation(s)
- Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy;
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy
| | - Jennifer Meessen
- Department of Cardiovascular Research, IRCCS—Istituto di Ricerche Farmacologiche Mario Negri, 19 Via Giuseppe La Masa, 20156 Milan, Italy; (J.M.); (R.L.)
| | | | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy;
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy
| | | | - Roberto Latini
- Department of Cardiovascular Research, IRCCS—Istituto di Ricerche Farmacologiche Mario Negri, 19 Via Giuseppe La Masa, 20156 Milan, Italy; (J.M.); (R.L.)
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy;
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy
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Koschker AC, Warrings B, Morbach C, Seyfried F, Rickert N, Jung P, Geier A, Dischinger U, Krauthausen M, Herrmann MJ, Stier C, Frantz S, Malzahn U, Störk S, Fassnacht M. Cardio-psycho-metabolic outcomes of bariatric surgery: design and baseline of the WAS trial. Endocr Connect 2022; 11:e210338. [PMID: 35015697 PMCID: PMC8859939 DOI: 10.1530/ec-21-0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 12/02/2022]
Abstract
Obesity is a rapidly emerging health problem and an established risk factor for cardiovascular diseases. Bariatric surgery profoundly reduces body weight and mitigates sequelae of obesity. The open, randomized controlled Würzburg Adipositas Studie (WAS) trial compares the effects of Roux-en-Y gastric bypass (RYGB) vs psychotherapy-supported lifestyle modification in morbidly obese patients. The co-primary endpoint addresses 1-year changes in cardiovascular function (peak VO2 during cardiopulmonary exercise testing) and the quality of life (QoL) (Short-Form-36 physical functioning scale). Prior to randomization, all included patients underwent a multimodal anti-obesity treatment for 6-12 months. Thereafter, the patients were randomized and followed through month 12 to collect the primary endpoints. Afterwards, patients in the lifestyle group could opt for surgery, and final visit was scheduled for all patients 24 months after randomization. Sample size calculation suggested to enroll 90 patients in order to arrive at minimally 22 patients per group evaluable for the primary endpoint. Secondary objectives were to quantify changes in body weight, left ventricular hypertrophy, systolic and diastolic function (by echocardiography and cardiac MRI), functional brain MRI, psychometric scales, and endothelial and metabolic function. WAS enrolled 93 patients (72 women, median age 38 years, BMI 47.5 kg/m2) exhibiting a relevantly compromised exercise capacity (median peakVO2 18.3 mL/min/kg) and the QoL (median physical functioning scale 50). WAS is the first randomized controlled trial focusing on the effects of RYGB on cardiovascular function beyond hypertension. In addition, it will provide a wealth of high-quality data on the cerebral, psychiatric, hepatic, and metabolic function in obese patients after RYGB.
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Affiliation(s)
- Ann-Cathrin Koschker
- Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
| | - Bodo Warrings
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
- Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
| | - Nicole Rickert
- Department of Radiology, University Hospital, University of Würzburg, Würzburg, Germany
| | - Pius Jung
- Division of Pneumology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Andreas Geier
- Division of Hepatology, Department of Internal Medicine II, University Hospital, University of Würzburg, Würzburg, Germany
| | - Ulrich Dischinger
- Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Maike Krauthausen
- Department of General Practice, University Hospital, University of Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany
| | - Christine Stier
- Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
- Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefan Frantz
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
- Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Uwe Malzahn
- Center for Clinical Trials, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
- Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
- Correspondence should be addressed to M Fassnacht:
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220
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Tejani S, McCoy C, Ayers CR, Powell-Wiley TM, Després JP, Linge J, Leinhard OD, Petersson M, Borga M, Neeland IJ. Cardiometabolic Health Outcomes Associated With Discordant Visceral and Liver Fat Phenotypes: Insights From the Dallas Heart Study and UK Biobank. Mayo Clin Proc 2022; 97:225-237. [PMID: 34598789 PMCID: PMC8818017 DOI: 10.1016/j.mayocp.2021.08.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the cardiometabolic outcomes associated with discordant visceral adipose tissue (VAT) and liver fat (LF) phenotypes in 2 cohorts. PATIENTS AND METHODS Participants in the Dallas Heart Study underwent baseline imaging from January 1, 2000, through December 31, 2002, and were followed for incident cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) through 2013. Associations between VAT-LF groups (low-low, high-low, low-high, and high-high) and outcomes were assessed using multivariable-adjusted regression and were replicated in the independent UK Biobank. RESULTS The Dallas Heart Study included 2064 participants (mean ± SD age, 44±9 years; 54% female; 47% black). High VAT-high LF and high VAT-low LF were associated with prevalent atherosclerosis, whereas low VAT-high LF was not. Of 1731 participants without CVD/T2DM, 128 (7.4%) developed CVD and 95 (5.5%) T2DM over a median of 12 years. High VAT-high LF and high VAT-low LF were associated with increased risk of CVD (hazard ratios [HRs], 2.0 [95% CI, 1.3 to 3.2] and 2.4 [95% CI, 1.4 to 4.1], respectively) and T2DM (odds ratios [ORs], 7.8 [95% CI, 3.8 to 15.8] and 3.3 [95% CI, 1.4 to 7.8], respectively), whereas low VAT-high LF was associated with T2DM (OR, 2.7 [95% CI, 1.1 to 6.7]). In the UK Biobank (N=22,354; April 2014-May 2020), only high VAT-low LF remained associated with CVD after multivariable adjustment for age and body mass index (HR, 1.5 [95% CI, 1.2 to 1.9]). CONCLUSION Although VAT and LF are each associated with cardiometabolic risk, these observations demonstrate the importance of separating their cardiometabolic implications when there is presence or absence of either or both in an individual.
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Affiliation(s)
- Sanaa Tejani
- University of Texas Southwestern Medical School, Dallas, TX
| | - Cody McCoy
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Colby R Ayers
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Jean-Pierre Després
- Department of Kinesiology, Faculty of Medicine, Université Laval and VITAM - Centre de rercherche en santé durable, CIUSSS Capitale-Nationale, Québec, QC, Canada
| | - Jennifer Linge
- AMRA Medical AB, Linköping, Sweden; Division of Society and Health, Linköping University, Linköping, Sweden
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linköping, Sweden; Division of Diagnostics and Specialist Medicine, Linköping University, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | | | - Magnus Borga
- AMRA Medical AB, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Division of Biomedical Engineering, Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Ian J Neeland
- University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, Cleveland, OH.
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Camastra S, Ferrannini E. Role of anatomical location, cellular phenotype and perfusion of adipose tissue in intermediary metabolism: A narrative review. Rev Endocr Metab Disord 2022; 23:43-50. [PMID: 35031911 PMCID: PMC8873050 DOI: 10.1007/s11154-021-09708-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 02/07/2023]
Abstract
It is well-established that adipose tissue accumulation is associated with insulin resistance through multiple mechanisms. One major metabolic link is the classical Randle cycle: enhanced release of free fatty acids (FFA) from hydrolysis of adipose tissue triglycerides impedes insulin-mediated glucose uptake in muscle tissues. Less well studied are the different routes of this communication. First, white adipose tissue depots may be regionally distant from muscle (i.e., gluteal fat and diaphragm muscle) or contiguous to muscle but separated by a fascia (Scarpa's fascia in the abdomen, fascia lata in the thigh). In this case, released FFA outflow through the venous drainage and merge into arterial plasma to be transported to muscle tissues. Next, cytosolic triglycerides can directly, i.e., within the cell, provide FFA to myocytes (but also pancreatic ß-cells, renal tubular cells, etc.). Finally, adipocyte layers or lumps may be adjacent to, but not anatomically segregated, from muscle, as is typically the case for epicardial fat and cardiomyocytes. As regulation of these three main delivery paths is different, their separate contribution to substrate competition at the whole-body level is uncertain. Another important link between fat and muscle is vascular. In the resting state, blood flow is generally higher in adipose tissue than in muscle. In the insulinized state, fat blood flow is directly related to whole-body insulin resistance whereas muscle blood flow is not; consequently, fractional (i.e., flow-adjusted) glucose uptake is stimulated in muscle but not fat. Thus, reduced blood supply is a major factor for the impairment of in vivo insulin-mediated glucose uptake in both subcutaneous and visceral fat. In contrast, the insulin resistance of glucose uptake in resting skeletal muscle is predominantly a cellular defect.
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Affiliation(s)
- Stefania Camastra
- Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy.
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Mashayekhi M, Wanjalla CN, Warren CM, Simmons JD, Ghoshal K, Pilkinton M, Bailin SS, Gabriel CL, Pozzi A, Koethe JR, Brown NJ, Kalams SA, Luther JM. The soluble epoxide hydrolase inhibitor GSK2256294 decreases the proportion of adipose pro-inflammatory T cells. Prostaglandins Other Lipid Mediat 2022; 158:106604. [PMID: 34922004 PMCID: PMC8742790 DOI: 10.1016/j.prostaglandins.2021.106604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/12/2021] [Accepted: 12/11/2021] [Indexed: 02/03/2023]
Abstract
Adipose tissue contains a complex immune environment and is a central contributor to heightened systemic inflammation in obese persons. Epoxyeicosatrienoic acids (EETs) are lipid signaling molecules that decrease inflammation in obese animals, but their effect on inflammation in humans is unknown. The enzyme soluble epoxide hydrolase (sEH) hydrolyzes EETs to less active diols, and we hypothesized that pharmacologic sEH inhibition would decrease adipose inflammation in obese individuals. We treated obese prediabetic adults with the sEH inhibitor GSK2256294 versus placebo in a crossover design, collected subcutaneous abdominal adipose tissue via lipoaspiration and characterized the tissue T cell profile. Treatment with GSK2256294 decreased the percentage of pro-inflammatory T cells producing interferon-gamma (IFNγ), but not interleukin (IL)-17A, and decreased the amount of secreted tumor necrosis factor-alpha (TNFα). Understanding the contribution of the EET/sEH pathway to inflammation in obesity could lead to new strategies to modulate adipose and systemic inflammation.
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Affiliation(s)
- Mona Mashayekhi
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, TN, United States.
| | - Celestine N Wanjalla
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Christian M Warren
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Joshua D Simmons
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Kakali Ghoshal
- Vanderbilt University Medical Center, Department of Medicine, Division of Nephrology, Nashville, TN, United States
| | - Mark Pilkinton
- Saint Thomas Hospital West, Nashville, TN, United States
| | - Samuel S Bailin
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Curtis L Gabriel
- Vanderbilt University Medical Center, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Nashville, TN, United States
| | - Ambra Pozzi
- Vanderbilt University Medical Center, Department of Medicine, Division of Nephrology, Nashville, TN, United States; Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United States
| | - John R Koethe
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States; Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, United States
| | - Nancy J Brown
- Yale School of Medicine, Nashville, TN, United States
| | - Spyros A Kalams
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - J Matthew Luther
- Vanderbilt University Medical Center, Department of Medicine, Division of Clinical Pharmacology, Nashville, TN, United States
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Dwan D, Ramin SK, Chen Y, Muller KE, diFlorio-Alexander RM. Decrease in the Size of Fat-Enlarged Axillary Lymph Nodes and Serum Lipids after Bariatric Surgery. Cells 2022; 11:cells11030482. [PMID: 35159291 PMCID: PMC8834314 DOI: 10.3390/cells11030482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Ectopic fat deposition in obesity is associated with organ dysfunction; however, little is known about fat deposition within the lymphatic system and associated lymphatic dysfunction. METHODS One hundred fifty-five women who underwent routine screening mammography before and after a Roux-en-y gastric bypass or a sleeve gastrectomy were retrospectively reviewed and after excluding women without visible nodes both before and after bariatric surgery, 84 patients were included in the final analysis. Axillary lymph node size, patient weight in kilograms, body mass index, and a diagnosis of hypertension, type 2 diabetes, and dyslipidemia were evaluated before and after surgery. Binary linear regression models and Fischer's exact test were used to evaluate the relationship between the size of fat-infiltrated axillary lymph nodes, patient age, change in patient weight, and diagnosis of hypertension, type 2 diabetes, and dyslipidemia. RESULTS Fat-infiltrated axillary lymph nodes demonstrated a statistically significant decrease in size after bariatric surgery with a mean decrease of 4.23 mm (95% CI: 3.23 to 5.2, p < 0.001). The resolution of dyslipidemia was associated with a decrease in lymph node size independent of weight loss (p = 0.006). CONCLUSIONS Mammographically visualized fat-infiltrated axillary lymph nodes demonstrated a statistically significant decrease in size after bariatric surgery. The decrease in lymph node size was significantly associated with the resolution of dyslipidemia, independent of weight loss, age, and type of surgery.
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Affiliation(s)
- Dennis Dwan
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA;
| | - Seth K. Ramin
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA;
| | - Youdinghuan Chen
- Faculty of Science, Wilmington University, 320 N Dupont Hwy, New Castle, DE 19720, USA;
| | - Kristen E. Muller
- Department of Pathology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA;
| | - Roberta M. diFlorio-Alexander
- Department of Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA
- Correspondence: ; Tel.: +1-603-650-4477
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224
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Hanlon CL, Yuan L. Nonalcoholic Fatty Liver Disease: The Role of Visceral Adipose Tissue. Clin Liver Dis (Hoboken) 2022; 19:106-110. [PMID: 35355841 PMCID: PMC8958250 DOI: 10.1002/cld.1183] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 02/04/2023] Open
Abstract
Content available: Author Audio Recording.
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Affiliation(s)
- Courtney L. Hanlon
- Department of MedicineUniversity of Southern CaliforniaKeck School of Medicine of USCLos AngelesCA
| | - Liyun Yuan
- Department of MedicineUniversity of Southern CaliforniaKeck School of Medicine of USCLos AngelesCA,Division of Gastrointestinal and Liver DiseasesUniversity of Southern CaliforniaKeck Hospital of USCLos AngelesCA
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225
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Patel KV, Segar MW, Lavie CJ, Kondamudi N, Neeland IJ, Almandoz JP, Martin CK, Carbone S, Butler J, Powell-Wiley TM, Pandey A. Diabetes Status Modifies the Association Between Different Measures of Obesity and Heart Failure Risk Among Older Adults: A Pooled Analysis of Community-Based NHLBI Cohorts. Circulation 2022; 145:268-278. [PMID: 34860539 PMCID: PMC8792339 DOI: 10.1161/circulationaha.121.055830] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Obesity and diabetes are associated with a higher risk of heart failure (HF). The interrelationships between different measures of adiposity-overall obesity, central obesity, fat mass (FM)-and diabetes status for HF risk are not well-established. METHODS Participant-level data from the ARIC study (Atherosclerosis Risk in Communities; visit 5) and the CHS (Cardiovascular Health Study; visit 1) cohorts were obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center, harmonized, and pooled for the present analysis, excluding individuals with prevalent HF. FM was estimated in all participants using established anthropometric prediction equations additionally validated using the bioelectrical impedance-based FM in the ARIC subgroup. Incident HF events on follow-up were captured across both cohorts using similar adjudication methods. Multivariable-adjusted Fine-Gray models were created to evaluate the associations of body mass index (BMI), waist circumference (WC), and FM with risk of HF in the overall cohort as well as among those with versus without diabetes at baseline. The population attributable risk of overall obesity (BMI≥30 kg/m2), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF was evaluated among participants with and without diabetes. RESULTS The study included 10 387 participants (52.9% ARIC; 25.1% diabetes; median age, 74 years). The correlation between predicted and bioelectrical impedance-based FM was high (R2=0.90; n=5038). During a 5-year follow-up, 447 participants developed HF (4.3%). Higher levels of each adiposity measure were significantly associated with higher HF risk (hazard ratio [95% CI] per 1 SD higher BMI=1.15 [1.05, 1.27], WC=1.22 [1.10, 1.36]; FM=1.13 [1.02, 1.25]). A significant interaction was noted between diabetes status and measures of BMI (P interaction=0.04) and WC (P interaction=0.004) for the risk of HF. In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (hazard ratio [95% CI] per 1 SD higher BMI=1.29 [1.14-1.47]; WC=1.48 [1.29-1.70]; FM=1.25 [1.09-1.43]) but not those without diabetes, including participants with prediabetes and euglycemia. The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, and 13.7%, respectively) versus those without diabetes (≤1% for each). CONCLUSIONS Higher BMI, WC, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes.
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Affiliation(s)
- Kershaw V. Patel
- Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
| | | | - Carl J. Lavie
- Department of Internal Medicine, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Nitin Kondamudi
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ian J. Neeland
- University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, Cleveland, OH
| | - Jaime P. Almandoz
- Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA,VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD,Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
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226
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Yu Z, Luo R, Li Y, Li X, Yang Z, Peng J, Huang K. ADAR1 inhibits adipogenesis and obesity by interacting with dicer to promote the maturation of miR-155-5P. J Cell Sci 2022; 135:274090. [PMID: 35067718 DOI: 10.1242/jcs.259333] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/08/2022] [Indexed: 11/20/2022] Open
Abstract
Adipogenesis is closely related to various metabolic diseases, such as obesity, type 2 diabetes, cardiovascular diseases, and cancer. This cellular process is highly dependent on the expression and sequential activation of a diverse group of transcription factors. Here, we report that ADAR1 could inhibit adipogenesis through binding with Dicer, resulting in enhanced production of miR-155-5p, which downregulates the adipogenic early transcription factor C/EBPβ. Consequently, the expression levels of late transcription factors (C/ebpα and PPARγ) are reduced and adipogenesis is inhibited. More importantly, in vivo studies reveal that overexpression of ADAR1 suppresses white adipose tissue expansion in high fat diet-induced obese mice, leading to improved metabolic phenotypes such as insulin sensitivity and glucose tolerance.
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Affiliation(s)
- Zuying Yu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruijie Luo
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yutian Li
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, USA
| | - Xiaoguang Li
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengrui Yang
- Department of Cardiology, The 2nd people's Hospital of Lincang city, Lincang, China
| | - Jiangtong Peng
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Cardiology, The 2nd people's Hospital of Lincang city, Lincang, China
| | - Kai Huang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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227
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Lee MH, Neeland IJ, de Albuquerque Rocha N, Hughes C, Malloy CR, Jin ES. A randomized clinical trial evaluating the effect of empagliflozin on triglycerides in obese adults: Role of visceral fat. Metabol Open 2022; 13:100161. [PMID: 35024596 PMCID: PMC8728102 DOI: 10.1016/j.metop.2021.100161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background Empagliflozin, a sodium glucose cotransporter 2 inhibitor, is a medication to treat type 2 diabetes. The effect of empagliflozin in persons without diabetes has received less attention. Here we conducted a randomized, double-blind placebo-controlled clinical trial to examine the effect of empagliflozin on plasma triglycerides in obese non-diabetic adults. Methods Participants (n = 35; BMI ≥ 30 kg/m2) underwent body composition assessments using MRI, and were randomly assigned to either placebo or empagliflozin (10 mg/d) for three months. At the baseline and post-treatment visit, after an overnight fast, blood was drawn for biochemical analysis. Participants received [U–13C3]glycerol orally followed by multiple blood draws over 3 h to examine glycerol incorporation into triglycerides using NMR spectroscopy. Results The changes in blood triglyceride concentration with empagliflozin therapy related to the mass of baseline visceral adipose tissue (VAT; r = 0.53, p = 0.04). Empagliflozin slightly lowered triglycerides in obese subjects with low VAT, but increased triglycerides in the subjects with high VAT. Consistently, empagliflozin effectively suppressed triglyceride synthesis following [U–13C3]glycerol administration in the subjects with low VAT (p < 0.05), but not in the subjects with high VAT. The subjects with high VAT lost body weight after three months of empagliflozin treatment. In all subjects, about 20% of the triglyceride backbone originated from mitochondrial metabolism of glycerol. Conclusions The effect of empagliflozin on triglycerides in obese adults differed depending on VAT. Empagliflozin suppressed triglyceride synthesis in the subjects with low VAT, but tended to increase triglycerides in those with high VAT. Visceral fat modulates the effect of empagliflozin on triglycerides in obese adults. Empagliflozin suppresses triglyceride synthesis in obese adults with low visceral fat. Empagliflozin tends to increase triglycerides in obese adults with high visceral fat. Empagliflozin induces weight loss in obese adults with high visceral fat.
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Affiliation(s)
- Min Hee Lee
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Ian J. Neeland
- Department of Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Connor Hughes
- Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
| | - Craig R. Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
- Department of Radiology, University of Texas Southwestern Medical Center, USA
- VA North Texas Health Care System, Dallas, TX, 75216, USA
| | - Eunsook S. Jin
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
- Corresponding author. Advanced Imaging Research Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8568, USA.
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228
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Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. Int J Mol Sci 2022; 23:ijms23020786. [PMID: 35054972 PMCID: PMC8775991 DOI: 10.3390/ijms23020786] [Citation(s) in RCA: 422] [Impact Index Per Article: 211.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022] Open
Abstract
Metabolic syndrome (MetS) forms a cluster of metabolic dysregulations including insulin resistance, atherogenic dyslipidemia, central obesity, and hypertension. The pathogenesis of MetS encompasses multiple genetic and acquired entities that fall under the umbrella of insulin resistance and chronic low-grade inflammation. If left untreated, MetS is significantly associated with an increased risk of developing diabetes and cardiovascular diseases (CVDs). Given that CVDs constitute by far the leading cause of morbidity and mortality worldwide, it has become essential to investigate the role played by MetS in this context to reduce the heavy burden of the disease. As such, and while MetS relatively constitutes a novel clinical entity, the extent of research about the disease has been exponentially growing in the past few decades. However, many aspects of this clinical entity are still not completely understood, and many questions remain unanswered to date. In this review, we provide a historical background and highlight the epidemiology of MetS. We also discuss the current and latest knowledge about the histopathology and pathophysiology of the disease. Finally, we summarize the most recent updates about the management and the prevention of this clinical syndrome.
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229
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Miklishanskaya SV, Solomasova LV, Orlovsky AA, Nasonova SN, Mazur NA. Heterogeneity of abdominal obesity in patients with cardiovascular diseases. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2021-12-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim: To assess the content of visceral adipose tissue (VAT) in patients with abdominal obesity and its relationship with metabolic disorders.Material and methods. Patients with abdominal obesity (n=107) were included in the study. All participants had an assessment of anthropometric parameters (height, weight), calculation of body mass index (BMI), proportion of total adipose tissue and VAT (bioimpedance analyzer), high-density lipoprotein cholesterol (HDL-c) levels, triglycerides, fasting blood glucose, epicardial thickness adipose tissue (two-dimensional echocardiography).Results. The median share of VAT (bioimpedance method) was 13%. Patients with abdominal obesity are divided by VAT into 2 groups: ≥14% or ≤13%. Patients with VAT≥14% had significantly higher levels of triglycerides (1.76 [1.27; 2.38] mmol / L) and glucose (6.33 [5.78; 7.87] mmol / L), and below HDL-c levels (0.95 [0.85; 1.21] mmol / L) compared with patients with VAT≤13% (1.32 [1.02; 1.50], 5.59 [5, 11; 6.16] and 1.31 [1.07; 1.58] mmol / L, respectively; p<0.001 for all three comparisons). A significant correlation was found between VAT and triglyceride, glucose and HDL-c levels (r=0.40; r=0.40; r=-0.31, respectively; p<0.001).Conclusion. Persons with abdominal obesity are heterogeneous in the proportion of VAT. The proportion of VAT above the median is associated with metabolic disorders that are significant for the development and progression of atherosclerosis. An increase in BMI in obese individuals is not associated with an increase in VAT and an increase in the severity of metabolic disorders.
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Affiliation(s)
| | | | | | | | - N. A. Mazur
- Russian Medical Academy of Continuous Professional Education
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230
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Lentjes MAH, Oude Griep LM, Mulligan AA, Montgomery S, Wareham NJ, Khaw KT. Face Validity of Observed Meal Patterns Reported with 7-Day Diet Diaries in a Large Population-Based Cohort Using Diurnal Variation in Concentration Biomarkers of Dietary Intake. Nutrients 2022; 14:238. [PMID: 35057419 PMCID: PMC8780432 DOI: 10.3390/nu14020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 12/04/2022] Open
Abstract
In a cross-sectional analysis of a population-based cohort (United Kingdom, N = 21,318, 1993-1998), we studied how associations between meal patterns and non-fasting triglyceride and glucose concentrations were influenced by the hour of day at which the blood sample was collected to ascertain face validity of reported meal patterns, as well as the influence of reporting bias (assessed using formula of energy expenditure) on this association. Meal size (i.e., reported energy content), mealtime and meal frequency were reported using pre-structured 7-day diet diaries. In ANCOVA, sex-specific means of biomarker concentrations were calculated by hour of blood sample collection for quartiles of reported energy intake at breakfast, lunch and dinner (meal size). Significant interactions were observed between breakfast size, sampling time and triglyceride concentrations and between lunch size, sampling time and triglyceride, as well as glucose concentrations. Those skipping breakfast had the lowest triglyceride concentrations in the morning and those skipping lunch had the lowest triglyceride and glucose concentrations in the afternoon, especially among acceptable energy reporters. Eating and drinking occasion frequency was weakly associated with glucose concentrations in women and positively associated with triglyceride concentrations in both sexes; stronger associations were observed for larger vs. smaller meals and among acceptable energy reporters. Associations between meal patterns and concentration biomarkers can be observed when accounting for diurnal variation and underreporting. These findings support the use of 7-day diet diaries for studying associations between meal patterns and health.
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Affiliation(s)
- Marleen A. H. Lentjes
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK; (A.A.M.); (K.-T.K.)
- Clinical Epidemiology and Biostatistics/Nutrition Gut Brain Interactions Research Centre, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
| | - Linda M. Oude Griep
- MRC Epidemiology Unit, Institute of Metabolic Sciences, University of Cambridge, Cambridge CB2 0QQ, UK; (L.M.O.G.); (N.J.W.)
- NIHR Biomedical Research Centre, Diet, Anthropometry and Physical Activity (DAPA) Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Angela A. Mulligan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK; (A.A.M.); (K.-T.K.)
- NIHR Biomedical Research Centre, Diet, Anthropometry and Physical Activity (DAPA) Group, MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics/Nutrition Gut Brain Interactions Research Centre, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institute, 17177 Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Nick J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Sciences, University of Cambridge, Cambridge CB2 0QQ, UK; (L.M.O.G.); (N.J.W.)
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK; (A.A.M.); (K.-T.K.)
- School of Clinical Medicine/Clinical Gerontology, University of Cambridge, Cambridge CB1 8RN, UK
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Wei D, Marrachelli VG, Melgarejo JD, Liao CT, Janssens S, Verhamme P, Vanassche T, Van Aelst L, Monleon D, Redón J, Zhang ZY. Lipoprotein profiles of fat distribution and its association with insulin sensitivity. Front Endocrinol (Lausanne) 2022; 13:978745. [PMID: 36387872 PMCID: PMC9640977 DOI: 10.3389/fendo.2022.978745] [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: 06/26/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fat deposition is associated with adverse outcomes. Waist-to-hip (WHR) ratio is a simple feasible index to assess fat distribution. Lipoprotein particle composition in relation to WHR and to what extent their association is mediated by insulin sensitivity are less investigated. METHODS In 504 randomly recruited Flemish (mean age: 48.9 years; women: 51.6%), we analyzed the lipoprotein particle constitutions using nuclear magnetic resonance spectroscopy. WHR obesity described a WHR of ≥ 0.85 for women or 0.9 for men. Insulin sensitivity was evaluated by the homeostasis model assessment-estimated insulin resistance (HOMA-IR). SCORE-2 risk algorithm was applied to estimate 10-year cardiovascular risk. Statistical methods included multivariable-adjusted linear regression analysis, logistic regression analysis, and mediation analysis. RESULTS The prevalence of WHR obesity was 54.6%, approximately 3 times of BMI-determined obesity (19.1%). Individuals with WHR obesity had significantly higher metabolic complications, such as hypertension (57.1%), dyslipidemia (61.8%), and insulin resistance (14.2%). WHR and WHR obesity were positively associated with total very-low-density lipoprotein (VLDL) particle concentration, remnant cholesterol, and triglycerides, but were negatively associated with VLDL particle size (P ≤ 0.027), independent of body mass index and other covariates. WHR was inversely associated with total high-density lipoprotein (HDL) particle concentration, whereas WHR obesity was inversely associated with HDL cholesterol (P ≤ 0.039). Neither WHR nor WHR obesity was associated with the concentration of total low-density lipoprotein (LDL) particles, LDL particle size, and LDL cholesterol (P ≥ 0.089). In the mediation analysis, insulin sensitivity significantly mediated the effect of WHR on total VLDL particle concentration (mediation percentage: 37.0%), remnant cholesterol (47.7%), and HDL cholesterol (41.1%). Individuals with WHR obesity were at increased cardiovascular risk, regardless of LDL cholesterol (P ≤0.028). In WHR obesity, higher total VLDL particle concent36ration and remnant cholesterol, and lower HDL cholesterol were associated with an increased cardiovascular risk (P≤ 0.002). CONCLUSIONS Upper-body fat deposition was independently associated with an unfavorable lipoprotein profile, and insulin sensitivity significantly mediated this association. LDL cholesterol might underestimate lipid abnormality for people with upper-body obesity and lowering VLDL particles and remnant cholesterol might potentially reduce the residual cardiovascular risk.
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Affiliation(s)
- Dongmei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Vannina González Marrachelli
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Jesus D. Melgarejo
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Chia-Te Liao
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Stefan Janssens
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Thomas Vanassche
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Lucas Van Aelst
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Daniel Monleon
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
- Department of Pathology, University of Valencia, Valencia, Spain
| | - Josep Redón
- INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- *Correspondence: Zhen-Yu Zhang,
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Amaro A, Skolnik NS, Sugimoto D. Cardiometabolic risk factors efficacy of semaglutide in the STEP program. Postgrad Med 2022; 134:18-27. [PMID: 36691308 DOI: 10.1080/00325481.2022.2147325] [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: 01/25/2023]
Abstract
People with overweight or obesity often suffer from associated cardiometabolic diseases and comorbidities. Current therapies for obesity include lifestyle intervention, bariatric surgery, and pharmacotherapy. The magnitude of weight loss achieved with these therapies can determine the level of improvement in various comorbidities. Once-weekly subcutaneous semaglutide 2.4 mg is a glucagon-like peptide-1 receptor agonist recently approved by the US Food and Drug Administration for the treatment of obesity. This article reviews data from the global phase 3 Semaglutide Treatment Effect in People with obesity (STEP) program, comparing the efficacy of once-weekly subcutaneous semaglutide 2.4 mg versus placebo for weight loss and improvements in cardiometabolic parameters across the STEP 1 to 5 trials. In STEP 1 to 3 and STEP 5, semaglutide led to greater reductions from baseline versus placebo in body weight, waist circumference, body mass index, systolic blood pressure (SBP), and diastolic blood pressure, as well as positive changes in glycated hemoglobin (HbA1c), C-reactive protein, and lipid levels. In STEP 4, all participants had a 20-week run-in period on semaglutide before either continuing on semaglutide or switching to placebo at week 20 in a 2:1 ratio for 48 weeks. At week 68, continued semaglutide led to further reductions from week 20 in HbA1c, improvements in lipid profile, and stabilization of SBP. Overall, across the STEP trials, treatment with semaglutide 2.4 mg versus placebo improved cardiometabolic risk factors associated with obesity, illustrating an effective treatment option for people with overweight (and associated comorbidities) or obesity.
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Affiliation(s)
- Anastassia Amaro
- Penn Metabolic Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil S Skolnik
- Abington Family Medicine, Abington Jefferson Health, Jenkintown, PA, USA
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Parcha V, Heindl B, Kalra R, Li P, Gower B, Arora G, Arora P. Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES. J Clin Endocrinol Metab 2022; 107:e25-e37. [PMID: 34473288 PMCID: PMC8684535 DOI: 10.1210/clinem/dgab645] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated (1) the prevalence and trends of IR and cardiometabolic risk factors and (2) the association between measures of adiposity and IR among adults 18 to 44 years of age without diabetes and preexisting cardiovascular disease. METHODS Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models. RESULTS Among 6247 young adults 18 to 44 years of age, the prevalence of IR was 44.8% (95% CI: 42.0%-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4%-44.2%) in 2015-2018 (P for trend = 0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all Ps < 0.001). Participants with IR had a higher prevalence of hypertension [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)], hypercholesterolemia [16.0% (95% CI: 12.4%-19.5%) vs 7.0% (95% CI: 5.8%-8.5%)], obesity [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)], and poor physical activity levels [18.3% (95% CI: 16.4%-20.2%) vs 11.7% (95%CI: 10.3-13.1%)] compared to participants without IR (all Ps < 0.05). CONCLUSIONS Four-in-10 young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are nonobese. Screening efforts for IR irrespective of BMI may be required.
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Affiliation(s)
- Vibhu Parcha
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittain Heindl
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajat Kalra
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Peng Li
- School of Nursing, University of Alabama at Birmingham, AL, USA
| | - Barbara Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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234
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Cui Y, Mo Z, Ji P, Zhong J, Li Z, Li D, Qin L, Liao Q, He Z, Guo W, Chen L, Wang Q, Dong G, Chen W, Xiao Y, Xing X. Benzene Exposure Leads to Lipodystrophy and Alters Endocrine Activity In Vivo and In Vitro. Front Endocrinol (Lausanne) 2022; 13:937281. [PMID: 35909554 PMCID: PMC9326257 DOI: 10.3389/fendo.2022.937281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Benzene is a ubiquitous pollutant and mainly accumulates in adipose tissue which has important roles in metabolic diseases. The latest studies reported that benzene exposure was associated with many metabolic disorders, while the effect of benzene exposure on adipose tissue remains unclear. We sought to investigate the effect using in vivo and in vitro experiments. Male adult C57BL/6J mice were exposed to benzene at 0, 1, 10 and 100 mg/kg body weight by intragastric gavage for 4 weeks. Mature adipocytes from 3T3-L1 cells were exposed to hydroquinone (HQ) at 0, 1, 5 and 25 μM for 24 hours. Besides the routine hematotoxicity, animal experiments also displayed significant body fat content decrease from 1 mg/kg. Interestingly, the circulating non-esterified fatty acid (NEFA) level increased from the lowest dose (ptrend < 0.05). Subsequent analysis indicated that body fat content decrease may be due to atrophy of white adipose tissue (WAT) upon benzene exposure. The average adipocyte area of WAT decreased significantly even from 1 mg/kg with no significant changes in total number of adipocytes. The percentages of small and large adipocytes in WAT began to significantly increase or decrease from 1 mg/kg (all p < 0.05), respectively. Critical genes involved in lipogenesis and lipolysis were dysregulated, which may account for the disruption of lipid homeostasis. The endocrine function of WAT was also disordered, manifested as significant decrease in adipokine levels, especially the leptin. In vitro cell experiments displayed similar findings in decreased fat content, dysregulated critical lipid metabolism genes, and disturbed endocrine function of adipocytes after HQ treatment. Pearson correlation analysis showed positive correlations between white blood cell (WBC) count with WAT fat content and plasma leptin level (r = 0.330, 0.344, both p < 0.05). This study shed light on the novel aspect that benzene exposure could induce lipodystrophy and disturb endocrine function of WAT, and the altered physiology of WAT might in turn affect benzene-induced hematotoxicity and metabolic disorders. The study provided new insight into understanding benzene-induced toxicity and the relationship between benzene and adipose tissue.
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Affiliation(s)
- Ying Cui
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ziying Mo
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Penglei Ji
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jingyi Zhong
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zongxin Li
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Daochuan Li
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lina Qin
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Qilong Liao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhini He
- School of Public Health, Food Safety and Health Research Center, Southern Medical University, Guangzhou, China
| | - Wei Guo
- State Key Laboratory of Conservation and Utilization of Bio-Resources in Yunnan and Center for Life Science, School of Life Sciences, Yunnan University, Kunming, China
| | - Liping Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qing Wang
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yongmei Xiao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiumei Xing
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Xiumei Xing,
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235
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Li B, Wang J, Zhou X, Liu Y, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Ning G, Mu Y. Chinese Visceral Adiposity Index Is More Closely Associated With Hypertension and Prehypertension Than Traditional Adiposity Indices in Chinese Population: Results From the REACTION Study. Front Endocrinol (Lausanne) 2022; 13:921997. [PMID: 35846316 PMCID: PMC9280650 DOI: 10.3389/fendo.2022.921997] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The optimal adiposity index that is strongly associated with hypertension or prehypertension remains inconclusive in Chinese population. This study aimed to investigate the relationship between Chinese visceral adiposity index (CVAI) and hypertension and prehypertension, as well as to compare the discriminative power of CVAI, visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), low-density lipoprotein cholesterol (LDL-C), and waist-to-hip ratio (WHR) with hypertension and prehypertension in Chinese general population. PATIENTS AND METHODS A total of 34732 participants from REACTION study were recruited. Multiple logistic regression analyses were performed to detect the association between adiposity indices (CVAI, VAI, BMI, WC, WHtR, WHR, LDL-C) and hypertension and prehypertension. RESULTS Multivariate logistic regression analysis showed that compared with other obesity indices, CVAI remained significantly associated with hypertension and prehypertension (Hypertension: odds ratio (OR) 3.475, 95% confidence interval (CI) 3.158-3.824, p<0.001 in total subjects; OR 2.762, 95% CI 2.369-3.221, p<0.001 in men; OR 3.935, 95% CI 3.465-4.469, p<0.001 in women, Prehypertension: OR 2.747, 95% CI 2.460-3.068, p<0.001 in total subjects; OR 2.605, 95% CI 2.176-3.119, p<0.001 in men; OR 2.854, 95% CI 2.465-3.304, p<0.001 in women).In a stratified analysis, CVAI was significantly associated with hypertension and prehypertension at any level of blood glucose, age or estimated glomerular filtration rate(eGFR). CONCLUSION CVAI is significantly associated with hypertension and prehypertension. CVAI shows the superior discriminative ability for hypertension and prehypertension compared with VAI, BMI, WC, WHtR, WHR and LDL-C in Chinese general population.
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Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Jie Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xin Zhou
- Graduate School, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- The Second Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Yang Liu
- Graduate School, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Department of Endocrinology, Eighth Medical Center of People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Central Hospital, Dalian, China
| | - Xulei Tang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China
| | - Li Yan
- Department of Endocrinology, Zhongshan University Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Qin Wan
- Department of Endocrinology, Southwest Medical University Affiliated Hospital, Luzhou, China
| | - Zuojie Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guijun Qin
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lulu Chen
- Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Guang Ning
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- School of Medicine, Nankai University, Tianjin, China
- Department of Endocrinology, First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- Graduate School, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Yiming Mu,
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236
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Busnatu SS, Serbanoiu LI, Lacraru AE, Andrei CL, Jercalau CE, Stoian M, Stoian A. Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:82. [PMID: 35052246 PMCID: PMC8775269 DOI: 10.3390/healthcare10010082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022] Open
Abstract
This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.
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Affiliation(s)
- Stefan Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Liviu Ionut Serbanoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Andreea Elena Lacraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Catalina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Cosmina Elena Jercalau
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Marilena Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Anca Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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237
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Bland VL, Kindler JM, Blew RM, Morrill KE, Roe DJ, Going SB. Visceral adipose tissue and cardiometabolic risk factors in young Hispanic and non-Hispanic girls. Front Pediatr 2022; 10:892206. [PMID: 36172390 PMCID: PMC9510700 DOI: 10.3389/fped.2022.892206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/23/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Risk factors for cardiometabolic diseases (e.g., type 2 diabetes, cardiovascular disease) can begin developing in childhood. Elevated body mass index (BMI) is associated with greater likelihood of developing such diseases; however, this relationship varies by race and ethnicity. Notably, Hispanics tend to have high rates of obesity and are disproportionately affected by type 2 diabetes. We aimed to determine if visceral adiposes tissue (VAT) is associated with cardiometabolic risk factors (i.e., triglycerides, cholesterol, insulin resistance, C-reactive protein, and blood pressure), independent of BMI percentile, in a sample of primarily Hispanic adolescent girls. METHODS AND RESULTS A total of 337 girls (73% Hispanic) took part in the cross-sectional study. Hispanic girls generally had greater BMI percentile, VAT, and cardiometabolic risk factors compared to non-Hispanic girls. Multiple linear regression was used to assess the relationships between Dual-energy X-ray Absorptiometry (DXA)-derived VAT and cardiometabolic outcomes, controlling for BMI percentile (<85th percentile or ≥85th percentile), age, ethnicity (Hispanic/non-Hispanic), and Tanner stage. Significant interactions between VAT and BMI percentile were identified for almost all cardiometabolic outcomes. Upon stratification, the association between VAT and cardiometabolic outcomes was strongest in girls ≥85th BMI percentile, as compared to girls <85th percentile. However, VAT was only significantly associated with higher triglycerides (girls ≥85th percentile) and higher insulin resistance (both BMI percentiles) after stratification. CONCLUSION VAT was associated with increased triglycerides and insulin resistance in girls with overweight or obesity. These findings warrant further investigation between VAT and cardiometabolic health in Hispanic adolescents who tend to accumulate more adipose tissue during adolescence.
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Affiliation(s)
- Victoria L Bland
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, United States
| | - Joseph M Kindler
- Department of Nutritional Sciences, University of Georgia, Athens, GA, United States
| | - Robert M Blew
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, United States.,Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | | | - Denise J Roe
- The University of Arizona Cancer Center, Tucson, AZ, United States.,Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States
| | - Scott B Going
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, United States
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238
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Agius R, Pace NP, Fava S. Reduced leukocyte mitochondrial copy number in metabolic syndrome and metabolically healthy obesity. Front Endocrinol (Lausanne) 2022; 13:886957. [PMID: 35957819 PMCID: PMC9357898 DOI: 10.3389/fendo.2022.886957] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the associations between peripheral blood leukocyte mitochondrial copy number, metabolic syndrome, and adiposity-related body composition phenotypes in a high prevalence population. METHODS A single center cross-sectional study was conducted, consisting of 521 middle-aged subjects of Maltese-Caucasian ethnicity. Participants were stratified according to the presence of metabolic syndrome and different metabolic health definitions based on NCEP-ATP III criteria. Relative leukocyte mitochondrial DNA copy number was determined by quantitative polymerase chain reaction and corrected for leukocyte and platelet count. The associations between mitochondrial copy number and metabolic syndrome components was evaluated and adjusted for age and gender. RESULTS Significant negative correlations between mtDNA copy number and BMI, waist circumference, triglyceride levels, fasting plasma glucose, HbA1c, HOMA-IR and hsCRP were observed, along with a positive correlation with HDL-C levels. Mitochondrial copy number was lower in individuals with metabolic syndrome. When compared to metabolically healthy normal weight subjects, a reduction in mtDNA copy number was observed in both the metabolically healthy and unhealthy obese categories. CONCLUSION Our data supports the association between reduced leukocyte mtDNA copy number, obesity, and metabolic syndrome. This investigation expands on the spectrum of associations between mtDNA copy number and metabolic phenotypes in different populations and underpins the role of mitochondrial dysfunction in the development and progression of metabolic syndrome and its components.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Medicine, Mater Dei Hospital, Msida, Malta
| | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
- *Correspondence: Nikolai Paul Pace,
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Medicine, Mater Dei Hospital, Msida, Malta
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239
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王 森, 郑 翔, 毕 文, 周 雪. [Obesity Combined with Chronic Restraint Stress-Induced Hypertension in Mice Is Associated with the Damage of Noradrenergic Neurons in Nucleus Tractus Solitarii]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2022; 53:77-82. [PMID: 35048604 PMCID: PMC10408846 DOI: 10.12182/20220160505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate whether obesity combined with chronic restraint stress (CRS) can increase blood pressure in mice and its relationship with the damage of the intermediate part of the nucleus tractus solitarius (iNTS). METHODS The CRS mouse model was constructed, and 51 mice were assigned to four groups, low-fat diet non-restraint group (LF group), low-fat diet restraint group (LS group), high-fat diet non-restraint group (HF group), and high-fat diet restraint group (HS group). Interventions were carried out in four cycles (over the course of 40 consecutive days), with each cycle consisting of 7 days of restraint and 3 days of free movement. The body weight and the arterial systolic blood pressure of the mice were measured on the day 9 of every cycle. The mice were sacrificed on day 40 and the brain tissues of the mice were collected afterwards in order to perform immunohistochemical staining and Western blot to examine the expression of glial fibrillary acidic protein (GFAP) and tyrosine hydroxylase (TH). The protein expression of vascular endothelial growth factor A (VEGFA) was examined with Western blot on epididymal fat pad to assess the vascular density of lipid tissue. RESULTS On day 40, the arterial systolic pressure of mice in HS group was significantly higher than that of mice in the three other groups. Body mass of high-fat diet group (HF group and HS group) increased significantly. Mice in the four groups did not present significant difference in VEGFA protein expression. INTS astrocytes were activated in the brain of mice in the restraint groups (LS group and HS group), and iNTS TH expression was decreased in HS group. Mice in HF group and LS group did not show abnormal changes in their blood pressure. Blood pressure of mice in the HS group generally rose, and hypertension (arterial systolic blood pressure ≥140 mmHg, 1 mmHg=0.133 kPa) was observed in 37.5% of the mice in this group. CONCLUSION Obesity combined with CRS may cause an increase in arterial blood pressure in mice, the mechanism of which may be related to the damage of noradrenergic neurons in the nucleus tractus solitarius.
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Affiliation(s)
- 森甲 王
- 四川大学华西基础医学与法医学院 组织胚胎学与神经生物学教研室 (成都 610041)Department of Histology, Embryology and Neurobiology, West China School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - 翔 郑
- 四川大学华西基础医学与法医学院 组织胚胎学与神经生物学教研室 (成都 610041)Department of Histology, Embryology and Neurobiology, West China School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - 文杰 毕
- 四川大学华西基础医学与法医学院 组织胚胎学与神经生物学教研室 (成都 610041)Department of Histology, Embryology and Neurobiology, West China School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - 雪 周
- 四川大学华西基础医学与法医学院 组织胚胎学与神经生物学教研室 (成都 610041)Department of Histology, Embryology and Neurobiology, West China School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu 610041, China
- 四川大学华西基础医学与法医学院 基础医学专业实验室 (成都 610041)Laboratory of Basic Medicine, West China School of Basic Medicine and Forensic Medicine, Sichuan University, Chengdu 610041, China
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240
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Montecucco F, Montecucco F. Osteopontin in CardioMetabolic Medicine: a risk stratification biomarker with future therapeutic implication? Curr Med Chem 2021; 29:4314-4316. [PMID: 34963431 DOI: 10.2174/0929867329666211228113716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Federico Montecucco
- First Clinic of internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- RCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy
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241
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Mehran L, Amouzegar A, Fanaei SM, Masoumi S, Azizi F. Anthropometric measures and risk of all-cause and cardiovascular mortality: An 18 years follow-up. Obes Res Clin Pract 2021; 16:63-71. [PMID: 34969646 DOI: 10.1016/j.orcp.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The contribution of anthropometric measures to predict mortality in normal-weight subjects is unclear. We aimed to study the association of central obesity measures, e.g., waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), with the risk of all-cause and CVD mortality. METHODS In a prospective population-based Tehran Lipid and Glucose Study, 8287 participants aged ≥30 y, followed for a median of 18 years. The association of WC, WHR and WHtR with the risk for mortality was estimated using multivariate Cox proportional hazard models in different BMI groups. RESULTS We documented 821 deaths, of which 251 were related to CVD mortality. Normal weight individuals with central obesity were significantly at increased risk of all-cause (HR: 1.5; 95% CI: 1.10, 2.1) and CVD mortality (HR: 1.6; 95% CI: 0.92, 2.9) compared with normal-weight individuals without central obesity; the risk remained significant only in women. Also, normal-weight women (not men) with high WHR were at increased risk of all-cause (HR: 1.7; 95% CI: 1.0, 2.8) and CVD mortality (HR: 5.9; 95% CI: 1.5, 23.2). High WHtR increased the risk of all-cause (HR: 1.5; 95% CI: 1.2, 1.8) and CVD mortality (HR: 1.8; 95% CI: 1.2, 2.7) which remained significant in normal-weight men and women. All central obesity indicators were significantly associated with all-cause and CVD mortality in subjects aged under 65. CONCLUSION Even in normal-weight individuals, WC and WHR in women and WHtR in both sexes are predictors of all-cause and CVD mortality. WHtR shows a stronger association, especially in the population aged under 65.
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Affiliation(s)
- Ladan Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyedeh Melika Fanaei
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Safdar Masoumi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Demiralp N, Özel F. Evaluation of metabolic syndrome and sleep quality in shift workers. Occup Med (Lond) 2021; 71:453-459. [PMID: 34791382 DOI: 10.1093/occmed/kqab140] [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: 11/13/2022] Open
Abstract
BACKGROUND Shift workers have risks associated with metabolic syndrome and low sleep quality. AIMS This study aimed to examine metabolic syndrome and sleep quality in firefighters and mine workers working shifts and daytime hours. METHODS A comparative descriptive study was conducted in two institutions on firefighters and mine workers (n = 120) who were working shifts (n = 84) and working daytime hours (n = 36). The data were obtained using a questionnaire including socio-demographic information, anthropometric measurements and the Pittsburgh Sleep Quality Index. RESULTS When risk of metabolic syndrome was compared with sleep quality, it was found that according to International Diabetes Federation criteria, 11% of those diagnosed with metabolic syndrome among shift-working firefighters and 5% of those diagnosed with metabolic syndrome among shift-working miners had low sleep quality. It was found that according to the National Cholesterol Education Program-Adult Treatment Panel III criteria, 9% of those diagnosed with metabolic syndrome among shift firefighters and 2% of those diagnosed with metabolic syndrome among shift miners had low sleep quality. CONCLUSIONS Preventive measures should be taken to reduce the risk of metabolic syndrome in shift workers.
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Affiliation(s)
- N Demiralp
- Department of Civil Defense and Fire Fighting Program, Kastamonu University, Bozkurt Vocational High School, Kastamonu, Turkey
| | - F Özel
- Department of Nursing, Kastamonu University, School of Health Science, Kastamonu, Turkey
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243
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Raffield LM, Howard AG, Graff M, Lin D, Cheng S, Demerath E, Ndumele C, Palta P, Rebholz CM, Seidelmann S, Yu B, Gordon‐Larsen P, North KE, Avery CL. Obesity Duration, Severity, and Distribution Trajectories and Cardiovascular Disease Risk in the Atherosclerosis Risk in Communities Study. J Am Heart Assoc 2021; 10:e019946. [PMID: 34889111 PMCID: PMC9075238 DOI: 10.1161/jaha.121.019946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/22/2021] [Indexed: 12/14/2022]
Abstract
Background Research examining the role of obesity in cardiovascular disease (CVD) often fails to adequately consider heterogeneity in obesity severity, distribution, and duration. Methods and Results We here use multivariate latent class mixed models in the biracial Atherosclerosis Risk in Communities study (N=14 514; mean age=54 years; 55% female) to associate obesity subclasses (derived from body mass index, waist circumference, self-reported weight at age 25, tricep skinfold, and calf circumference across up to four triennial visits) with total mortality, incident CVD, and CVD risk factors. We identified four obesity subclasses, summarized by their body mass index and waist circumference slope as decline (4.1%), stable/slow decline (67.8%), moderate increase (24.6%), and rapid increase (3.6%) subclasses. Compared with participants in the stable/slow decline subclass, the decline subclass was associated with elevated mortality (hazard ratio [HR] 1.45, 95% CI 1.31, 1.60, P<0.0001) and with heart failure (HR 1.41, 95% CI 1.22, 1.63, P<0.0001), stroke (HR 1.53, 95% CI 1.22, 1.92, P=0.0002), and coronary heart disease (HR 1.36, 95% CI 1.14, 1.63, P=0.0008), adjusting for baseline body mass index and CVD risk factor profile. The moderate increase latent class was not associated with any significant differences in CVD risk as compared to the stable/slow decline latent class and was associated with a lower overall risk of mortality (HR 0.85, 95% CI 0.80, 0.90, P<0.0001), despite higher body mass index at baseline. The rapid increase latent class was associated with a higher risk of heart failure versus the stable/slow decline latent class (HR 1.34, 95% CI 1.10, 1.62, P=0.004). Conclusions Consideration of heterogeneity and longitudinal changes in obesity measures is needed in clinical care for a more precision-oriented view of CVD risk.
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Affiliation(s)
| | - Annie Green Howard
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNC
| | - Misa Graff
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North CarolinaChapel HillNC
| | - Dan‐Yu Lin
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNC
| | - Susan Cheng
- Smidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Ellen Demerath
- Division of Epidemiology and Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Chiadi Ndumele
- Johns Hopkins Ciccarone Center for the Prevention of Heart DiseaseJohns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Priya Palta
- Departments of Medicine and EpidemiologyColumbia University Medical CenterNew YorkNY
| | - Casey M. Rebholz
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
| | - Sara Seidelmann
- Cardiovascular DivisionBrigham and Women's Hospital and Harvard Medical SchoolBostonMA
| | - Bing Yu
- Department of Epidemiology, Human Genetics and Environmental SciencesSchool of Public HealthUniversity of Texas Health Science Center at HoustonTX
| | - Penny Gordon‐Larsen
- Department of NutritionGillings School of Global Public Health and School of MedicineUniversity of North CarolinaChapel HillNC
| | - Kari E. North
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North CarolinaChapel HillNC
- Carolina Center of Genome SciencesUniversity of North Carolina at Chapel HillChapel HillNC
| | - Christy L. Avery
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North CarolinaChapel HillNC
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Villedon de Naide M, Pereira B, Courteix D, Dutheil F, Cassagnes L, Boirie Y, Soubrier M, Tournadre A. Assessment of Intramuscular Fat and Correlation with Body Composition in Patients with Rheumatoid Arthritis and Spondyloarthritis: A Pilot Study. Nutrients 2021; 13:nu13124533. [PMID: 34960085 PMCID: PMC8707224 DOI: 10.3390/nu13124533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 01/17/2023] Open
Abstract
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are associated with changes in body composition. Ectopic intramuscular fat (IMAT) may alter muscle function and contribute to cardiometabolic disorders. In a pilot study, we analyzed IMAT in the calf with peripheral quantitative computed tomography (pQCT) and examined correlations between IMAT quantity and body composition parameters. In 20 patients with active RA and 23 with active SpA, IMAT was correlated with visceral fat (VAT; r = 0.5143 and 0.6314, respectively; p < 0.05) and total lean mass (r = 0.5414 and 0.8132, respectively; p < 0.05), but not with whole body fat mass. Total lean mass mediated 16% and 33% of the effects of VAT on IMAT in RA and SpA, respectively. In both RA and SpA, calf muscle area was correlated with total lean mass (r = 0.5940 and r = 0.8597, respectively; p < 0.05) and fat area was correlated with total body fat (r = 0.6767 and 0.5089, respectively; p < 0.05) and subcutaneous fat (r = 0.6526 and 0.5524, respectively; p < 0.05). Fat area was inversely correlated with handgrip and walking tests, and it was associated with disease activity and disability. We showed that ectopic IMAT, measured with pQCT, was correlated with VAT, but not with total body fat, in RA and SpA. This result suggests that metabolically active fat was specifically associated with IMAT.
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Affiliation(s)
- Marc Villedon de Naide
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P-EA 3533), University Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Frederic Dutheil
- Preventive and Occupational Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Lucie Cassagnes
- Service de Radiologie Adultes, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
- Thérapies Guidées par l’Image, Institut Pascal, UMR 6602 CNRS-SIGMA-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition Clinique, CHU Gabriel Montpied, 63003 Clermont-Ferrand, France;
- Unité de Nutrition Humaine, UMR 1019 INRAe-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
| | - Anne Tournadre
- Rheumatology Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (M.V.d.N.); (M.S.)
- Unité de Nutrition Humaine, UMR 1019 INRAe-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence:
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245
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Lau DCW, Erichsen L, Francisco AM, Satylganova A, le Roux CW, McGowan B, Pedersen SD, Pietiläinen KH, Rubino D, Batterham RL. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet 2021; 398:2160-2172. [PMID: 34798060 DOI: 10.1016/s0140-6736(21)01751-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/13/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Natural amylin is a pancreatic hormone that induces satiety. Cagrilintide is a long-acting amylin analogue under investigation for weight management. We assessed the dose-response relationship of cagrilintide regarding the effects on bodyweight, safety, and tolerability. METHODS We conducted a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial at 57 sites including hospitals, specialist clinics, and primary care centres in ten countries (Canada, Denmark, Finland, Ireland, Japan, Poland, Serbia, South Africa, the UK, and the USA). Eligible participants were adults aged at least 18 years without diabetes, with a body-mass index of at least 30 kg/m2 or at least 27 kg/m2 with hypertension or dyslipidaemia. Participants were randomly assigned (6:1) to subcutaneous self-injections of once-weekly cagrilintide (0·3, 0·6, 1·2, 2·4, or 4·5 mg), once-daily liraglutide 3·0 mg, or volume-matched placebo (for six placebo groups). The trial had a 26-week treatment period, including a dose-escalation period of up to 6 weeks, and a 6-week follow-up period without treatment. Participants and investigators were masked to the assigned study treatment with respect to active versus pooled placebo treatment, but not to different active treatments. The primary endpoint was the percentage change in bodyweight from baseline to week 26, assessed in all randomly assigned participants according to the trial product estimand (assuming all participants were adherent to treatment) and to the treatment policy estimand (regardless of adherence to treatment). Safety was assessed in all participants who received at least one dose of randomised treatment. This trial is registered with ClinicalTrials.gov, NCT03856047, and is closed to new participants. FINDINGS Between March 1 and Aug 19, 2019, we randomly assigned 706 participants to cagrilintide 0·3-4·5 mg (100-102 per dose group), 99 to liraglutide 3·0 mg, and 101 to placebo. Permanent treatment discontinuation (n=73 [10%]) occurred similarly across treatment groups, mostly due to adverse events (n=30 [4%]). In total, 29 participants (4%) withdrew from the trial. According to the trial product estimand, mean percentage weight reductions from baseline were greater with all doses of cagrilintide (0·3-4·5 mg, 6·0%-10·8% [6·4-11·5 kg]) versus placebo (3·0% [3·3 kg]; estimated treatment difference range 3·0%-7·8%; p<0·001). Weight reductions were also greater with cagrilintide 4·5 mg versus liraglutide 3·0 mg (10·8% [11·5 kg] vs 9·0% [9·6 kg]; estimated treatment difference 1·8%, p=0·03). Similar weight loss reductions were observed with the treatment policy estimand. The most frequent adverse events were gastrointestinal disorders (eg, nausea, constipation, and diarrhoea) and administration-site reactions. More participants receiving cagrilintide 0·3-4·5 mg had gastrointestinal adverse events compared with placebo (41%-63% vs 32%), primarily nausea (20%-47% vs 18%). INTERPRETATION Treatment with cagrilintide in people with overweight and obesity led to significant reductions in bodyweight and was well tolerated. The findings support the development of molecules with novel mechanisms of action for weight management. FUNDING Novo Nordisk A/S.
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Affiliation(s)
- David C W Lau
- Julia McFarlane Diabetes Research Centre and Libin Cardiovascular Institute of Alberta, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
| | | | | | | | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Barbara McGowan
- Guy's & St Thomas' Hospital, Department of Diabetes and Endocrinology, London, UK
| | - Sue D Pedersen
- C-ENDO Diabetes & Endocrinology Clinic Calgary, Calgary, AB, Canada
| | - 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
| | | | - Rachel L Batterham
- National Institute of Health Research, UCLH Biomedical Research Centre, London, UK; Centre for Obesity Research, Department of Medicine, University College London, London, UK
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Testa G, Mora-Maltas B, Camacho-Barcia L, Granero R, Lucas I, Agüera Z, Jiménez-Murcia S, Baños R, Bertaina-Anglade V, Botella C, Bulló M, Casanueva FF, Dalsgaard S, Fernández-Real JM, Franke B, Frühbeck G, Fitó M, Gómez-Martínez C, Pintó X, Poelmans G, Tinahones FJ, de la Torre R, Salas-Salvadó J, Serra-Majem L, Vos S, Wimberley T, Fernández-Aranda F. Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes. Nutrients 2021; 13:nu13124426. [PMID: 34959979 PMCID: PMC8707121 DOI: 10.3390/nu13124426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022] Open
Abstract
Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive–compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.
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Affiliation(s)
- Giulia Testa
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
| | - Roser Granero
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Rosa Baños
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Instituto Polibienestar, Universitat de Valencia, 46010 Valencia, Spain
| | | | - Cristina Botella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Basic Psychology Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, 12071 Castellón, Spain
| | - Mònica Bulló
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Rovira i Virgili (URV), 43201 Reus, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
| | - Felipe F. Casanueva
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Molecular and Cellular Endocrinology Group, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago de Compostela University (USC) and Centro de Investigacion Biomedica en Red Fisiopatologia de la Obesidad Y Nutricion (Ciberobn), 15705 Santiago de Compostela A Coruña, Spain
| | - Søren Dalsgaard
- National Centre for Register-Based Research, Department of Economics and Business Economics, Business and Social Sciences, Aarhus University and iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (Copenhagen-Aarhus), DK-8210 Aarhus, Denmark;
| | - José-Manuel Fernández-Real
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Medical Sciences, School of Medicine, Hospital of Girona Dr. Josep Trueta, University of Girona, 17004 Girona, Spain
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Gema Frühbeck
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Endocrinology, Instituto de Investigación Sanitaria de Navarra, University of Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Institute for Medical Research (IMIM), 08003 Barcelona, Spain
| | - Carlos Gómez-Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, 43201 Reus, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Geert Poelmans
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Francisco J. Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, 29016 Málaga, Spain
| | - Rafael de la Torre
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Integrative Pharmacology and Systems Neurosciences Research Group, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), 08003 Barcelona, Spain
- IMIM-Hospital del Mar Medical Research Institute and CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), University Pompeu Fabra (DCEXS-UPF), 08003 Barcelona, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, 43201 Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, 43204 Reus, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Stephanie Vos
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Theresa Wimberley
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, DK-8000 Aarhus, Denmark;
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607227
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Ghanemi A, Yoshioka M, St-Amand J. Diet Impact on Obesity beyond Calories and Trefoil Factor Family 2 (TFF2) as an Illustration: Metabolic Implications and Potential Applications. Biomolecules 2021; 11:1830. [PMID: 34944474 PMCID: PMC8698828 DOI: 10.3390/biom11121830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 12/13/2022] Open
Abstract
Obesity is a health problem with increasing impacts on public health, economy and even social life. In order to reestablish the energy balance, obesity management focuses mainly on two pillars; exercise and diet. Beyond the contribution to the caloric intake, the diet nutrients and composition govern a variety of properties. This includes the energy balance-independent properties and the indirect metabolic effects. Whereas the energy balance-independent properties are close to "pharmacological" effects and include effects such as antioxidant and anti-inflammatory, the indirect metabolic effects represent the contribution a diet can have on energy metabolism beyond the caloric contribution itself, which include the food intake control and metabolic changes. As an illustration, we also described the metabolic implication and hypothetical pathways of the high-fat diet-induced gene Trefoil Factor Family 2. The properties the diet has can have a variety of applications mainly in pharmacology and nutrition and further explore the "pharmacologically" active food towards potential therapeutic applications.
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Affiliation(s)
- Abdelaziz Ghanemi
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Québec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Québec, QC G1V 4G2, Canada
| | - Mayumi Yoshioka
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Québec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Québec, QC G1V 4G2, Canada
| | - Jonny St-Amand
- Functional Genomics Laboratory, Endocrinology and Nephrology Axis, CHU de Québec-Université Laval Research Center, Québec, QC G1V 4G2, Canada; (A.G.); (M.Y.)
- Department of Molecular Medicine, Faculty of Medicine, Laval University, Québec, QC G1V 4G2, Canada
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248
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Salman AA, Salman MA, Soliman A, Youssef A, Labib S, Helmy MY, Marie MA, Shawkat M, Mostafa A, Tourky MS, Sarhan MD, Qassem MG, Shaaban HED, Omar MG, Abouelregal TE. Changes of epicardial fat thickness after laparoscopic sleeve gastrectomy: a prospective study. Ann Med 2021; 53:523-530. [PMID: 34008443 PMCID: PMC8143592 DOI: 10.1080/07853890.2021.1903072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Epicardial fat thickness is an interesting parameter of early atherosclerosis. We prospectively assessed whether weight loss following laparoscopic sleeve gastrectomy (LSG) leads to a significant reduction in the epicardial fat thickness (EFT) and the correlation between the decline in the epicardial fat thickness with other clinical parameters. METHODS A prospective analysis of 98 cases that were scheduled to undergo LSG and followed up for 12 months was conducted. EFT was assessed using two-dimensional (2 D) echocardiography. RESULTS A total of 98 cases and 70 controls were enrolled. EFT demonstrated a significant reduction at follow-up in the whole group (median 8.9 (1.95) versus 7.65 (1.67) mm, respectively). The degree of reduction was higher in the LSG cohort compared to control cohort 1.3 (0.4) versus 1 (0.4), respectively; p < .001). The univariate regression analysis demonstrated a notable correlation of the EFT with the weight, body mass index (BMI), fasting blood glucose (FBG), and creatinine with a p-value of <.0001, .001, .022, and .018, respectively while the multivariate analysis showed a strong correlation between EFT and weight and creatinine with a p-value of <.0001 and .033 respectively. CONCLUSION LSG can have a favourable impact on metabolic syndrome aspects, namely EFT, as it can decrease it considerably.
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Affiliation(s)
| | | | - Ahmed Soliman
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Youssef
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Safa Labib
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mona Youssry Helmy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed A. Marie
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Shawkat
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Amir Mostafa
- Cardiovascular Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Sabry Tourky
- Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Mohamed D. Sarhan
- General Surgery Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Gamal Qassem
- Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hossam El-Din Shaaban
- Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mahmoud Gouda Omar
- Internal Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
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249
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Samadoulougou S, Idzerda L, Letarte L, McKay R, Quesnel-Vallée A, Lebel A. Self-perceived health status among adults with obesity in Quebec: a cluster analysis. Ann Epidemiol 2021; 67:43-49. [PMID: 34863927 DOI: 10.1016/j.annepidem.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE People with obesity are a highly heterogeneous group. Characterizing this heterogeneity may help to improve public health by offering adapted interventions and treatments to more homogeneous sub-groups among obese patients. This research aims to (1) identify distinct clusters of people with obesity based on demographic, behavioural, and clinical factors in the province of Quebec (Canada) and (2) assess the association of these clusters with self-perceived health. METHODS We conducted a sex specific cluster analysis (multiple correspondence analysis and hierarchical clustering) of adults with body mass index (BMI) ≥ 30kg/m2 from the 2015-2016 Canadian Community Health Survey in Quebec. Clusters were based on demographic, clinical, and behavioural characteristics. The clusters were tested for association with poor self-perceived health using logistic regression. RESULTS Three clusters of individuals with obesity were identified. These were (1) young individuals, (2) people with higher levels of depression and anxiety, and (3) older adults with high comorbidity. Those with high levels of depression and anxiety (9% of men versus 13% of women) were associated with the poorest self-perceived health. CONCLUSION People with obesity in Quebec can be categorized into three clusters based on demographic, clinical, and behavioural characteristics. The findings of this study draw attention to the need to examine the coexistence of obesity with depression and anxiety, particularly as it relates to self-perceived health.
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Affiliation(s)
- Sékou Samadoulougou
- Centre for Research on Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Centre, Quebec, Canada; Graduate School of Land Management and Regional Planning, Faculty of Planning, Architecture, Art and Design, Laval University, Quebec, Canada.
| | - Leanne Idzerda
- Centre for Research on Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Centre, Quebec, Canada; Graduate School of Land Management and Regional Planning, Faculty of Planning, Architecture, Art and Design, Laval University, Quebec, Canada; Evidence Synthesis and Knowledge Translation Unit, Public Health Agency of Canada, Ottawa, Canada
| | - Laurence Letarte
- Centre for Research on Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Centre, Quebec, Canada; Graduate School of Land Management and Regional Planning, Faculty of Planning, Architecture, Art and Design, Laval University, Quebec, Canada
| | - Rachel McKay
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada
| | - Amélie Quesnel-Vallée
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health and Department of Sociology, McGill University, Montreal, Canada
| | - Alexandre Lebel
- Centre for Research on Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Centre, Quebec, Canada; Graduate School of Land Management and Regional Planning, Faculty of Planning, Architecture, Art and Design, Laval University, Quebec, Canada
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250
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Girard L, Djemili F, Devineau M, Gonzalez C, Puech B, Valance D, Renou A, Dubois G, Braunberger E, Allou N, Allyn J, Vidal C. Effect of Body Mass Index on the Clinical Outcomes of Adult Patients Treated With Venoarterial ECMO for Cardiogenic Shock. J Cardiothorac Vasc Anesth 2021; 36:2376-2384. [PMID: 34903457 DOI: 10.1053/j.jvca.2021.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/21/2021] [Accepted: 11/07/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Current guidelines consider obesity to be a relative contraindication to venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock. The authors investigated the effect of body mass index (BMI) on clinical outcomes in patients treated with VA-ECMO for cardiogenic shock. DESIGN This was a retrospective and observational study. SETTING University hospital. PARTICIPANTS The study comprised 150 adult patients who underwent VA-ECMO for cardiogenic shock. MEASUREMENTS AND MAIN RESULTS The primary outcome was intensive care unit (ICU) mortality. Of the 150 included patients, 10 were underweight (BMI < 18.5 kg/m²), 62 were normal weight (BMI = 18.5-24.9 kg/m²), 34 were overweight (BMI = 25.0-29.9 kg/m²), 34 were obese class I (BMI = 30.0-34.9 kg/m²), and 10 were obese class II (BMI = 35.0-39.9 kg/m²). All-cause ICU mortality was 62% (underweight, 70%; normal weight, 53%; overweight, 65%; class I obese, 71%; class II obese, 70%). After multivariate logistic regression, BMI was not associated with ICU mortality (adjusted odds ratio [aOR] 0.99 [0.92-1.07], p = 0.8). Analysis by BMI category showed unfavorable mortality trends in underweight patients (aOR 3.58 [0.82-19.6], p = 0.11) and class I obese patients (aOR 2.39 [0.95-6.38], p = 0.07). No statistically significant differences were found among BMI categories in the incidences of complications. CONCLUSION The results suggested that BMI alone should not be considered an exclusion criterion for VA-ECMO. The unfavorable trend observed in underweight patients could be the result of malnutrition.
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Affiliation(s)
- Léandre Girard
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France.
| | - Fares Djemili
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Marjolaine Devineau
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Céline Gonzalez
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Bérénice Puech
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Dorothée Valance
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Amélie Renou
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Gilbert Dubois
- Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Eric Braunberger
- Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Nicolas Allou
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Jérôme Allyn
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
| | - Charles Vidal
- Réanimation Polyvalente, Centre Hospitalier Universitaire de La Réunion Site Félix Guyon, Saint-Denis, France
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