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Park B, Yoon J, Tran TXM. Accounting for time-varying exposures and covariates in the relationship between obesity and diabetes: analysis using parametric g-formula. J Epidemiol Community Health 2024; 78:729-736. [PMID: 39025645 DOI: 10.1136/jech-2023-221882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Previous studies investigating the association between obesity and diabetes often did not consider the role of time-varying covariates affected by previous obesity status. This study quantified the association between obesity and diabetes using parametric g-formula. METHODS We included 8924 participants without diabetes from the Korean Genome and Epidemiology Study-Ansan and Ansung study(2001-2002)-with up to the seventh biennial follow-up data from 2015 to 2016. Obesity status was categorised as normal (body mass index (BMI) <23.5 kg/m2), overweight (23.5-24.9 kg/m2), obese 1 (25.0-27.4 kg/m2) and obese 2 (≥27.5 kg/m2). Hazard ratios (HRs) comparing baseline or time-varying obesity status were estimated using Cox models, whereas risk ratio (RR) was estimated using g-formula. RESULTS The Cox model for baseline obesity status demonstrated an increased risk of diabetes in overweight (HR 1.85; 95% CI=1.48-2.31), obese 1 (2.40; 1.97-2.93) and obese 2 (3.65; 2.98-4.47) statuses than that in normal weight status. Obesity as a time-varying exposure with time-varying covariates had HRs of 1.31 (1.07-1.60), 1.55 (1.29-1.86) and 2.58 (2.14-3.12) for overweight, obese 1 and obese 2 statuses. Parametric g-formula comparing if everyone had been in each obesity category versus normal over 15 years showed increased associations of RRs of 1.37 (1.34-1.40), 1.78 (1.76-1.80) and 2.42 (2.34-2.50). CONCLUSIONS Higher BMI classification category was associated with increased risk of diabetes after accounting for time-varying covariates using g-formula. The results from g-formula were smaller than when considering baseline obesity status only but comparable with the results from time-varying Cox model.
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Affiliation(s)
- Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea (the Republic of)
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea (the Republic of)
| | - Junghyun Yoon
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea (the Republic of)
| | - Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea (the Republic of)
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Alptekin İM, Çakıroğlu FP, Reçber T, Nemutlu E. Inulin may prevent the high-fat diet induced-obesity via suppressing endocannabinoid system in the prefrontal cortex in Wistar rats. Int J Food Sci Nutr 2024:1-12. [PMID: 39363521 DOI: 10.1080/09637486.2024.2408545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 09/18/2024] [Accepted: 09/20/2024] [Indexed: 10/05/2024]
Abstract
High-fat diets contribute to various metabolic disorders. Inulin supplementation has been shown to reduce appetite, lower food intake, and promote weight loss. Although there is evidence that the endocannabinoid system has metabolic effects in the prefrontal cortex, studies investigating the effects of inulin on the endocannabinoid system are limited. This study investigated the impact of inulin on obesity through the endocannabinoid system in the prefrontal cortex. Twenty-four male Wistar rats were fed one of four diets over 12 weeks. Findings indicated that a high-fat diet led to obesity, whereas inulin reduced food intake and supported weight loss. Consequently, inulin supplementation both prevented obesity and significantly decreased the expressions of Adrb3 and Adcy1, and anandamide and 2-arachidonylglycerol levels in the prefrontal cortex. Additionally, inulin lowered leptin in circulation and stimulated Trpv1. Thus, inulin may mitigate obesity development, possibly by modulating gene expressions linked to obesity in the prefrontal cortex via endocannabinoids.
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Affiliation(s)
- İsmail Mücahit Alptekin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Atatürk University, Erzurum, Türkiye
| | - Funda Pınar Çakıroğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Türkiye
| | - Tuba Reçber
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, Türkiye
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, Türkiye
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Zhang B, Hart JE, Laden F, Bozigar M, James P. Environmental mixtures and body mass index in two prospective US-based cohorts of female nurses. JOURNAL OF HAZARDOUS MATERIALS 2024; 480:135794. [PMID: 39265401 DOI: 10.1016/j.jhazmat.2024.135794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/23/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
We estimated the joint effect of particulate matter ≤ 2.5 µm in diameter (PM2.5), nitrogen dioxide (NO2), seasonal temperature, noise, greenness, light at night, and neighborhood socioeconomic status (NSES) on body mass index (BMI) in a mixture context among 194,966 participants from the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII) over 30 years. BMI was calculated from self-reported weight and height. Single- and multi-exposure generalized estimating equations models were used to estimate the difference in BMI per interquartile range (IQR) increase of environmental factors, and quantile g-computation methods were used to estimate joint associations. In both cohorts, we consistently observed positive associations of BMI with PM2.5 and NO2 concentrations as well as negative associations with light at night and NSES regardless modeling approach. A positive association with noise was only observed in NHS. Negative associations with greenness and winter temperature were only observed in NHSII. Overall, the changes in BMI per quintile increase in all eight exposures were -0.11 (-0.13, -0.08) in NHS and -0.39 (-0.41, -0.37) in NHSII, which were largely driven by air pollution and nighttime noise (18-45 %) in the positive direction and NSES (>70 %) in the negative direction. Future intervention on environmental factors, especially reducing PM2.5, NO2 and noise or improving the NSES, might be helpful to lower BMI.
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Affiliation(s)
- Boya Zhang
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Matthew Bozigar
- School of Nutrition and Public Health, College of Health, Oregon State University, 160 SW 26th Street, Corvallis, OR 97331, USA
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Mousavi M, Saei Ghare Naz M, Firouzi F, Azizi F, Ramezani Tehrani F. Impact of adiposity indices changes across the lifespan on risk of diabetes in women: trajectory modeling approach. BMC Public Health 2024; 24:2429. [PMID: 39243051 PMCID: PMC11378475 DOI: 10.1186/s12889-024-19996-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024] Open
Abstract
AIMS The impact of life-course different adiposity indices on diabetes mellitus (DM) is poorly understood. We aimed to do trajectory analysis with repeated measurements of adiposity indices in the development of DM among women across the lifespan. METHODS This study prospectively investigated the 1,681 population of Tehran Lipid and Glucose Study. At baseline, all individuals were free of diabetes. Trajectory analysis was used to identify homogeneous distinct clusters of adiposity indices trajectories and assign individuals to unique clusters. RESULTS Of the 1681 healthy women, 320 progressed to the DM. Three distinct body mass index (BMI) trajectories and 2 distinct trajectories of other adiposity indices (waist circumstance (WC), conicity index (C-index), and body roundness index (BRI)) were chosen as the best fitting of the latent class growth mixture model. In the adjusted model, total participants [HR (CI 95%): 2.83 (2.05, 3.91); p < 0.001], and menopause [1.35 (1.10, 2.11); p = 0.001] and reproductive-age women [2.93 (1.80, 4.78); p = 0.003] of the high BMI trajectory compared to the ones in the low trajectory of BMI were more likely to develop DM. The high BRI in menopause had a significantly higher risk of DM compared to the low trajectory. In menopause (1.80 (1.26, 2.58)) and reproductive-age women (4.32 (2.49, 7.47)) with high trajectory of C-index, the DM risk decreased after adjustment. CONCLUSIONS The risk of DM was greater for high BMI, WC, C-index, and BRI trajectories than for lower trajectories. Hence, the development of general, abdominal, and visceral obesity trajectories in the prevention of DM should be considered by clinicians.
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Affiliation(s)
- Maryam Mousavi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Faegheh Firouzi
- Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The foundation for research & Education Excellence, Vestaria Hills, Al, USA
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Lamichhane G, Lee DY, Franks R, Olawale F, Jin JB, Egan JM, Kim Y. Curcumin-Rich Diet Mitigates Non-Alcoholic Fatty Liver Disease (NAFLD) by Attenuating Fat Accumulation and Improving Insulin Sensitivity in Aged Female Mice under Nutritional Stress. BIOLOGY 2024; 13:472. [PMID: 39056667 PMCID: PMC11274271 DOI: 10.3390/biology13070472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND The high incidence of metabolic syndrome in the elderly poses a significant challenge to the healthcare system, emphasizing the need for interventions tailored to geriatric patients. Given the limited focus on females in previous studies, this research aimed to evaluate the effects of dietary curcumin on obesity and NAFLD outcomes in naturally aged (18-month-old) female mice. METHODS Female C57BL/6 mice aged 18 months were fed a normal chow diet (NCD) and a HFHSD, with or without curcumin (0.4% w/w), for an 8-week period. Parameters included food intake, body weight, insulin tolerance test (ITT), glucose tolerance test (GTT), percentage fat mass, hepatic triglyceride, and cholesterol levels, and a histological examination for NAFLD detection, qPCR, and immunoblotting analyses were performed. RESULTS The cumulative body weight gain after 8 weeks in the aged female mice supplemented with curcumin and fed an HFHSD was significantly lower (10.84 ± 1.09 g) compared to those fed a HFHSD alone (15.28 ± 1.26 g). Curcumin supplementation also resulted in reduced total body fat (HFHSD group 50.83 ± 1.71% vs. HFHSD+CUR 41.46 ± 3.21%), decreased epidydimal fat mass (HFHSD: 3.79 ± 0.29 g vs. HFHSD+CUR: 2.66 ± 0.30 g), and repaired adipogenic signaling in the white adipose tissue. Furthermore, curcumin lowered triglyceride and cholesterol deposition in the liver, preventing hepatic steatosis and improving hepatic insulin sensitivity. CONCLUSIONS Curcumin demonstrates the ability to ameliorate the deleterious effects of HFHSD in aged female mice by reducing body fat composition, modulating adipogenic signaling in the white adipose tissue, and improving insulin homeostasis and non-alcoholic fatty deposition in the liver.
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Affiliation(s)
- Gopal Lamichhane
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
| | - Da-Yeon Lee
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
| | - Rienna Franks
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
| | - Femi Olawale
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
| | - Jong-Beom Jin
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
| | - Josephine M. Egan
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD 21224, USA;
| | - Yoo Kim
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (G.L.); (D.-Y.L.); (R.F.); (F.O.); (J.-B.J.)
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Krag C, Svane MS, Madsbad S, Graversen SB, Christensen JF, Sørensen TIA, Lehrskov LL, Laurberg T. The impact of surgery and oncological treatment on risk of type 2 diabetes onset in patients with colorectal cancer: nationwide cohort study in Denmark. eLife 2024; 12:RP89354. [PMID: 38829205 PMCID: PMC11147501 DOI: 10.7554/elife.89354] [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] [Indexed: 06/05/2024] Open
Abstract
Background Comorbidity with type 2 diabetes (T2D) results in worsening of cancer-specific and overall prognosis in colorectal cancer (CRC) patients. The treatment of CRC per se may be diabetogenic. We assessed the impact of different types of surgical cancer resections and oncological treatment on risk of T2D development in CRC patients. Methods We developed a population-based cohort study including all Danish CRC patients, who had undergone CRC surgery between 2001 and 2018. Using nationwide register data, we identified and followed patients from date of surgery and until new onset of T2D, death, or end of follow-up. Results In total, 46,373 CRC patients were included and divided into six groups according to type of surgical resection: 10,566 Right-No-Chemo (23%), 4645 Right-Chemo (10%), 10,151 Left-No-Chemo (22%), 5257 Left-Chemo (11%), 9618 Rectal-No-Chemo (21%), and 6136 Rectal-Chemo (13%). During 245,466 person-years of follow-up, 2556 patients developed T2D. The incidence rate (IR) of T2D was highest in the Left-Chemo group 11.3 (95% CI: 10.4-12.2) per 1000 person-years and lowest in the Rectal-No-Chemo group 9.6 (95% CI: 8.8-10.4). Between-group unadjusted hazard ratio (HR) of developing T2D was similar and non-significant. In the adjusted analysis, Rectal-No-Chemo was associated with lower T2D risk (HR 0.86 [95% CI 0.75-0.98]) compared to Right-No-Chemo.For all six groups, an increased level of body mass index (BMI) resulted in a nearly twofold increased risk of developing T2D. Conclusions This study suggests that postoperative T2D screening should be prioritised in CRC survivors with overweight/obesity regardless of type of CRC treatment applied. Funding The Novo Nordisk Foundation (NNF17SA0031406); TrygFonden (101390; 20045; 125132).
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Affiliation(s)
- Caroline Krag
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Saur Svane
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Surgical Gastroenterology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Jesper Frank Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Louise Lang Lehrskov
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Tinne Laurberg
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
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AL-asiri IS, Almatrafi FG, Al-thagafi SD, AlQarni AM, Aljubran HJ, Aljamaan AK, Al-Zahrani N. The Prevalence of Sleep Disorders in People with Type 2 Diabetes and Obesity in Saudi Arabia: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:2075-2083. [PMID: 38799281 PMCID: PMC11122321 DOI: 10.2147/dmso.s455945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose Difficulty falling or staying asleep are considered sleep disorders, and these are common among people with type 2 diabetes mellitus (T2DM) and obesity. The presence of sleep disorders may cause poor glycemic control among this population. We therefore designed this study to assess sleep disorders among patients with T2DM and obesity. Patients and Methods This cross-sectional study examined the prevalence of sleep disorders in 148 patients with T2DM and obesity at a hospital in Taif, Saudi Arabia using a validated questionnaire. Results Among those patients who have been involved in this study, we found a moderate level of sleep disorders and disturbances. The average sleep disorder assessment score for the patients with T2DM and obesity was 2.8 ± 1.4. Additionally, the average score for the sleep pattern assessment was 2.7 ± 1.3 and 2.9 ± 1.5 for symptoms of lack of sleep. Our study also revealed that those patients also had suboptimal weight and glycemic control. Conclusion These findings demonstrate that patients with T2DM and obesity are at a higher risk of developing sleep disorders. Therefore, these patients need to be screened for sleep disorders to avoid further diabetes-related complications and to have an early lifestyle intervention.
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Affiliation(s)
- Ibrahim S AL-asiri
- Diabetes and Endocrine Specialist Centre, Prince Mansour Military Hospital, Taif, Saudi Arabia
| | - Fahad G Almatrafi
- Diabetes and Endocrine Specialist Centre, Prince Mansour Military Hospital, Taif, Saudi Arabia
| | - Saja D Al-thagafi
- Diabetes and Endocrine Specialist Centre, Prince Mansour Military Hospital, Taif, Saudi Arabia
| | - Amani M AlQarni
- Family and Community Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Hussain J Aljubran
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah K Aljamaan
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Noura Al-Zahrani
- Diabetes and Endocrine Center, Hera General Hospital, Ministry of Health, Makkah, Saudi Arabia
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Wu C, Liu P, Yuan Z. Prospective association between fruit and vegetable intake and the risk of type 2 diabetes amongst Chinese adults: the China Health and Nutrition Survey. Int J Food Sci Nutr 2024; 75:81-91. [PMID: 37933616 DOI: 10.1080/09637486.2023.2278418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
This study aimed to prospectively explore the relationship between fruit and vegetable intake (FVI) and type 2 diabetes (T2D) risk amongst 13,175 Chinese adults. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of T2D events in relation to FVI. Results showed that the highest quintile of FVI was inversely associated with T2D risk in men (HR = 0.72, 95% CI: 0.50, 0.98) and women (HR = 0.74, 95% CI: 0.55, 0.97), whereas no such associations were observed between total vegetable intake and T2D in either men (HR = 0.92, 95% CI: 0.65, 1.26) or women (HR = 1.02, 95% CI: 0.77, 1.38). In addition, greater fruit intake was inversely associated with T2D risk in men (HR = 0.42, 95% CI: 0.28, 0.63) and women (HR = 0.64, 95% CI: 0.45, 0.90). Overall, FVI and total fruit intake were inversely associated with T2D risk amongst Chinese adults.
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Affiliation(s)
- Caifeng Wu
- Research Center, Chengdu Medical College, Chengdu, China
| | - Pingping Liu
- Hefei Yaohai District Center for Disease Control and Prevention, Hefei, China
| | - Zhanpeng Yuan
- School of Public Health, Wuhan University, Wuhan, China
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Hao N, Bai X, Hu A, Zhao G, Chen Y, Zhao J, Ling Q, Li X, Cai C, Wang Q, Wang Z, Fang J. Assessing the Global, Regional, and National Impact of High Body Mass Index on Alzheimer's Disease and Other Dementias Between 1990 and 2019. J Alzheimers Dis 2024; 97:293-307. [PMID: 38043013 DOI: 10.3233/jad-230827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Obesity significantly increases Alzheimer's disease (AD) and dementia risk. Understanding the link between a high body mass index (BMI) and these conditions is crucial for effective management and prevention. OBJECTIVE We aimed to estimate the burden of AD and other dementias attributed to high BMI from 1990 to 2019 based on sex, age, and socio-demographic indicators (SDI) at global, regional, and national levels. METHODS We collected data on deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) from the 2019 Global Burden of Disease study for AD and dementia attributed to high BMI. We explored the correlation between SDI levels and ASDR. RESULTS In 2019, there were 198,476.2 deaths (95% UI: 32,695.4-593,366.4) and 3,159,912.4 DALYs (848,330.5-8,042,531) attributed to high BMI. Numbers of deaths, DALYs, ASMR, and ASDR increased since 1990. Females had higher deaths, ASMR, and ASDR than males. Mortality and DALYs rates increased with age. ASMR and ASDR increased across five SDI levels, with the highest rise in Low-middle SDI. High-income North America had the most deaths [30,993.9 (5,101.7-89,912.9)], while North Africa and the Middle East had the highest ASMR [4.61 (0.79-13.64)] and ASDR [72.56 (20.98-181.16)] in 2019. CONCLUSIONS The burden of AD and other dementias attributed to high BMI increased since 1990 globally and is still heaviest in developed regions. Females accounted predominantly for the burden than males. Timely measures are needed to against high BMI.
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Affiliation(s)
- Ning Hao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xue Bai
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - An Hu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Gaofeng Zhao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yansheng Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jianhe Zhao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qiong Ling
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiangyu Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuipu Cai
- College of Engineering, Shantou University, Shantou, China
| | - Qi Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhaojun Wang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jiansong Fang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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10
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Qi Y, Lv R, Zhao M, Huang Y, Zhang Y, Zhang H, Li Z, Jia P, Zhang H, Yang Z, Lai J, Song P, Yuan C. Parental adherence to healthy lifestyles in relation to the risk of obesity in offspring: A prospective cohort study in China. J Glob Health 2023; 13:04181. [PMID: 38115717 PMCID: PMC10731135 DOI: 10.7189/jogh.13.04181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Background While maternal adherence to a healthy lifestyle was shown to be associated with a lower risk of obesity in offspring, the potential role of overall parental lifestyles has not yet been explored. We aimed to address this gap by exploring whether parental adherence to an overall healthy lifestyle was associated with a lower risk of obesity in offspring. Methods We included 5881 children and adolescents aged 6-15 years at enrolment in the 2010, 2012, and 2014 waves of the China Family Panel Studies (CFPS) who were free of obesity and followed them until 2020. Parental healthy lifestyle score at study baseline was composed of five modifiable lifestyle factors (0-5; 1 for each): never smoking, non-habitual drinking, weekly exercise, modified dietary diversity score ≥5 points, and body mass index (BMI) of 18.5-23.9 kg/m2. We defined obesity according to the age- and gender-specific cutoffs by the BMI percentile curves for Chinese children aged 6-18 years. We used multivariable Cox proportional hazard models to examine the association between parental healthy lifestyle score (both as continuous and categorical variables) and risk of offspring obesity. Results Overall, 597 (10.2%) offspring developed obesity during a median follow-up of 6 years. Compared to the lowest tertile of parental healthy lifestyle score, participants in the highest tertile had a 42% (hazard ratio (HR) = 0.58; 95% confidence interval (CI) = 0.45-0.74) lower risk of obesity. Both maternal (HR = 0.75; 95% CI = 0.61-0.92) and paternal (HR = 0.73; 95% CI = 0.60-0.89) healthy lifestyle scores were associated with lower risks of obesity in offspring. For specific lifestyle factors, we observed beneficial associations for paternal diverse diet (HR = 0.73; 95% CI = 0.60-0.88) and healthy BMI (HR = 0.65; 95% CI = 0.55-0.78). Conclusions Adherence to an overall parental healthier lifestyle was associated with a lower risk of obesity in childhood and adolescence. This finding highlights the potential benefits of promoting a healthy lifestyle among parents for the primary prevention of offspring obesity.
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Affiliation(s)
- Ye Qi
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Rongxia Lv
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Mengjia Zhao
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuhui Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaodan Zhang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hangrui Zhang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan, China
| | - Huanmei Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenyu Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianqiang Lai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peige Song
- School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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11
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Sidhu SK, Aleman JO, Heffron SP. Obesity Duration and Cardiometabolic Disease. Arterioscler Thromb Vasc Biol 2023; 43:1764-1774. [PMID: 37650325 PMCID: PMC10544713 DOI: 10.1161/atvbaha.123.319023] [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: 04/21/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
Cardiovascular disease risk is known to be influenced by both the severity of a risk factor and the duration of exposure (eg, LDL [low-density lipoprotein] cholesterol, tobacco smoke). However, this concept has been largely neglected within the obesity literature. While obesity severity has been closely linked with cardiometabolic diseases, the risk of developing these conditions among those with obesity may be augmented by greater obesity duration over the life span. Few longitudinal or contemporary studies have investigated the influence of both factors in combination-cumulative obesity exposure-instead generally focusing on obesity severity, often at a single time point, given ease of use and lack of established methods to encapsulate duration. Our review focuses on what is known about the influence of the duration of exposure to excess adiposity within the obesity-associated cardiometabolic disease risk equation by means of summarizing the hypothesized mechanisms for and evidence surrounding the relationships of obesity duration with diverse cardiovascular and metabolic disease. Through the synthesis of the currently available data, we aim to highlight the importance of a better understanding of the influence of obesity duration in cardiovascular and metabolic disease pathogenesis. We underscore the clinical importance of aggressive early attention to obesity identification and intervention to prevent the development of chronic diseases that arise from exposure to excess body weight.
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Affiliation(s)
- Sharnendra K. Sidhu
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Jose O. Aleman
- Laboratory of Translational Obesity Research, Division of Endocrinology, Diabetes & Metabolism, New York University Grossman School of Medicine, New York, NY, USA
| | - Sean P. Heffron
- Center for the Prevention of Cardiovascular Disease, Leon H. Charney Division of Cardiology, NYU Langone Health, New York University Grossman School of Medicine, New York, NY, USA
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12
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Kurtzhals P, Flindt Kreiner F, Singh Bindra R. The role of weight control in the management of type 2 diabetes mellitus: Perspectives on semaglutide. Diabetes Res Clin Pract 2023; 203:110881. [PMID: 37591343 DOI: 10.1016/j.diabres.2023.110881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/13/2023] [Indexed: 08/19/2023]
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used to address multiple aspects of type 2 diabetes mellitus (T2DM) management, including glycaemic control, weight loss, and cardiovascular risk reduction. Semaglutide, a well-established GLP-1 RA approved for T2DM treatment and weight management, demonstrates marked efficacy in achieving these clinically important goals. The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus report emphasizes the importance of a holistic approach to T2DM treatment, with weight control as a key component for improving patient outcomes. Notably, semaglutide is mentioned in the consensus report as having 'very high' efficacy for both glucose lowering and weight loss in T2DM treatment. Nevertheless, as has been observed with other weight-lowering drugs, weight loss observed with semaglutide appears less profound in individuals with T2DM than in those with obesity without T2DM, a phenomenon requiring further investigation. The semaglutide safety and tolerability profiles are well established, and it is approved in some countries to reduce cardiovascular risk in certain populations with T2DM. Thus, semaglutide offers a well-established therapeutic option that aligns well with guideline recommendations for T2DM management, emphasizing the high importance of weight control and amelioration of other cardiometabolic risk factors.
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Affiliation(s)
- Peter Kurtzhals
- Novo Nordisk A/S, Vandtaarnsvej 110-114 DK-2860, Søborg, Denmark.
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13
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Wu J, Feng Z, Duan J, Li Y, Deng P, Wang J, Yang Y, Meng C, Wang W, Wang A, Wang J. Global burden of type 2 diabetes attributable to non-high body mass index from 1990 to 2019. BMC Public Health 2023; 23:1338. [PMID: 37438808 DOI: 10.1186/s12889-023-15585-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/02/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes mellitus (T2DM) currently was increased in some countries of the world like China. However, the epidemiological trends of T2DM attributable to non-high body mass index (BMI) remain unclear. Thus, we aimed to describe the burden of T2DM attributable to non-high BMI. METHODS To estimate the burden of T2DM attributable to non-high BMI, data from the Global Burden of Disease Study 2019 were used to calculate the deaths and disability-adjusted life years (DALYs) by age, sex, year, and location. The estimated annual percentage change (EAPC) was applied in the analysis of temporal trends in T2DM from 1990 to 2019. RESULTS Globally in 2019, the number of death cases and DALYs of T2DM attributable to non-high BMI accounted for 57.9% and 48.1% of T2DM-death from all risks, respectively. Asia accounted for 59.5% and 63.6% of the global non-high-BMI-related death cases and DALYs of T2DM in 2019, respectively. From 1990 to 2019, regions in the low-income experienced a rise in DALYs attributable to non-high BMI. As compared to other age groups, older participants had higher deaths and DALYs of T2DM attributable to non-high BMI. The death and DALY rates of T2DM due to non-high BMI were higher in males and people in regions with low socio-demographic index (SDI) countries. CONCLUSIONS The burden of T2DM attributable to non-high BMI is higher in the elderly and in people in regions with low- and middle-SDI, resulting in a substantial burden on human health and the social cost of healthcare.
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Affiliation(s)
- Jingjing Wu
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Zeying Feng
- Clinical Trial Institution Office, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, No. 50 Boyuan Avenue, Liuzhou City, Guangxi Province, 545001, China
| | - Jingwen Duan
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Yalan Li
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Peizhi Deng
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Jie Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Yiping Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Changjiang Meng
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Wei Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China
- Clinical Research Center, Central South University, Changsha, Hunan, China
| | - Anli Wang
- Information Center of The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China.
| | - Jiangang Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410013, China.
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14
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Fan H, Zhang X. Association between the age at onset of overweight and obesity and the subsequent risk of hypertension in Chinese adults. BMC Cardiovasc Disord 2023; 23:333. [PMID: 37391689 PMCID: PMC10311763 DOI: 10.1186/s12872-023-03347-z] [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: 07/14/2022] [Accepted: 06/13/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Data on the impact of age at onset of overweight/obesity on the risk of hypertension are limited. We aimed to investigate the above-mentioned association in Chinese population. METHODS 6700 adults who participated in at least three survey waves and were free of overweight/obesity and hypertension on first survey were included using China Health and Nutrition Survey. The age of participants at the onset of overweight/obesity (body mass index ≥ 24 kg/m2) and subsequent hypertension occurrence (blood pressure ≥ 140/90 mmHg or use of antihypertensive medication) were identified. We used the covariate-adjusted Poisson model with robust standard error to calculate the relative risk (RR) and 95% confidence interval (95%CI) to examine the relationship between the age at onset of overweight/obesity and hypertension. RESULTS There were 2,284 new-onset overweight/obesity cases and 2,268 incident cases of hypertension during an average 13.8-year follow-up period. Compared with the population without overweight/obesity, the RR (95% CI) of hypertension was 1.45 (1.28-1.65), 1.35 (1.21-1.52) and 1.16 (1.06-1.28) for overweight/obesity onset in participants aged < 38 years, 38-47 years, and ≥ 47 years, respectively. The risk of hypertension increased linearly with a decrease in age at onset of overweight/obesity (P < 0.001 for trend). The sensitivity analyses results were similar after excluding the participants taking antihypertensive medications or those with new-onset obesity or using waist circumference to define overweight/obesity. CONCLUSIONS Our results emphasize the importance of assessing age at onset of overweight/obesity to prevent hypertension.
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Affiliation(s)
- Hui Fan
- Department of Epidemiology and Health Statistics, School of Public Health, North Sichuan Medical College, Nanchong, Sichuan China
| | - Xingyu Zhang
- Thomas E.Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, USA
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15
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Abstract
The prevalence of preobesity and obesity is rising globally, multiple epidemiologic studies have identified preobesity and obesity as predisposing factors to a number of noncommunicable diseases including type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer. In this review, we discuss the epidemiology of obesity in both children and adults in different regions of the world. We also explore the impact of obesity as a disease not only on physical and mental health but also its economic impact.
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Affiliation(s)
- Nasreen Alfaris
- King Fahad Medical City, 3895 Susah, Alwurud, Riyadh 12252-7111, Saudi Arabia.
| | | | - Naji Alamuddin
- RCSI Bahrain, King Hamad University Hospital, Alsayh, Sheikh Eisa Bin Salman Bridge, 7J62+X92, Bahrain
| | - Georgia Rigas
- St George Private Hospital, 1 South Street, Kogarah, New South Wales 2217, Australia
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16
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Wan Q, Calhoun C, Zahr T, Qiang L. Uncoupling Lipid Synthesis from Adipocyte Development. Biomedicines 2023; 11:biomedicines11041132. [PMID: 37189751 DOI: 10.3390/biomedicines11041132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/20/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
Obesity results from the expansion of adipose tissue, a versatile tissue regulating energy homeostasis, adipokine secretion, thermogenesis, and inflammation. The primary function of adipocytes is thought to be lipid storage through lipid synthesis, which is presumably intertwined with adipogenesis. However, during prolonged fasting, adipocytes are depleted of lipid droplets yet retain endocrine function and an instant response to nutrients. This observation led us to question whether lipid synthesis and storage can be uncoupled from adipogenesis and adipocyte function. By inhibiting key enzymes in the lipid synthesis pathway during adipocyte development, we demonstrated that a basal level of lipid synthesis is essential for adipogenesis initiation but not for maturation and maintenance of adipocyte identity. Furthermore, inducing dedifferentiation of mature adipocytes abrogated adipocyte identity but not lipid storage. These findings suggest that lipid synthesis and storage are not the defining features of adipocytes and raise the possibility of uncoupling lipid synthesis from adipocyte development to achieve smaller and healthier adipocytes for the treatment of obesity and related disorders.
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Affiliation(s)
- Qianfen Wan
- Naomi Berrie Diabetes Center, Columbia University, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10032, USA
| | - Carmen Calhoun
- Naomi Berrie Diabetes Center, Columbia University, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10032, USA
| | - Tarik Zahr
- Naomi Berrie Diabetes Center, Columbia University, New York, NY 10032, USA
- Molecular Pharmacology and Therapeutics, Columbia University, New York, NY 10032, USA
| | - Li Qiang
- Naomi Berrie Diabetes Center, Columbia University, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10032, USA
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17
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Jung FUCE, Riedel-Heller SG, Luck-Sikorski C. The relationship between weight history and psychological health-Differences related to gender and weight loss patterns. PLoS One 2023; 18:e0281776. [PMID: 36780486 PMCID: PMC9925088 DOI: 10.1371/journal.pone.0281776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/31/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities. METHOD The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics. RESULTS According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a "weight maintainer" was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a "weight maintainer" was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past. CONCLUSION Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.
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Affiliation(s)
- Franziska U. C. E. Jung
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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18
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Nielsen J, Narayan KV, Cunningham SA. Incidence of obesity across adulthood in the United States, 2001-2017-a national prospective analysis. Am J Clin Nutr 2023; 117:141-148. [PMID: 36789933 PMCID: PMC10196588 DOI: 10.1016/j.ajcnut.2022.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/13/2022] [Accepted: 10/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In the United States, the prevalence of obesity among adults has increased 3-fold since the 1980s, but patterns of incidence of new cases of obesity are not known. OBJECTIVES To examine the incidence of new cases of obesity: overall, by demographic and educational subgroups, by weight status, and changes during this century. METHODS We analyzed adult (≥20 y) anthropometric records from the US nationally representative Panel Study of Income Dynamics from 2001 to 2017. Among those not having obesity (body mass index, BMI, ≥30 kg/m2) at first observation, we used Poisson models to estimate the incidence of obesity [cases/1000 person-years (PYs)] and incidence rate ratio (IRR). RESULTS Among 13,888 adults followed for 115,797 PYs, the incidence of obesity in 2001-2017 was 28.1/1000 PYs (95% CI: 26.7, 29.7). Over the periods 2001-2005, 2005-2009, and 2009-2013, the incidence of obesity was stable, but in 2013-2017 the incidence increased by 18% compared to 2009-2013 [IRR: 1.18 (95% CI: 1.06, 1.30)]. Blacks had higher obesity incidence [47.9/1000 PYs (95% CI: 42.7, 53.1)] than Whites [26.2/1000 PYs (95% CI: 24.6, 27.9)]. Risk was particularly high among Black females [57.9/1000 PYs (95% CI: 49.1, 66.8)] and Black young adults (20-29 y) [65.5/1000 PYs (95% CI: 54.2, 76.7)]. Across race, obesity incidence was highest in young adults (20-29 y) [34.1/1000 PYs (95% CI: 31.5, 36.7)] and declined with age [age 70+ y: 18.9/1000 PYs (95% CI: 16.6, 21.8)]. Those with overweight had an obesity risk 7 times higher than those with normal weight [62.1/1000 PYs (95% CI: 58.8, 65.3) vs. 8.8/1000 PYs (95% CI: 8.1, 9.6)]. Those with less than high-school education had higher obesity incidence than those with education beyond high-school [39.4/1000 PYs (95% CI: 34.4, 44.4) vs. 24.7/1000 PYs (95% CI: 23.1, 26.3)]. CONCLUSIONS Incidence of obesity was stable over the first 13 y of the last 2 decades but increased by 18% in 2013-2017. Blacks and younger adults were at highest risk, and those with overweight were also at high risk for developing obesity.
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Affiliation(s)
- Jannie Nielsen
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Km Venkat Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Solveig A Cunningham
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Głąbska D, Janowska M, Bartosz E, Guzek D. Analysis of the Nutritional Value of the Diets Presented in Women's and Sports Magazines before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169859. [PMID: 36011498 PMCID: PMC9407771 DOI: 10.3390/ijerph19169859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 05/13/2023]
Abstract
For consumers, among the most important sources of information related to nutrition are popular journals and magazines, including women’s and sports, but the diets presented there may lead to unhealthy weight-control behaviors. The aim of the study was to assess the nutritional value of regular and low-calorie diets presented in Polish women’s and sports magazines before and during COVID-19 pandemic. The study was based on two popular Polish magazines—one women’s magazine and one sports magazine, which regularly present various types of diets. The nutritional value of all the diets published from January 2014 to May 2022 was analyzed. The total number of included single-day menus was n = 119, while for analysis they were stratified based on: type of magazine (published in the women’s magazine n = 41 and in the sports magazine n = 78), year of publication (before the COVID-19 pandemic n = 78 and during n = 41), and type of diet (regular n = 61 and low-calorie n = 58). The analysis included the energy value and nutritional value. For the type of magazine, the diets published in the sports magazine were characterized by a higher intake of fat (p < 0.0001 for intake in grams and in % of energy) and calcium (p = 0.0330), whereas the diets published in the women’s magazine were characterized by a higher intake of carbohydrates (p = 0.0226 for intake in grams, and p = 0.0002 for intake in % of energy) and fiber (p = 0.0163). For the year of publication, the diets published during the COVID-19 pandemic were characterized by a higher intake of protein (p = 0.0166 for intake in grams), sodium (p = 0.0465), calcium (p < 0.0001), vitamin D (p = 0.0197), vitamin B6 (p = 0.0207), and vitamin B12 (p = 0.0277), whereas the diets published before the COVID-19 pandemic were characterized by a higher intake of carbohydrates (p = 0.0243 for intake in % of energy). For the type of diet, the regular diets were characterized by a higher energy value (p = 0.0020), as well as by a higher intake of fat (p = 0.0162 for intake in grams), carbohydrates (p = 0.0390 for intake in grams), mono- and oligosaccharides (p = 0.0084 for intake in % of energy), fiber (p < 0.0001), magnesium (p = 0.0323), iron (p = 0.0307), and vitamin B6 (p = 0.0204). The nutritional value of the diets presented in the Polish women’s and sports magazines was not justified by the type of magazine or type of diet, associated with the target group, which may cause the following of improperly balanced diets. However, the changes in the typical nutritional value of diets presented in the Polish women’s and sports magazines during the COVID-19 pandemic were justified by some specific needs for the prevention and treatment of COVID-19.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-593-71-26
| | - Maria Janowska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Ewa Bartosz
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Dominika Guzek
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
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20
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Mishali M, Kisner M. Psycho-behavioral Factors Related to Weight Regain After Bariatric Surgery. Obes Surg 2022; 32:3041-3046. [PMID: 35819696 DOI: 10.1007/s11695-022-06195-6] [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: 08/30/2021] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the connection between weight regain 2 to 5 years after bariatric surgery and three psycho-behavioral factors: mental health, general health efficacy, and emotional regulation. METHOD A convenience sample of 120 participants was recruited, 80 of whom had already had bariatric surgery 2 to 5 years earlier, whereas 40 were candidates for such procedure but did not undergo it yet. Each participant filled a consent form, a socio-demographic one, and extra three questionnaires related to socio-behavioral characteristics: Mental Health Inventory (MHI), General Self-efficacy (GSE), and Difficulty in Emotional Regulation Scale (DERS). SPSS version 25 was used to analyze the data, and a one-sample Kolmogorov-Smirnov test was conducted to examine the distribution of the continuous variables. RESULTS Those in the non-reducers group experienced (2.19 ± 0.63) greater difficulties than the reducers group (1.82 ± 0.39) when it came to their emotional regulation, whereas the candidate group (1.96 ± 0.47) were situated in-between the groups already operated in terms of their DERS scores (p = 0.008). The reducers group had higher GSE scores (2.75 ± 0.35) than the non-reducers group (2.59 ± 0.39) (p = 0.03). CONCLUSIONS Effective emotional regulation is linked to weight loss maintenance after bariatric surgery. Difficulties in emotional regulation are negatively correlated with maintaining weight loss among bariatric patients who undergo surgery. General self-efficacy is positively correlated with weight loss maintenance after bariatric surgery.
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Affiliation(s)
- Moshe Mishali
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, ZIP Code 3498838, Haifa, Israel
| | - Mirit Kisner
- A. Mishali Counselling Services, Remez St. 47, ZIP Code 3604447, Kiryat Tivon, Israel.
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Karin A, Jon E, Martin A, Lena B, Martin L, Naveed S, Marcus L, Maria Å, Annika R. Body mass index in adolescence, risk of type 2 diabetes and associated complications: A nationwide cohort study of men. EClinicalMedicine 2022; 46:101356. [PMID: 35330801 PMCID: PMC8938860 DOI: 10.1016/j.eclinm.2022.101356] [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: 11/24/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/02/2022] Open
Abstract
Background Obesity is a predominant factor in development of type 2 diabetes but to which extent adolescent obesity influences adult diabetes is unclear. We investigated the association between body mass index (BMI) in young men and subsequent type 2 diabetes and how, in diagnosed diabetes, adolescent BMI relates to glycemic control and diabetes complications. Methods Baseline data from the Swedish Conscript Register for men drafted 1968-2005 was combined with data from the National Diabetes and Patient registries. Diabetes risk was estimated through Cox regression and Kaplan-Meier survival estimates. Relationships between BMI, glycemic control and diabetes complications were assessed through multiple linear and logistic regression. Findings Among 1,647,826 men, 63,957 (3·88%) developed type 2 diabetes over a median follow-up of 29.0 years (IQR[21.0-37.0]). The risk of diabetes within 40 years after conscription was nearly 40% in individuals with adolescent BMI ≥35 kg/m2. Compared to BMI 18·5-<20 kg/m2 (reference), diabetes risk increased in a linear fashion from HR 1·18(95%CI 1·15-1·21) for BMI 20-<22·5 kg/m2 to HR 15·93(95%CI 14·88-17·05) for BMI ≥35 kg/m2, and a difference in age at onset of 11·4 years was seen. Among men who developed diabetes, higher adolescent BMI was associated with higher HbA1c levels and albuminuria rates. Interpretation Rising adolescent BMI was associated with increased risk of type 2 diabetes diagnosed at a younger age, with poorer metabolic control, and a greater prevalence of albuminuria, all suggestive of worse prognosis.
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Affiliation(s)
- Andréasson Karin
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
| | - Edqvist Jon
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Adiels Martin
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björck Lena
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine, Östra, Gothenburg, Sweden
| | - Lindgren Martin
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Diagnosvägen 11,Östra, Gothenburg 41650, Sweden
| | - Sattar Naveed
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Lind Marcus
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Medicine, NU-Hospital Group, Uddevalla, Sweden
| | - Åberg Maria
- School of Public Health and Community Medicine, Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
- Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Rosengren Annika
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Diagnosvägen 11, Gothenburg 41650, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Diagnosvägen 11,Östra, Gothenburg 41650, Sweden
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22
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Jayedi A, Soltani S, Motlagh SZT, Emadi A, Shahinfar H, Moosavi H, Shab-Bidar S. Anthropometric and adiposity indicators and risk of type 2 diabetes: systematic review and dose-response meta-analysis of cohort studies. BMJ 2022; 376:e067516. [PMID: 35042741 PMCID: PMC8764578 DOI: 10.1136/bmj-2021-067516] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To present a comprehensive review of the association between measures of body weight, waist, and fat, and different ratios of these measures, and the risk of type 2 diabetes. DESIGN Systematic review and dose-response meta-analysis of cohort studies. DATA SOURCES PubMed, Scopus, and Web of Science up to 1 May 2021. REVIEW METHODS Cohort studies looking at the association between general or central adiposity and body fat content and the risk of type 2 diabetes in the general adult population were included. Two of the authors extracted the data in duplicate. Random effects dose-response meta-analyses were performed to estimate the degree of the associations. Curvilinear associations were modelled with a one stage weighted mixed effects meta-analysis. RESULTS 216 cohort studies with 2.3 million individuals with type 2 diabetes among 26 million participants were identified. Relative risks were 1.72 (95% confidence interval 1.65 to 1.81; n=182 studies) for an increase in body mass index of 5 units, 1.61 (1.52 to 1.70; n=78) for a 10 cm larger waist circumference, 1.63 (1.50 to 1.78; n=34) for an increase in waist-to-hip ratio of 0.1 units, 1.73 (1.51 to 1.98; n=25) for an increase in waist-to-height ratio of 0.1 units, 1.42 (1.27 to 1.58; n=9) for an increase in visceral adiposity index of 1 unit, 2.05 (1.41 to 2.98; n=6) for a 10% higher percentage body fat, 1.09 (1.05 to 1.13, n=5) for an increase in body shape index of 0.005 units, 2.55 (1.59 to 4.10, n=4) for a 10% higher body adiposity index, and 1.11 (0.98 to 1.27; n=14) for a 10 cm larger hip circumference. A strong positive linear association was found between body mass index and the risk of type 2 diabetes. Positive linear or monotonic associations were also found in all regions and ethnicities, without marked deviation from linearity at a specific cut-off value. Indices of central fatness, independent of overall adiposity, also had positive linear or monotonic associations with the risk of type 2 diabetes. Positive linear or monotonic associations were also found for total and visceral fat mass, although the number of studies was small. CONCLUSIONS A higher body mass index was associated with a greater risk of developing type 2 diabetes. A larger waist circumference, independent of overall adiposity, was strongly and linearly associated with the risk of type 2 diabetes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021255338.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinant of Health Research Centre, Semnan University of Medical Sciences, Semnan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sheida Zeraat-Talab Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Hosein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hanieh Moosavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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23
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Tutunchi H, Naeini F, Ebrahimi-Mameghani M, Najafipour F, Mobasseri M, Ostadrahimi A. Metabolically healthy and unhealthy obesity and the progression of liver fibrosis: A cross-sectional study. Clin Res Hepatol Gastroenterol 2021; 45:101754. [PMID: 34303827 DOI: 10.1016/j.clinre.2021.101754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The development of liver fibrosis is the most important predictor of adverse outcomes in patients with non-alcoholic fatty liver disease (NAFLD). Little is known regarding the risk factors for the progression of NAFLD to liver fibrosis. The present cross-sectional study aimed to examine the association of liver fibrosis with metabolically healthy and unhealthy obesity among patients with NAFLD. METHODS The severity of fatty liver was examined using ultrasonography. We used the NAFLD fibrosis score to determine the severity of liver fibrosis. Anthropometric indices, physical activity, and body composition were assessed. Blood samples were collected to determine serum metabolic parameters. Participants without any component of metabolic syndrome and homeostasis model assessment of insulin resistance (HOMA-IR) <2.5 were considered as metabolically healthy. To examine the association of liver fibrosis with metabolically healthy and unhealthy obesity, multivariable-adjusted odds ratios (ORs) were applied. RESULTS The current study included a total of 246 patients with NAFLD and low probability of fibrosis. 46.3% of subjects were metabolically healthy and 53.7% were metabolically unhealthy. Among metabolically healthy subjects, multivariable-adjusted ORs (CIs) for worsening of NAFLD fibrosis score comparing body mass indexes (BMIs) 23.0-24.9, 25-29.9, and ≥30 with a BMI=18.5-22.9 kg/m2 were 1.28 (1.09-1.56), 1.99 (1.49-2.63), and 3.96 (2.89-4.71), respectively. The corresponding ORs (95% CIs) among metabolically unhealthy subjects were 1.39 (1.32-1.64), 2.27 (1.98-2.49), and 4.11 (3.12-4.93), respectively. Moreover, in both healthy and unhealthy individuals, higher percentages of body fat and waist circumference were significantly associated with worsening of NAFLD fibrosis score. CONCLUSION Excess body fat contributes to the progression of liver fibrosis regardless of metabolic health status.
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Affiliation(s)
- Helda Tutunchi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran university of medical science, Tehran, Iran
| | - Mehrangiz Ebrahimi-Mameghani
- Social Determinant of Health Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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24
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Gezginci-Oktayoglu S, Sancar S, Karatug-Kacar A, Bolkent S. miR-375 induces adipogenesis through targeting Erk1 in pancreatic duct cells under the influence of sodium palmitate. J Cell Physiol 2021; 236:3881-3895. [PMID: 33107061 DOI: 10.1002/jcp.30129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022]
Abstract
The goal of this study was to research long-term saturated fatty acid overexposure that can induce differentiation of pancreatic duct cells into adipocytes and also into β-cells. The important findings can be summarized as follows: (i) adipogenesis and early stage β-cell differentiation were stimulated in duct cells under lipotoxicity and glucolipotoxicity conditions, (ii) miR-375 expression was upregulated while its target Erk1 was downregulated and miR-375 inhibitor upregulated Erk1 while expression of adipogenesis markers was downregulated in duct cells under both conditions, (iii) apoptosis was induced in β and duct cells under both conditions, (iv) lipotoxicity induced proliferation of co-cultured β-cells. These findings suggest that long-term saturated fatty acid overexposure may cause intrapancreatic fat accumulation by inducing differentiation of duct cells into adipocytes and it may contributes to β-cell compensation by stimulating the early stage of β-cell differentiation in duct cells. In addition, miR-375 may have the potential to be a new target in the treatment of Type 2 diabetes, and NAFPD due to its role in the adipogenesis of duct cells.
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Affiliation(s)
- Selda Gezginci-Oktayoglu
- Biology Department, Molecular Biology Section, Faculty of Science, Istanbul University, Vezneciler, Istanbul, Turkey
| | - Serap Sancar
- Biology Department, Molecular Biology Section, Faculty of Science, Istanbul University, Vezneciler, Istanbul, Turkey
| | - Ayse Karatug-Kacar
- Biology Department, Molecular Biology Section, Faculty of Science, Istanbul University, Vezneciler, Istanbul, Turkey
| | - Sehnaz Bolkent
- Biology Department, Molecular Biology Section, Faculty of Science, Istanbul University, Vezneciler, Istanbul, Turkey
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25
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Roberts SB, Silver RE, Das SK, Fielding RA, Gilhooly CH, Jacques PF, Kelly JM, Mason JB, McKeown NM, Reardon MA, Rowan S, Saltzman E, Shukitt-Hale B, Smith CE, Taylor AA, Wu D, Zhang FF, Panetta K, Booth S. Healthy Aging-Nutrition Matters: Start Early and Screen Often. Adv Nutr 2021; 12:1438-1448. [PMID: 33838032 PMCID: PMC8994693 DOI: 10.1093/advances/nmab032] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/11/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression-and in some cases effectively treat-many established aging-associated conditions. However, middle-aged and older adults are vulnerable to unhealthy dietary patterns, and typically consume diets with inadequate servings of healthy food groups and essential nutrients, along with an abundance of energy-dense but nutrient-weak foods that contribute to obesity. However, based on menu examples, diets that are nutrient-dense, plant-based, and with a moderately low glycemic load are better equipped to meet the nutritional needs of many older adults than current recommendations in US Dietary Guidelines. These summary findings indicate that healthy nutrition is more important for healthy aging than generally recognized. Improved public health messaging about nutrition and aging, combined with routine screening and medical referrals for age-related conditions that can be treated with a nutrition prescription, should form core components of a national nutrition roadmap to reduce the epidemic of unhealthy aging.
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Affiliation(s)
| | - Rachel E Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jennifer M Kelly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Joel B Mason
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Meaghan A Reardon
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sheldon Rowan
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Barbara Shukitt-Hale
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caren E Smith
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Allen A Taylor
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Dayong Wu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Karen Panetta
- School of Engineering, Tufts University, Medford, MA, USA
| | - Sarah Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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26
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García-García I, Morys F, Dagher A. Nucleus accumbens volume is related to obesity measures in an age-dependent fashion. J Neuroendocrinol 2020; 32:e12812. [PMID: 31758711 DOI: 10.1111/jne.12812] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022]
Abstract
Motivation theories of obesity suggest that one of the brain mechanisms underlying pathological eating and weight gain is the dysregulation of dopaminergic circuits. Although these dysregulations likely occur at the microscopic level, studies on grey matter volume report macroscopic differences associated with obesity. One region suggested to play a key role in the pathophysiology of obesity is the nucleus accumbens (NAcc). We performed a meta-analysis of findings regarding NAcc volume and overweight/obesity. We additionally examined whether grey matter volume in the NAcc and other mesolimbic areas depends on the longitudinal trajectory of obesity, using the UK Biobank dataset. To this end, we analysed the data using a latent growth model, which identifies whether a certain variable of interest (eg, NAcc volume) is related to another variable's (body mass index [BMI]) initial values or longitudinal trajectories. Our meta-analysis showed that, overall, NAcc volume is positively related to BMI. However, further analyses revealed that the relationship between NAcc volume and BMI is dependent on age. For younger individuals, such a relationship is positive, whereas, for older adults, it is negative. This was corroborated by our analysis in the UK Biobank dataset, which includes older adults, where we found that a higher BMI was associated with a lower NAcc and thalamus volume. Overall, the present study suggests that increased NAcc volume at a young age might be a vulnerability factor for obesity, whereas, at an older age, decreased NAcc volume with increased BMI might be an effect of prolonged influences of neuroinflammation on the brain.
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Affiliation(s)
| | - Filip Morys
- Montreal Neurological Institute, McGill University, Montréal, Québec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montréal, Québec, Canada
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27
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Norris T, Cole TJ, Bann D, Hamer M, Hardy R, Li L, Ong KK, Ploubidis GB, Viner R, Johnson W. Duration of obesity exposure between ages 10 and 40 years and its relationship with cardiometabolic disease risk factors: A cohort study. PLoS Med 2020; 17:e1003387. [PMID: 33290405 PMCID: PMC7723271 DOI: 10.1371/journal.pmed.1003387] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals with obesity do not represent a homogeneous group in terms of cardiometabolic risk. Using 3 nationally representative British birth cohorts, we investigated whether the duration of obesity was related to heterogeneity in cardiometabolic risk. METHODS AND FINDINGS We used harmonised body mass index (BMI) and cardiometabolic disease risk factor data from 20,746 participants (49.1% male and 97.2% white British) enrolled in 3 British birth cohort studies: the 1946 National Survey of Health and Development (NSHD), the 1958 National Child Development Study (NCDS), and the 1970 British Cohort Study (BCS70). Within each cohort, individual life course BMI trajectories were created between 10 and 40 years of age, and from these, age of obesity onset, duration spent obese (range 0 to 30 years), and cumulative obesity severity were derived. Obesity duration was examined in relation to a number of cardiometabolic disease risk factors collected in mid-adulthood: systolic (SBP) and diastolic blood pressure (DBP), high-density-lipoprotein cholesterol (HDL-C), and glycated haemoglobin (HbA1c). A greater obesity duration was associated with worse values for all cardiometabolic disease risk factors. The strongest association with obesity duration was for HbA1c: HbA1c levels in those with obesity for <5 years were relatively higher by 5% (95% CI: 4, 6), compared with never obese, increasing to 20% (95% CI: 17, 23) higher in those with obesity for 20 to 30 years. When adjustment was made for obesity severity, the association with obesity duration was largely attenuated for SBP, DBP, and HDL-C. For HbA1c, however, the association with obesity duration persisted, independent of obesity severity. Due to pooling of 3 cohorts and thus the availability of only a limited number harmonised variables across cohorts, our models included adjustment for only a small number of potential confounding variables, meaning there is a possibility of residual confounding. CONCLUSIONS Given that the obesity epidemic is characterised by a much earlier onset of obesity and consequently a greater lifetime exposure, our findings suggest that health policy recommendations aimed at preventing early obesity onset, and therefore reducing lifetime exposure, may help reduce the risk of diabetes, independently of obesity severity. However, to test the robustness of our observed associations, triangulation of evidence from different epidemiological approaches (e.g., mendelian randomization and negative control studies) should be obtained.
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Affiliation(s)
- Tom Norris
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- * E-mail:
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - David Bann
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, United Kingdom
| | - Mark Hamer
- Division of Surgery & Interventional Science/Institute of Sport, Exercise and Health, UCL, London, United Kingdom
| | | | - Leah Li
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ken K. Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, United Kingdom
| | - Russell Viner
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - William Johnson
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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28
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Pamungkas RA, Chamroonsawasdi K. Family Functional-based Coaching Program on Healthy Behavior for Glycemic Control among Indonesian Communities: A Quasi-experimental Study. Oman Med J 2020; 35:e173. [PMID: 32995047 PMCID: PMC7507601 DOI: 10.5001/omj.2020.115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/07/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study sought to examine the impact of a family functional-based coaching program on improving the perceived family functioning practice and clinical outcomes among patients with glycemic uncontrolled type 2 diabetes mellitus (T2DM) in the Indonesian community. METHODS We applied a quasi-experimental study, pretest, and posttest design with a non-equivalent control group. Sixty pairs of T2DM patient-caretaker dyads were recruited and assigned to either an intervention or control group. The Family Function Questionnaire (FFQ) was used to assess the perception of family functioning practices by T2DM patients of their caretakers to support their diabetes self-management. The clinical outcomes were measured using clinical outcome devices and laboratory tests. These measurements were conducted and compared at a baseline and 12 weeks after completing the program. RESULTS Patients who received the family functional-based coaching program saw significant improvement in perception of family function practice, compared to the control group who received usual care. The findings also showed a positive decline glycated hemoglobin and total cholesterol levels after receiving the 12-week program. However, no significant difference was found in body mass index. CONCLUSIONS It can be concluded that a family functional-based coaching program is feasible to implement among uncontrolled T2DM in a large scale study.
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Affiliation(s)
- Rian Adi Pamungkas
- Department of Nursing, Faculty of Health Science, Esa Unggul University, Jakarta, Indonesia
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29
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Wu F, Juonala M, Sabin MA, Buscot MJ, Pahkala K, Smith KJ, Hutri-Kähönen N, Kähönen M, Laitinen TP, Viikari JSA, Raitakari OT, Magnussen CG. Association of Body Mass Index in Youth With Adult Cardiometabolic Risk. J Am Heart Assoc 2020; 9:e015288. [PMID: 32627629 PMCID: PMC7660723 DOI: 10.1161/jaha.119.015288] [Citation(s) in RCA: 4] [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] [Indexed: 12/12/2022]
Abstract
Background Whether long‐term exposure to overweight or obesity from early life to adulthood has a detrimental influence on health outcomes is unknown. We aimed to investigate whether duration of overweight or obesity from youth to adulthood is associated with adult cardiometabolic risk. Methods and Results A population‐based cohort study was performed of 1268 youths, aged 3 to 18 years, with follow‐ups at 3, 6, 9, 12, 21, 27, and 31 years. Duration of overweight or obesity over 31‐year follow‐up was calculated. Adulthood outcomes included type 2 diabetes mellitus, impaired fasting glucose, high insulin levels, high carotid intima‐media thickness, hypertension, low high‐density lipoprotein cholesterol, high low‐density lipoprotein cholesterol and triglycerides, arterial pulse wave velocity, carotid artery compliance, Young elastic modulus, and stiffness index. Rates of overweight/obesity were 7.9% at baseline and 55.9% after 31 years. After adjustment for confounders, longer duration of overweight or obesity was associated with increased risk of all outcomes (relative risk ranged from 1.45–9.06 for type 2 diabetes mellitus, impaired fasting glucose, carotid intima‐media thickness, hypertension, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, and triglycerides; β from 0.370–0.543 m/s for pulse wave velocity; –0.193 to –0.237 %/10 mm Hg for carotid artery compliance; 52.1–136.8 mm Hg·mm for Young elastic modulus; and 0.554–0.882 for stiffness index). When body mass index was further adjusted, these associations disappeared or were substantially reduced. Detrimental associations of adult body mass index with all outcomes were robust to adjustment for confounders and duration of overweight or obesity. Conclusions Overweight or obesity in adulthood rather than childhood appears to be more important for adult cardiometabolic health.
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Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Markus Juonala
- Department of Medicine University of Turku Finland.,Division of Medicine Turku University Hospital Turku Finland
| | - Matthew A Sabin
- Department of Paediatrics Murdoch Children's Research InstituteRoyal Children's HospitalUniversity of Melbourne Vic. Australia
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Finland.,Paavo Nurmi Centre Sports & Exercise Medicine Unit Department of Physical Activity and Health University of Turku Finland.,Centre for Population Health Research University of Turku and Turku University Hospital Turku Finland
| | - Kylie J Smith
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics Tampere University and Tampere University Hospital Tampere Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology Department of Clinical Physiology Tampere University HospitalTampere University Tampere Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital and University of Eastern Finland Kuopio Finland
| | - Jorma S A Viikari
- Department of Medicine University of Turku Finland.,Division of Medicine Turku University Hospital Turku Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Finland.,Centre for Population Health Research University of Turku and Turku University Hospital Turku Finland.,Department of Clinical Physiology and Nuclear Medicine Turku University Hospital Turku Finland
| | - Costan G Magnussen
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Finland.,Centre for Population Health Research University of Turku and Turku University Hospital Turku Finland
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30
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Zamarron BF, Porsche CE, Luan D, Lucas HR, Mergian TA, Martinez-Santibanez G, Cho KW, DelProposto JL, Geletka LM, Muir LA, Singer K, Lumeng CN. Weight Regain in Formerly Obese Mice Hastens Development of Hepatic Steatosis Due to Impaired Adipose Tissue Function. Obesity (Silver Spring) 2020; 28:1086-1097. [PMID: 32281747 PMCID: PMC7245566 DOI: 10.1002/oby.22788] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/20/2020] [Accepted: 02/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Weight regain after weight loss is common, and there is evidence to suggest negative effects on health because of weight cycling. This study sought to investigate the impact of weight regain in formerly obese mice on adipose tissue architecture and stromal cell function. METHODS A diet-switch model was employed for obesity induction, weight loss, and weight regain in mice. Flow cytometry quantified adipose tissue leukocytes in adipose tissue. Liver and adipose tissue depots were compared to determine tissue-specific effects of weight cycling. RESULTS Epididymal white adipose tissue of formerly obese mice failed to expand in response to repeat exposure to high-fat diet and retained elevated numbers of macrophages and T cells. Weight regain was associated with disproportionally elevated liver mass, hepatic triglyceride content, serum insulin concentration, and serum transaminase concentration. These effects occurred despite an extended 6-month weight loss cycle and they demonstrate that formerly obese mice maintain durable alterations in their physiological response to weight regain. Conditioned media from epididymal adipose tissue of formerly obese mice inhibited adipogenesis of 3T3-L1 preadipocytes, suggesting a potential mechanism to explain failed epididymal adipose tissue expansion during weight regain. CONCLUSIONS Metabolic abnormalities related to defects in adipose tissue expansion and ongoing dysfunction manifest in formerly obese mice during weight regain.
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Affiliation(s)
- Brian F Zamarron
- Graduate Program in Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Cara E Porsche
- Graduate Program in Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Danny Luan
- College of Literature Sciences and Arts, University of Michigan, Ann Arbor, Michigan, USA
| | - Hannah R Lucas
- College of Literature Sciences and Arts, University of Michigan, Ann Arbor, Michigan, USA
| | - Taleen A Mergian
- College of Literature Sciences and Arts, University of Michigan, Ann Arbor, Michigan, USA
| | - Gabriel Martinez-Santibanez
- Graduate Program in Cellular and Molecular Biology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kae Won Cho
- Soonchunhyang Institute of Medi-Bio Science, Soonchunhyang University, Cheonan-si, Chungcheongnam-do, Korea
| | - Jennifer L DelProposto
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lynn M Geletka
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lindsey A Muir
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kanakadurga Singer
- Graduate Program in Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Carey N Lumeng
- Graduate Program in Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Graduate Program in Cellular and Molecular Biology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
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31
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Pinchevsky Y, Butkow N, Raal FJ, Chirwa T, Rothberg A. Demographic and Clinical Factors Associated with Development of Type 2 Diabetes: A Review of the Literature. Int J Gen Med 2020; 13:121-129. [PMID: 32280262 PMCID: PMC7127847 DOI: 10.2147/ijgm.s226010] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
Diabetes mellitus is a complex and chronic condition that requires lifelong management and interaction with a healthcare system. Failure to control risk factors through preventive care may lead to a host of diabetes-related complications. Underperforming healthcare systems and poor awareness among the general population/healthcare professionals has been suggested as reasons why so many patients remain undiagnosed. Due to the asymptomatic nature of early and even intermediate diabetes mellitus, several years may pass without any diagnosis before complications begin to manifest. Other factors include age, gender, ethnicity, education, marital and unemployment status which may also increase the risk of developing morbidity and mortality associated with diabetes mellitus. This review summarizes the current demographic risk factors and clinical characteristics associated with diabetes mellitus. A literature search was conducted using PubMed, MEDLINE, and Sabinet by using the following search terms: diabetes mellitus, risk factors, characteristics and complications.
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Affiliation(s)
- Yacob Pinchevsky
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil Butkow
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frederick J Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Chirwa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alan Rothberg
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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32
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Luo J, Hodge A, Hendryx M, Byles JE. Age of obesity onset, cumulative obesity exposure over early adulthood and risk of type 2 diabetes. Diabetologia 2020; 63:519-527. [PMID: 31858184 DOI: 10.1007/s00125-019-05058-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/31/2019] [Indexed: 02/08/2023]
Abstract
AIMS/HYPOTHESIS Obesity is a risk factor for type 2 diabetes, yet little is known about how timing and cumulative exposure of obesity are related to disease risk. The aim of this study was to examine the associations between BMI trajectories, age of onset of obesity and obese-years (a product of degree and duration of obesity) over early adulthood and subsequent risk of type 2 diabetes. METHODS Women aged 18-23 years at baseline (n = 11,192) enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) in 1996 were followed up about every 3 years via surveys for up to 19 years. Self-reported weights were collected up to seven times. Incident type 2 diabetes was self-reported. A growth mixture model was used to identify distinct BMI trajectories over the early adult life course. Cox proportional hazards regression models were used to examine the associations between trajectories and risk of diabetes. RESULTS One hundred and sixty-two (1.5%) women were newly diagnosed with type 2 diabetes during a mean of 16 years of follow-up. Six distinct BMI trajectories were identified, varying by different initial BMI and different slopes of increase. Initial BMI was positively associated with risk of diabetes. We also observed that age at onset of obesity was negatively associated with risk of diabetes (HR 0.87 [95% CI 0.79, 0.96] per 1 year increment), and number of obese-years was positively associated with diabetes (p for trend <0.0001). CONCLUSIONS/INTERPRETATION Our data revealed the importance of timing of obesity, and cumulative exposure to obesity in the development of type 2 diabetes in young women, suggesting that preventing or delaying the onset of obesity and reducing cumulative exposure to obesity may substantially lower the risk of developing diabetes.
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Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E 7th Street, Bloomington, IN, 47405, USA.
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
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Delvecchio M, Pastore C, Valente F, Giordano P. Cardiovascular Implications in Idiopathic and Syndromic Obesity in Childhood: An Update. Front Endocrinol (Lausanne) 2020; 11:330. [PMID: 32582026 PMCID: PMC7296059 DOI: 10.3389/fendo.2020.00330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/28/2020] [Indexed: 01/02/2023] Open
Abstract
Childhood obesity is a modern worldwide epidemic with significant burden for health. It is a chronic metabolic disorder associated with multiple cardiovascular risk factors such as dyslipidemia, hypertension, stroke, and insulin resistance. Many obese adolescents remain obese into adulthood, with increased morbidity and mortality. As childhood obesity is a risk factor for adult obesity, the childhood obesity-related disorders account for an increased risk of cardiovascular consequences in adults, in addition to the effects already exerted by the fat mass in adulthood. Several papers have already described the cardiovascular implications of idiopathic obesity, while few data are available about syndromic obesity, due to the small sample size, not homogeneous phenotypes, and younger age at death. The aim of this mini-review is to give a comprehensive overview on knowledge about cardiovascular implications of idiopathic and syndromic obesity to allow the reader a quick comparison between them. The similarities and differences will be highlighted.
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Affiliation(s)
- Maurizio Delvecchio
- Metabolic Disorders and Diabetes Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
- *Correspondence: Maurizio Delvecchio
| | - Carmela Pastore
- “B. Trambusti” Pediatric Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
| | - Federica Valente
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Paola Giordano
- “B. Trambusti” Pediatric Unit, “Giovanni XXIII” Children Hospital, AOU Policlinico di Bari, Bari, Italy
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Pamungkas RA, Chamroonsawasdi K. Self-management based coaching program to improve diabetes mellitus self-management practice and metabolic markers among uncontrolled type 2 diabetes mellitus in Indonesia: A quasi-experimental study. Diabetes Metab Syndr 2020; 14:53-61. [PMID: 31887715 DOI: 10.1016/j.dsx.2019.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/07/2019] [Accepted: 12/07/2019] [Indexed: 12/11/2022]
Abstract
Diabetes mellitus self-management practice is an essential part of diabetes management among uncontrolled type 2 diabetes mellitus (T2DM). This study aimed to examine the effectiveness of the diabetes mellitus self-management (DMSM) based coaching program on improvement of the DMSM practice and metabolic markers. A quasi-experimental study, pre-test, and post-test design with the non-equivalent control group were applied in this study. Sixty samples were selected and were randomly assigned to both the experimental group and the control group. The Diabetes Self-Management Questionnaire (DSMQ) was used to measure the DMSM practice, while metabolic biomarkers were assessed by using the laboratory test. We conducted and compared the DMSM practice and clinical value at baseline and 12 weeks after completing the program. The DMSM based coaching program was a 12-week program with several strategies based on a self-management model. The findings showed that patients who received the DMSM based coaching program have a positive effect on DMSM practice and metabolic marker except for body mass index (BMI). This study revealed that the DMSM based coaching program was practical and feasible for implementation in a broad population with uncontrolled T2DM in Indonesia.
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Affiliation(s)
- Rian Adi Pamungkas
- Department of Nursing, Faculty of Health Sciences, Esa Unggul University, Jakarta, 11530, Indonesia.
| | - Kanittha Chamroonsawasdi
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand.
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Cristi-Montero C, Steell L, Petermann F, Garrido-Méndez A, Díaz-Martínez X, Salas-Bravo C, Ramirez-Campillo R, Alvarez C, Rodriguez F, Aguilar-Farias N, Martinez MA, Leiva AM, Poblete-Valderrama F, Willis ND, Celis-Morales CA. Joint effect of physical activity and sedentary behaviour on cardiovascular risk factors in Chilean adults. J Public Health (Oxf) 2019; 40:485-492. [PMID: 29045709 DOI: 10.1093/pubmed/fdx134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/13/2017] [Indexed: 11/12/2022] Open
Abstract
Background To investigate the associations between combined categories of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with markers of adiposity and cardiovascular risk in adults. Methods Overall, 5040 participants (mean age 46.4 years and 59.3% women) from the cross-sectional Chilean National Health Survey 2009-2010 were included in this study. MVPA and SB were measured using the Global Physical Activity questionnaire. Four categories were computed using MVPA- and SB-specific cut-offs ('High-SB & Active', 'Low-SB & Active', 'High-SB & Inactive' and 'Low-SB & Inactive'). Results Compared to the reference group ('High-SB & Inactive'), those in 'High-SB & Active' and 'Low-SB & Active' were less likely to have an obese BMI (OR: 0.67 [0.54; 0.85], P = 0.0001 and 0.74 [0.59; 0.92] P = 0.0007, respectively) and less likely to have metabolic syndrome (OR: 0.63 [0.49; 0.82], P < 0.0001 and 0.72 [0.57; 0.91], P = 0.007), central obesity (OR: 0.79 [0.65; 0.96], P = 0.016 and 0.71 [0.59; 0.84], P < 0.0001), diabetes (OR: 0.45 [0.35; 0.59], P < 0.0001 and 0.44 [0.34; 0.56], P < 0.0001) and hypertension (OR: 0.52 [0.43; 0.63], P < 0.0001 and 0.60 [0.50; 0.72], P < 0.0001), respectively. Conclusions Being physically active and spending less time in SBs was associated with lower adiposity and improvements in cardiovascular risk factors.
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Affiliation(s)
- Carlos Cristi-Montero
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Lewis Steell
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Fanny Petermann
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | | | - Ximena Díaz-Martínez
- Grupo de Investigación Calidad de Vida y Estilos de vida saludables, Facultades de Educación y Humanidades, Universidad del Bío-Bío, Chillan, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción, Chile
| | - Rodrigo Ramirez-Campillo
- Departamento de Ciencias de la Actividad Física, Núcleo de Investigación en Salud, Actividad Física y Deporte, Universidad de los Lagos, Osorno, Chile
| | - Cristian Alvarez
- Departamento de Ciencias de la Actividad Física, Núcleo de Investigación en Salud, Actividad Física y Deporte, Universidad de los Lagos, Osorno, Chile
| | - Fernando Rodriguez
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Nicolas Aguilar-Farias
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco, Chile
| | - Maria A Martinez
- Instituto de Farmacia, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - Ana M Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | | | - Naomi D Willis
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Carlos A Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.,Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Centro de Fisiología y Biomecánica, Universidad Mayor, Santiago, Chile
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Yu YH, Bodnar LM, Brooks MM, Himes KP, Naimi AI. Comparison of Parametric and Nonparametric Estimators for the Association Between Incident Prepregnancy Obesity and Stillbirth in a Population-Based Cohort Study. Am J Epidemiol 2019; 188:1328-1336. [PMID: 31111944 DOI: 10.1093/aje/kwz081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/13/2022] Open
Abstract
While prepregnancy obesity increases risk of stillbirth, few studies have evaluated the role of newly developed obesity independent of long-standing obesity. Additionally, researchers have relied almost exclusively on parametric models, which require correct specification of an unknown function for consistent estimation. We estimated the association between incident obesity and stillbirth in a cohort constructed from linked birth and death records in Pennsylvania (2003-2013). Incident obesity was defined as body mass index (weight (kg)/height (m)2) greater than or equal to 30. We used parametric G-computation, semiparametric inverse-probability weighting, and parametric/nonparametric targeted minimum loss-based estimation (TMLE) to estimate the association between incident prepregnancy obesity and stillbirth. Compared with pregnancies from women who stayed nonobese, women who became obese prior to their next pregnancy were estimated to have 2.0 (95% confidence interval (CI): 0.5, 3.5) more stillbirths per 1,000 pregnancies using parametric G-computation. However, despite well-behaved stabilized inverse probability weights, risk differences estimated from inverse-probability weighting, nonparametric TMLE, and parametric TMLE represented 6.9 (95% CI: 3.7, 10.0), 0.4 (95% CI: 0.1, 0.7), and 2.9 (95% CI: 1.5, 4.2) excess stillbirths per 1,000 pregnancies, respectively. These results, particularly those derived from nonparametric TMLE, were highly sensitive to covariates included in the propensity score models. Our results suggest that caution is warranted when using nonparametric estimators to quantify exposure effects.
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Affiliation(s)
- Ya-Hui Yu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa M Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania
| | - Maria M Brooks
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Katherine P Himes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Magee-Womens Research Institute, Pittsburgh, Pennsylvania
| | - Ashley I Naimi
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Livesey G, Taylor R, Livesey HF, Buyken AE, Jenkins DJA, Augustin LSA, Sievenpiper JL, Barclay AW, Liu S, Wolever TMS, Willett WC, Brighenti F, Salas-Salvadó J, Björck I, Rizkalla SW, Riccardi G, Vecchia CL, Ceriello A, Trichopoulou A, Poli A, Astrup A, Kendall CWC, Ha MA, Baer-Sinnott S, Brand-Miller JC. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: Assessment of Causal Relations. Nutrients 2019; 11:E1436. [PMID: 31242690 PMCID: PMC6628270 DOI: 10.3390/nu11061436] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 12/22/2022] Open
Abstract
While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill's criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost-benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.
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Affiliation(s)
- Geoffrey Livesey
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Richard Taylor
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Helen F Livesey
- Independent Nutrition Logic Ltd, 21 Bellrope Lane, Wymondham NR180QX, UK.
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, 33098 Paderborn, Germany.
| | - David J A Jenkins
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Livia S A Augustin
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Epidemiology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Napoli, Italy.
| | - John L Sievenpiper
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Division of Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Alan W Barclay
- Glycemic Index Foundation, 26 Arundel St, Glebe, Sydney NSW 2037, Australia.
| | - Simin Liu
- Department of Epidemiology and Medicine, Brown University, Providence, RI 02912, USA.
| | - Thomas M S Wolever
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard T. H. Chan School of Public Health and Harvard Medical School, Boston, MA 02115, USA.
| | - Furio Brighenti
- Department of Food and Drug, University of Parma, 43120 Parma, Italy.
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, 43201 Reus, Spain.
- Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 27400 Madrid, Spain.
| | - Inger Björck
- Retired from Food for Health Science Centre, Antidiabetic Food Centre, Lund University, S-221 00 Lund, Sweden.
| | - Salwa W Rizkalla
- Institute of Cardiometabolism and Nutrition, ICAN, Pitié Salpêtrière Hospital, F75013 Paris, France.
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, 80147 Naples, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 201330 Milan, Italy.
| | - Antonio Ceriello
- IRCCS MultiMedica, Diabetes Department, Sesto San Giovanni, 20099 Milan, Italy.
| | | | - Andrea Poli
- Nutrition Foundation of Italy, Viale Tunisia 38, I-20124 Milan, Italy.
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports (NEXS) Faculty of Science, University of Copenhagen, 2200 Copenhagen, Denmark.
| | - Cyril W C Kendall
- Departments of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5B5, Canada.
| | - Marie-Ann Ha
- Spinney Nutrition, Shirwell, Barnstaple, Devon EX31 4JR, UK.
| | | | - Jennie C Brand-Miller
- Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Sydney NSW 2006, Australia.
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Qi J, Su Y, Song Q, Ding Z, Cao M, Cui B, Qi Y. Reconsidering the HbA1c Cutoff for Diabetes Diagnosis Based on a Large Chinese Cohort. Exp Clin Endocrinol Diabetes 2019; 129:86-92. [PMID: 31039601 DOI: 10.1055/a-0833-8119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The HbA1c has been considered as the 'gold standard' in diabetes diagnosis and management, however, age, gender and body mass index (BMI) might have certain effects on HbA1c. We are aiming to further investigate the correlation between age and HbA1c, and whether it was affected by gender and BMI. METHODS A cross-sectional survey including 135,893 nondiabetic individuals who took the physical examination between 2013 and 2017 was conducted. The subjects were grouped by gender, age and BMI, and the interactive and independent effects of the 3 factors on the HbA1c were detected. The median and 95% confidence interval (CI) of HbA1c levels were calculated. RESULTS The HbA1c levels gradually increased along with age, both in female and male, and there is a positive association between BMI and the HbA1c. The difference on HbA1c in gender was associated with both age and BMI, the age-related increase in HbAlc was accentuated in the subgroup with higher BMI, and there was a marked accentuation of the positive association between BMI and HbA1c as age increased. In almost all the young and middle-aged (aged 20-59) subgroups, the 97.5th percentiles of HbA1c levels were lower than 6.5%, suggesting that the single HbA1c cutoff value is probably not applicable to the young and middle-aged population. CONCLUSIONS We recommend that the effects of age, gender and BMI should be taken into consideration when using HbA1c for the diagnosis and management of diabetes, especially in the young and middle-aged population.
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Affiliation(s)
- Jiying Qi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yang Su
- Clinical Laboratory, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China.,Chinese Academy of Sciences, Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Qianqian Song
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhaojun Ding
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Min Cao
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bin Cui
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yan Qi
- Department of Endocrine and Metabolic Diseases, Ruijin Hospital North, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Baden MY, Satija A, Hu FB, Huang T. Change in Plant-Based Diet Quality Is Associated with Changes in Plasma Adiposity-Associated Biomarker Concentrations in Women. J Nutr 2019; 149:676-686. [PMID: 30927000 PMCID: PMC6461739 DOI: 10.1093/jn/nxy301] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/15/2018] [Accepted: 11/13/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A healthful plant-based diet is associated with lower risk of cardiometabolic diseases. However, it is still unclear whether such benefits are due to its favorable effects on adiposity-associated biomarkers. OBJECTIVE We investigated the associations between biomarkers and 3 plant-based diet indices: an overall plant-based diet index (PDI); a healthful plant-based diet index (hPDI); and an unhealthful plant-based diet index (uPDI). METHODS In the Nurses' Health Study II, 831 women [baseline mean age: 45 y; body mass index (BMI, kg/m2): 24.6] were randomly selected from those who provided 2 blood samples in 1996-1999 and 2010-2011 to measure plasma concentrations of adiponectin, leptin, soluble leptin receptor (sOB-R), insulin, retinol-binding protein-4, high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6). Plant-based diet indices were derived from semiquantitative food frequency questionnaires assessed at each blood collection. Linear mixed models were used to evaluate cross-sectional associations, and general linear models were used to evaluate longitudinal associations. RESULTS In cross-sectional analyses with multivariable adjustment including BMI, higher hPDI was associated with lower concentrations of leptin, insulin, and hsCRP, and higher adiponectin and sOB-R concentrations (biomarker differences per 10-point higher hPDI: -7.2%, -10.0%, -13.6%, 3.0%, and 1.9%, respectively; P ≤ 0.025). A higher uPDI was associated with higher concentrations of leptin and insulin (4.4% and 4.8%, respectively; P ≤ 0.048). In longitudinal analyses with multivariable adjustment including weight change, an increase in hPDI (improved plant-based diet quality) was inversely associated with changes in leptin and hsCRP (biomarker changes per 10-point hPDI increase: -7.7% and -17.8%, respectively; P ≤ 0.005), whereas an increase in uPDI (worsened plant-based diet quality) was positively associated with changes in leptin, hsCRP, and IL-6 (10.1%, 13.5%, and 12.4%, respectively; P ≤ 0.021). CONCLUSIONS Adherence to a healthful plant-based diet is associated with favorable long-term changes in adiposity-associated biomarker concentrations in women.
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Affiliation(s)
- Megu Y Baden
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Ambika Satija
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Departments of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Tianyi Huang
- Departments of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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Weihrauch-Blüher S, Schwarz P, Klusmann JH. Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism 2019; 92:147-152. [PMID: 30529454 DOI: 10.1016/j.metabol.2018.12.001] [Citation(s) in RCA: 275] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/28/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022]
Abstract
Prevalence of childhood obesity has worldwide more than doubled since 1980. Underlying factors are complex and are far from completely understood. Strategies to prevent childhood obesity have mainly focused on behavioral intervention; and obesity therapy was mainly based on lifestyle modification to date. However, effects for both have been quite limited so far and no country has succeeded in fighting the obesity epidemy we are facing. Normalization of body weight before onset of puberty is crucial for several reasons: First, obese children and adolescents frequently stay obese until adulthood. Second, obesity during adolescence is significantly associated with increased risk for cardiovascular and metabolic disease such as type 2 diabetes in adulthood. And third, recent data have shown a strong association between higher body mass index (BMI) during adolescence and increased risk for several malignancies such as leukemia, Hodgkin's disease, colorectal cancer, breast cancer and others in adulthood. This review summarizes our current understanding of epidemiology, underlying factors, concomitant disease, as well as available intervention strategies and gives an overview of what has been reached so far and what measures should be undertaken to counteract the obesogenic environment.
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Affiliation(s)
| | - Peter Schwarz
- Department of Prevention and Care of Diabetes, Technical University Dresden, Germany; German Center for Diabetes Research (DZD), Paul Langerhans Institute Dresden, Germany
| | - Jan-Henning Klusmann
- Department of Pediatrics I, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Peterson SJ, Shapiro JI, Thompson E, Singh S, Liu L, Weingarten JA, O’Hanlon K, Bialczak A, Bhesania SR, Abraham NG. Oxidized HDL, Adipokines, and Endothelial Dysfunction: A Potential Biomarker Profile for Cardiovascular Risk in Women with Obesity. Obesity (Silver Spring) 2019; 27:87-93. [PMID: 30569635 PMCID: PMC6309990 DOI: 10.1002/oby.22354] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE High BMI predicts adverse cardiovascular outcomes and positively correlates with increased levels of adipokines. The relationship among BMI, IL-6, TNFα, adiponectin, and oxidized high-density lipoprotein (Ox-HDL) with circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) has not been well studied. Elevated CEC levels have been described in both humans and mice with obesity and diabetes. Ox-HDL has been shown to be a potent driver of adipogenesis in vivo and in vitro. In this study, elevated BMI was examined in 2 groups of women studied in Brooklyn, New York, and Huntington, West Virginia, respectively. METHODS Twenty-six females with obesity and five lean controls without overt cardiovascular disease were enrolled, 13 from Huntington and 13 from Brooklyn. Cytokine levels, EPCs, and CECs were determined. RESULTS Females with obesity had elevated levels of leptin, IL-6, and Ox-HDL, increased CEC levels, and decreased EPC and adiponectin levels (all P < 0.01). The Ox-HDL levels were higher in women from Brooklyn versus Huntington (P < 0.01), possibly from higher TNFα levels in Brooklyn or higher adiponectin levels in Huntington. Seventy-five percent of the variance in Ox-HDL levels could be predicted in this population (P < 0.01). CONCLUSIONS This study reveals a unique inflammatory biomarker profile in females with obesity.
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Affiliation(s)
- Stephen J. Peterson
- Weill Cornell Medical College, NY, NY 10021
- New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11215
- Correspondence: Stephen J. Peterson, MD, ()
| | - Joseph I. Shapiro
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701
| | - Ellen Thompson
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701
| | - Shailendra Singh
- Departments of Medicine and Pharmacology, New York Medical College, Valhalla, NY 10595
| | - Lu Liu
- Departments of Medicine and Pharmacology, New York Medical College, Valhalla, NY 10595
| | - Jeremy A. Weingarten
- Weill Cornell Medical College, NY, NY 10021
- New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11215
| | - Kathleen O’Hanlon
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701
| | - Angelica Bialczak
- New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY 11215
| | | | - Nader G. Abraham
- Departments of Medicine and Pharmacology, New York Medical College, Valhalla, NY 10595
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Abstract
PURPOSE OF REVIEW This review summarizes our current understanding of factors associated with childhood obesity, including latest prevalence rates, effectiveness of intervention strategies, and risk for concomitant disease later in life. RECENT FINDINGS Obesity has reached global dimensions, and prevalence of childhood obesity has increased eightfold since 1975. Interventions for obesity prevention have mainly focused on behavioral settings to date, i.e., interventions that have focused on behavioral changes of the individuum such as increasing daily physical exercise or optimizing diet. However, effects have been very limited worldwide and could not stop the increase of obesity prevalence so fare. Thus, community-based/environment-oriented measures are urgently needed, such as promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals in kindergarten and schools, increase of daily physical activity at kindergartens, and schools as well as ban on unhealthy food advertisement for children. Restructuring obesity interventions towards community-based/environment-oriented measures to counteract an obesogenic environment is mandatory for sustainable success and to stop the obesity epidemy. There is need to move fast, as already moderate overweight before the start of puberty is associated with significantly increased risk for type 2 diabetes and cardiovascular disease in midlife.
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Affiliation(s)
- Susann Weihrauch-Blüher
- Department of Pediatrics I/Pediatric Endocrinology, University Hospital of Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle/Saale, Germany.
| | - Susanna Wiegand
- Center for Social-Pediatric Care/Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Berlin, Germany
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Khalyfa A, Gozal D. Connexins and Atrial Fibrillation in Obstructive Sleep Apnea. CURRENT SLEEP MEDICINE REPORTS 2018; 4:300-311. [PMID: 31106116 PMCID: PMC6516763 DOI: 10.1007/s40675-018-0130-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF THE REVIEW To summarize the potential interactions between obstructive sleep apnea (OSA), atrial fibrillation (AF), and connexins. RECENT FINDINGS OSA is highly prevalent in patients with cardiovascular disease, and is associated with increased risk for end-organ substantial morbidities linked to autonomic nervous system imbalance, increased oxidative stress and inflammation, ultimately leading to reduced life expectancy. Epidemiological studies indicate that OSA is associated with increased incidence and progression of coronary heart disease, heart failure, stroke, as well as arrhythmias, particularly AF. Conversely, AF is very common among subjects referred for suspected OSA, and the prevalence of AF increases with OSA severity. The interrelationships between AF and OSA along with the well-known epidemiological links between these two conditions and obesity may reflect shared pathophysiological pathways, which may depend on the intercellular diffusion of signaling molecules into either the extracellular space or require cell-to-cell contact. Connexin signaling is accomplished via direct exchanges of cytosolic molecules between adjacent cells at gap membrane junctions for cell-to-cell coupling. The role of connexins in AF is now quite well established, but the impact of OSA on cardiac connexins has only recently begun to be investigated. Understanding the biology and regulatory mechanisms of connexins in OSA at the transcriptional, translational, and post-translational levels will undoubtedly require major efforts to decipher the breadth and complexity of connexin functions in OSA-induced AF. SUMMARY The risk of end-organ morbidities has initiated the search for circulating mechanistic biomarker signatures and the implementation of biomarker-based algorithms for precision-based diagnosis and risk assessment. Here we summarize recent findings in OSA as they relate to AF risk, and also review potential mechanisms linking OSA, AF and connexins.
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Affiliation(s)
- Abdelnaby Khalyfa
- Department of Pediatrics, Biological Sciences Division, Pritzker School of Medicine, The University of Chicago, Chicago IL 60637, USA
| | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO 65201, USA
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Renner S, Blutke A, Dobenecker B, Dhom G, Müller TD, Finan B, Clemmensen C, Bernau M, Novak I, Rathkolb B, Senf S, Zöls S, Roth M, Götz A, Hofmann SM, Hrabĕ de Angelis M, Wanke R, Kienzle E, Scholz AM, DiMarchi R, Ritzmann M, Tschöp MH, Wolf E. Metabolic syndrome and extensive adipose tissue inflammation in morbidly obese Göttingen minipigs. Mol Metab 2018; 16:180-190. [PMID: 30017782 PMCID: PMC6157610 DOI: 10.1016/j.molmet.2018.06.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/16/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The worldwide prevalence of obesity has increased to 10% in men and 15% in women and is associated with severe comorbidities such as diabetes, cancer, and cardiovascular disease. Animal models of obesity are central to experimental studies of disease mechanisms and therapeutic strategies. Diet-induced obesity (DIO) models in rodents have provided important insights into the pathophysiology of obesity and, in most instances, are the first in line for exploratory pharmacology studies. To deepen the relevance towards translation to human patients, we established a corresponding DIO model in Göttingen minipigs (GM). METHODS Young adult female ovariectomized GM were fed a high-fat/high-energy diet for a period of 70 weeks. The ration was calculated to meet the requirements and maintain body weight (BW) of lean adult minipigs (L-GM group) or increased stepwise to achieve an obese state (DIO-GM group). Body composition, blood parameters and intravenous glucose tolerance were determined at regular intervals. A pilot chronic treatment trial with a GLP1 receptor agonist was conducted in DIO-GM. At the end of the study, the animals were necropsied and a biobank of selected tissues was established. RESULTS DIO-GM developed severe subcutaneous and visceral adiposity (body fat >50% of body mass vs. 22% in L-GM), increased plasma cholesterol, triglyceride, and free fatty acid levels, insulin resistance (HOMA-IR >5 vs. 2 in L-GM), impaired glucose tolerance and increased heart rate when resting and active. However, fasting glucose concentrations stayed within normal range throughout the study. Treatment with a long-acting GLP1 receptor agonist revealed substantial reduction of food intake and body weight within four weeks, with increased drug sensitivity relative to observations in other DIO animal models. Extensive adipose tissue inflammation and adipocyte necrosis was observed in visceral, but not subcutaneous, adipose tissue of DIO-GM. CONCLUSIONS The Munich DIO-GM model resembles hallmarks of the human metabolic syndrome with extensive adipose tissue inflammation and adipocyte necrosis reported for the first time. DIO-GM may be used for evaluating novel treatments of obesity and associated comorbidities. They may help to identify triggers and mechanisms of fat tissue inflammation and mechanisms preventing complete metabolic decompensation despite morbid obesity.
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Affiliation(s)
- Simone Renner
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
| | - Andreas Blutke
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, LMU Munich, Veterinärstr. 13, 80539, Munich, Germany
| | - Britta Dobenecker
- Chair of Animal Nutrition and Dietetics, Department of Veterinary Sciences, LMU Munich, Schönleutnerstr. 8, 85764, Oberschleißheim, Germany
| | - Georg Dhom
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany
| | - Timo D Müller
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Brian Finan
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christoffer Clemmensen
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Maren Bernau
- Livestock Center of the Veterinary Faculty, LMU Munich, St.-Hubertus-Str. 12, 85764, Oberschleißheim, Germany
| | - Istvan Novak
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany
| | - Birgit Rathkolb
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Mouse Clinic (GMC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Steffanie Senf
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Susanne Zöls
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Mirjam Roth
- Animal aspects, 88400, Biberach an der Riss, Germany
| | - Anna Götz
- Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Department of Internal Medicine I, University Hospital RWTH Aachen, Pauwelstr. 30, 52074, Aachen, Germany
| | - Susanna M Hofmann
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute of Diabetes and Regeneration Research (IDR), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Medizinische Klinik und Poliklinik IV, Klinikum der LMU, Ziemssenstr, 180336, Munich, Germany
| | - Martin Hrabĕ de Angelis
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Mouse Clinic (GMC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Genome Analysis Center (GAC), Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health and Chair of Experimental Genetics, Technische Universität, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Rüdiger Wanke
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, LMU Munich, Veterinärstr. 13, 80539, Munich, Germany
| | - Ellen Kienzle
- Chair of Animal Nutrition and Dietetics, Department of Veterinary Sciences, LMU Munich, Schönleutnerstr. 8, 85764, Oberschleißheim, Germany
| | - Armin M Scholz
- Livestock Center of the Veterinary Faculty, LMU Munich, St.-Hubertus-Str. 12, 85764, Oberschleißheim, Germany
| | - Richard DiMarchi
- Novo Nordisk Research Center Indianapolis, 5225 Exploration Drive, Indianapolis, IN, 46241, USA; Department of Chemistry, Indiana University, 800 E. Kirkwood Ave., Bloomington, IN, 47405-7102, USA
| | - Mathias Ritzmann
- Clinic for Swine, Center for Clinical Veterinary Medicine, LMU Munich, Sonnenstr. 16, 85764, Oberschleißheim, Germany
| | - Matthias H Tschöp
- German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Diabetes and Obesity (IDO), Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität, Ismaninger Str. 22, 81675, Munich, Germany
| | - Eckhard Wolf
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764, Oberschleißheim, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, Feodor-Lynen-Str. 25, 81377, Munich, Germany
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Bjerregaard LG, Baker JL. Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes. N Engl J Med 2018; 378:2537. [PMID: 29949486 DOI: 10.1056/nejmc1805984] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
As a leading cause of morbidity and mortality in the United States and worldwide, obesity is a disease that is frequently encountered in clinical practice today and requires a range of medical interventions. While obesity affects both men and women across all ages, multiple issues are particularly germane to women's health, particularly as obesity is more prevalent among women than men in the United States and obesity among women of reproductive health relates to the growing issue of childhood obesity. Discussed herein are the epidemiology and pathophysiology of obesity along with the impact of perinatal obesity on fetal programming. Guidance on screening and management of obesity through lifestyle intervention, pharmacologic therapy, and bariatric surgery, as well as avoidance of weight-promoting medications wherever possible, is elaborated. Particular attention is paid to the contribution of these modalities to weight loss as well as their impact on obesity-related comorbidities that affect a woman's overall health, such as type 2 diabetes and hypertension, and her reproductive and gynecologic health. With modest weight loss, women with obesity can achieve notable improvements in chronic medical conditions, fertility, pregnancy outcomes, and symptoms of pelvic floor disorders. Moreover, as children born to women after bariatric surgery-induced weight loss show improved metabolic outcomes, this demonstrates a role for maternal weight loss in reducing risk of development of metabolic disturbances in children. In light of the immense cost burden and mortality from obesity, it is important to emphasize the role of lifestyle intervention, pharmacologic management, and bariatric surgery for weight loss in clinical practice to mitigate the impact of obesity on women's health.
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Affiliation(s)
| | - Gricelda Gomez
- Harvard Medical School, Boston, Massachusetts
- Department of Surgery-Urology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Fatima Cody Stanford
- Division of Gastroenterology and Endocrinology, Department of Internal Medicine and Pediatrics, Massachusetts General Hospital Weight Center, Boston, Massachusetts
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Lifestyle of women before pregnancy and the risk of offspring obesity during childhood through early adulthood. Int J Obes (Lond) 2018; 42:1275-1284. [PMID: 29568108 DOI: 10.1038/s41366-018-0052-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/13/2017] [Accepted: 01/22/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND In women, adhering to an overall healthy lifestyle is associated with a dramatically reduced risk of cardio-metabolic disorders. Whether such a healthy lifestyle exerts an intergenerational effects on child health deserves examination. METHODS We included 5701 children (9-14 years old at baseline) of the Growing Up Today Study 2, and their mothers, who are participants in the Nurses' Health Study II. Pre-pregnancy healthy lifestyle was defined as a normal body mass index, no smoking, physical activity ≥150 min/week, and diet in the top 40% of the Alternative Healthy Eating Index-2010. Obesity during childhood and adolescence was defined using the International Obesity Task Force age- and sex-specific cutoffs. Multivariable log-binominal regression models with generalized estimating equations were used to evaluate the association of pre-pregnancy healthy lifestyle and offspring obesity. RESULTS We identified 520 (9.1%) offspring who became obese during follow-up. A healthy body weight of mothers and no smoking before pregnancy was significantly associated with a lower risk of obesity among offspring: the relative risks [RRs; 95% confidence intervals (CIs)] were 0.37 (0.31-0.43) and 0.64 (0.49-0.84), respectively. Eating a healthy diet and regular moderate-to-vigorous physical activities were inversely related to offspring obesity risk, but these relations were not statistically significant. Compared to children of mothers who did not meet any low-risk lifestyle factors, offspring of women who adhered to all four healthy lifestyle factors had 75% lower risk of obesity (RR: 0.25, 95% CI: 0.14-0.43). CONCLUSION Adherence to an overall healthy lifestyle before pregnancy is strongly associated with a low risk of offspring obesity in childhood, adolescence, and early adulthood. These findings highlight the importance of an overall healthy lifestyle before pregnancy as a potential strategy to prevent obesity in future generations.
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Edqvist J, Rawshani A, Adiels M, Björck L, Lind M, Svensson AM, Gudbjörnsdottir S, Sattar N, Rosengren A. BMI and Mortality in Patients With New-Onset Type 2 Diabetes: A Comparison With Age- and Sex-Matched Control Subjects From the General Population. Diabetes Care 2018; 41:485-493. [PMID: 29298801 DOI: 10.2337/dc17-1309] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 12/04/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Type 2 diabetes is strongly associated with obesity, but the mortality risk related to elevated body weight in people with type 2 diabetes compared with people without diabetes has not been established. RESEARCH DESIGN AND METHODS We prospectively assessed short- and long-term mortality in people with type 2 diabetes with a recorded diabetes duration ≤5 years identified from the Swedish National Diabetes Register (NDR) between 1998 and 2012 and five age- and sex-matched control subjects per study participant from the general population. RESULTS Over a median follow-up of 5.5 years, there were 17,546 deaths among 149,345 patients with type 2 diabetes (mean age 59.6 years [40% women]) and 68,429 deaths among 743,907 matched control subjects. Short-term all-cause mortality risk (≤5 years) displayed a U-shaped relationship with BMI, with hazard ratios (HRs) ranging from 0.81 (95% CI 0.75-0.88) among patients with diabetes and BMI 30 to <35 kg/m2 to 1.37 (95% CI 1.11-1.71) with BMI ≥40 kg/m2 compared with control subjects after multiple adjustments. Long-term, all weight categories showed increased mortality, with a nadir at BMI 25 to <30 kg/m2 and a stepwise increase up to HR 2.00 (95% CI 1.58-2.54) among patients with BMI ≥40 kg/m2, that was more pronounced in patients <65 years old. CONCLUSIONS Our findings suggest that the apparent paradoxical findings in other studies in this area may have been affected by reverse causality. Long-term, overweight (BMI 25 to <30 kg/m2) patients with type 2 diabetes had low excess mortality risk compared with control subjects, whereas risk in those with BMI ≥40 kg/m2 was substantially increased.
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Affiliation(s)
- Jon Edqvist
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .,Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Araz Rawshani
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Adiels
- Health Metrics Unit, Sahlgrenska Academy, Gothenburg, Sweden
| | - Lena Björck
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Marcus Lind
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,NU Hospital Organisation, Uddevalla, Sweden
| | - Ann-Marie Svensson
- Swedish National Diabetes Register, Centre of Registers, Gothenburg, Sweden
| | | | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, U.K
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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Zameni F, Bakhtiyari M, Mansournia MA, Ramezankhani A, Azizi F, Hadaegh F. Is incident type 2 diabetes associated with cumulative excess weight and abdominal adiposity? Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 2018; 136:134-142. [PMID: 29229382 DOI: 10.1016/j.diabres.2017.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 10/28/2017] [Accepted: 12/05/2017] [Indexed: 11/29/2022]
Abstract
AIMS To examine the association of the risk of incident type 2 diabetes (T2D) with cumulative excess weight (CEW) and cumulative excess waist circumference (CEWC) scores. METHODS Adults participants without T2D (n = 4635) aged ≥20 years were included in the study. The differences between the body mass index (BMI) and waist circumference (WC) values and their normal references were calculated until the incident T2D. The CEW and CEWC scores represent the accumulation of BMI and WC deviations from normal values over time, i.e. (kg/m2 × years and cm × years, respectively). Time-dependent Cox models, adjusting for confounders were used to examine the association between CEW/CEWC and the risk of T2D. Further multivariate analyses were performed to examine the association of CEW and CEWC with incident diabetes in baseline BMI and WC strata. RESULTS There were 503 incident cases of T2D over a median follow-up 9.38 years. The multivariate sex adjusted hazard ratios (HR) per one standard deviation (SD) increase in CEW and CEWC were 1.23 (95% CI: 1.15-1.32) and 1.41 (1.25-1.59), respectively. After further adjustment for baseline BMI and WC, no significant association was observed for CEW (1.02: 0.84-1.23) and CEWC (1.09: 0.93-1.28) and incident T2D. A strong association was found between CEW and CEWC with incident diabetes among overweight (2.12: 1.20-3.74) and centrally obese individuals (1.29: 1.10-1.51), respectively. CONCLUSIONS Generally, CEW and CEWC were not associated with risk of T2D, independent of baseline values for BMI and WC, respectively. Moreover, CEW and CEWC highlighted an increased risk among overweight and centrally obese participants for T2D.
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Affiliation(s)
- Fatemeh Zameni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmood Bakhtiyari
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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50
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Long-term patterns of fasting blood glucose levels and pancreatic cancer incidence. Cancer Causes Control 2017; 29:135-142. [PMID: 29197995 DOI: 10.1007/s10552-017-0988-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/21/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Whether type 2 diabetes is cause or consequence, or both, of pancreatic cancer (PaC) remains unresolved. Leveraging repeated measurements of fasting blood glucose (FBG), we examined the temporal relationship between hyperglycemia and PaC incidence. METHODS We conducted a nested case-control study of 278 cases and 826 matched-controls from the Korean National Health Insurance Service-Health Screening Cohort. Over 11 years before index date (date of PaC diagnosis for cases), all participants had at least one FBG measurement in each of the three time windows: - 11 to - 8, - 7 to - 4, and - 3 to 0 years. Using conditional logistic regression, we estimated odds ratios(ORs) of PaC and 95% confidence intervals (CIs) for hyperglycemia in the overall period and at each interval; for major long-term patterns of FBG across the three intervals (recent-onset, medium-term, and long-standing hyperglycemia). RESULTS Higher FBG over the past 11 years was associated with an increased odds of PaC (p trend < .0001), with recent FBG more predictive of PaC than distant FBG. By FBG assessed in the - 3 to 0 interval, OR was 1.97 (95% CI 1.32-2.93) for 110-125 mg/dL and 3.17 (95% CI 2.09-4.80) for ≥ 126 mg/dL. By long-term patterns of FBG, compared to consistent normoglycemia, OR was 2.02 (95% CI 1.24-3.31) for long-standing hyperglycemia and 3.38 (95% CI 1.87-6.13) for recent-onset hyperglycemia. These associations were more pronounced among never-smokers than ever-smokers (p interaction = .06). CONCLUSION Recent-onset hyperglycemia may be an early manifestation of undetected PaC, while long-lasting hyperglycemia may serve as a moderate etiologic factor for PaC.
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