Abdominal Obesity, Adipokines and Non-communicable Diseases

Associations of bisphenol A exposure with metabolic syndrome and its components: A systematic review and meta-analysis

Mounting evidence shows that bisphenol A (BPA) is associated with metabolic risk factors. The aim of this study was to review related epidemiologic studies and conduct a meta-analysis to quantitatively estimate the association between BPA and metabolic syndrome. Four electronic databases were systematically searched to identify suitable articles. A total of 47 published studies were finally included. Two studies involved metabolic syndrome. Of the 17, 17, 14, and 13 studies on the relationship between BPA with abdominal obesity, blood pressure, fasting plasma glucose, and dyslipidemia, 10, 6, 3, and 4 studies were included in the meta-analysis, respectively. The results showed that the risk of abdominal obesity increased with the increase of BPA exposure, especially in the group with higher BPA exposure levels (Quartile 2 vs. Quartile 1, pooled OR = 1.16, 95%CI: 1.01, 1.33; Q3 vs. Q1, pooled OR = 1.31, 95%CI: 1.13, 1.51; Q4 vs. Q1, pooled OR = 1.40, 95%CI: 1.21, 1.61). However, there was no significant correlation between BPA exposure and metabolic syndrome components including hypertension, abnormal fasting plasma glucose, and dyslipidemia. The present study found that BPA exposure is significantly associated with a higher risk of abdominal obesity. However, the relationship between BPA with metabolic syndrome and its other components needs further longitudinal studies to verify.

The Burden Cancer-Related Deaths Attributable to High Body Mass Index in a Gulf Cooperation Council: Results from the Global Burden of Disease Study 2019

BACKGROUND

BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI).

METHOD

Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman's correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs).

RESULTS

Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI.

CONCLUSION

The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries.

Association of sleep fragmentation with general and abdominal obesity: a population-based longitudinal study

OBJECTIVE

To evaluate the causal relationship between sleep fragmentation (SF) parameters with general and abdominal obesity in free-living conditions.

METHODS

SF parameters were assessed by ActiGraph accelerometers for 7 consecutive days. Obesity was measured at baseline and 1-year follow-up with InBody S10 body composition analyzer.

RESULTS

At baseline, the mean age of the study population was 18.7 years old (SD = 0.9) and 139 (35.7%) were male. Each 1-unit increase of baseline sleep fragmentation index (SFI) was associated with 0.08 kg/m2-increase of body mass index (BMI) (95% CI: 0.03, 0.14), 0.20%-increase of percentage of body fat (PBF) (95% CI: 0.07, 0.32), 0.15 kg-increase of fat mass (FM) (95% CI: 0.03, 0.27), 0.15 cm-increase of waist circumference (WC) (95% CI: 0.03, 0.26) and 0.91 cm2-increase of visceral fat area (VFA) (95% CI: 0.36, 1.46) at the 1-year follow-up. In addition, each 1-unit increase of baseline SFI was associated with 15% increased risk of general obesity (OR = 1.15, 95% CI = 1.04-1.28; p = 0.006) and 7% increased risk of abdominal obesity (OR = 1.07, 95% CI = 1.01-1.13; p = 0.021) in the following year.

CONCLUSIONS

Fragmented sleep is independently associated with an increased risk of both general and abdominal obesity. The result highlights SF as a modifiable risk factor for the prevention and treatment of obesity.

Effects of N-acetylcysteine on the expressions of UCP1 and factors related to thyroid function in visceral adipose tissue of obese adults: a randomized, double-blind clinical trial

BACKGROUND

Evidences have shown that obesity is influenced by various factors, including various hormones such as thyroid hormones and the body's metabolism rate. It seems that practical solutions such as weight loss diets and common drugs can affect these potential disorders. In this study, we investigate one of these common drugs, N-Acetylcysteine (NAC), on expressions of UCP1 and factors related to thyroid function in adults with obesity.

METHODS AND ANALYSIS

The current investigation was carried out as a randomized clinical trial (RCT) including 43 adults with obesity who were potential candidates for bariatric surgery. These individuals were randomly divided into two groups: 600 mg of NAC (n = 22) or placebo (n = 21) for a duration of 8 weeks. Visceral adipose tissue was utilized in the context of bariatric surgery to investigate the gene expression of UCP1 and thyroid function. Polymerase chain reaction (PCR) was performed in duplicate for UCP1, DIO2, DIO3, THRα and β, and 18s RNA (as an internal control) using the provided instructions to investigate the expression of the respective genes.

RESULTS

Our findings revealed that after 8 weeks compared to placebo, NAC caused a significant decrease in the expression of the DIO3 gene as one of the genes related to thyroid function and metabolism. However, regarding other related genes, no statistically significant was found (despite the increase in UCP1, DIO2, and THRα expression and decrease in THRβ expression). In addition, after adjustment of possible confounders, no significant effect was observed on anthropometric factors and serum levels of thyroid hormones.

CONCLUSION

The results of this study indicate that, following an 8-week period, NAC effectively decreases the expression of the DIO3 gene in the visceral fat tissue, in comparison to the placebo.

Association of serum creatinine to cystatin C to waist circumference ratios and hypertension: evidence from China health and retirement longitudinal study

Background

The objective of this study was to explore the association between the ratio of serum creatinine to cystatin C to waist circumference (CCR/WC) and hypertension.

Methods

The study utilized data extracted from the China Health and Retirement Longitudinal Study. In the cross-sectional analysis, logistic regression analyses were employed to examine the association between the CCR/WC ratio and hypertension. By utilizing restricted cubic splines, potential non-linear associations between the CCR/WC ratio and hypertension were explored. In the longitudinal analysis, the association between CCR/WC quartiles (Q1-Q4) and the risk of new-onset hypertension was evaluated by Cox proportional-hazards models.

Results

In total, 7,253 participants were enrolled. The study unveiled an inverse association with hypertension, demonstrating an odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.23-0.37, P < 0.001). Among males, an OR of 0.38 (95% CI: 0.25-0.58, P < 0.001) was observed, while among females, an OR of 0.41 (95% CI: 0.28-0.60, P < 0.001) was noted. There was an absence of a nonlinear association between the CCR/WC ratio and hypertension. Cox regression analysis unveiled a reduced risk of hypertension in Q3 (Hazard ratios [HR]: 0.69, 95% CI: 0.58-0.82, P < 0.001) and Q4: (HR: 0.70, 95% CI: 0.59-0.83, P < 0.001) in compared to the Q1 of the CCR/WC ratio, and sex-specific analysis yielded consistent results.

Conclusion

This study emphasizes the potential association between an elevated CCR/WC ratio and a reduced risk of hypertension.

Dietary determinants of overnutrition among hypertensive patients in southwest Ethiopia: an ordinal regression model

Overnutrition is a recognized risk factor for hypertension, but evidence is lacking among hypertensive patients for tailored dietary interventions. This study assessed dietary factors in 331 hypertensive patients in southwest Ethiopia. The data was collected through a questionnaire and analyzed using factor analysis. Body mass index (BMI) was calculated, and a BMI above 25 kg m-2 was considered overnutrition. An ordinal logistic regression model was used to model the data and control confounders. Adjusted odds ratio and p-values were reported. Among the 331 respondents, consumption of cereals and grains (57.0%); roots and tubers (58.5); and legumes (50.0%), while 28.6% drink alcohol, was common. About 29.0% (24.1-34.2) had overnutrition (22%, 17.6-26.6%, overweight and 7.0%, 4.5-10.3%, obesity). While the predicted odds of overnutrition were higher among males (AOR = 2.85; 1.35-6.02), married (AOR = 1.47; 0.69-3.12), illiterates (AOR = 2.09; 1.18-3.72), advanced age (AOR = 1.65; 0.61-4.61), government employees (AOR = 6.83; 1.19-39.2), and urban dwellers (AOR = 4.06; 1.76-9.36), infrequent vegetable consumption (AOR = 1.47; 0.72-2.96) and lower and higher terciles of cereals and animal-source food consumption (AOR = 1.56; 0.72-3.34). Overnutrition among hypertensive patients was significantly high and associated with unhealthy dietary consumption, educational status, residence, and occupation, emphasizing the need for targeted dietary counseling.

Association between Metabolic Score for Visceral Fat and the risk of hypertension in different ethnic groups: a prospective cohort study in Southwest China

Objective

Visceral adipose tissue assessment holds significant importance in hypertension prevention. This study aimed to explore the association between the Metabolic Score for Visceral Fat (METS-VF), a new indicator based on laboratory and anthropometry measures, and hypertension risk and to further investigate the association between the METS-VF and the risk of hypertension in different ethnic groups.

Methods

In this study, a total of 9,280 people from 48 townships in 12 districts (counties) of Guizhou Province were selected for the survey using a multistage cluster random sampling method, and 5,127 cases were finally included in the analysis after excluding those with missing relevant data, losing visits, dying at follow-up, those who suffered from hypertension at baseline, and those whose information on the outcome of hypertension was not clear. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) between METS-VF and incident hypertension, and an accelerated failure time (AFT) model was applied to analyze the association between METS-VF and the onset time of hypertension.

Results

The total person-years (PYs) of the 5,127 subjects were 36,188.52 years, and the median follow-up time was 6.64 years. During follow-up, 1,127 patients were newly diagnosed with hypertension, and the incidence density was 31.14/1,000 PYs. After adjusting for multivariables, compared with the METS-VF first (Q1), the third (Q3) and fourth (Q4) groups of the METS-VF increased by 29.9% and 61.5%, respectively (HR = 1.299 [1.061, 1.590] and 1.615 [1.280, 2.036]). The risk of hypertension increased with higher METS-VF values (HR = 1.323 [1.167, 1.500], ptrend < 0.001). In the Han Chinese population, Q2 and Q3 increased the risk of hypertension (HR = 1.459 [1.111, 1.917], 1.999 [1.417, 2.718]), and the onset of hypertension was advanced by 0.653 (β = -0.653 (-0.930, -0.375]) years for per 1 unit increase in METS-VF. However, these associations were not found in ethnic minorities.

Conclusion

METS-VF was significantly positively associated with the risk of hypertension, and the association was different among ethnic groups.

The interplay between obesity, immunosenescence, and insulin resistance

Obesity, which is the accumulation of fat in adipose tissue, has adverse impacts on human health. Obesity-related metabolic dysregulation has similarities to the metabolic alterations observed in aging. It has been shown that the adipocytes of obese individuals undergo cellular aging, known as senescence. Senescence can be transmitted to other normal cells through a series of chemical factors referred to as the senescence-associated secretory phenotype (SASP). Most of these factors are pro-inflammatory compounds. The immune system removes these senescent T-cells, but immunosenescence, which is the senescence of immune cells, disrupts the clearance of senescent T-cells. Immunosenescence occurs as a result of aging or indirectly through transmission from senescent tissues. The significant occurrence of senescence in obesity is expected to cause immunosenescence and impairs the immune response to resolve inflammation. The sustained and chronic inflammation disrupts insulin's metabolic actions in metabolic tissues. Therefore, this review focuses on the role of senescent adipocyte cells in obesity-associated immunosenescence and subsequent metabolic dysregulation. Moreover, the article suggests novel therapeutic approaches to improve metabolic syndrome by targeting senescent T-cells or using senotherapeutics.

Severity of abdominal obesity and cardiometabolic diseases in US adults

OBJECTIVES

To determine the prevalence of cardiometabolic diseases (CMDs) among adults with abdominal obesity and to evaluate the necessity of differentiating severity of abdominal obesity.

STUDY DESIGN

Cross-sectional study and prospective cohort study.

METHODS

National Health and Nutrition Examination Survey (NHANES) data between 2011 and 2020 were included for cross-sectional analyses. Class I, II and III abdominal obesity were created by dividing waist circumference within sex-specific abdominal obesity range into tertiles. Age-standardized prevalence of CMDs was estimated and differences by severity of abdominal obesity were compared using Poisson regressions. Prospective analyses were performed using NHANES data between 1988 and 2018 with linked mortality data. Cox proportional hazards models were used to assess the association between severity of abdominal obesity and mortality.

RESULTS

Among 23,168 adults included (mean age: 47.8 years, 49.3% men), 13,307 (57.4%) had abdominal obesity. Among adults with abdominal obesity, the estimated prevalence of diabetes was 17.3% (95% confidence interval: 16.3%, 18.2%), hypertension 39.3% (38.2%, 40.3%), dyslipidemia 59.5% (58.0%, 61.1%), cardiovascular disease 9.0% (8.3%, 9.8%), chronic kidney disease 16.8% (15.9%, 17.7%) and non-alcoholic fatty liver disease 39.9% (38.4%, 41.4%). The estimated prevalence was 55.5% (53.8%, 57.2%) for having ≥2 CMDs. Compared with class I abdominal obesity, class III abdominal obesity was related to a 43%-184% higher prevalence of CMDs and a 44% higher risk of all-cause mortality.

CONCLUSIONS

The prevalence of CMDs was high and multimorbidity of CMDs was common among US adults with abdominal obesity. The prevalence of CMDs and risk of mortality differed significantly by severity of abdominal obesity.

Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity

Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.

Association of changes in waist circumference, waist-to-height ratio and weight-adjusted-waist index with multimorbidity among older Chinese adults: results from the Chinese longitudinal healthy longevity survey (CLHLS)

BACKGROUND

The association of changes in waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted-waist index (WWI) with subsequent risk of multimorbidity remains unclear among older Chinese adults. Therefore, we aimed to assess this association by utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

METHODS

Our study was based on the 2011/2012 wave of the CLHLS whose follow-up surveys were conducted in 2014 and 2017/2018. A total of 2900 participants aged 65 and above at baseline were enrolled. WC, WHtR, and WWI were calculated from measured height, weight, and waist circumference. Multimorbidity refers to the coexistence of two or more of 18 chronic diseases. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) to evaluate the effect of three-year changes in WC, WHtR, and WWI on the risk of multimorbidity.

RESULTS

During a mean follow-up time of 4.2 (2.0) years, 906 multimorbidity cases were identified. Compared to participants in the persistently low WC group, those in the WC gain group and the persistently high WC group had a higher multimorbidity risk with adjusted HRs (95%CI) of 1.23 (1.01-1.50) and 1.34(1.14-1.58), respectively. Participants in the WHtR gain group and the persistently high WHtR group also had higher risks of multimorbidity with HRs (95%CI) of 1.35 (1.08-1.67) and 1.27 (1.05-1.53), respectively, relative to the persistently low WHtR group. Compared to the persistently low WWI group, those in the WWI loss group had a lower risk of multimorbidity with HRs (95%CI) of 0.80 (0.66-0.98). For every standard deviation increase in WC, WHtR, and WWI over three years, the risk of multimorbidity was higher by 12% (95%CI: 1.05-1.19), 13% (95%CI: 1.06-1.20), and 12% (95%CI: 1.05-1.20), respectively.

CONCLUSIONS

Associations of changes in WC, WHtR and WWI with multimorbidity are significant among older Chinese adults. The findings highlight the importance of evaluating changes in WC, WHtR, and WWI in screening and prevention of multimorbidity in older adults.

Visceral obesity determined in routine preoperative CT scans predicts risk of postoperative burst abdomen

Burst abdomen (BA) remains a severe postoperative complication after abdominal surgery. Obesity is a known risk factor for postoperative complications but objective parameters such as body mass index fail to predict BA after abdominal surgery. In recent literature, CT-derived body composition assessment could predict obesity-related diseases and surgical site infections. We report data from the institutional wound register, comparing patients with BA to a subgroup of patients without BA. The CT images were evaluated for intraabdominal and subcutaneous fat tissues. Univariate and multivariate risk factor analysis was performed in order to evaluate CT-derived obesity parameters as risk factor for BA. 92 patients with BA were compared to 32 controls. Patients with BA had significantly more visceral obesity (VO; p < 0.001) but less subcutaneous obesity (SCO) on CT scans. VO and SCO both were positively correlated with BMI (r = 0.452 and 0.572) but VO and SCO were inversely correlated (r = -0.189). Multivariate analysis revealed VO as significant risk factor for postoperative BA (OR 1.257; 95% CI 1.084-1.459; p = 0.003). Our analysis of patients with postoperative BA revealed VO as major risk factor for postoperative BA. Thus, preoperative CT scans gives valuable information on possible risk stratification.

Onion supplementation and health metabolic parameters: A systematic review and meta-analysis of randomized controlled trials

INTRODUCTION

Functional foods, such as onions, have been the center of many recent investigations. In this systematic-review and meta-analysis, we aimed to gather up the existing information with regard to the impact of onion supplementation on anthropometric measurements/indices, lipid profile, indices of glycemic control and hepatic health, systolic and diastolic blood pressures (SBP and DBP), and adiponectin and leptin.

METHODS

All major online datasets (PubMed, Web of Science, Cochrane, and Scopus) were thoroughly searched from inception up to October 2022. Relevant randomized controlled trials (RCTs) were obtained using the eligibility criteria. Weighted mean differences (WMDs) were calculated and reported. Statistical significance was set as p-values <0.05.

RESULTS

Among all the retrieved data, 14 RCTs were eligible to be included. The results of the crude analysis showed that onion supplementation significantly improved body fat percentage (BFP), low-density lipoprotein-cholesterol (LDL-c), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), systolic blood pressure, adiponectin, and aspartate aminotransferase (AST). Subgroup analysis revealed that interventions lasting more than 12 weeks can significantly alter weight, waist circumference (WC), body mass index (BMI), BFP, LDL-c, TC, SBP, and DBP. Moreover, the intake of dosages of >300 mg/day of onion supplementation could significantly improve weight, WC, BMI, BFP, LDL-c, HDL-C, TC, AST, ALT, SBP and DBP.

CONCLUSION

It seems that the intake of onion supplementation can improve health metabolic parameters. We observed that with either longer follow-up periods or higher dosages of onion supplementation, improvements in cardio-metabolic parameters could be expected.

How Interdisciplinary Interventions Can Improve the Educational Process of Children Regarding the Nutritional Labeling of Foods

This research aimed to evaluate the effect of interdisciplinary educational interventions on children's attitudes, knowledge, preferences, and perceptions about different nutrition labels. Four hundred and ten elementary school children, aged between seven and ten years, participated in the research. The children completed questionnaires on attitudes, knowledge, and preferences about nutrition labeling and on perceived healthiness of a food product considering different types of nutrition labels (Pre-Intervention). They then participated in educational interventions as a strategy to address nutrition labeling of foods (Intervention). Finally, the Pre-Intervention questionnaires were reapplied (Post-Intervention). The intervention improved children's attitudes and knowledge about nutrition labeling. It also showed that this public has a greater preference for labels printed on the front of the food package. The label in the form of a warning was considered the most favorable for comparing the healthiness of the food product among children, while the table was the least preferred. It is concluded that interdisciplinary educational interventions are effective in improving children's attitudes, knowledge, preferences, and perceptions about different nutrition labels on a food product. The front label model is the most suitable for food packaging aimed at children.

Association of the number of remaining teeth with kidney function in community-dwelling healthy older adults: a cross-sectional study

Objectives

Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function.

Materials and Methods

We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL).

Results

The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=-0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function.

Conclusion

This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

The association of body composition and fat distribution with hypertension in community-dwelling older adults: the Bushehr Elderly Health (BEH) program

BACKGROUND

A significant proportion of the global burden of disability and premature mortality has caused by hypertension. It seems that the relationship between obesity and hypertension is not only associated with excessive body fat mass (FM) but also with body adipose distribution patterns. The present study investigated the association between regional fat distribution using dual-energy X-ray absorptiometry and hypertension in older adults.

METHODS

This cross-sectional study was performed using the data from Bushehr Elderly Health Program (BEH) on a total of 2419 participants aged 60 and over. Hypertension was defined as SBP of at least 140 mmHg and/or DBP of at least 90 mmHg. SBP between 120 and 139 mmHg and/or a DBP between 80 and 89 mmHg were considered prehypertension. Participants underwent body composition measurement by dual-energy x-ray absorptiometry to analyze FM, fat-free mass (FFM) in trunk and extremities composition.

RESULTS

The results showed that 460 (19.02%) of participants had prehypertension, and 1,818 (75.15% ) had hypertension. The odds of having prehypertension (OR: 1.06, 95%CI: 1.01-1.12) and hypertension (OR: 1.08, 95%CI: 1.03-1.13) increased with a rise in total body FM percentage. Moreover, people with a higher FM to FFM ratio had increased odds of being prehypertensive (OR: 9.93, 95%CI: 1.28-76.99) and hypertensive (OR: 16.15, 95%CI: 2.47-105.52). Having a higher android to gynoid FM ratio was related to increased odds of being prehypertensive and hypertensive.

CONCLUSIONS

This study showed that a higher body FM, particularly in the android region, is associated with higher odds of having hypertension in older adults.

Perioperative Nutritional Management in Enhanced Recovery after Bariatric Surgery

Obesity is a crucial health problem because it leads to several chronic diseases with an increased risk of mortality and it is very hard to reverse with conventional treatment including changes in lifestyle and pharmacotherapy. Bariatric surgery (BS), comprising a range of various surgical procedures that modify the digestive tract favouring weight loss, is considered the most effective medical intervention to counteract severe obesity, especially in the presence of metabolic comorbidities. The Enhanced Recovery After Bariatric Surgery (ERABS) protocols include a set of recommendations that can be applied before and after BS. The primary aim of ERABS protocols is to facilitate and expedite the recovery process while enhancing the overall effectiveness of bariatric procedures. ERABS protocols include indications about preoperative fasting as well as on how to feed the patient on the day of the intervention, and how to nourish and hydrate in the days after BS. This narrative review examines the application, the feasibility and the efficacy of ERABS protocols applied to the field of nutrition. We found that ERABS protocols, in particular not fasting the patient before the surgery, are often not correctly applied for reasons that are not evidence-based. Furthermore, we identified some gaps in the research about some practises that could be implemented in the presence of additional evidence.

General and abdominal obesity and dietary nutrient intake among university students in Bangladesh: A cross-sectional study targeting potential risk factors

BACKGROUND & AIMS

The overall national increase in the prevalence of overweight and obesity has emerged among university students in Bangladesh. Though, poor dietary habits and lifestyle is quite common among university students, their dietary nutrient intake level, obesity prevalence and potential risk factors has hitherto given little priority. This study aimed to understand the prevalence and factors associated with general and abdominal obesity and level of dietary nutrient intake among university students in Bangladesh.

METHODS

Data from 320 unselected tertiary level students (81.6% males, 18.4% females; average age 22.7±3.0, BMI 22.4±3.1 and waist-hip ratio (WHR) 0.88 ± 0.1) was collected randomly, in a single visit, from Islamic University, Kushtia, Bangladesh. Basic demographic and anthropometric information were collected. Twenty-four hour (24H) dietary recall and food frequency questionnaire (FFQ) was used to collect dietary nutrient level retrospectively. Descriptive statistics, chi-square test, t-test, ANOVA, and binomial logistic regression analysis were done.

RESULTS

Around 3% and 42% student were reported to be obese and overweight respectively. Whereas abdominal obesity was prevalent among ∼52% and more than 67% of student were reportedly obese/overweight by either BMI or WHR or WHtR category. Energy and carbohydrate (CHO) intake were reported to be significantly higher (P < 0.05) among overweight who born by C-section delivery and were fed formula milk than those were normal weight and born by vaginal-birth and were breastfed. The overweight individual with a history of preterm birth was reported to intake significantly higher (P < 0.05) carbohydrates compared to normal-weight individuals with a history of term birth. While total fat intake was significantly higher (P < 0.05) among overweight individuals with their mother had gestational diabetes than those with normal weight individuals with mother without gestational diabetes.

CONCLUSIONS

General and abdominal obesity is common among university students and possibly associated with mode of birth, gestational duration, gestational diabetes, and breastfeeding practice.

Sleep-Body Composition Relationship: Roles of Sleep Behaviors in General and Abdominal Obesity in Chinese Adolescents Aged 17-22 Years

This study aimed to investigate the association between sleep behaviors and body composition, which was measured by bioelectrical impedance analysis (BIA) among Chinese adolescents. Overall, 444 students (65.3% females, 19.12 ± 1.177 years) completed questionnaires describing sleep characteristics. Sleep characteristics were derived from subjective means. Body composition was obtained from BIA by InBody 720 (Biospace Co. Ltd., Seoul, Republic of Korea). Regression models tested relationships between sleep and body composition after adjustment for covariates. Students with weekday nap duration (>30 min/d) exerted higher waist-height ratio (WHtR) (B = 0.013, FDR-corrected p = 0.080). Average sleep duration (≤7 h/d) was linked to more WHtR (B = 0.016, FDR-corrected p = 0.080). People with high social jetlag showed gained visceral fat area (B = 7.475), WHtR (B = 0.015), waist to hip ratio (B = 0.012), fat mass index (B = 0.663) and body fat percentage (B = 1.703) (all FDR-corrected p < 0.1). Individuals with screen time before sleep (>0.5 h) exhibited higher visceral fat area (B = 7.934, FDR-corrected p = 0.064), WHtR (B = 0.017, FDR-corrected p = 0.080), waist to hip ratio (B = 0.016, FDR-corrected p = 0.090), fat mass index (B = 0.902, FDR-corrected p = 0.069) and body fat percentage (B = 2.892, FDR-corrected p = 0.018). We found poor sleep characteristics were closely related to general and abdominal obesity.

Effects of N-acetylcysteine on aging cell and obesity complications in obese adults: a randomized, double-blind clinical trial

Background

We decided to conduct this study with the aim of investigating the effects of N-Acetylcysteine (NAC) on obesity complications and senescence of visceral adipose tissue in obese adults.

Methods and analysis

The present study was conducted as a randomized clinical trial (RCT) (Clinical trial registry number: IRCT20220727055563N1) on 40 obese adults candidates for bariatric surgery, who were randomly assigned to receive 600 mg of NAC (n = 20) or placebo as a control (n = 20) for 4 weeks. During bariatric surgery, visceral adipose tissue was used to examine gene expression and senescence cells using SA-β-gal.

Results

Our findings showed that intervention with NAC significantly reduces SA-β-gal activity (as a marker of senescence) and expression of p16 and interleukin 6 (IL-6) genes in the visceral adipose tissue compared to placebo in obese adults for 4 weeks. In addition, our findings showed the potential and beneficial effect of NAC administration on reducing the levels of inflammatory factors including IL-6 and high-sensitivity C-reactive protein (hs-CRP), as well as the level of fasting blood sugar (FBS), homeostatic model assessment of insulin resistance (HOMA-IR), and insulin compared to placebo after adjusting for confounders. No significant effect was indicated on anthropometric factors and lipid profile.

Conclusion

Findings showed that NAC, in addition to having a potential beneficial effect on reducing some of the complications caused by obesity, seems to have synolytic/senomorphic potential as well.

Clinical trial registration

[https://clinicaltrials.gov/], identifier [IRCT20220727055563N1].

Non-communicable disease multimorbidity among tribal older adults in India: evidence from Study on Global AGEing and adult health, 2015

Introduction

Multimorbidity defined as the simultaneous presence of two or more chronic conditions in an individual is on the rise in low- and middle-income countries such as India. With India aiming to achieve universal health coverage, it is imperative to address the inequalities in accessing healthcare, especially among vulnerable groups such as tribal. Moreover, changing lifestyle has led to the emergence of multimorbidity among tribals in India. We aimed to estimate the prevalence and assess the correlates of multimorbidity among tribal older adults in India.

Methods

We employed nationally representative data from the World Health Organization's Study on Global AGEing and Adult Health conducted in 2015. We included 522 participants aged ≥50 years who reported their caste to be 'Scheduled Tribe' in the survey. A multivariable regression model assessed the association between multimorbidity and various attributes.

Results

Arthritis, cataract, and hypertension were the most common chronic conditions. The overall prevalence of multimorbidity was ~22.61%. We observed a higher likelihood of having multimorbidity among respondents aged ≥80 years [AOR: 4.08 (1.17-14.18)] than the younger age groups, and among the most affluent group [AOR: 2.64 (1.06-6.56)] than the most deprived class.

Conclusion

The prevalence of multimorbidity among tribal older adults is emerging which cannot be overlooked. Health and wellness centers may be a window of opportunity to provide egalitarian and quality preventive and curative services to achieve universal health coverage. Future studies should explore the outcomes of multimorbidity in terms of healthcare utilization, expenditure, and quality of life in this group.

Combined Effect of Leisure-Time Physical Activity and Sedentary Behavior on Abdominal Obesity in ELSA-Brasil Participants

INTRODUCTION

Abdominal obesity is a pattern of obesity that has been considered a public health problem. Physical activity is considered an important factor for the prevention of abdominal obesity. Increased time in sedentary behavior has been associated with negative health outcomes, including abdominal obesity.

OBJECTIVE

The aim of this study was to investigate which combination of leisure-time physical activity and sedentary behavior contributes most to the prevention of abdominal obesity in adults participating in ELSA-Brasil (Longitudinal Study of Adult Health).

METHODS

The study was cross-sectional and participants from the first follow-up of the ELSA-Brasil cohort (2012-2014) were analyzed. The independent variables were physical activity, assessed by IPAQ, and sedentary behavior, assessed by a standard questionnaire applied in ELSA-Brasil; the dependent variable was abdominal obesity, determined by waist circumference. The covariates analyzed were the following: age, education, binge drinking, smoking and menopause. The associations between the dependent variable and the independent variables were analyzed using logistic regression. The odds ratio with 95 CI% was estimated.

RESULTS

For men, the combinations were more significant when they were more physically active and spent less time on the sedentary behaviors analyzed, on both a weekday and a weekend day. For menopausal women, both younger and older, all associations of the combinations between sufficient leisure-time physical activity and little time spent in sedentary behaviors contributed to the prevention of abdominal obesity. In non-menopausal women, positive associations were observed in almost all combinations between leisure-time physical activity and sedentary behaviors, with some results that were not statistically significant among younger women.

CONCLUSIONS

Our results showed that being sufficiently active and reducing the time spent in sedentary behavior was the combination that contributed the most to the prevention of abdominal obesity, both in men and women.

The independent and combined effects of dietary and sleep patterns on the risk of metabolic dysfunction-associated fatty liver disease: a population-based cohort study

Background & aims: accumulating evidence shows that various sleep behaviors are related to metabolic dysfunction-associated fatty liver disease (MAFLD), and that diet plays an important role in both preventing and treating this condition. However, the overall effect of a healthy sleep pattern and its joint effect with diet on the risk of MAFLD remain unclear. The aim of this study is to explore the independent and combined effects of dietary and sleep patterns on the MAFLD risk. Methods: this population-based prospective cohort study was conducted in China with a sample size of 13 687 participants. MAFLD was diagnosed through abdominal ultrasound and international expert consensus. Five healthy sleep behaviors were identified to create a healthy sleep pattern, while factor analysis was used to determine dietary patterns. Cox proportional hazards regression was utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: during a total of 49 912 person-years of follow-up, 2977 new cases of MAFLD were identified. The adjusted HRs (95% CIs) of MAFLD in relation to the healthy sleep pattern score were 0.87 (0.78-0.97), 0.83 (0.75-0.92), and 0.77 (0.68-0.87) for scores of 3, 4, and 5, respectively, compared to participants with the lowest score (0-2). A higher intake of animal food (adjusted HR_{4th quartile vs. 1st quartile}, 1.15, 95% CI, 1.03-1.27) and a lower intake of vegetables (adjusted HR_{4th quartile vs. 1st quartile}, 0.88, 95% CI, 0.78-0.99) were associated with a higher risk of MAFLD. Participants who adhered to both healthy dietary and sleep patterns had the lowest MAFLD risk compared to those who followed only one or neither of them. Conclusions: a healthy sleep pattern, especially in combination with a healthy diet, was associated with a lower risk of MAFLD. Future prevention strategies for MAFLD should include consideration of sleep behaviors, in addition to the current recommendations.

Body Composition in Fussy-Eating Children, with and without Neurodevelopmental Disorders, and Their Parents, Following a Taste Education Intervention

Fussy eaters may have an increased risk of becoming overweight or obese as adolescents, with fussy eating and weight status also correlating with neurodevelopmental disorders (NDs) such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Further, maternal and children's weight status relationships are well-established. In this study, we analyzed the body composition of parent-child dyads using bioelectrical impedance analysis (BIA). Fifty-one children aged 8-12 years, with an ND (n = 18) and without (n = 33), and their parents, participated in a 7-week food-based Taste Education intervention with 6-month follow-up. The paired t-test was used to compare differences in body composition based on children's ND status. In logistic regression analysis, odds of children being in the overweight/obese or overfat/obese categories increased by a factor of 9.1 and 10.6, respectively, when having NDs, adjusting for parents' BMI (body mass index) or fat percentage (FAT%). Children with NDs and their parents had significantly higher mean BMI-SDS (BMI standard deviation score) and FAT% at pre-intervention than children without NDs and their parents. Mean BMI-SDS and FAT% lowered significantly between time points for children with NDs and their parents but not for children without NDs or their parents. The findings underline the need for additional exploration into the relationships between children's and parents' body composition based on children's ND status.

Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults

We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.

Muscle Quality Index in Morbidly Obesity Patients Related to Metabolic Syndrome Markers and Cardiorespiratory Fitness

BACKGROUND

Muscle quality index (MQI) is an emerging health indicator obtained by dividing handgrip strength by body mass index (BMI) that needs to be studied in morbidly obese patients (defined by BMI ≥ 35 kg/m²).

OBJECTIVE

To determine the association between MQI, metabolic syndrome (MetS) markers, and cardiorespiratory fitness (CRF), and as a second objective to determine the potential mediation role of MQI in the relationship between abdominal obesity and systolic blood pressure (SBP) in this sample.

METHODS

This cross-sectional study included 86 severely/morbidly obese patients (age = 41.1 ± 11.9 y, nine men). MQI, metabolic syndrome markers, CRF, and anthropometric parameters were measured. Two groups were developed according to MQI; High-MQI (n = 41) and Low-MQI (n = 45).

RESULTS

The Low-MQI group reported higher abdominal obesity (High-MQI: 0.7 ± 0.1 vs. Low-MQI: 0.8 ± 0.1 WC/height; p = 0.011), SBP (High-MQI: 133.0 ± 17.5 vs. Low-MQI: 140.1 ± 15.1 mmHg; p = 0.048), and lower CRF (High-MQI; 26.3 ± 5.9 vs. Low-MQI; 22.4 ± 6.1 mL/kg/min, p = 0.003) than the High-MQI group. Waist-to-height ratio (β: -0.07, p = 0.011), SBP (β: -18.47, p = 0.001), and CRF (β: 5.21, p = 0.011) were linked to MQI. In a mediation model, the indirect effect confirms that MQI is a partial mediator of the association between abdominal obesity with SBP.

CONCLUSIONS

MQI in morbidly obesity patients reported an inverse association with MetS markers and a positive association with CRF (VO2_max). It mediates the relationship between abdominal obesity and SBP.

Association between being Overweight in Young Childhood and during School Age and Puberty

To examine whether body type at birth, body weight, and obesity in early childhood are associated with overweight/obesity during school age and puberty. Data from maternal and child health handbooks, baby health checkup information, and school physical examination information of participants at birth and three-generation cohort studies were linked. Association between body type and body weight at different time intervals (at birth and at 1.5, 3.5, 6, 11, and 14 years of age) were comprehensively analyzed using a multivariate regression model adjusted for gender, maternal age at childbirth, maternal parity, and maternal body mass index, and drinking and smoking statuses at pregnancy confirmation. Children who are overweight in young childhood had a greater risk of being overweight. Particularly, overweight at one year of age during checkup was associated with overweight at 3.5 years (adjusted odds ratio (aOR), 13.42; 95% confidence interval (CI), 4.46-45.42), 6 years (aOR, 6.94; 95% CI, 1.64-33.46), and 11 years (aOR, 5.22; 95% CI, 1.25-24.79) of age. Therefore, being overweight in young childhood could increase the risk of being overweight and obese during school age and puberty. Early intervention in young childhood may be warranted to prevent obesity during school age and puberty.

Adipokine-Cytokine Profile in Patients with Unstable Atherosclerotic Plaques and Abdominal Obesity

The goal of the research was to study the levels of adipokines and their associations with unstable atherosclerotic plaques in patients with coronary atherosclerosis and abdominal obesity (AO).

METHODS

The study included 145 men aged 38-79 with atherosclerosis of the coronary arteries (CA) and stable angina pectoris II-III FC who were hospitalized for coronary bypass surgery (2011-2022). The final analysis included 116 patients. Notably, 70 men had stable plaques in the CA (of which 44.3% had AO), and 46 men had unstable plaques in the CA (of which 43.5% had AO). Adipocytokine levels were determined using multiplex analysis (Human Metabolic Hormone V3 panel).

RESULTS

In the subgroup of patients with unstable plaques, patients with AO had a GLP-1 level that was 1.5 times higher and a lipocalin-2 level that was 2.1 times lower, respectively. GLP-1 is direct, and lipocalin-2 is inversely associated with AO in patients with unstable plaques. Among patients with AO, the level of lipocalin-2 in patients with unstable plaques was 2.2 times lower than in patients with stable plaques in the CA. The level of lipocalin-2 was inversely associated with the presence of unstable atherosclerotic plaques in the CA.

CONCLUSION

GLP-1 is directly associated with AO in patients with unstable atherosclerotic plaques. Lipocalin-2 is inversely associated with unstable atherosclerotic plaques in patients with AO.

Obesity and Abdominal Obesity in Indian Population: Findings from a Nationally Representative Study of 698,286 Participants

This study aims to determine and compare the prevalence and correlates of obesity and abdominal obesity in India among participants aged 18-54 years. Data were acquired from the nationally representative National Family Health Survey 2019-21. Age and sex standardized descriptive analyses were conducted to determine the prevalence of obesity and abdominal obesity, and multivariable multilevel logistic regression was performed to identify the factors associated with these conditions. Gender-specific analyses were also conducted. The sample weight was adjusted throughout. The final sample size for this study was 698,286. The prevalence of obesity and abdominal obesity was 13.85% and 57.71%, respectively. Older age, being female, increased educational status and increased wealth index, being married at any point, and residing in an urban area all increased the odds of both obesity and abdominal obesity. Being a resident of the North zone and having a current alcohol intake increased the odds of abdominal obesity. On the other hand, being a resident of the South zone of India increased the odds of obesity. Targeting these high-risk groups can be a strategy for public health promotion programs.

Amelioration of Obesity-Related Disorders in High-Fat Diet-Fed Mice following Fecal Microbiota Transplantation from Inulin-Dosed Mice

The role of inulin in alleviating obesity-related disorders has been documented; yet, its underlying mechanisms still need to be further investigated. This study attempted to elucidate the causative link between the gut microbiota and the beneficial effect of inulin on obesity-related disorders via transferring the fecal microbiota from inulin-dosed mice to high-fat diet (HFD)-induced obese recipient mice. The results show that inulin supplementation can decrease body weight, fat accumulation, and systemic inflammation and can also enhance glucose metabolism in HFD-induced obese mice. Treatment with inulin reshaped the structure and composition of the gut microbiota in HFD-induced obese mice, as characterized by increases in the relative abundances of Bifidobacterium and Muribaculum and decreases in unidentified_Lachnospiraceae and Lachnoclostridium. In addition, we found that these favorable effects of inulin could be partially transferable by fecal microbiota transplantation, and Bifidobacterium and Muribaculum might be the key bacterial genera. Therefore, our results suggest that inulin ameliorates obesity-related disorders by targeting the gut microbiota.

The effect of empowerment program to reduce Sugar Consumption based on the Multi-Theory Model on Body Mass Index and abdominal obesity in Iranian women

BACKGROUND

Considering the prevalence of overweight and abdominal obesity in middle-aged women, this study was conducted to determine the effect of empowerment program to reduce sugar consumption based on the Multi-Theory Model (MTM) on Body Mass Index (BMI) and abdominal obesity in women aged 30-60 in Joven.

METHODS

This quasi-experimental study (include descriptive and interventional sections) was conducted on the Joven city, Khorasan Razavi province, Iran country from October 2020 to August 2021. Sampling was performed as a multi-stage cluster. First, a descriptive study was performed among 400 women, and then 128 people who were eligible to enter the interventional phase of the study were selected. In the control group, 63 people and in the intervention group, 65 people were eligible to enter the study. The educational intervention was performed in five 60-minute sessions for groups of 12 people. The instruments included the demographic questionnaire, sugar consumption checklist and researcher-made questionnaire based on MTM constructs. Before the intervention, one, three and six months after the intervention, the questionnaire was completed by both intervention and control groups also measurement of waist circumference and BMI were performed using standard instruments. The obtained data were analyzed by SPSS 17.

RESULTS

After the educational intervention, there was a significant difference between the intervention and control groups in all the MTM constructs. Also, six months after the educational intervention, BMI, waist circumference and amount of consumption of sugary substances decreased significantly in the intervention group (p < 0.05).

CONCLUSION

Educational intervention based on the MTM can be effective in reducing the consumption of sugary substances and shaping behaviors related to healthy lifestyle in women.

Gender and Age Differences in Anthropometric Characteristics of Taiwanese Older Adults Aged 65 Years and Older

A previous study provided reference data on the age and gender distribution of anthropometric parameters in Taiwanese adults. However, there are very few large-scale analyses of anthropometric data of older adults in Taiwan. Therefore, the main purpose of this study was to describe gender- and age-specific distributions of anthropometric measurements and anthropometry assessments of Taiwanese older adults. This was a cross-sectional study conducted on 22,389 adults aged 65 years or older (8017 males and 14,372 females) who participated in Taiwan's National Physical Fitness Survey 2014-2015. All participants were recruited using stratified convenience sampling from 46 physical fitness test stations in 22 cities or counties in Taiwan. The anthropometric measurements and anthropometry assessments included in the present study were the assessments of height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The results showed statistically significant differences in weight, height, WC, and WHR across all age groups among both male and female individuals aged 65 years and older in Taiwan. However, there was no significant difference in BMI and HC between males and females in all age groups. Anthropometric status provides an initial assessment of the overall health of the population. This study uses a representative population of Taiwanese older adults over the age of 65 for analysis and provides detailed information on anthropometric data distribution.

Mechanisms of Oxidative Stress in Metabolic Syndrome

Metabolic syndrome is a cluster of conditions associated with the risk of diabetes mellitus type 2 and cardiovascular diseases (CVDs). Metabolic syndrome is closely related to obesity. Increased adiposity promotes inflammation and oxidative stress, which are precursors of various complications involving metabolic syndrome components, namely insulin resistance, hypertension, and hyperlipidemia. An increasing number of studies confirm the importance of oxidative stress and chronic inflammation in the etiology of metabolic syndrome. However, few studies have reviewed the mechanisms underlying the role of oxidative stress in contributing to metabolic syndrome. In this review, we highlight mechanisms by which reactive oxygen species (ROS) increase mitochondrial dysfunction, protein damage, lipid peroxidation, and impair antioxidant function in metabolic syndrome. Biomarkers of oxidative stress can be used in disease diagnosis and evaluation of severity.

Effect of a Multispecies Synbiotic Supplementation on Body Composition, Antioxidant Status, and Gut Microbiomes in Overweight and Obese Subjects: A Randomized, Double-Blind, Placebo-Controlled Study

Studies investigating the effect of multispecies synbiotic supplementation in obesity management are limited. The current study was performed to evaluate the effects of multispecies probiotics mixed with fructooligosaccharides on body composition, antioxidant status, and gut microbiome composition in overweight and obese individuals. We employed a randomized, double-blind, placebo-controlled trial design, in which 63 individuals aged 18-45 years were assigned to receive either a synbiotic supplement or placebo for 12 weeks. The synbiotic group consumed a daily dose of 37 × 10⁹ colony-forming units (CFU) of a unique blend of seven different probiotics, along with 2 g of fructooligosaccharides, while the placebo group consumed 2 g of maltodextrin daily. Assessments were performed at baseline, week 6, and the end of the study. The results of the study indicated that synbiotic supplementation resulted in a significant reduction in waist circumference and body fat percentage compared to the baseline measurements, as observed at 12 weeks. At the end of the study, there were no significant differences observed in body weight, BMI, waist circumference, or percentage of body fat between the synbiotic group and the placebo group. An analysis of plasma antioxidant capacity revealed that synbiotic supplementation caused a significant increase in Trolox equivalent antioxidant capacity (TEAC) and a concomitant decrease in malondialdehyde (MDA) in the test group when compared to the placebo. For the gut microbiota analysis, synbiotic supplementation significantly decreased Firmicutes abundance and the Firmicutes/Bacteroidetes (F/B) ratio at week 12 as compared to the placebo group. Nevertheless, the synbiotic group did not exhibit any substantial alterations in other biochemical blood parameters compared to the placebo group. These findings suggest that multispecies synbiotic supplementation could be a beneficial strategy to improve body composition, antioxidant status, and gut microbiome composition in overweight and obese subjects.

Predictive ability of traditional and novel anthropometric measurement indices for cardio-metabolic diseases in Chinese adults: China Health and Nutrition Survey (CHNS) cohort study

BACKGROUND AND AIMS

Cardio-metabolic diseases has been shown to be strongly associated with obesity. The aim of this study was to compare the predictive value of traditional and novel anthropometric measurement indices for cardio-metabolic diseases risk and evaluate whether new indicators can provide important information in addition to traditional indicators.

METHODS AND RESULTS

China Health and Nutrition Survey (CHNS) data were obtained for this study. Baseline information for healthy participants was gathered from 1997 to 2004. The incidence of cardio-metabolic diseases was collected from 2009 to 2015 for cohort analysis. The predictive ability of each index for the risk of cardio-metabolic diseases was evaluated with time-dependent ROC analysis. Body mass index (BMI) showed the greatest predictive ability for cardio-metabolic disease incidence among all traditional and novel indices (Harrell's C statistic (95% CI): 0.7386 (0.7266-0.7507) for hypertension, 0.7496 (0.7285-0.7706) for diabetes, 0.7895 (0.7593-0.8196) for stroke and 0.7581 (0.7193-0.7969) for myocardial infarction). The addition of novel indices separately into the BMI model did not improve the predictive ability. Novel anthropometric measurement indices such as a body shape index (ABSI), abdominal volume index (AVI) and triponderal mass index (TMI), had a certain prediction ability for adults with BMI <24 kg/m² compared to those with BMI ≥24 kg/m².

CONCLUSION

No strong evidence supports novel anthropometric measurement indices were better than BMI in the prediction of cardio-metabolic diseases incidence among Chinese adults. Novel anthropometric measurement indices, mainly for abdominal obesity, may have a high predictive effect for adults with BMI <24 kg/m².

The association between abdominal obesity and femoral neck bone mineral density in older adults

BACKGROUND

The relationship between obesity and osteoporosis is complex, with contradictory findings reported. Our aim was to evaluate the association between waist circumference (WC), as an easy-to-determine clinical index of abdominal obesity, and femoral neck bone mineral density (BMD) among older adults, using the National Health and Nutrition Examination Survey (NHANES) database.

METHODS

Data of five NHANES cycles (2005-2010, 2013-2014, and 2017-2018), including 5801 adults aged ≥ 60 years, were used in the analysis. Weighted multiple regression analyses were performed to evaluate the association between WC and femoral neck BMD. Weighted generalized additive models and smooth curve fitting were further performed to characterize nonlinearities in the association.

RESULTS

There was a positive association between WC and femoral neck BMD in non-adjusted models. After adjusting for body mass index (BMI), the association became negative. On subgroup analysis stratified by sex, this negative association only existed for men. An inverted U-shaped curve relationship between WC and femoral neck BMD was further identified, with an inflection point at a WC of 95 cm for both men and women.

CONCLUSIONS

Abdominal obesity is a negative predictor of bone health among older adults, independent of BMI. The association between WC and femoral neck BMD followed an inverted U-shaped curve.

Malnutrition Patterns in Children with Chronic Kidney Disease

Malnutrition is frequent in children with chronic kidney disease (CKD). Apart from undernutrition and protein energy wasting (PEW), overnutrition prevalence is rising, resulting in fat mass accumulation. Sedentary behavior and unbalanced diet are the most important causal factors. Both underweight and obesity are linked to adverse outcomes regarding renal function, cardiometabolic risk and mortality rate. Muscle wasting is the cornerstone finding of PEW, preceding fat loss and may lead to fatigue, musculoskeletal decline and frailty. In addition, clinical data emphasize the growing occurrence of muscle mass and strength deficits in patients with fat mass accumulation, attributed to CKD-related wasting processes, reduced physical activity and possibly to obesity-induced inflammatory diseases, leading to sarcopenic obesity. Moreover, children with CKD are susceptible to abdominal obesity, resulting from high body fat distribution into the visceral abdomen compartment. Both sarcopenic and abdominal obesity are associated with increased cardiometabolic risk. This review analyzes the pathogenetic mechanisms, current trends and outcomes of malnutrition patterns in pediatric CKD. Moreover, it underlines the importance of body composition assessment for the nutritional evaluation and summarizes the advantages and limitations of the currently available techniques. Furthermore, it highlights the benefits of growth hormone therapy and physical activity on malnutrition management.

Sex discrepancy in establishing mouse visceral obesity model induced by high-fat diet

OBJECTIVES

To establish a mouse visceral obesity model, and to investigate the effect of animal sex on this model.

METHODS

Thirty-two 4-week-old BALB/c mice were randomly divided into female control group, female high-fat group, male control group and male high-fat group with 8 mice in each group.The control groups were given ordinary diet, and the high-fat groups were given high-fat diet. After 12 weeks of feeding, body weight, visceral fat, fasting blood glucose, glucose tolerance, blood lipid and metabolism-related hormone levels were measured, and the composition of gut microbiota of mice was analyzed by 16S rRNA sequencing.

RESULTS

The high fat diet resulted in a significant increase of body weight and visceral fat content in male mice; the pathological results showed significantly increased fat area, accumulation of liver fat droplets, increased total cholesterol, fasting blood glucose, oral glucose tolerance and serum insulin levels (all P<0.05), as well as significant insulin resistance (P<0.01). However, the above changes were not significant in female mice. Compared with the control groups, there was an increase in the relative abundance of obesity-related gut microbiota in the model groups (such as Blautia), and the microbiota structure changed significantly, while the changes were less obvious in female mice.

CONCLUSIONS

A visceral obesity mouse model has been stably established by feeding high-fat diet in BALB/c male mice, showing visceral fat accumulation, metabolic dysfunction and gut microbiota changes; while female mice are not sensitive in this obesity model.

Asian race is not associated with increased 30-day serious complications or mortality: a MBSAQIP analysis of 594 837 patients

INTRODUCTION

With expansion of bariatric surgery indications to include Asian patients with diabetes and body mass index (BMI) ≥ 27.5, or BMI ≥ 32.5, it is important to characterize Asian patient population undergoing bariatric surgery and assess their postoperative outcomes.

METHODS

This retrospective study analyzed the 2015-2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. All patients undergoing Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) who self-reported as Asian or White race were included. The primary outcomes were to characterize the Asian race population in North American and to identify if Asian race was associated with serious complications or mortality at 30 days.

RESULTS

Overall, 594,837 patients met inclusion, with 4229 self-reporting Asian racial status. Patients of Asian race were younger (41.8 vs 45.5 years, p < 0.001) and had a lower BMI (42.8 vs 44.7 kg/m² p < 0.001) than White patients. They were also more likely to have insulin dependent diabetes (10.9% vs 8.2%, p < 0.001), have received prior cardiac surgery (10.0% vs 1.2% p < 0.001), and suffer from renal insufficiency (1.0% vs 0.5%, p < 0.001). There were no significant differences between rates of RYGB (28.3% vs 28.9%, p = 0.4) and mean operative duration (87.7 vs 87.5 min, p = 0.7). Additionally, there were no differences in 30 day outcomes including leak (0.5% vs 0.5%, p = 0.625), bleeding (1.2% vs 1.0%, p = 0.1), serious complications (3.4% vs 3.5%, p = 0.6), or mortality (0.1% vs 0.1%, p = 0.7) and after confounder control, Asian race was not independently associated with serious complications (OR 1.0, CI 0.9-1.2, p = 0.7), or mortality (OR 1.1, CI 0.3-3.3, p = 0.1).

CONCLUSIONS

Despite the increased metabolic burden of Asian patients, no differences in 30-day outcomes compared to White patients occurs. This data supports evidence suggesting these patients may safely undergo bariatric surgery independent of their increased metabolic burden.

Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India

The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262;  ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.

Brain-Imaging Mechanisms on Female Abdominal Obesity Treated by "Shu-Mu" Acupoint Catgut Embedding and Compatibility Relation: Study Protocol for a 12-Week Randomized Controlled Trial

BACKGROUND

Acupoint catgut embedding (ACE) has been proven to be effective and safe in the treatment of obesity, but few studies have been conducted involving its central mechanisms. Our previous study has demonstrated the effectiveness of Shu-Mu ACE in the treatment of abdominal obesity (AO). However, the neurological mechanism of Shu-Mu ACE for weight loss has not yet been elucidated. The mechanism of the combination of the Shu and Mu acupoints may be related to the central integrative effects of the brain. This paper aims to explore the potential neural mechanisms of Shu-Mu ACE in female patients with AO.

METHODS AND ANALYSIS

A total of 100 eligible female AO patients and 20 healthy female subjects will be recruited for this study. 100 AO patients will be randomly allocated to five groups: Shu-Mu ACE (Group A), Shu ACE (Group B), Mu ACE (Group C), sham ACE (Group D), and waiting-list (Group E). Treatment will be administrated once every two weeks for 12 weeks. The body mass index (BMI), waist circumference (WC), Visual Analog Scales (VAS) of appetite, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) will be utilized to evaluate the clinical efficacy. Outcomes will be assessed at baseline and at each time point of treatment. Multimodal MRI will be performed at baseline and after 12-week treatment and the results will be used to investigate the neural mechanisms of ACE for obesity. Neurological changes and clinical data will be analysed for correlation.

DISCUSSIONS

This study hypothesized that Shu-Mu ACE therapy has a synergistic effect and may treat AO by modulating the neuropathological alterations in the brain. Our findings will demonstrate the neurological mechanism of AO treated by "Shu-Mu" Acupoint Catgut Embedding and compatibility relation.

TRIAL REGISTRATION

This trial is registered at the Chinese Clinical Trial Registration Center (No. ChiCTR2100048920).

Correlation between the Severity of Metabolic Dysfunction-Associated Fatty Liver Disease and Serum Uric Acid to Serum Creatinine Ratio

PURPOSE

As one of the most common chronic liver diseases, metabolic dysfunction-associated fatty liver disease (MAFLD) had different prognoses between mild and moderate-severe levels. Serum uric acid to serum creatinine ratio (sUA/Cr) can reflect the overall metabolic status of the body. To explore a convenient indicator to screen MAFLD and distinguish the severity of the disease, this study analyzed the correlation between sUA/Cr and the severity of MAFLD.

METHODS

228 participants were enrolled and divided into 2 groups, including mild MAFLD and non-MAFLD group and moderate-severe MAFLD group, based on liver/spleen computed tomography (CT) ratios. The correlations between sUA/Cr and the severity of MAFLD were analyzed by logistic and linear regression. Receiver operating characteristics (ROCs) analyzed the predictive ability of sUA/Cr for the severity of MAFLD expressed by the area under curve (AUC).

RESULTS

The level of sUA/Cr was higher in themoderate-severe MAFLD group than mild MAFLD and non-MAFLD group (6.14 ± 1.55 vs. 5.51 ± 1.19, P = 0.008). After adjustment for confounders, the correlation analysis showed that patients with elevated sUA/Cr had a higher risk of moderate-severe MAFLD (OR: 1.350, P = 0.036). A higher sUA/Cr level was associated with lower liver CT values (β = -0.133, P = 0.039) and liver/spleen CT ratio (β = -0.154, P = 0.016). sUA/Cr had the ability to discriminate the severity of MAFLD (AUC: 0.623).

CONCLUSION

sUA/Cr was positively associated with the risk of moderate-severe MAFLD and had the predictive ability to discriminate the moderate-severe MAFLD from mild MAFLD and non-MAFLD. The sUA/Cr level was suggested to be monitored and controlled in the screening and treatment of MAFLD.

Establishment of an indicator framework for global One Health Intrinsic Drivers index based on the grounded theory and fuzzy analytical hierarchy-entropy weight method

BACKGROUND

One Health has become a global consensus to deal with complex health problems. However, the progress of One Health implementation in many countries is still relatively slow, and there is a lack of systematic evaluation index. The purpose of this study was to establish an indicator framework for global One Health Intrinsic Drivers index (GOH-IDI) to evaluate human, animal and environmental health development process globally.

METHOD

First, 82 studies were deeply analyzed by a grounded theory (GT) method, including open coding, axial coding, and selective coding, to establish a three-level indicator framework, which was composed of three selective codes, 19 axial codes, and 79 open codes. Then, through semi-structured interviews with 28 health-related experts, the indicators were further integrated and simplified according to the inclusion criteria of the indicators. Finally, the fuzzy analytical hierarchy process combined with the entropy weight method was used to assign weights to the indicators, thus, forming the evaluation indicator framework of human, animal and environmental health development process.

RESULTS

An indicator framework for GOH-IDI was formed consisting of three selective codes, 15 axial codes and 61 open codes. There were six axial codes for "Human Health", of which "Infectious Diseases" had the highest weight (19.76%) and "Injuries and Violence" had the lowest weight (11.72%). There were four axial codes for "Animal Health", of which "Animal Epidemic Disease" had the highest weight (39.28%) and "Animal Nutritional Status" had the lowest weight (11.59%). Five axial codes were set under "Environmental Health", among which, "Air Quality and Climate Change" had the highest weight (22.63%) and "Hazardous Chemicals" had the lowest weight (17.82%).

CONCLUSIONS

An indicator framework for GOH-IDI was established in this study. The framework were universal, balanced, and scientific, which hopefully to be a tool for evaluation of the joint development of human, animal and environmental health in different regions globally.

Effects of growth hormone on lipid metabolism and sexual development in pubertal obese male rats

To investigate the effects of growth hormone (GH) on pubertal obese male rats, a rat model of high-fat diet-induced obesity was established in juvenile male rats. The model rats were divided into the treatment group (GH) and the non-treatment group (physiological saline). After 4 weeks, we measured the levels of alanine transaminase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), estrogen (E2), testosterone (T), and insulin-like growth factor (IGF-1). The morphological changes of the liver and testis were assessed, and the expression of aromatase was detected. The levels of ALT, AST, TC, TG, LDL-C, E2, and IGF-1 in the treatment group were significantly lower than in the non-treated model rats (P < 0.001). The levels of HDL-C and T of GH-treated rats were significantly higher than those of the non-treatment group (P < 0.001). Compared with non-treated model rats, GH-treated model rats showed reduced liver steatosis, improved morphological structure of the testicular seminiferous tubules, and an increased number of spermatogenic cells. The treatment group also showed lower expression of aromatase in the liver and testis compared with the non-treatment group. GH partially protected pubertal male rats from obesity-induced lipid metabolic disorder and sexual retardation.

Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study

OBJECTIVES

India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years.

DESIGN AND SETTING

We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017-2018.

PARTICIPANTS

This study was conducted among n=59 073 respondents.

OUTCOME MEASURES

Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction.

RESULTS

The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups.

CONCLUSION

Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.

Effect of a Novel Sugar Blend on Weight and Cardiometabolic Health among Healthy Indian Adults: A Randomized, Open-Label Study

Obesity is one of the major factors contributing to noncommunicable diseases (NCDs), which is associated with a high intake of a sugar-rich diet. Sugar blend (a novel combination of sugar and stevia) has half the calories of sugar with the same sweetness at recommended use and offers better compliance. A randomized controlled trial was conducted to evaluate the efficacy and safety of this sugar blend in normal to mildly overweight subjects with a body mass index (BMI) of 23−26 kg/m. Sixty subjects were categorized into Group A: Sugar group (n = 30), and Group B: Sugar blend group (n = 30). The primary outcomes evaluated were weight, waist circumference, hip circumference, waist/hip ratio, BMI, and the secondary outcomes evaluated were lipid profile, random blood sugar, and HbA1c. All these parameters were assessed at baseline, 30 days, 60 days, and 90 days. Group B showed a significantly higher weight loss (p = 0.013) at 90 days compared with Group A. A significant reduction in waist circumference (p < 0.0001) by 4.4 cm was noted at 90 days, in addition to reduction in total cholesterol (p < 0.0001), triglyceride (p = 0.006), LDL cholesterol (p = 0.0490), and VLDL cholesterol (p = 0.006) in Group B compared with the baseline. The study revealed that the sugar blend is an effective formulation in reducing weight, anthropometric factors, and other related metabolic parameters. It has been proven to be well tolerated and promotes weight loss when used in conjunction with a daily balanced diet and exercise plan.

Associations between novel anthropometric measures and the prevalence of hypertension among 45,853 adults: A cross-sectional study

AIMS

Traditional anthropometric measures, including body mass index (BMI), are insufficient for evaluating the risk of hypertension. We aimed to investigate the association between novel anthropometric indices and hypertension risk in a large population in the United States.

METHODS

Forty-five thousand eight hundred fifty-three participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) were enrolled. Social demographic information, lifestyle factors, blood biochemical measurements and anthropometric indices, including body weight, body mass index (BMI), waist circumference, waist-to-height ratio (WtHR), conicity index (CI), a body shape index (ABSI), body roundness index (BRI) and lipid accumulation product (LAP) were collected. Multivariable logistic regression and restricted cubic spline were adopted to investigate the associations between hypertension risk and anthropometric indices. We also performed receiver operating characteristic (ROC) curve analyses to further evaluate the discriminatory powers of anthropometric measurements for screening hypertension risk. Moreover, participants were randomly assigned to the training group and the validation group in a ratio of 3 to 1. A nomogram model based on anthropometric measures was established and validated in the training group and validation group, respectively.

RESULTS

All of the anthropometric measurements investigated were positively and independently associated with the hypertension risk. Among all anthropometric indices, per-SD increment in ABSI had the highest OR (OR: 3.4; 95% CI: 2.73-4.24) after adjusting for age, sex, race/ethnicity, education, smoking, drinking, diabetes, and eGFR. Moreover, results from restricted cubic splines revealed the non-linear association between anthropometric measurements and hypertension risk. In ROC analyses, CI had superior discriminatory power for hypertension (area under the curve: 0.71; 95% CI: 0.706-0.715; optimal cutoff value: 1.3) compared with other indices. Nomogram model based on age, sex, diabetes, CI and LAP showed favorable predicting ability of hypertension risk with an AUC (95% CI) in training group of 80.2% (79.7-80.6%), and the AUC (95% CI) in validation group was 79.5% (78.3-80.1%). Meanwhile, calibration plot showed good consistency.

CONCLUSIONS

Anthropometric measurements including BMI, WtHR, CI, ABSI, BRI and LAP are closely associated with hypertension risk in the present study. For better prevention and treatment of hypertension, more attention should be paid to anthropometric indices, especially novel anthropometric indices.

Adipokines, Metabolic Hormones and Their Associations with Abdominal Obesity against a Background of Hyper-LDL-C in Young People

BACKGROUND

The present study was devoted to the search for possible associations between various adipokines/cytokines associated with the secretory activity of visceral adipocytes, elevated blood levels of LDL-C and abdominal obesity in people under 45 years.

METHODS

A population sample of Novosibirsk residents (n = 1415) was divided into deciles based on the levels of LDL-C. The study included 158 people, 87 men and 71 women, who had serum LDL-C levels of ≥4.2 mmol/L. Abdominal obesity was found in 50% of people (54% men, 45% women). By multiplex analysis using the human metabolic hormone V3 panel and the human adipokine magnetic bead panel, levels of adipokines and inflammatory markers were determined on a Luminex MAGPIX flow fluorimeter.

RESULTS

According to multivariate regression analysis (binary logistic regression), the most significant biomolecules, regardless of other factors, associated with the presence of AO against the background of hyper-LDL-C in young people were leptin (direct association) and lipocalin-2 (reverse association), leptin in young men (direct association), and leptin and TNF-alpha in women (direct association).

CONCLUSIONS

Thus, in young people under 45 years with the presence of two important, potentially atherogenic risk factors-hyper-LDL-C and abdominal obesity-a complex of adipokines and metabolic hormones were associated with the presence of these diseases.

Famine exposure in adolescence is associated with a higher risk of overweight/obesity and abdominal obesity in adulthood: A meta-analysis

Some studies have shown that famine exposure during adolescence can increase cardiovascular disease and diabetes susceptibility in later life. The association between famine exposure in adolescence and overweight/obesity and abdominal obesity in adulthood has been inconsistent. Based on previous studies, we hypothesized that famine exposure in adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. Eight databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched from their inception until November 2021. We initially identified 3982 records and finally included 7 articles after screening. The included articles were of moderate to high quality, containing 16 estimates of overweight/obesity and 3 estimates of abdominal obesity. Pooled odds ratios (ORs) with 95% CIs were used to estimate the association between them. The random effects model was adopted as the pooling method. There was a significant association between famine exposure in adolescence and overweight/obesity in adulthood (OR, 1.17; 95% CI, 1.02-1.33). Adolescents exposed to famine had a greater risk of abdominal obesity in adulthood than their unexposed counterparts (OR, 1.35; 95% CI, 1.03-1.76). These results were more pronounced in females than in males. In summary, our meta-analysis indicates that famine exposure during adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. This suggests that we need to pay timely attention to the nutritional status of adolescents to prevent adverse health consequences of malnutrition. More high-quality studies are needed to confirm these conclusions, given the limitations of this study.