Genetic, dietary, and non-dietary risk factors of obesity among preparatory-year female students at Taibah University, Saudi Arabia

The Impact of Age, Gender, Temporality, and Geographical Region on the Prevalence of Obesity and Overweight in Saudi Arabia: Scope of Evidence

OBJECTIVES

The objectives of this scoping review are to estimate the prevalence of obesity and overweight in the Saudi community and in different age groups, genders, and geographical location, in addition to the change in prevalence over time.

METHODS

This scoping review of evidence was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The population of this review was categorized into four age groups: young adults (18-25 years), adults (26-45), (mid-life adults) (46-60) and old people (60+). Each group was then categorized by gender into males and females. We included studies of adults aged 18 years and above. The pooled prevalence of obesity and overweight of the population, based on BMI, was estimated after stratification based on the age, gender, and geographical area. In addition, the change in the prevalence of obesity/overweight over time from 2011 to 2021 was investigated from the pooled data. The Metaprop program in Stata was used for statistical analysis.

RESULTS

A total of 39 studies with 640,952 participants were included in this review. The pooled prevalence of obesity and overweight in the age group of ≤25 years old, including both genders, was 30%. However, it was higher in young males (40%) compared to young females (25%). The prevalence of obesity and overweight among young adults has dropped by over 40% between 2012 and 2021. The overall pooled prevalence rate of obesity and overweight in the age groups >25 years old (adults, mid-life, and old people), including both genders, was 66%, with similar prevalence among males (68%) and females (71%). In addition, a similar prevalence was observed among both adult and old people (62% and 65%, respectively), but was higher in the mid-life group (76%). Furthermore, mid-life women had the highest prevalence among all groups (87%), compared to 77% among males in the same age group. The same difference in prevalence between the gender persisted in older females compared to older males (79% vs. 65%, respectively). There is a noticeable drop in the pooled prevalence of overweight and obesity among adults > 25 years old of over 28% between 2011 and 2021. There was no difference in the prevalence of obesity/overweight by geographical region.

CONCLUSIONS

Despite the noticeable drop in the prevalence of obesity in the Saudi community, the prevalence of high BMI is high in Saudi Arabia irrespective of age, gender, or geographical location. Mid-life women have the highest prevalence of high BMI, which makes them the focus of a tailored strategy for intervention. Further research is needed to investigate which are the most effective interventions to address obesity in the country.

Effect of Bariatric Surgery on Glycaemic Control in King Fahad Hospital

BACKGROUND

Laparoscopic Sleeve Gastrectomy (LSG) is an approved procedure for weight reduction in obese patients. This outcome of weight loss is essential to achieve optimal control in patients with type 2 diabetes mellitus (T2DM).

OBJECTIVES

This study was designed to evaluate the effect of LSG on glycemic control among a sample of obese patients in Al-Madinah Al-Munawwarah, Saudi Arabia, through assessment of reduction in hemoglobin A1c (HbA1c) associated with weight loss following LSG.

METHODS

In this cross-sectional study, we studied 102 patients with a body mass index (BMI) of ≥30 kg/m2 and aged ≥18 years who underwent LSG between January 2017 and December 2019. Patient age, characteristics, preoperative and postoperative records of BMI and HbA1c were collected. The data of BMI and HbA1c were analyzed based on baseline and mean postoperative readings with variable postoperative visits after LSG.

RESULTS

There was a 30% reduction in BMI and a 26.4% reduction in HbA1c following LSG from baseline in all patients. We noted 44 patients achieved BMI <40kg/m2 with HbA1c <6.5% and 32 patients achieved BMI <40kg/m2 with HbA1c <5.7% within a mean follow-up time of 10 months.

CONCLUSIONS

Laparoscopic Sleeve Gastrectomy (LSG) has a positive effect on glycemic control in obese patients in short term, evidenced by the significant reduction of weight and HbA1c. Larger longitudinal studies are needed to assess the long-term impact of LSG glycemic control and the related factors associated with maintaining weight reduction and optimal glycemic control in Saudi Arabia for patients with obesity.

Laparoscopic sleeve gastrectomy for weight loss and treatment of type 2 diabetes mellitus

Objectives

Weight loss is a key component in the management of type 2 diabetes mellitus (T2DM). This outcome can be potentially achieved by laparoscopic sleeve gastrectomy (LSG). This study aims to determine the efficacy of LSG in reducing weight and to evaluate its impact on controlling T2DM by measuring HbA1c and body mass index (BMI) preoperatively and during the first year following the procedure.

Methods

This retrospective study was carried out on 340 patients aged ≥15 years who had T2DM and a BMI of ≥ 35 kg/m². These patients had LSG at King Fahad Hospital Almadinah Almunawwarah KSA between January 2015 and July 2019. Their HbA1c and BMI were measured preoperatively and then postoperatively at less than one month, 1-3, 4-6, 7-9, and 10-12 months as well as after one year.

Results

Average BMI dropped consistently from a preoperative BMI of 49.27 kg/m² to 32.72 kg/m² at 10-12 months following LSG. A reduction in HbA1c from 8.38% to 6.43% was observed over one year (p = 0.0001). Seventy-five percent of the patients achieved the HbA1c target of 6.5% or less within one year. The remaining 25% of the patients showed improvement in their HbA1c but did not reach the target level.

Conclusion

This study endorses a positive impact of LSG on both weight loss and diabetic status. There was a significant reduction of both BMI (up to the first year) and HbA1c levels postoperatively.

Genetic polymorphisms associated with obesity in the Arab world: a systematic review

BACKGROUND

Obesity, one of the most common chronic health conditions worldwide, is a multifactorial disease caused by complex genetic and environmental interactions. Several association studies have revealed a considerable number of candidate loci for obesity; however, the genotype-phenotype correlations remain unclear. To date, no comprehensive systematic review has been conducted to investigate the genetic risk factors for obesity among Arabs.

OBJECTIVES

This study aimed to systematically review the genetic polymorphisms that are significantly associated with obesity in Arabs.

METHODS

We searched four literature databases (PubMed, Science Direct, Scopus, and Google Scholar) from inception until May 2020 to obtain all reported genetic data related to obesity in Arab populations. Quality assessment and data extraction were performed individually by three investigators.

RESULTS

In total, 59 studies comprising a total of 15,488 cases and 9,760 controls were included in the systematic review. A total of 76 variants located within or near 49 genes were reported to be significantly associated with obesity. Among the 76 variants, two were described as unique to Arabs, as they have not been previously reported in other populations, and 19 were reported to be distinctively associated with obesity in Arabs but not in non-Arab populations.

CONCLUSIONS

There appears to be a unique genetic and clinical susceptibility profile of obesity in Arab patients.