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Zhang L, Wang P, Huang J, Xing Y, Wong FS, Suo J, Wen L. Gut microbiota and therapy for obesity and type 2 diabetes. Front Endocrinol (Lausanne) 2024; 15:1333778. [PMID: 38596222 PMCID: PMC11002083 DOI: 10.3389/fendo.2024.1333778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/06/2024] [Indexed: 04/11/2024] Open
Abstract
There has been a major increase in Type 2 diabetes and obesity in many countries, and this will lead to a global public health crisis, which not only impacts on the quality of life of individuals well but also places a substantial burden on healthcare systems and economies. Obesity is linked to not only to type 2 diabetes but also cardiovascular diseases, musculoskeletal disorders, and certain cancers, also resulting in increased medical costs and diminished quality of life. A number of studies have linked changes in gut in obesity development. Dysbiosis, a deleterious change in gut microbiota composition, leads to altered intestinal permeability, associated with obesity and Type 2 diabetes. Many factors affect the homeostasis of gut microbiota, including diet, genetics, circadian rhythms, medication, probiotics, and antibiotics. In addition, bariatric surgery induces changes in gut microbiota that contributes to the metabolic benefits observed post-surgery. Current obesity management strategies encompass dietary interventions, exercise, pharmacotherapy, and bariatric surgery, with emerging treatments including microbiota-altering approaches showing promising efficacy. While pharmacotherapy has demonstrated significant advancements in recent years, bariatric surgery remains one of the most effective treatments for sustainable weight loss. However, access to this is generally limited to those living with severe obesity. This underscores the need for non-surgical interventions, particularly for adolescents and mildly obese patients. In this comprehensive review, we assess longitudinal alterations in gut microbiota composition and functionality resulting from the two currently most effective anti-obesity treatments: pharmacotherapy and bariatric surgery. Additionally, we highlight the functions of gut microbiota, focusing on specific bacteria, their metabolites, and strategies for modulating gut microbiota to prevent and treat obesity. This review aims to provide insights into the evolving landscape of obesity management and the potential of microbiota-based approaches in addressing this pressing global health challenge.
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Affiliation(s)
- Luyao Zhang
- Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
- Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
| | - Pai Wang
- Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
- Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
| | - Juan Huang
- Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, Changsha, Hunan, China
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanpeng Xing
- Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
- Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
| | - F. Susan Wong
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Jian Suo
- Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Li Wen
- Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
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Ma C, Jian C, Guo L, Li W, Zhang C, Wang L, Yuan M, Zhang P, Dong J, He P, Shi L. Adipose Tissue Targeting Ultra-Small Hybrid Nanoparticles for Synergistic Photodynamic Therapy and Browning Induction in Obesity Treatment. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2308962. [PMID: 37949812 DOI: 10.1002/smll.202308962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/25/2023] [Indexed: 11/12/2023]
Abstract
Photodynamic therapy (PDT), as a means of locally and rapidly inducing adipocyte death via light illumination, in combination with adipose browning induction, a more gradual and widespread effect that could transform white adipose tissue into thermogenic adipose tissue, manifests a promising approach to combat obesity. Herein, adipose-targeting ultra-small hybrid nanoparticles (Pep-PPIX-Baic NPs) composed of an adipose-targeting peptide, Fe3+ , a photosensitizer (protoporphyrin IX), and a browning agent (baicalin) are introduced. Pep-PPIX-Baic NPs have been designed to simultaneously enhance the photodynamic effect and induce browning. After intravenous injection in obese mice, the hybrid nanoparticles can specifically accumulate in white adipose tissues, especially those rich in blood supply, and drive adipose reduction owing to the synergy of the PDT effect and baicalin browning induction. Overall, Pep-PPIX-Baic NPs exhibited superior anti-obesity potential through PDT synergistic with adipose browning induction. The designed multifunctional adipose-targeting hybrid nanoparticles present a prospective nanoplatform for obesity treatment.
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Affiliation(s)
- Chuan Ma
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Chuanjiang Jian
- Department of Pharmacology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Lihao Guo
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Wenting Li
- Department of Pharmacology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Cai Zhang
- Department of Pharmacology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Li Wang
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Miaomiao Yuan
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
| | - Peng Zhang
- Department of Pharmacy, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, 47 Youyi Road, Shenzhen, 518001, China
| | - Jinqiao Dong
- School of Chemistry and Chemical Engineering, Frontiers Science Center for Transformative Molecules and State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Ping He
- Department of Pharmacology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Leilei Shi
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China
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Dong TS, Gee GC, Beltran-Sanchez H, Wang M, Osadchiy V, Kilpatrick LA, Chen Z, Subramanyam V, Zhang Y, Guo Y, Labus JS, Naliboff B, Cole S, Zhang X, Mayer EA, Gupta A. How Discrimination Gets Under the Skin: Biological Determinants of Discrimination Associated With Dysregulation of the Brain-Gut Microbiome System and Psychological Symptoms. Biol Psychiatry 2023; 94:203-214. [PMID: 36754687 PMCID: PMC10684253 DOI: 10.1016/j.biopsych.2022.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Discrimination is associated with negative health outcomes as mediated in part by chronic stress, but a full understanding of the biological pathways is lacking. Here we investigate the effects of discrimination involved in dysregulating the brain-gut microbiome (BGM) system. METHODS A total of 154 participants underwent brain magnetic resonance imaging to measure functional connectivity. Fecal samples were obtained for 16S ribosomal RNA profiling and fecal metabolites and serum for inflammatory markers, along with questionnaires. The Everyday Discrimination Scale was administered to measure chronic and routine experiences of unfair treatment. A sparse partial least squares-discriminant analysis was conducted to predict BGM alterations as a function of discrimination, controlling for sex, age, body mass index, and diet. Associations between discrimination-related BGM alterations and psychological variables were assessed using a tripartite analysis. RESULTS Discrimination was associated with anxiety, depression, and visceral sensitivity. Discrimination was associated with alterations of brain networks related to emotion, cognition and self-perception, and structural and functional changes in the gut microbiome. BGM discrimination-related associations varied by race/ethnicity. Among Black and Hispanic individuals, discrimination led to brain network changes consistent with psychological coping and increased systemic inflammation. For White individuals, discrimination was related to anxiety but not inflammation, while for Asian individuals, the patterns suggest possible somatization and behavioral (e.g., dietary) responses to discrimination. CONCLUSIONS Discrimination is attributed to changes in the BGM system more skewed toward inflammation, threat response, emotional arousal, and psychological symptoms. By integrating diverse lines of research, our results demonstrate evidence that may explain how discrimination contributes to health inequalities.
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Affiliation(s)
- Tien S Dong
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California; Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, California.
| | - Gilbert C Gee
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - Hiram Beltran-Sanchez
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - May Wang
- Department of Community Health Sciences Fielding School of Public Health, Los Angeles, California
| | - Vadim Osadchiy
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Lisa A Kilpatrick
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Zixi Chen
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Vishvak Subramanyam
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Yurui Zhang
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Yinming Guo
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California
| | - Jennifer S Labus
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Bruce Naliboff
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Steve Cole
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles, Los Angeles, California
| | - Xiaobei Zhang
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Emeran A Mayer
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; UCLA Microbiome Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, Los Angeles, California.
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Angelidi AM, Belanger MJ, Kokkinos A, Koliaki CC, Mantzoros CS. Novel Noninvasive Approaches to the Treatment of Obesity: From Pharmacotherapy to Gene Therapy. Endocr Rev 2022; 43:507-557. [PMID: 35552683 PMCID: PMC9113190 DOI: 10.1210/endrev/bnab034] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Indexed: 02/08/2023]
Abstract
Recent insights into the pathophysiologic underlying mechanisms of obesity have led to the discovery of several promising drug targets and novel therapeutic strategies to address the global obesity epidemic and its comorbidities. Current pharmacologic options for obesity management are largely limited in number and of modest efficacy/safety profile. Therefore, the need for safe and more efficacious new agents is urgent. Drugs that are currently under investigation modulate targets across a broad range of systems and tissues, including the central nervous system, gastrointestinal hormones, adipose tissue, kidney, liver, and skeletal muscle. Beyond pharmacotherapeutics, other potential antiobesity strategies are being explored, including novel drug delivery systems, vaccines, modulation of the gut microbiome, and gene therapy. The present review summarizes the pathophysiology of energy homeostasis and highlights pathways being explored in the effort to develop novel antiobesity medications and interventions but does not cover devices and bariatric methods. Emerging pharmacologic agents and alternative approaches targeting these pathways and relevant research in both animals and humans are presented in detail. Special emphasis is given to treatment options at the end of the development pipeline and closer to the clinic (ie, compounds that have a higher chance to be added to our therapeutic armamentarium in the near future). Ultimately, advancements in our understanding of the pathophysiology and interindividual variation of obesity may lead to multimodal and personalized approaches to obesity treatment that will result in safe, effective, and sustainable weight loss until the root causes of the problem are identified and addressed.
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Affiliation(s)
- Angeliki M Angelidi
- Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
- Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matthew J Belanger
- Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alexander Kokkinos
- First Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Chrysi C Koliaki
- First Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Christos S Mantzoros
- Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
- Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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5
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Lu PH, Chen YY, Tsai FM, Liao YL, Huang HF, Yu WH, Kuo CY. Combined Acupoints for the Treatment of Patients with Obesity: An Association Rule Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:7252213. [PMID: 35341146 PMCID: PMC8947926 DOI: 10.1155/2022/7252213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/28/2022] [Accepted: 02/15/2022] [Indexed: 11/21/2022]
Abstract
Obesity is a prevalent metabolic disease that increases the risk of other diseases, such as hypertension, diabetes, hyperlipidemia, cardiovascular disease, and certain cancers. A meta-analysis of 11 randomized sham-controlled trials indicates that acupuncture had adjuvant benefits in improving simple obesity, and previous studies have reported that acupoint combinations were more useful than single-acupoint therapy. The Apriori algorithm, a data mining-based analysis that finds potential correlations in datasets, is broadly applied in medicine and business. This study, based on the Apriori algorithm-based association rule analysis, found the association rules of acupoints among 11 randomized controlled trials (RCTs). There were 23 acupoints extracted from 11 RCTs. We used Python to calculate the association between acupoints and disease. We found the top 10 frequency acupoints were Extra12, TF4, LI4, LI11, ST25, ST36, ST44, CO4, CO18, and CO1. We investigated the 1118 association rule and found that {LI4, ST36} ≥ {ST44}, {LI4, ST44} ≥ {ST36}, and {ST36, ST44} ≥ {LI4} were the most associated rules in the data. Acupoints, including LI4, ST36, and ST44, are the core acupoint combinations in the treatment of simple obesity.
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Affiliation(s)
- Ping-Hsun Lu
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yu-Yang Chen
- Department of Mathematics National Central University, Taoyuan, Taiwan
| | - Fu-Ming Tsai
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yuan-Ling Liao
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Hui-Fen Huang
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wei-Hsuan Yu
- Department of Mathematics National Central University, Taoyuan, Taiwan
| | - Chan-Yen Kuo
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
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Effect of Acupoint Catgut Embedding for Middle-Aged Obesity: A Multicentre, Randomised, Sham-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4780019. [PMID: 35265146 PMCID: PMC8898815 DOI: 10.1155/2022/4780019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022]
Abstract
Objectives This study aimed to examine the efficacy and safety of acupoint catgut embedding (ACE) for obesity over a 16-week treatment period using sham stimulation as the control. Methods A multicenter, randomised, parallel, sham-controlled trial was conducted from February 10, 2017, to May 15, 2018. Men with waistlines ≥85 cm and women with ≥80 cm at three sites were randomised to receive eight sessions (over 16 weeks) of ACE (n = 108) or sham ACE (n = 108) with skin penetration at sham acupoints. The catgut was embedded once every two weeks using two alternating sets of acupoints. The follow-up lasted for an additional 24 weeks. The primary outcome was the percentage waistline reduction from baseline to week 16. Results We included 216 individuals in the intention-to-treat analysis. At 16 weeks, the rate of waistline reduction was 8.80% (95% confidence interval (CI), 7.93% to 9.66%) in the ACE group and 4.09% (95% CI, 3.18% to 5.00%) in the sham control group, with a between-group difference of 4.71% (95% CI, 3.47% to 5.95%; P < 0.0001). This difference persisted throughout the entire follow-up period (between-group difference after 24-week additional weeks, 4.94% (95% CI, 3.58% to 6.30%); P < 0.001). The subgroup analyses of waistline by sex (male/female) revealed treatment effects of 1.93 (95% CI, -0.37 to 4.23, P = 0.1) in the male group and 3.19 (95% CI, 1.99 to 4.39, P < 0.001) in the female group. The adverse event analysis suggested that ACE and laboratory tests confirmed the safety of ACE. Discussion. ACE for 16 weeks could decrease the waistline and weight and was safe for the treatment of obesity. Further research is needed to evaluate the long-term efficacy and sex differences. This trial is registered with NCT02936973.
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Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients 2021; 13:nu13124349. [PMID: 34959901 PMCID: PMC8707041 DOI: 10.3390/nu13124349] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 01/11/2023] Open
Abstract
Patients with chronic kidney disease (CKD) and dialysis have higher mortality than those without, and cardiovascular disease (CVD) is the main cause of death. As CVD is caused by several mechanisms, insulin resistance plays an important role in CVD. This review summarizes the importance and mechanism of insulin resistance in CKD and discusses the current evidence regarding insulin resistance in patients with CKD and dialysis. Insulin resistance has been reported to influence endothelial dysfunction, plaque formation, hypertension, and dyslipidemia. A recent study also reported an association between insulin resistance and cognitive dysfunction, non-alcoholic fatty liver disease, polycystic ovary syndrome, and malignancy. Insulin resistance increases as renal function decrease in patients with CKD and dialysis. Several mechanisms increase insulin resistance in patients with CKD, such as chronic inflammation, oxidative stress, obesity, and mineral bone disorder. There is the possibility that insulin resistance is the potential future target of treatment in patients with CKD.
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Bintoro DA, Nareswari I. The Role of Electroacupuncture in the Regulation of Appetite-Controlling Hormone and Inflammatory Response in Obesity. Med Acupunct 2021; 33:264-268. [PMID: 34471444 PMCID: PMC8403175 DOI: 10.1089/acu.2020.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Obesity, a condition with serious complications, needs special attention. It is a complex and multifactorial problem and regulation of calorie balance involving various humoral and central factors is the main key for managing obesity. In addition, there is an increase in various proinflammatory cytokines and an increase in oxidative stress. There is a need to discover a useful therapy for obesity management. The goal of this review was to examine the literature on electroacupuncture (EA) as a potential therapy. Methods: This review explores the literature on EA, which has proven to be effective for inducing weight loss in experimental human and animal studies. Both continuous and dense-disperse EA waves have their own roles in hormone regulation of obesity using ST 25, CV 9, CV 12, CV 4, SP 6, ST 36, and ST 44; this is discussed the associated mechanism related to this is through suppression of various orexigenic peptides, enhancement of anorexigenic peptides, suppression of inflammatory factors, and improvement in the balance of pro-oxidants and antioxidants. Conclusions: The absence of another definitive therapy for obesity and EA's minimal side-effects make it a potential therapy for managing obesity.
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Affiliation(s)
- Dinda Aniela Bintoro
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central Public Hospital, Central Jakarta, Jakarta, Indonesia
| | - Irma Nareswari
- Department of Medical Acupuncture, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central Public Hospital, Central Jakarta, Jakarta, Indonesia
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9
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Study of LEP, MRAP2 and POMC genes as potential causes of severe obesity in Brazilian patients. Eat Weight Disord 2021; 26:1399-1408. [PMID: 32578125 DOI: 10.1007/s40519-020-00946-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Monogenic forms of obesity are caused by single-gene variants which affect the energy homeostasis by increasing food intake and decreasing energy expenditure. Most of these variants result from disruption of the leptin-melanocortin signaling, which can cause severe early-onset obesity and hyperphagia. These mutation have been identified in genes encoding essential proteins to this pathway, including leptin (LEP), melanocortin 2 receptor accessory proteins 2 (MRAP2) and proopiomelanocortin (POMC). We aimed to investigate the prevalence of LEP, MRAP2 and POMC rare variants in severely obese adults, who developed obesity during childhood. To the best of our knowledge, this is the first study screening rare variants of these genes in patients from Brazil. METHODS A total of 122 Brazilian severely obese patients (BMI ≥ 35 kg/m2) were screened for the coding regions of LEP, MRAP2 and POMC by Sanger sequencing. All patients are candidates to the bariatric surgery. Clinical characteristics were described in patients with novel and/or potentially pathogenic variants. RESULTS Sixteen different variants were identified in these genes, of which two were novel. Among them, one previous variant with potentially deleterious effect in MRAP2 (p.Arg125Cys) was found. In addition, two heterozygous mutations in POMC (p.Phe87Leu and p.Arg90Leu) were predicted to impair protein function. We also observed a POMC homozygous 9 bp insertion (p.Gly99_Ala100insSerSerGly) in three patients. No pathogenic variant was observed in LEP. CONCLUSION Our study described for the first time the prevalence of rare potentially pathogenic MRAP2 and POMC variants in a cohort of Brazilian severely obese adults. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Dutton GR, Kinsey AW, Howell CR, Pisu M, Dobelstein AE, Allison DB, Xun P, Levitsky DA, Fontaine K. The daily Self-Weighing for Obesity Management in Primary Care Study: Rationale, design and methodology. Contemp Clin Trials 2021; 107:106463. [PMID: 34082075 DOI: 10.1016/j.cct.2021.106463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022]
Abstract
Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. Self-Weighing for Obesity Management in Primary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m2 ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).
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Affiliation(s)
- Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amber W Kinsey
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Maria Pisu
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amy E Dobelstein
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA.
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA
| | - David A Levitsky
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, 244 Garden Ave, Ithaca, NY 14853, USA.
| | - Kevin Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA.
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Okida LF, Sasson M, Wolfers M, Hong L, Balzan J, Lo Menzo E, Szomstein S, Grove M, Navia J, Rosenthal RJ. Bariatric surgery is associated with reduced admission for aortic dissection: a nationwide case-control analysis. Surg Obes Relat Dis 2021; 17:1603-1610. [PMID: 34144915 DOI: 10.1016/j.soard.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Aortic dissection (AD) is an uncommon but life-threatening condition associated with high morbidity and mortality. Hypertension (HTN) and hyperlipidemia (HLD) are common modifiable risk factors. OBJECTIVES Since bariatric surgery is associated with remission of obesity-related co-morbidities, we hypothesize that surgical weight loss might be protective against this feared aortic pathology. SETTING A cross-sectional analysis was performed using the National Inpatient Sample database from 2010 to 2015. METHODS The treatment group included bariatric patients and the control group patients with obesity (body mass index [BMI] ≥ 35kg/m2) without previous bariatric surgery. Analyzed covariates included demographics, co-morbidities, aortic diseases, and AD. A multivariate logistic regression analysis (MLRA) was performed to assess the odds of admission for AD in both groups. RESULTS A total of 2,300,845 patients were identified (2,004,804 controls and 296,041 cases). The mean (SEM) age was 54.4 (.05) versus 51.9 (.05) years, for the control and treatment groups, respectively (P < .0001). Bariatric patients posed a significantly lower prevalence of type 2 diabetes (T2D), HTN, HLD, aortic aneurysm, and bicuspid aortic valve (P < .0001) than control subjects. In the control group, 1411 individuals (.070%) had AD, whereas only 94 patients (.032%) in the bariatric surgery group had such diagnosis (P < .0001). The MLRA showed that non-bariatric obese patients had a significantly higher likelihood of suffering from AD (OR = 1.8 [95%CI 1.44-2.29] P < .0001). Considering different age groups, bariatric surgery was found to be less associated with admission for AD for individuals below and above 40 years of age (OR = 2.95 [95%CI 1.09-7.99] P = .0345) and (OR = 1.75 [95%CI 1.38-2.22] P < .0001), respectively. CONCLUSIONS Bariatric surgery could be a protective factor against aortic dissection and should be considered in patients with obesity and risk factors for this cardiovascular complication.
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Affiliation(s)
- Luis Felipe Okida
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Morris Sasson
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Matthew Wolfers
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Liang Hong
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Jorge Balzan
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Emanuele Lo Menzo
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Samuel Szomstein
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Mark Grove
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Jose Navia
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Raul J Rosenthal
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
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12
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Chalazan B, Palm D, Sridhar A, Lee C, Argos M, Daviglus M, Rehman J, Konda S, Darbar D. Common genetic variants associated with obesity in an African-American and Hispanic/Latino population. PLoS One 2021; 16:e0250697. [PMID: 33983957 PMCID: PMC8118531 DOI: 10.1371/journal.pone.0250697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Over 35% of all adults in the world are currently obese and risk of obesity in racial or ethnic minority groups exist in the US, but the causes of these differences are not all known. As obesity is a leading cause of cardiovascular disease, an improved understanding of risk factors across racial and ethnic groups may improve outcomes. Objective The objective of this study was to determine if susceptibility to obesity is associated with genetic variation in candidate single nucleotide polymorphisms (SNPs) in African Americans and Hispanic/Latinos. Materials and methods We examined data from 534 African Americans and 557 Hispanic/Latinos participants from the UIC Cohort of Patients, Family and Friends. Participants were genotyped for the top 26 obesity-associated SNPs within FTO, MC4R, TUB, APOA2, APOA5, ADIPOQ, ARL15, CDH13, KNG1, LEPR, leptin, and SCG3 genes. Results The mean (SD) age of participants was 49±13 years, 55% were female, and mean body mass index (BMI) was 31±7.5 kg/m2. After adjusting for age and sex, we found that rs8050136 in FTO (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.1–1.8; P = 0.01) among African Americans and rs2272383 in TUB (OR 1.34, 95% CI 1.04–1.71; P = 0.02) among Hispanic/Latinos were associated with obesity. However, none of the SNPs in multivariable analysis of either AA or H/L cohorts were significant when adjusted for multiple correction. Conclusions We show that candidate SNPs in the FTO and TUB genes are associated with obesity in African Americans and Hispanic/Latinos individuals respectively. While the underlying pathophysiological mechanisms by which common genetic variants cause obesity remain unclear, we have identified novel therapeutic targets across racial and ethnic groups.
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Affiliation(s)
- Brandon Chalazan
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Denada Palm
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Arvind Sridhar
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Christina Lee
- Broad Institute of MIT and Harvard, Boston, Massachusetts, United States of America
| | - Maria Argos
- Division of Epidemiology and Biostatics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Martha Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Jalees Rehman
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Pharmacology, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Sreenivas Konda
- Division of Epidemiology and Biostatics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Dawood Darbar
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Pharmacology, University of Illinois at Chicago, Chicago, Illinois, United States of America
- * E-mail:
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13
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Rubio-Arias JÁ, Martínez-Aranda LM, Andreu-Caravaca L, Sanz G, Benito PJ, Ramos-Campo DJ. Effects of Whole-Body Vibration Training on Body Composition, Cardiometabolic Risk, and Strength in the Population Who Are Overweight and Obese: A Systematic Review With Meta-analysis. Arch Phys Med Rehabil 2021; 102:2442-2453. [PMID: 33965395 DOI: 10.1016/j.apmr.2021.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/24/2021] [Accepted: 03/23/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the effects of whole-body vibration training (WBVT) on body composition, metabolic and cardiovascular risk variables, and lower limb strength in participants who are overweight/obese. DATA SOURCES A systematic review with meta-analysis was conducted in 3 databases (PubMed-MEDLINE, Web of Science, and Cochrane Library) from inception through to January 26, 2020. STUDY SELECTION Studies analyzing the effect of WBVT on body composition variables, metabolic profile, blood pressure, heart rate, and lower limb strength in the population who are overweight/obese, with interventions of a minimum length of 2 weeks were included. DATA EXTRACTION After applying the inclusion and exclusion criteria, 23 studies involving 884 participants who were obese/overweight (experimental group: 543; weight=79.9 kg; body mass index (BMI) =31.3 kg/m2, obesity class I according to World Health Organization) were used in the quantitative analysis. The sex of the participants involved in the studies were as follows: (1) 17 studies included only female participants; (2) 1 study included only boys, and (3) 5 studies included both sexes. Meta-analysis, subgroup analysis, and meta-regression methods were used to calculate the mean difference and standardized mean difference (SMD; ± 95% confidence intervals [CIs]) as well as to analyze the effects of pre-post intervention WBVT and differences from control groups. DATA SYNTHESIS WBVT led to a significant decrease in fat mass (-1.07 kg, not clinically significant). In addition, WBVT reduced systolic blood pressure (-7.01 mmHg, clinically significant), diastolic blood pressure (-1.83 mmHg), and heart rate (-2.23 bpm), as well as increased the lower extremity strength (SMD=0.63; range, 0.40-0.86). On the other hand, WBVT did not modify the weight, BMI, muscle mass, cholesterol, triglycerides, or glucose. CONCLUSIONS WBVT could be an effective training modality to reduce blood pressure (clinically relevant) and resting heart rate. In addition, WBVT led to improved lower limb strength. However, these findings were not consistent with significant improvements on other variables associated with metabolic syndrome (body composition, cholesterol, triglycerides, glucose).
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Affiliation(s)
- Jacobo Á Rubio-Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain; Department of Education. University of Almería, Almeria, Spain.
| | | | - Luis Andreu-Caravaca
- Faculty of Sport, Catholic University of San Antonio (UCAM), Murcia, Spain; International Chair of Sports Medicine, Catholic University of San Antonio (UCAM), Murcia, Spain
| | - Gema Sanz
- Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Gnomics, Murcia, Spain
| | - Pedro J Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Domingo J Ramos-Campo
- Faculty of Sport, Catholic University of San Antonio (UCAM), Murcia, Spain; Department of Education, University of Alcalá, Madrid, Spain
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Chen R, Huang S, Lin T, Ma H, Shan W, Duan F, Lv J, Zhang J, Ren L, Nie L. Photoacoustic molecular imaging-escorted adipose photodynamic-browning synergy for fighting obesity with virus-like complexes. NATURE NANOTECHNOLOGY 2021; 16:455-465. [PMID: 33526836 DOI: 10.1038/s41565-020-00844-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Photodynamic therapy and adipose browning induction are two promising approaches to reverse obesity. The former strategy acts rapidly and locally, whereas the latter has a more gradual and widespread effect. Despite their complementarity, they have rarely been combined and imaged non-invasively in vivo. Here we introduce an adipose-targeting hepatitis B core protein complex that contains a traceable photosensitizer (ZnPcS4 (zinc phthalocyanine tetrasulfonate)) and a browning agent (rosiglitazone) that allows simultaneous photodynamic and browning treatments, with photoacoustic molecular imaging. After intravenous injection in obese mice, the complex binds specifically to white adipose tissues, especially those rich in blood supply, and drives adipose reduction thanks to the synergy of ZnPcS4 photodynamics and rosiglitazone browning. Using photoacoustic molecular imaging, we could monitor the changes induced by the treatment, which included complex activity, lipid catabolism and angiogenesis. Our findings demonstrate the anti-obesity potential of our feedback-based synergic regimen orchestrated by the targeted hepatitis B core complex.
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Affiliation(s)
- Ronghe Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Shanshan Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Tongtong Lin
- Department of Biomaterials, Key Laboratory of Biomedical Engineering of Fujian Province, State Key Laboratory of Physical Chemistry of Solid Surface, College of Materials, Xiamen University, Xiamen, China
| | - Haosong Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Wenjun Shan
- Department of Pharmacology, College of Pharmacy, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fei Duan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Jing Lv
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Jinde Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Lei Ren
- Department of Biomaterials, Key Laboratory of Biomedical Engineering of Fujian Province, State Key Laboratory of Physical Chemistry of Solid Surface, College of Materials, Xiamen University, Xiamen, China
| | - Liming Nie
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China.
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15
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Nash MS, Gater DR. Cardiometabolic Disease and Dysfunction Following Spinal Cord Injury. Phys Med Rehabil Clin N Am 2020; 31:415-436. [DOI: 10.1016/j.pmr.2020.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Kim BY, Kang SM, Kang JH, Kim KK, Kim B, Kim SJ, Kim YH, Kim JH, Kim JH, Nam GE, Park JY, Son JW, Shin HJ, Oh TJ, Lee H, Jeon EJ, Chung S, Hong YH, Kim CH. Current Long-Term Pharmacotherapies for the Management of Obesity. J Obes Metab Syndr 2020; 29:99-109. [PMID: 32378399 PMCID: PMC7338489 DOI: 10.7570/jomes20010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/27/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023] Open
Abstract
Obesity is a serious and growing worldwide health challenge associated with type 2 diabetes mellitus, cardiovascular disease, osteoarthritis, some cancers, sleep apnea, asthma, and nonalcoholic fatty liver. The Korean Society for the Study of Obesity recommends that pharmacotherapy should be considered when intensive lifestyle modifications fail to achieve a weight reduction in obese patients with a body mass index ≥25 kg/m2. Long-term medications for obesity have traditionally fallen into two major categories: centrally acting anorexiant medications and peripherally acting medications, such as orlistat. In this paper, we provide an overview of the anti-obesity medications currently available for the long-term and individualized treatment of obesity.
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Affiliation(s)
- Bo-Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Seon Mee Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sun Medical Center, Daejeon, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Kyoung Kon Kim
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Bomtaeck Kim
- Department of Family Practice and Community Health, Ajou University Medical Center, Suwon, Korea
| | - Seung Jun Kim
- Department of Psychiatry, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jung-Hwan Kim
- Department of Family Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yeon Park
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Jang Won Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyug Lee
- Central St' Mary's Clinic Internal Medicine, Seoul, Korea
| | - Eon-Ju Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Chong Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
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Nash MS, Groah SL, Gater DR, Dyson-Hudson TA, Lieberman JA, Myers J, Sabharwal S, Taylor AJ. Identification and Management of Cardiometabolic Risk after Spinal Cord Injury. J Spinal Cord Med 2019; 42:643-677. [PMID: 31180274 PMCID: PMC6758611 DOI: 10.1080/10790268.2018.1511401] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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18
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Costa Pereira LM, Aidar FJ, de Matos DG, de Farias Neto JP, de Souza RF, Sobral Sousa AC, de Almeida RR, Prado Nunes MA, Nunes-Silva A, da Silva Júnior WM. Assessment of Cardiometabolic Risk Factors, Physical Activity Levels, and Quality of Life in Stratified Groups up to 10 Years after Bariatric Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111975. [PMID: 31167365 PMCID: PMC6603870 DOI: 10.3390/ijerph16111975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/25/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022]
Abstract
Obesity is a highly prevalent chronic metabolic disease, with an increasing incidence, and is currently approaching epidemic proportions in developing countries. Ouraim was to evaluate the activity levels, quality of life (QoL), clinical parameters, laboratory parameters, and cardiometabolic risk factors afterbariatric surgery (BS). We classified78 patients who underwentBS into four groups, as follows: Those evaluated 1–2 years after BS (BS2), 2–4 years after BS (BS4), 4–6 years after BS (BS6), and 6–10 years after BS (BS+6). Body weight (BW), body mass index (BMI), comorbidities associated with obesity (ACRO), physical activity level, and QoL were evaluated. Patients exhibited improvements in BW, BMI, cardiometabolic risk, hypertension, dyslipidemia, and diabetes and significant changes in lipid profiles in the first postoperative yearafter BS.The physical activity level inthe BS2, BS4, and BS6 groups was increased, compared with that in the first postoperative year, with a decrease in International Physical Activity Questionnaire scores at 1 year in the BS2 (207.50 ± 30.79), BS4 (210.67 ± 33.69), and BS6 (220.00 ± 42.78) groups. The QoL of patients in theBS2 and BS4 groups was excellent and that of patients in the BS4 and BS+6 groupswas very good. These findings suggest that BS promoted improved physical activity levels and QoL and reduced comorbidities in patients with morbid obesity.
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Affiliation(s)
| | - Felipe J Aidar
- Post Graduate Program in Physical Education, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
- Department of Physical Education, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports-GEPEPS, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
- Post Graduate Program in Health Sciences, Federal University of Sergipe-UFS, São Cristovão, SE 49100-000, Brazil.
- Post Graduate Program in Physiological Sciences, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
| | - Dihogo Gama de Matos
- Group of Studies and Research of Performance, Sport, Health and Paralympic Sports-GEPEPS, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
| | - Jader Pereira de Farias Neto
- Post Graduate Program in Health Sciences, Federal University of Sergipe-UFS, São Cristovão, SE 49100-000, Brazil.
- Department of Physical Therapy, UniversityHospital, Federal University of Sergipe, Aracaju, SE 49100-000, Brazil.
| | - Raphael Fabrício de Souza
- Department of Physical Education, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
| | | | - Rebeca Rocha de Almeida
- Post Graduate Program in Health Sciences, Federal University of Sergipe-UFS, São Cristovão, SE 49100-000, Brazil.
| | - Marco Antonio Prado Nunes
- Post Graduate Program in Health Sciences, Federal University of Sergipe-UFS, São Cristovão, SE 49100-000, Brazil.
| | - Albená Nunes-Silva
- Exercise's Inflammation and Immunology Laboratory, Sports Center, Federal University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil.
| | - Walderi Monteiro da Silva Júnior
- Post Graduate Program in Physical Education, Federal University of Sergipe, São Cristovão, SE 49100-000, Brazil.
- Department of Physical Therapy, UniversityHospital, Federal University of Sergipe, Aracaju, SE 49100-000, Brazil.
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Wang LH, Huang W, Wei D, Ding DG, Liu YR, Wang JJ, Zhou ZY. Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:5796381. [PMID: 30854010 PMCID: PMC6378065 DOI: 10.1155/2019/5796381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/25/2018] [Indexed: 12/15/2022]
Abstract
Simple obesity is a worldwide epidemic associated with rapidly growing morbidity and mortality which imposes an enormous burden on individual and public health. As a part of Traditional Chinese Medicine (TCM), acupuncture has shown the positive efficacy in the management of simple obesity. In this article, we comprehensively review the clinical and animal studies that demonstrated the potential mechanisms of acupuncture treatment for simple obesity. Clinical studies suggested that acupuncture regulates endocrine system, promotes digestion, attenuates oxidative stress, and modulates relevant molecules of metabolism in patients of simple obesity. Evidence from laboratory indicated that acupuncture regulates lipid metabolism, modulates inflammatory responses, and promotes white adipose tissue browning. Acupuncture also suppresses appetite through regulating appetite regulatory hormones and the downstream signaling pathway. The evidence from clinical and animal studies indicates that acupuncture induces multifaceted regulation through complex mechanisms and moreover a single factor may not be enough to explain the beneficial effects against simple obesity.
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Affiliation(s)
- Li-Hua Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
| | - Wei Huang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, China
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Dan Wei
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - De-Guang Ding
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Yi-Ran Liu
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Jia-Jie Wang
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Zhong-Yu Zhou
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
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Amodeo G, Cuomo A, Bolognesi S, Goracci A, Trusso MA, Piccinni A, Neal SM, Baldini I, Federico E, Taddeucci C, Fagiolini A. Pharmacotherapeutic strategies for treating binge eating disorder. Evidence from clinical trials and implications for clinical practice. Expert Opin Pharmacother 2019; 20:679-690. [DOI: 10.1080/14656566.2019.1571041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Giovanni Amodeo
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Alessandro Cuomo
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Simone Bolognesi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Maria A Trusso
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Armando Piccinni
- UniCamillus - Saint Camillus International University of Health Sciences, Roma, Italy
| | - Stephen M Neal
- Department of Psychiatry, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Irene Baldini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Eugenio Federico
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Costanza Taddeucci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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21
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da Fonseca ACP, Abreu GM, Zembrzuski VM, Campos Junior M, Carneiro JRI, Nogueira Neto JF, Cabello GMK, Cabello PH. The association of the fat mass and obesity-associated gene (FTO) rs9939609 polymorphism and the severe obesity in a Brazilian population. Diabetes Metab Syndr Obes 2019; 12:667-684. [PMID: 31213864 PMCID: PMC6537458 DOI: 10.2147/dmso.s199542] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 02/28/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Obesity occurs due to the interaction between the genetic background and environmental factors, including an increased food intake and a sedentary lifestyle. Nowadays, it is clear that there is a specific circuit, called leptin-melanocortin pathway, which stimulates and suppresses food intake and energy expenditure. Therefore, the aim of this study was to evaluate the influence of genetic variants related to appetite regulation and energy expenditure on severe obesity susceptibility and metabolic phenotypes in a Brazilian cohort. Material and methods: A total of 490 participants were selected (298 severely obese subjects and 192 normal-weight individuals). Genomic DNA was extracted and polymorphisms in protein related to agouti (AGRP; rs5030980), ghrelin (GHRL; rs696217), neuropeptide Y (NPY; rs535870237), melanocortin 4 receptor (MC4R; rs17782313), brain-derived neurotrophic factor (BDNF; rs4074134) and fat mass and obesity-associated (FTO; rs9939609) genes were genotyped using TaqMan® probes. Demographic, anthropometric, biochemical and blood pressure parameters were obtained from the participants. Results: Our results showed that FTO rs9939609 was associated with severe obesity susceptibility. This polymorphism was also related to body weight, body mass index (BMI), waist to weight ratio (WWR) and inverted BMI. Individuals carrying the mutant allele (A) showed higher levels of BMI as well as lower values of WWR and inverted BMI. Conclusion: This study showed that FTO rs9939609 polymorphism plays a significant role in predisposing severe obesity in a Brazilian population.
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Affiliation(s)
- Ana Carolina Proença da Fonseca
- Human Genetics Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Rio de Janeiro, Brazil
- Correspondence: Ana Carolina Proença da FonsecaHuman Genetics Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Leônidas Deane Building, room 615, Leônidas Deane Building, room 615, Rio de Janeiro, RJ21040-360, BrazilEmail
| | | | | | - Mario Campos Junior
- Human Genetics Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Rio de Janeiro, Brazil
| | - João Regis Ivar Carneiro
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Pedro Hernán Cabello
- Human Genetics Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Rio de Janeiro, Brazil
- Human Genetics Laboratory, Grande Rio University, Rio de Janeiro, Brazil
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Diallo K, Oppong AK, Lim GE. Can 14-3-3 proteins serve as therapeutic targets for the treatment of metabolic diseases? Pharmacol Res 2019; 139:199-206. [DOI: 10.1016/j.phrs.2018.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 12/12/2022]
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Design of the Rural LEAP randomized trial: An evaluation of extended-care programs for weight management delivered via group or individual telephone counseling. Contemp Clin Trials 2018; 76:55-63. [PMID: 30408606 DOI: 10.1016/j.cct.2018.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 11/24/2022]
Abstract
Obesity is a major contributor to the greater prevalence of chronic disease morbidity and mortality observed in rural versus nonrural areas of the U.S. Nonetheless, little research attention has been given to modifying this important driver of rural/urban disparities in health outcomes. Although lifestyle treatments produce weight reductions of sufficient magnitude to improve health, the existing research is limited with respect to the long-term maintenance of treatment effects and the dissemination of services to underserved populations. Recent studies have demonstrated the feasibility of delivering lifestyle programs through the infrastructure of the U.S. Cooperative Extension Service (CES), which has >2900 offices nationwide and whose mission includes nutrition education and health promotion. In addition, several randomized trials have shown that supplementing lifestyle treatment with extended-care programs consisting of either face-to-face sessions or individual telephone counseling can improve the maintenance of weight loss. However, both options entail relatively high costs that inhibit adoption in rural communities. The delivery of extended care via group-based telephone intervention may represent a promising, cost-effective alternative that is well suited to rural residents who tend to be isolated, have heightened concerns about privacy, and report lower quality of life. The Rural Lifestyle Eating and Activity Program (Rural LEAP) is a randomized trial, conducted via CES offices in rural communities, targeted to adults with obesity (n = 528), and designed to evaluate the effectiveness and cost-effectiveness of extended-care programs delivered via group or individual telephone counseling compared to an education control condition on long-term changes in body weight.
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Dutton GR, Lewis CE, Cherrington A, Pisu M, Richman J, Turner T, Phillips JM. A weight loss intervention delivered by peer coaches in primary care: Rationale and study design of the PROMISE trial. Contemp Clin Trials 2018; 72:53-61. [PMID: 30055336 PMCID: PMC6133734 DOI: 10.1016/j.cct.2018.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 01/06/2023]
Abstract
Primary care offers a familiar and accessible clinical venue for patients with obesity to receive evidence-based lifestyle interventions for weight management. However, there are numerous barriers to the implementation of such programs in primary care, and previous primary care weight loss interventions demonstrate modest and temporary effects. Weight loss treatment delivered within primary care by peer coaches may offer a viable and effective alternative. The purpose of this trial is to test the effects of weight loss treatment that includes ongoing support from a peer coach (i.e., trained, salaried community health workers) as compared to self-directed treatment. Peer coach treatment will be delivered over 18 months and includes a combination of in-person, group-based office visits and individual telephone contacts. This weight loss trial will include 375 adults with obesity (BMI = 30-50 kg/m2) randomized from 10 primary care practices. The primary outcome will be changes in body weight at month 18. Secondary outcomes will include key patient-centered outcomes, including quality-of-life, physical and social functioning, mood, and treatment satisfaction. The cost-effectiveness of the peer coach intervention will also be evaluated. If this novel intervention is effective, it could offer a practical and sustainable approach for the delivery of weight loss treatment in primary care that has the potential to improve clinical outcomes for patients, increase treatment options for primary care providers, and reduce obesity-related healthcare utilization and costs.
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Affiliation(s)
- Gareth R Dutton
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Cora E Lewis
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1717 11th Avenue South, Birmingham, AL 35205, USA
| | - Andrea Cherrington
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1717 11th Avenue South, Birmingham, AL 35205, USA
| | - Maria Pisu
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1717 11th Avenue South, Birmingham, AL 35205, USA
| | - Joshua Richman
- University of Alabama at Birmingham, Department of Surgery, 1922 7th Avenue South, Birmingham 35233, USA
| | - Tamela Turner
- University of Alabama at Birmingham, Department of Family and Community Medicine, 930 20th Street South, Birmingham, AL 35294, USA
| | - Janice M Phillips
- University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1717 11th Avenue South, Birmingham, AL 35205, USA
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Abstract
Obesity poses a severe threat to human health, including the increased prevalence of hypertension, insulin resistance, diabetes mellitus, cancer, inflammation, sleep apnoea and other chronic diseases. Current therapies focus mainly on suppressing caloric intake, but the efficacy of this approach remains poor. A better understanding of the pathophysiology of obesity will be essential for the management of obesity and its complications. Knowledge gained over the past three decades regarding the aetiological mechanisms underpinning obesity has provided a framework that emphasizes energy imbalance and neurohormonal dysregulation, which are tightly regulated by autophagy. Accordingly, there is an emerging interest in the role of autophagy, a conserved homeostatic process for cellular quality control through the disposal and recycling of cellular components, in the maintenance of cellular homeostasis and organ function by selectively ridding cells of potentially toxic proteins, lipids and organelles. Indeed, defects in autophagy homeostasis are implicated in metabolic disorders, including obesity, insulin resistance, diabetes mellitus and atherosclerosis. In this Review, the alterations in autophagy that occur in response to nutrient stress, and how these changes alter the course of obesogenesis and obesity-related complications, are discussed. The potential of pharmacological modulation of autophagy for the management of obesity is also addressed.
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Affiliation(s)
- Yingmei Zhang
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China.
- Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY, USA.
| | - James R Sowers
- Diabetes and Cardiovascular Research Center, University of Missouri-Columbia School of Medicine, Columbia, MO, USA
| | - Jun Ren
- Department of Cardiology, Fudan University Zhongshan Hospital, Shanghai, China.
- Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY, USA.
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26
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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27
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Goodarzi MO. Genetics of obesity: what genetic association studies have taught us about the biology of obesity and its complications. Lancet Diabetes Endocrinol 2018; 6:223-236. [PMID: 28919064 DOI: 10.1016/s2213-8587(17)30200-0] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 01/01/2023]
Abstract
Genome-wide association studies (GWAS) for BMI, waist-to-hip ratio, and other adiposity traits have identified more than 300 single-nucleotide polymorphisms (SNPs). Although there is reason to hope that these discoveries will eventually lead to new preventive and therapeutic agents for obesity, this will take time because such developments require detailed mechanistic understanding of how an SNP influences phenotype (and this information is largely unavailable). Fortunately, absence of functional information has not prevented GWAS findings from providing insights into the biology of obesity. Genes near loci regulating total body mass are enriched for expression in the CNS, whereas genes for fat distribution are enriched in adipose tissue itself. Gene by environment and lifestyle interaction analyses have revealed that our increasingly obesogenic environment might be amplifying genetic risk for obesity, yet those at highest risk could mitigate this risk by increasing physical activity and possibly by avoiding specific dietary components. GWAS findings have also been used in mendelian randomisation analyses probing the causal association between obesity and its many putative complications. In supporting a causal association of obesity with diabetes, coronary heart disease, specific cancers, and other conditions, these analyses have clinical relevance in identifying which outcomes could be preventable through weight loss interventions.
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Affiliation(s)
- Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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28
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Nash MS, Groah SL, Gater DR, Dyson-Hudson TA, Lieberman JA, Myers J, Sabharwal S, Taylor AJ. Identification and Management of Cardiometabolic Risk after Spinal Cord Injury: Clinical Practice Guideline for Health Care Providers. Top Spinal Cord Inj Rehabil 2018; 24:379-423. [PMID: 30459501 PMCID: PMC6241225 DOI: 10.1310/sci2404-379] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Mark S Nash
- Departments of Neurological Surgery and Physical Medicine & Rehabilitation, Applied Physiology Research Laboratory, The Miami Project to Cure Paralysis, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Suzanne L Groah
- Paralysis Rehabilitation and Recovery Program, Spinal Cord Injury Research, MedStar National Rehabilitation Hospital, Washington, DC
- Rehabilitation Medicine, Georgetown University Hospital, Washington, DC
| | - David R Gater
- Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Trevor A Dyson-Hudson
- Spinal Injury Research and Outcomes Assessment Research, Kessler Foundation, West Orange, New Jersey
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Jesse A Lieberman
- Carolinas Rehabilitation and Carolinas Medical Center, Charlotte, North Carolina
| | - Jonathan Myers
- Department of Medicine, Stanford University, Stanford, California
- VA Palo Alto Health Care System, Palo Alto, California
| | - Sunil Sabharwal
- VA Boston Health Care System, Boston, Massachusetts
- VA Spinal Cord Injuries and Disorders System of Care, Boston, Massachusetts
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | - Allen J Taylor
- MedStar Georgetown University Hospital, MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, DC
- Uniformed University of the Health Sciences, Bethesda, Maryland
- Georgetown University, Washington, DC
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Abstract
More than one-third of adults in the USA have obesity, which causes, exacerbates or adversely impacts numerous medical comorbidities, including diabetes mellitus and cardiovascular disease. Despite intensive lifestyle modifications, the disease severity warrants further aggressive intervention, including pharmacotherapy, medical devices and bariatric surgery. Noninvasive anti-obesity drugs have thus now resurfaced as targeted adjunctive therapeutic approaches to intensive lifestyle intervention, bridging the gap between lifestyle and bariatric surgery. In this Review, we discuss FDA-approved anti-obesity drugs in terms of safety and efficacy. As most of these drugs have a mean percentage weight loss reported in clinical trials but individual variations in response rates, a future direction of obesity pharmacotherapy research might include the potential for personalized medicine to target early responders to these anti-obesity drugs.
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Affiliation(s)
- Gitanjali Srivastava
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, 720 Harrison Avenue, 8 th Floor, Suite 801, Boston, Massachusetts 02118, USA
| | - Caroline M Apovian
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, 720 Harrison Avenue, 8 th Floor, Suite 801, Boston, Massachusetts 02118, USA
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30
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Abstract
PURPOSE OF REVIEW This review examines the food addiction model and the role of food hedonic pathways in the pathogenesis and treatment of obesity. RECENT FINDINGS The hedonic pathway interacts with the obesogenic environment to override homeostatic mechanisms to cause increase in body weight. Weight gain sustained over time leads to "upward setting" of defended level of body-fat mass. There are neurobiological and phenotypic similarities and differences between hedonic pathways triggered by food compared with other addictive substances, and the entity of food addiction remains controversial. Treatment for obesity including pharmacotherapy and bariatric surgery impacts on neural pathways governing appetite and hedonic control of food intake. The food addiction model may also have significant impact on public health policy, regulation of certain foods, and weight stigma and bias. Recent rapid progress in delineation of food hedonic pathways advances our understanding of obesity and facilitates development of effective treatment measures against the disease.
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Affiliation(s)
- Phong Ching Lee
- Obesity and Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Bukit Merah, Singapore
| | - John B Dixon
- Clinical Obesity Research, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, 3004, Australia.
- Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia.
- Primary Care Research Unit, Monash University, Melbourne, Australia.
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da Fonseca ACP, Mastronardi C, Johar A, Arcos-Burgos M, Paz-Filho G. Genetics of non-syndromic childhood obesity and the use of high-throughput DNA sequencing technologies. J Diabetes Complications 2017; 31:1549-1561. [PMID: 28735903 DOI: 10.1016/j.jdiacomp.2017.04.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Childhood obesity is a serious public health problem associated with the development of several chronic diseases, such as type 2 diabetes mellitus, dyslipidemia, and hypertension. The elevated prevalence of obesity is mostly due to inadequate diet and lifestyle, but it is also influenced by genetic factors. OBJECTIVES To review recent advances in the field of the genetics of obesity. We summarize the list of genes associated with the rare non-syndromic forms of obesity, and explain their function. Furthermore, we discuss the technologies that are available for the genetic diagnosis of obesity. RESULTS Several studies reported that single gene variants cause Mendelian forms of obesity, determined by mutations of major effect in single genes. Rare, non-syndromic forms of obesity are a result of loss-of-function mutations in genes that act on the development and function of the hypothalamus or the leptin-melanocortin pathway. These variants disrupt enzymes and receptors that play a role in energy homeostasis, resulting in severe early-onset obesity and endocrine dysfunctions. Different approaches and technologies have been used to understand the genetic background of obesity. Currently, whole genome and whole exome sequencing are important diagnostic tools to identify new genes and variants associated with severe obesity, but other approaches are also useful at individual or population levels, such as linkage analysis, candidate gene sequencing, chromosomal microarray analysis, and genome-wide association studies. CONCLUSIONS The understanding of the genetic causes of obesity and the usefulness and limitations of the genetic diagnostic approaches can contribute to the development of new personalized therapeutic targets against obesity.
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Affiliation(s)
| | - Claudio Mastronardi
- Institute of Translational Medicine, Universidad del Rosario, Bogota, Colombia
| | - Angad Johar
- Department of Genome Sciences, John Curtin School of Medical Research, The Australian National University, Australia.
| | | | - Gilberto Paz-Filho
- Department of Genome Sciences, John Curtin School of Medical Research, The Australian National University, Australia.
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Gene Location, Expression, and Function of FNDC5 in Meishan Pigs. Sci Rep 2017; 7:7886. [PMID: 28801552 PMCID: PMC5554266 DOI: 10.1038/s41598-017-08406-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/19/2017] [Indexed: 01/06/2023] Open
Abstract
Irisin is a new muscular regulatory factor that is generated by the cleavage of its precursor protein fibronectin type III domain-containing protein 5 (FNDC5). Irisin promotes fat consumption due to its stimulatory role in the browning of the adipocytes in mice. Currently, there is no report on FNDC5 functions in pigs as model animals. In this study, we investigated the expression patterns and functions of FNDC5 in Meishan pigs. Our results showed that FNDC5 gene in Meishan pigs contains five transcripts, all of which can be translated into functional intact irisin proteins. Porcine FNDC5 is mainly expressed in skeletal muscle, with the expression level being significantly higher during the embryonic and juvenile periods than in the adulthood stage. In vitro study showed that FNDC5 stimulates the proliferation and adipogenic differentiation of primary adipocytes isolated from Meishan pigs, and FNDC5 enhances the expression of browning marker genes during adipogenic differentiation. Our study was the first report on FNDC5 expression patterns and functions in pigs. Data from this study provide valuable information related to the study on FNDC5 functions and future development of novel treatment for obesity.
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Mietlicki-Baase EG, Koch-Laskowski K, McGrath LE, Krawczyk J, Pham T, Lhamo R, Reiner DJ, Hayes MR. Daily supplementation of dietary protein improves the metabolic effects of GLP-1-based pharmacotherapy in lean and obese rats. Physiol Behav 2017; 177:122-128. [PMID: 28433470 DOI: 10.1016/j.physbeh.2017.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/01/2017] [Accepted: 04/18/2017] [Indexed: 12/30/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone released from intestinal L-cells in response to food entering into the gastrointestinal tract. GLP-1-based pharmaceuticals improve blood glucose regulation and reduce feeding. Specific macronutrients, when ingested, may trigger GLP-1 secretion and enhance the effects of systemic sitagliptin, a pharmacological inhibitor of DPP-IV (an enzyme that rapidly degrades GLP-1). In particular, macronutrient constituents found in dairy foods may act as potent secretagogues for GLP-1, and acute preclinical trials show that ingestion of dairy protein may represent a promising adjunct behavioral therapy in combination with sitagliptin. To test this hypothesis further, chow-maintained or high-fat diet (HFD)-induced obese rats received daily IP injections of sitagliptin (6mg/kg) or saline in combination with a twice-daily 8ml oral gavage of milk protein concentrate (MPC; 80/20% casein/whey; 0.5kcal/ml), soy protein (non-dairy control; 0.5kcal/ml) or 0.9% NaCl for two months. Food intake and body weight were recorded every 24-48h; blood glucose regulation was examined at baseline and at 3 and 6.5weeks via a 2h oral glucose tolerance test (OGTT; 25% glucose; 2g/kg). MPC and soy protein significantly suppressed cumulative caloric intake in HFD but not chow-maintained rats. AUC analyses for OGTT show suppression in glycemia by sitagliptin with MPC or soy in chow- and HFD-maintained rats, suggesting that chronic ingestion of dairy or soy proteins may augment endogenous GLP-1 signaling and the glycemic- and food intake-suppressive effects of DPP-IV inhibition.
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Affiliation(s)
- Elizabeth G Mietlicki-Baase
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Kieran Koch-Laskowski
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Lauren E McGrath
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Joanna Krawczyk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Tram Pham
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Rinzin Lhamo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - David J Reiner
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Matthew R Hayes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.
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Asano M, Hong G, Matsuyama Y, Wang W, Izumi S, Izumi M, Toda T, Kudo TA. Association of Oral Fat Sensitivity with Body Mass Index, Taste Preference, and Eating Habits in Healthy Japanese Young Adults. TOHOKU J EXP MED 2016; 238:93-103. [PMID: 26797054 DOI: 10.1620/tjem.238.93] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Oral fat sensitivity (OFS, the ability to detect fat) may be related to overeating-induced obesity. However, it is largely unknown whether OFS affects taste preference and eating habits. Therefore, we aimed to evaluate (1) the association between body mass index (BMI) and OFS and (2) the relationship of OFS with four types of taste preference (sweet, sour, salty, and bitter) and eating habits using serial concentrations of oleic acid (OA) homogenized in non-fat milk and a self-reported questionnaire. Participants were 25 healthy Japanese individuals (mean age: 27.0 ± 5.6 years), among whom the OA detection threshold was significantly associated with BMI. Participants were divided into two subgroups based on oral sensitivity to 2.8 mM OA: hypersensitive (able to detect 2.8 mM OA, n = 16) and hyposensitive (unable to detect 2.8 mM OA, n = 9). The degree of sweet taste preference of the hypersensitive group was significantly higher than that of the hyposensitive group. Furthermore, there was significantly higher degree of preference for high-fat sweet foods than low-fat sweet foods in the hypersensitive group. There was also a significant inverse correlation between the OA detection threshold and the degree of both spare eating and postprandial satiety. Thus, OFS is associated not only with BMI, but also with the preference for high-fat sweet foods and eating habits. The present study provides novel insights that measuring OFS may be useful for assessing the risk of obesity associated with overeating in countries, including Japan, where BMI is increasing in the population.
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Affiliation(s)
- Masanobu Asano
- Division of Oral Physiology, Tohoku University Graduate School of Dentistry
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35
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Marcon ER, Baglioni S, Bittencourt L, Lopes CLN, Neumann CR, Trindade MRM. What Is the Best Treatment before Bariatric Surgery? Exercise, Exercise and Group Therapy, or Conventional Waiting: a Randomized Controlled Trial. Obes Surg 2016; 27:763-773. [DOI: 10.1007/s11695-016-2365-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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36
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Manna P, Jain SK. Obesity, Oxidative Stress, Adipose Tissue Dysfunction, and the Associated Health Risks: Causes and Therapeutic Strategies. Metab Syndr Relat Disord 2016; 13:423-44. [PMID: 26569333 DOI: 10.1089/met.2015.0095] [Citation(s) in RCA: 578] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Obesity is gaining acceptance as a serious primary health burden that impairs the quality of life because of its associated complications, including diabetes, cardiovascular diseases, cancer, asthma, sleep disorders, hepatic dysfunction, renal dysfunction, and infertility. It is a complex metabolic disorder with a multifactorial origin. Growing evidence suggests that oxidative stress plays a role as the critical factor linking obesity with its associated complications. Obesity per se can induce systemic oxidative stress through various biochemical mechanisms, such as superoxide generation from NADPH oxidases, oxidative phosphorylation, glyceraldehyde auto-oxidation, protein kinase C activation, and polyol and hexosamine pathways. Other factors that also contribute to oxidative stress in obesity include hyperleptinemia, low antioxidant defense, chronic inflammation, and postprandial reactive oxygen species generation. In addition, recent studies suggest that adipose tissue plays a critical role in regulating the pathophysiological mechanisms of obesity and its related co-morbidities. To establish an adequate platform for the prevention of obesity and its associated health risks, understanding the factors that contribute to the cause of obesity is necessary. The most current list of obesity determinants includes genetic factors, dietary intake, physical activity, environmental and socioeconomic factors, eating disorders, and societal influences. On the basis of the currently identified predominant determinants of obesity, a broad range of strategies have been recommended to reduce the prevalence of obesity, such as regular physical activity, ad libitum food intake limiting to certain micronutrients, increased dietary intake of fruits and vegetables, and meal replacements. This review aims to highlight recent findings regarding the role of oxidative stress in the pathogenesis of obesity and its associated risk factors, the role of dysfunctional adipose tissue in development of these risk factors, and potential strategies to regulate body weight loss/gain for better health benefits.
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Affiliation(s)
- Prasenjit Manna
- Department of Pediatrics, LSU Health Sciences Center , Shreveport, Louisiana
| | - Sushil K Jain
- Department of Pediatrics, LSU Health Sciences Center , Shreveport, Louisiana
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37
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Carter A, Hendrikse J, Lee N, Yücel M, Verdejo-Garcia A, Andrews ZB, Hall W. The Neurobiology of "Food Addiction" and Its Implications for Obesity Treatment and Policy. Annu Rev Nutr 2016; 36:105-28. [PMID: 27296500 DOI: 10.1146/annurev-nutr-071715-050909] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a growing view that certain foods, particularly those high in refined sugars and fats, are addictive and that some forms of obesity can usefully be treated as a food addiction. This perspective is supported by a growing body of neuroscience research demonstrating that the chronic consumption of energy-dense foods causes changes in the brain's reward pathway that are central to the development and maintenance of drug addiction. Obese and overweight individuals also display patterns of eating behavior that resemble the ways in which addicted individuals consume drugs. We critically review the evidence that some forms of obesity or overeating could be considered a food addiction and argue that the use of food addiction as a diagnostic category is premature. We also examine some of the potential positive and negative clinical, social, and public policy implications of describing obesity as a food addiction that require further investigation.
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Affiliation(s)
- Adrian Carter
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia; .,University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland 4029 Australia
| | - Joshua Hendrikse
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Natalia Lee
- Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, California 90095
| | - Murat Yücel
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Zane B. Andrews
- School of Physiology, Monash University, Clayton, Victoria 3800, Australia
| | - Wayne Hall
- University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland 4029 Australia.,Centre for Youth Substance Abuse Research, University of Queensland, Herston, Queensland 4006 Australia
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Kanoski SE, Hayes MR, Skibicka KP. GLP-1 and weight loss: unraveling the diverse neural circuitry. Am J Physiol Regul Integr Comp Physiol 2016; 310:R885-95. [PMID: 27030669 DOI: 10.1152/ajpregu.00520.2015] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/26/2016] [Indexed: 02/07/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) is currently one of the most promising biological systems for the development of effective obesity pharmacotherapies. Long-acting GLP-1 analogs potently reduce food intake and body weight, and recent discoveries reveal that peripheral administration of these drugs reduces food intake largely through humoral pathways involving direct action on brain GLP-1 receptors (GLP-1R). Thus, it is of critical importance to understand the neural systems through which GLP-1 and long-acting GLP-1 analogs reduce food intake and body weight. In this review, we discuss several neural, physiological, cellular and molecular, as well as behavioral mechanisms through which peripheral and central GLP-1R signaling reduces feeding. Particular attention is devoted to discussion regarding the numerous neural substrates through which GLP-1 and GLP-1 analogs act to reduce food intake and body weight, including various hypothalamic nuclei (arcuate nucleus of the hypothalamus, periventricular hypothalamus, lateral hypothalamic area), hindbrain nuclei (parabrachial nucleus, medial nucleus tractus solitarius), hippocampus (ventral subregion; vHP), and nuclei embedded within the mesolimbic reward circuitry [ventral tegmental area (VTA) and nucleus accumbens (NAc)]. In some of these nuclei [VTA, NAc, and vHP], GLP-1R activation reduces food intake and body weight without concomitant nausea responses, suggesting that targeting these specific pathways may be of particular interest for future obesity pharmacotherapy. The widely distributed neural systems through which GLP-1 and GLP-1 analogs act to reduce body weight highlight the complexity of the neural systems regulating energy balance, as well as the challenges for developing effective obesity pharmacotherapies that reduce feeding without producing parallel negative side effects.
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Affiliation(s)
- Scott E Kanoski
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, California;
| | - Matthew R Hayes
- Translational Neuroscience Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia Pennsylvania; and
| | - Karolina P Skibicka
- Department of Physiology/Metabolic Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Gautron L, Elmquist JK, Williams KW. Neural control of energy balance: translating circuits to therapies. Cell 2015; 161:133-145. [PMID: 25815991 DOI: 10.1016/j.cell.2015.02.023] [Citation(s) in RCA: 169] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Indexed: 12/18/2022]
Abstract
Recent insights into the neural circuits controlling energy balance and glucose homeostasis have rekindled the hope for development of novel treatments for obesity and diabetes. However, many therapies contribute relatively modest beneficial gains with accompanying side effects, and the mechanisms of action for other interventions remain undefined. This Review summarizes current knowledge linking the neural circuits regulating energy and glucose balance with current and potential pharmacotherapeutic and surgical interventions for the treatment of obesity and diabetes.
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Affiliation(s)
- Laurent Gautron
- Division of Hypothalamic Research, Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9077, USA.
| | - Joel K Elmquist
- Division of Hypothalamic Research, Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9077, USA; Department of Pharmacology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9077, USA
| | - Kevin W Williams
- Division of Hypothalamic Research, Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9077, USA; Department of Neuroscience, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9077, USA.
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Kanoski SE, Ong ZY, Fortin SM, Schlessinger ES, Grill HJ. Liraglutide, leptin and their combined effects on feeding: additive intake reduction through common intracellular signalling mechanisms. Diabetes Obes Metab 2015; 17:285-93. [PMID: 25475828 PMCID: PMC4320650 DOI: 10.1111/dom.12423] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/14/2014] [Accepted: 12/01/2014] [Indexed: 01/05/2023]
Abstract
AIM To investigate the behavioural and intracellular mechanisms by which the glucagon like peptide-1 (GLP-1) receptor agonist, liraglutide, and leptin in combination enhance the food intake inhibitory and weight loss effects of either treatment alone. METHODS We examined the effects of liraglutide (a long-acting GLP-1 analogue) and leptin co-treatment, delivered in low or moderate doses subcutaneously (s.c.) or to the third ventricle, respectively, on cumulative intake, meal patterns and hypothalamic expression of intracellular signalling proteins [phosphorylated signal transducer and activator of transcription-3 (pSTAT3) and protein tyrosine phosphatase-1B (PTP1B)] in lean rats. RESULTS A low-dose combination of liraglutide (25 µg/kg) and leptin (0.75 µg) additively reduced cumulative food intake and body weight, a result mediated predominantly through a significant reduction in meal frequency that was not present with either drug alone. Liraglutide treatment alone also reduced meal size; an effect not enhanced with leptin co-administration. Moderate doses of liraglutide (75 µg/kg) and leptin (4 µg), examined separately, each reduced meal frequency, cumulative food intake and body weight; only liraglutide reduced meal size. In combination these doses did not further enhance the anorexigenic effects of either treatment alone. Ex vivo immunoblot analysis showed elevated pSTAT3 in the hypothalamic tissue after liraglutide-leptin co-treatment, an effect which was greater than that of leptin treatment alone. In addition, s.c. liraglutide reduced the expression of PTP1B (a negative regulator of leptin receptor signalling), revealing a potential mechanism for the enhanced pSTAT3 response after liraglutide-leptin co-administration. CONCLUSIONS Collectively, these results show novel behavioural and molecular mechanisms underlying the additive reduction in food intake and body weight after liraglutide-leptin combination treatment.
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Affiliation(s)
- Scott E. Kanoski
- Department of Biological Sciences, University of Southern California
| | - Zhi Yi Ong
- Department of Psychology, University of Pennsylvania
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Dutton GR, Nackers LM, Dubyak PJ, Rushing NC, Huynh TVT, Tan F, Anton SD, Perri MG. A randomized trial comparing weight loss treatment delivered in large versus small groups. Int J Behav Nutr Phys Act 2014; 11:123. [PMID: 25249056 PMCID: PMC4180323 DOI: 10.1186/s12966-014-0123-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 09/19/2014] [Indexed: 11/10/2022] Open
Abstract
Background Behavioral interventions for obesity are commonly delivered in groups, although the effect of group size on weight loss has not been empirically evaluated. This behavioral weight loss trial compared the 6- and 12-month weight changes associated with interventions delivered in a large group (LG) or small groups (SG). Methods Obese adults (N = 66; mean age = 50 years; mean BMI = 36.5 kg/m2; 47% African American; 86% women) recruited from a health maintenance organization were randomly assigned to: 1) LG treatment (30 members/group), or 2) SG treatment (12 members/group). Conditions were comparable in frequency and duration of treatment, which included 24 weekly group sessions (months 1–6) followed by six monthly extended care contacts (months 7–12). A mixed effects model with unstructured covariance matrix was applied to analyze the primary outcome of weight change while accounting for baseline weight and dependence among participants’ measurements over time. Results SG participants lost significantly more weight than LG participants at Month 6 (−6.5 vs. -3.2 kg; p = 0.03) and Month 12 (−7.0 vs. -1.7 kg; p < 0.002). SG participants reported better treatment engagement and self-monitoring adherence at Months 6 and 12, ps < 0.04, with adherence fully mediating the relationship between group size and weight loss. Conclusions Receiving obesity treatment in smaller groups may promote greater weight loss and weight loss maintenance. This effect may be due to improved adherence facilitated by SG interactions. These novel findings suggest that the perceived efficiency of delivering behavioral weight loss treatment to LGs should be balanced against the potentially better outcomes achieved by a SG approach.
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Deb KS, Gupta R, Varshney M. Orlistat abuse in a case of bulimia nervosa: the changing Indian society. Gen Hosp Psychiatry 2014; 36:549.e3-4. [PMID: 24953260 DOI: 10.1016/j.genhosppsych.2014.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 04/27/2014] [Accepted: 05/02/2014] [Indexed: 11/19/2022]
Abstract
Eating disorders like bulimia nervosa, generally considered to be rare in Asian countries, are currently on the rise among the youth, probably secondary to rapid westernization and globalization of the orient. Clinical manifestations of these disorders, which were previously thought to be different in the oriental countries, are now also often seen to parallel their western counterparts. However, detailed clinical descriptions of such cases from Asian countries, documenting the societal change, are missing. In addition, the possibility of abuse of various anti-obesity drugs as a part of bulimic compensatory behavior is high in this population, given the easy and unsupervised access of these drugs over the counter. We report a case of bulimia nervosa in a female medical graduate from India, presenting with classic bulimic symptomatology and with a compensatory behavior consisting almost exclusively of Orlistat abuse. This case sensitizes health professionals to the abuse liability of new medications like Orlistat and also documents the changing symptomatology of bulimia nervosa in India.
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Affiliation(s)
- Koushik Sinha Deb
- Dept. of Psychiatry, All India Institute of Medical Science, Jodhpur, India
| | - Rishab Gupta
- Dept. of Psychiatry, All India Institute of Medical Science, New Delhi, India.
| | - Mohit Varshney
- Dept. of Psychiatry, All India Institute of Medical Science, New Delhi, India
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Marrelli M, Loizzo MR, Nicoletti M, Menichini F, Conforti F. In vitro investigation of the potential health benefits of wild Mediterranean dietary plants as anti-obesity agents with α-amylase and pancreatic lipase inhibitory activities. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2014; 94:2217-2224. [PMID: 24535986 DOI: 10.1002/jsfa.6544] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/16/2013] [Accepted: 12/20/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Inhibition of digestive enzymes is one of the most widely studied mechanisms used to determine the potential efficacy of natural products as anti-obesity agents. In vitro studies reported here were performed to evaluate the inhibitory activity of formulations of edible plants from Italy on amylase and lipase by monitoring the hydrolysis of nitrophenyl caprilate and the hydrolysis of glycoside bonds in digestible carbohydrate foods. RESULTS The formulation obtained from Capparis sicula exhibited the strongest inhibitory effect on pancreatic lipase (IC50 = 0.53 mg mL(-1) ) while the Borago officinalis formulation exhibited the strongest inhibitory effect on α-amylase (IC50 = 31.61 µg mL(-1) ). In order to characterise the extracts, high-performance thin-layer chromatography analysis of the formulations was performed, revealing the predominance of (±)-catechin in Mentha aquatica formulation, rutin in C. sicula, and caffeic acid and chlorogenic acid in Echium vulgare. CONCLUSION The results obtained indicated that the extracts of C. sicula and B. officinalis could be good candidates for further studies to isolate pancreatic lipase and α-amylase inhibitors, respectively.
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Affiliation(s)
- Mariangela Marrelli
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, I-8736, Rende, (CS), Italy
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Cerium oxide nanoparticles inhibit adipogenesis in rat mesenchymal stem cells: potential therapeutic implications. Pharm Res 2014; 31:2952-62. [PMID: 24805277 DOI: 10.1007/s11095-014-1390-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 04/15/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE Cerium oxide nanoparticles (nanoceria, NC) have extraordinary antioxidant activity that made them suitable as a therapeutic agent for several diseases where reactive oxygen species (ROS) act by impairing the normal redox balance. Among different functions, it has been proven that ROS are cellular messengers involved in the adipogenesis: we thus investigated the implication of NC administration in the potential inhibition of adipogenic differentiation of mesenchymal stem cells (MSCs) used as a model of adipogenesis. METHODS We evaluated cytotoxic effects and adipogenic maturation of mesenchymal stem cells following in vitro NC administration, both at gene and at phenotype level. RESULTS Overall, our results demonstrated that NC efficiently inhibit the maturation of MSCs toward adipocytes owing to their ability to reduce the production of the ROS necessary during adipogenesis. CONCLUSIONS These findings, even if preliminary, represent an important step toward the potential pharmaceutical application of NC in the treatment of obesity.
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Zhou D, Jiang X, Ding W, Zhang D, Yang L, Zhen C, Lu L. Impact of bariatric surgery on ghrelin and obestatin levels in obesity or type 2 diabetes mellitus rat model. J Diabetes Res 2014; 2014:569435. [PMID: 24672803 PMCID: PMC3941146 DOI: 10.1155/2014/569435] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 11/21/2013] [Accepted: 11/21/2013] [Indexed: 12/19/2022] Open
Abstract
We aimed to evaluate the therapeutic efficacy on weight control by different bariatric surgeries and investigate the ghrelin and obestatin changes after these surgeries in obesity and nonobese type 2 diabetes mellitus (T2DM) rats. Obese rats were randomly assigned to receive sleeve gastrectomy (SG, n = 8), minigastric bypass (MGBP, n = 8), roux-en-Y gastric bypass (RYGBP, n = 8), and sham operation (SO, n = 4). Another 4 rats served as control. Besides, Goto-Kakisaki (GK) rats were also randomly divided into similar groups except for total gastrectomy (TG, n = 8) group. The results showed that in obese rats, weigh loss in RYGBP group was similar to that in MGBP group but larger than that in SG group. Ghrelin significantly increased in RYGB group, but obestatin increased in MGBP group. Ghrelin/obestatin ratio significantly decreased in SG group. In GK rats, weight loss was most obvious in TG group. Postoperatively, ghrelin was significantly increased in MGBP and RYGB groups but decreased in TG group. Obestatin also showed an increase in MGBP and RYGB groups. Ghrelin/obestatin in TG group decreased significantly. In conclusion, RYGB and MGBP may be more suitable for obese rats, but TG may be the best strategy for T2DM rats to control weight with different mechanisms.
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Affiliation(s)
- Donglei Zhou
- Department of General Surgery, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
| | - Xun Jiang
- Department of General Surgery, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
| | - Weixing Ding
- Department of General Surgery, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
| | - Dingyu Zhang
- August First Physical Culture and Sports Team, Haidian District, Beijing 100091, China
| | - Lei Yang
- Department of General Surgery, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
| | - Chengzhu Zhen
- Department of General Surgery, Changhai Hospital of the Second Military Medical University, Shanghai 200433, China
| | - Liesheng Lu
- Department of General Surgery, Shanghai Tenth People's Hospital of Tongji University, Shanghai 200072, China
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Mietlicki-Baase EG, Hayes MR. Amylin activates distributed CNS nuclei to control energy balance. Physiol Behav 2014; 136:39-46. [PMID: 24480072 DOI: 10.1016/j.physbeh.2014.01.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 01/13/2014] [Accepted: 01/16/2014] [Indexed: 01/25/2023]
Abstract
Amylin is a pancreas-derived neuropeptide that acts in the central nervous system (CNS) to reduce food intake. Much of the literature describing the anorectic effects of amylin are focused on amylin's actions in the area postrema, a hindbrain circumventricular structure. Although the area postrema is certainly an important site that mediates the intake-suppressive effects of amylin, several pieces of evidence indicate that amylin may also promote negative energy balance through action in additional CNS nuclei, including hypothalamic and mesolimbic structures. Therefore, this review highlights the distributed neural network mediating the feeding effects of amylin signaling with special attention being devoted to the recent discovery that the ventral tegmental area is physiologically relevant for amylin-mediated control of feeding. The production of amylin by alternative, extra-pancreatic sources and its potential relevance to food intake regulation is also considered. Finally, the utility of amylin and amylin-like compounds as a component of combination pharmacotherapies for the treatment of obesity is discussed.
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Affiliation(s)
- Elizabeth G Mietlicki-Baase
- Translational Neuroscience Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Matthew R Hayes
- Translational Neuroscience Program, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Olivos DR, McGrath LE, Turner CA, Montaubin O, Mietlicki-Baase EG, Hayes MR. Intraduodenal milk protein concentrate augments the glycemic and food intake suppressive effects of DPP-IV inhibition. Am J Physiol Regul Integr Comp Physiol 2013; 306:R157-63. [PMID: 24352410 DOI: 10.1152/ajpregu.00358.2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone released from intestinal L-cells in response to food entering into the gastrointestinal tract. GLP-1-based pharmaceuticals improve blood glucose regulation and may hold promise for obesity treatment, as GLP-1 drugs reduce food intake and body weight in humans and animals. In an effort to improve GLP-1 pharmacotherapies, we focused our attention on macronutrients that, when present in the gastrointestinal tract, may enhance GLP-1 secretion and improve glycemic regulation and food intake suppression when combined with systemic administration of sitagliptin, a pharmacological inhibitor of DPP-IV (enzyme responsible for GLP-1 degradation). In particular, previous data suggest that specific macronutrient constituents found in dairy foods may act as potent secretagogues for GLP-1 and therefore may potentially serve as an adjunct dietary therapy in combination with sitagliptin. To directly test this hypothesis, rats received intraperitoneal injections of sitagliptin (6 mg/kg) or saline vehicle followed by intraduodenal infusions of either milk protein concentrate (MPC; 80/20% casein/whey; 4 kcal), soy protein (nondairy control infusate; 4 kcal), or 0.9% NaCl. Food intake was assessed 30 min postinfusion. In separate studies, regulation of blood glucose was examined via a 2-h oral glucose tolerance test (2 g/kg) following identical sitagliptin treatment and intraduodenal nutrient infusions. Collectively, results show that intraduodenal MPC, but not soy protein, significantly enhances both the food intake suppression and improved control of blood glucose produced by sitagliptin. These data support the hypothesis that dietary intake of dairy protein may be beneficial as an adjunct behavioral therapy to enhance the glycemic and food intake suppressive effects of GLP-1-based pharmacotherapies.
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Affiliation(s)
- Diana R Olivos
- Translational Neuroscience Program, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Motani AS, Luo J, Liang L, Mihalic JT, Chen X, Tang L, Li L, Jaen J, Chen JL, Dai K. Evaluation of AMG 076, a potent and selective MCHR1 antagonist, in rodent and primate obesity models. Pharmacol Res Perspect 2013; 1:e00003. [PMID: 25505557 PMCID: PMC4184568 DOI: 10.1002/prp2.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 07/02/2013] [Accepted: 07/04/2013] [Indexed: 02/06/2023] Open
Abstract
Melanin-concentrating hormone (MCH) regulates food intake through activation of the receptor, MCHR1. We have identified AMG 076 as an orally bioavailable potent and selective small molecule antagonist of MCHR1. In mouse models of obesity, AMG 076 caused a reduction in body weight gain in wild-type (MCHR1+/+) but not in knockout (MCHR1−/−) mice. The body weight reduction was associated with decreases in food intake and increases in energy expenditure. Importantly, we show that these MCHR1-dependent effects of AMG 076 were also reflected in improved metabolic phenotypes, increased glucose tolerance and insulin sensitivity. Preliminary data on effects of AMG 076 in obese cynomolgus monkeys are also presented.
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Schneider JE, Wise JD, Benton NA, Brozek JM, Keen-Rhinehart E. When do we eat? Ingestive behavior, survival, and reproductive success. Horm Behav 2013; 64:702-28. [PMID: 23911282 DOI: 10.1016/j.yhbeh.2013.07.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 07/21/2013] [Accepted: 07/22/2013] [Indexed: 12/13/2022]
Abstract
The neuroendocrinology of ingestive behavior is a topic central to human health, particularly in light of the prevalence of obesity, eating disorders, and diabetes. The study of food intake in laboratory rats and mice has yielded some useful hypotheses, but there are still many gaps in our knowledge. Ingestive behavior is more complex than the consummatory act of eating, and decisions about when and how much to eat usually take place in the context of potential mating partners, competitors, predators, and environmental fluctuations that are not present in the laboratory. We emphasize appetitive behaviors, actions that bring animals in contact with a goal object, precede consummatory behaviors, and provide a window into motivation. Appetitive ingestive behaviors are under the control of neural circuits and neuropeptide systems that control appetitive sex behaviors and differ from those that control consummatory ingestive behaviors. Decreases in the availability of oxidizable metabolic fuels enhance the stimulatory effects of peripheral hormones on appetitive ingestive behavior and the inhibitory effects on appetitive sex behavior, putting a new twist on the notion of leptin, insulin, and ghrelin "resistance." The ratio of hormone concentrations to the availability of oxidizable metabolic fuels may generate a critical signal that schedules conflicting behaviors, e.g., mate searching vs. foraging, food hoarding vs. courtship, and fat accumulation vs. parental care. In species representing every vertebrate taxa and even in some invertebrates, many putative "satiety" or "hunger" hormones function to schedule ingestive behavior in order to optimize reproductive success in environments where energy availability fluctuates.
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Affiliation(s)
- Jill E Schneider
- Department of Biological Sciences, Lehigh University, 111 Research Drive, Bethlehem, PA 18015, USA
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Towards a 'systems'-level understanding of the nervous system and its disorders. Trends Neurosci 2013; 36:674-84. [PMID: 23988221 DOI: 10.1016/j.tins.2013.07.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 07/17/2013] [Accepted: 07/24/2013] [Indexed: 12/26/2022]
Abstract
It is becoming clear that nervous system development and adult functioning are highly coupled with other physiological systems. Accordingly, neurological and psychiatric disorders are increasingly being associated with a range of systemic comorbidities including, most prominently, impairments in immunological and bioenergetic parameters as well as in the gut microbiome. Here, we discuss various aspects of the dynamic crosstalk between these systems that underlies nervous system development, homeostasis, and plasticity. We believe a better definition of this underappreciated systems physiology will yield important insights into how nervous system diseases with systemic comorbidities arise and potentially identify novel diagnostic and therapeutic strategies.
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