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Chen Y, Wang C, Sun Q, Ye Q, Zhou H, Qin Z, Qi S, Wang W, Hong X. Comparison of novel and traditional anthropometric indices in Eastern-China adults: which is the best indicator of the metabolically obese normal weight phenotype? BMC Public Health 2024; 24:2192. [PMID: 39138449 PMCID: PMC11321156 DOI: 10.1186/s12889-024-19638-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND People with the metabolically obese normal weight (MONW) phenotype have been confirmed to significantly increase the risk of unfavorable health consequences. This study aimed to investigate the relationships between traditional and novel anthropometric indices with the MONW phenotype and compare the predictive ability of different anthropometric indices in identifying individuals with the MONW phenotype. METHODS This cross-sectional study involved a total of 26,332 participants aged 18 years or older with a normal weight from Nanjing, China. Sociodemographic information, biochemical measurements, and anthropometric indices were collected. The novel body fat anthropometric indices included body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), weight-adjusted-waist index (WWI), body adiposity index (BAI), conicity index (CI), waist-hip-height ratio (WHHR), as well as traditional indices such as waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).The prevalence ratio (PR) from modified poisson regression and area under the receiver-operating characteristic curve (AUC) were conducted to compare the association and predictive capacity of different obesity indicators for the MONW phenotype. All analyses were stratified by sex. RESULTS Modified poisson regression analyses revealed that weight, WC, HC, BMI, WHR, WHtR, ABSI, BRI, AVI, WWI, BAI, CI, and WHHR were independently associated with higher risk of the MONW phenotype, regardless of whether they were treated as a continuous or categorical variable (P < 0.05). Notably, BRI demonstrated the strongest association in both men (highest quartile VS lowest quartile; PR = 3.14, 95%CI, 2.49, 3.96; P < 0.001) and women (PR = 4.63, 95%CI, 3.81, 5.62; P < 0.001). Receiver operating characteristic analysis indicated that AUC for the different anthropometric indices ranged from 0.50 to 0.80. BRI and WHtR had the largest AUC in both males (both AUC = 0.733; 95% CI, 0.717, 0.750) and females (both AUC = 0.773; 95% CI, 0.761, 0.786). The optimal cut-off points for BRI, determined by maximizing the Youden's index, were 3.102 (sensitivity: 63.2%, specificity: 36.2%) in males and 3.136 (sensitivity: 68.9%, specificity: 44.2%) in females. Moreover, BRI and WHtR exhibited the highest diagnostic accuracy in younger age groups, specifically those aged 18-34 in both sexes. CONCLUSIONS BRI emerged as the optimal predictor and independent determinant of the MONW phenotype, regardless of gender. This association was particularly pronounced in young individuals.
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Affiliation(s)
- Yijia Chen
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Chenchen Wang
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Qiannan Sun
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Qing Ye
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Hairong Zhou
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Zhenzhen Qin
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Shengxiang Qi
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Weiwei Wang
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Xin Hong
- Department of Non-Communicable Chronic Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China.
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Gruneisen E, Kremer R, Duque G. Fat as a Friend or Foe of the Bone. Curr Osteoporos Rep 2024; 22:245-256. [PMID: 38416274 DOI: 10.1007/s11914-024-00864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW The objective of this review is to summarize the literature on the prevalence and diagnosis of obesity and its metabolic profile, including bone metabolism, focusing on the main inflammatory and turnover bone mediators that better characterize metabolically healthy obesity phenotype, and to summarize the therapeutic interventions for obesity with their effects on bone health. RECENT FINDINGS Osteoporosis and fracture risk not only increase with age and menopause but also with metabolic diseases, such as diabetes mellitus. Thus, patients with high BMI may have a higher bone fragility and fracture risk. However, some obese individuals with healthy metabolic profiles seem to be less at risk of bone fracture. Obesity has become an alarming disease with growing prevalence and multiple metabolic comorbidities, resulting in a significant burden on healthcare and increased mortality. The imbalance between increased food ingestion and decreased energy expenditure leads to pathological adipose tissue distribution and function, with increased secretion of proinflammatory markers and harmful consequences for body tissues, including bone tissue. However, some obese individuals seem to have a healthy metabolic profile and may not develop cardiometabolic disease during their lives. This healthy metabolic profile also benefits bone turnover and is associated with lower fracture risk.
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Affiliation(s)
- Elodie Gruneisen
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
| | - Richard Kremer
- Division of Endocrinology & Metabolism, Department of Medicine, McGill University Health Centre, Montréal, QC, Canada
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Gustavo Duque
- Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
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Cifre M, Palou A, Oliver P. The Metabolically Obese, Normal-Weight Phenotype in Young Rats Is Associated with Cognitive Impairment and Partially Preventable with Leptin Intake during Lactation. Int J Mol Sci 2023; 25:228. [PMID: 38203399 PMCID: PMC10778589 DOI: 10.3390/ijms25010228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
The intake of high-fat diets (HFDs) and obesity are linked to cognitive impairment. Here, we aimed to investigate whether an early metabolically obese, normal-weight (MONW) phenotype, induced with an HFD in young rats, also leads to cognitive dysfunction and to evaluate the potential cognitive benefits of neonatal intake of leptin. To achieve this, Wistar rats orally received physiological doses of leptin or its vehicle during lactation, followed by 11 weeks of pair-feeding with an HFD or control diet post-weaning. Working memory was assessed using a T-maze, and gene expression in the hippocampus and peripheral blood mononuclear cells (PBMCs) was assessed with real-time RT-qPCR to identify cognition biomarkers. Young MONW-like rats showed hippocampal gene expression changes and decreased working memory. Animals receiving leptin during lactation presented similar gene expression changes but preserved working memory despite HFD intake, partly due to improved insulin sensitivity. Notably, PBMC Syn1 expression appears as an accessible biomarker of cognitive health, reflecting both the detrimental effect of HFD intake at early ages despite the absence of obesity and the positive effects of neonatal leptin treatment on cognition. Thus, the MONW phenotype developed at a young age is linked to cognitive dysfunction, which is reflected at the transcriptomic level in PBMCs. Neonatal leptin intake can partly counteract this impaired cognition resulting from early HFD consumption.
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Affiliation(s)
- Margalida Cifre
- Nutrigenomics, Biomarkers and Risk Evaluation (NuBE) Group, University of the Balearic Islands (UIB), 07122 Palma, Spain (A.P.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Andreu Palou
- Nutrigenomics, Biomarkers and Risk Evaluation (NuBE) Group, University of the Balearic Islands (UIB), 07122 Palma, Spain (A.P.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Paula Oliver
- Nutrigenomics, Biomarkers and Risk Evaluation (NuBE) Group, University of the Balearic Islands (UIB), 07122 Palma, Spain (A.P.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
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Nematbakhsh R, Hajhashemy Z, Lotfi K, Shahdadian F, Rouhani P, Saneei P. Association between dietary insulin index and load with brain derived neurotrophic factor, adropin and metabolic health status in Iranian adults. Sci Rep 2023; 13:20540. [PMID: 37996610 PMCID: PMC10667526 DOI: 10.1038/s41598-023-48056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
The associations of high potential insulinogenic foods with metabolic health (MH) status and brain-derived neurotrophic factor (BDNF) and adropin were not investigated quite enough. We examined the relationship between dietary insulin load (DIL) and dietary insulin index (DII) with MH and serum levels of BDNF and adropin among Iranian adults. This cross-sectional investigation accomplished among 527 Iranian middle-aged adults (54.3% men). Dietary information was obtained by a validated food frequency questionnaire. Anthropometric indices and blood pressure were assessed. For measuring lipid and glycemic profile and serum levels of BDNF and adropin, blood samples were assembled after 12 h of fasting. MH was defined based on lipid and glycemic profile, high blood pressure, insulin resistance and chronic inflammation. After adjustments all confounders, participants in the highest tertile of DII compared to the lowest one had a 115% increased odds for metabolic unhealthy (MU) profile (ORT3 vs. T1 = 2.15, 95% CI 1.03-4.49). However, DIL was not related to MU. Higher DII was additionally associated with high blood pressure, in maximally-adjusted model (ORT3 vs. T1 = 3.57, 95% CI 1.61-7.92). Moreover, moderate DIL was significantly associated with hypertriglyceridemia (ORT2 vs. T1 = 2.56, 95% CI 1.01-6.45). Each tertile increase in DII or DIL was not significantly associated with serum BDNF or adropin values. Greater DII was associated with higher chance of MU and hypertension in Iranian adults; but no association was found between DIL and metabolic health. DIL or DII was not related to circulating BDNF or adropin. To confirm these findings, additional prospective investigations are required.
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Affiliation(s)
- Roxana Nematbakhsh
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
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Szczerbinski L, Florez JC. Precision medicine of obesity as an integral part of type 2 diabetes management - past, present, and future. Lancet Diabetes Endocrinol 2023; 11:861-878. [PMID: 37804854 DOI: 10.1016/s2213-8587(23)00232-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 10/09/2023]
Abstract
Obesity is a complex and heterogeneous condition that leads to various metabolic complications, including type 2 diabetes. Unfortunately, for some, treatment options to date for obesity are insufficient, with many people not reaching sustained weight loss or having improvements in metabolic health. In this Review, we discuss advances in the genetics of obesity from the past decade-with emphasis on developments from the past 5 years-with a focus on metabolic consequences, and their potential implications for precision management of the disease. We also provide an overview of the potential role of genetics in guiding weight loss strategies. Finally, we propose a vision for the future of precision obesity management that includes developing an obesity-centred multidisease management algorithm that targets both obesity and its comorbidities. However, further collaborative efforts and research are necessary to fully realise its potential and improve metabolic health outcomes.
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Affiliation(s)
- Lukasz Szczerbinski
- Diabetes Unit, Endocrine Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland; Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Jose C Florez
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Programs in Metabolism and Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
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Ye J, Guo K, Li X, Yang L, Zhou Z. The Prevalence of Metabolically Unhealthy Normal Weight and Its Influence on the Risk of Diabetes. J Clin Endocrinol Metab 2023; 108:2240-2247. [PMID: 36916473 DOI: 10.1210/clinem/dgad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023]
Abstract
CONTEXT Diabetes is a major health problem and metabolically unhealthy is an important risk factor. OBJECTIVE To conduct the first nationally representative study on epidemiological data of metabolically unhealthy normal weight (MUNW) focused only on nondiabetic subjects and determine the predictive effect on diabetes in China. METHODS A longitudinal study was conducted using data from the Rich Healthcare Group in China. Metabolic status was determined by the revised National Cholesterol Education Program Adult Treatment Panel III criteria, and individuals with 2 or more criteria were categorized as MUNW and diagnosed with metabolic syndrome (MetS) if they met 3 or more. RESULTS Of a total of 63 830 nondiabetic normal-weight individuals, 8935 (14.0%) were classified as MUNW and 1916 (3.00%) were diagnosed with MetS. After adjusting for potential confounders, individuals with MUNW had a greater diabetes risk (4.234, 95% CI 3.089-5.803) than those without MUNW during an average of 3.10 years of follow-up. Also, the multivariable-adjusted hazard ratios for developing diabetes were 3.069 (95% CI 1.790-5.263), 7.990 (95% CI 4.668-13.677), and 11.950 (95% CI 6.618-21.579) for participants with 1, 2, and 3 or more components, respectively, compared with those without any components. Further analyses suggested that the number of MetS components present is associated with the risk of diabetes, especially in metabolically unhealthy normal-weight young male adults. Multivariable-adjusted hazard ratios (95% CI) for incident diabetes among individuals with 1, 2, and at least 3 components were 4.45 (1.45-13.72), 9.82 (3.05-31.64), and 15.13 (3.70-61.84) for participants aged ≤44 years, and 3.55 (1.81-6.97), 8.52 (4.34-16.73), and 13.69 (6.51-28.77) for male participants, respectively. CONCLUSIONS The prevalence of MUNW is 14% in Chinese normal-weight nondiabetic individuals, and active intervention is necessary for this category of people. The presence of MUNW significantly increases the risk of diabetes, and the risk of diabetes is associated with the number of MetS components present in the patient.
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Affiliation(s)
- Jianan Ye
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Keyu Guo
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Xia Li
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Lin Yang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, Second Xiangya Hospital of Central South University, Changsha, 410011, China
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Zakerkish M, Hoseinian A, Alipour M, Payami SP. The Association between Cardio-metabolic and hepatic indices and anthropometric measures with metabolically obesity phenotypes: a cross-sectional study from the Hoveyzeh Cohort Study. BMC Endocr Disord 2023; 23:122. [PMID: 37246210 DOI: 10.1186/s12902-023-01372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/13/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND This study aimed to compare the cardio-metabolic, anthropometric, and liver function indices among metabolic obesity phenotypes. METHODS In this cross-sectional study, which was carried out in Hoveyzeh, Khuzestan Province, Iran, a total of 7,464 individuals (male: 2859, female: 4605), were recruited and classified into four groups, based on Body Mass Index (obese, BMI ≥ 30 kg/m2; non-obese, BMI = 18.5-29.9 kg/m2) and the National Cholesterol Education Program and Adult Treatment Panel (NCEP ATP) III criteria (Healthy group, ≤ 1 of the criteria; Unhealthy group, ≥ 2 of the criteria), as follows: Metabolically Healthy Non-Obese (MHNO, 28.14%), Metabolically Unhealthy Non-Obese (MUNO, 33.06%), Metabolically Healthy Obese (MHO, 6.54%), and Metabolically Unhealthy Obese (MUO, 32.26%). Anthropometric indices (Waist/Hip Ratio (WHR), Waist/Height Ratio (WHtR), Body Adiposity Index (BAI), Visceral Adiposity Index (VAI), and Weight adjusted Waist Index (WWI)), cardio-metabolic indices (Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardio-Metabolic Index (CMI), Lipoprotein Combine Index (LCI), Triglyceride-Glucose (TyG), TyG-BMI, TyG-WC, and Thrombolysis In Myocardial Infarction (TIMI) risk index), and hepatic indices (Hepatic Steatosis Index (HSI) and ALD/NAFLD index (ANI)) were calculated and compared between the groups. RESULTS WHR,VAI, AIP, LAP, CMI, LCI, TyG, and TIMI risk index values were significantly higher in the MUNO phenotype compared to the MHO phenotype (WHR: 0.97 vs. 0.95; VAI: 3.16 vs. 1.33; AIP: 0.58 vs. 0.25; LAP: 78.87 vs. 55.79; CMI: 2.69 vs. 1.25; LCI: 27.91 vs. 12.11; TyG: 9.21 vs. 8.41; TIMI: 18.66 vs. 15.63; p < 0.001). The highest and lowest HSI and ANI values were detected in the MUO phenotype. After adjustment for age, sex, physical activity, and years of education, VAI showed the highest Odds Ratio for MUNO (OR: 5.65; 95% CI: 5.12, 6.24) and MUO (OR: 5.40; 95% CI: 5.89, 5.95) compared to the MHNO phenotypes (p < 0.001). The ANI indices was associated with a reduced risk of MUO (OR: 0.76; 95% CI: 0.75-0.78), MUNO (OR: 0.88; 95% CI: 0.87-0.90), and MHO (OR: 0.79; 95% CI: 0.77-0.81) phenotypes (p < 0.001). CONCLUSION MUNO phenotype was exposed to a higher risk of cardiovascular disease compared to the MHO phenotype. VAI was found to be the optimal index for cardiovascular risk assessment.
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Affiliation(s)
- Mehrnoosh Zakerkish
- Diabetes research center, Health research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Azamsadat Hoseinian
- Diabetes research center, Health research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Meysam Alipour
- Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Seyed Peyman Payami
- Diabetes research center, Health research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Faramarzi E, Somi MH, Naghibi Irvani SS, Pourhashem N, Nourizadeh AM. Associations between Insulin Index and dietary insulin load with cardiometabolic phenotype in the AZAR cohort population in north-western Iran: a cross-sectionalstudy. BMJ Open 2023; 13:e068303. [PMID: 37130689 PMCID: PMC10163542 DOI: 10.1136/bmjopen-2022-068303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES Hyperinsulinaemia and insulin resistance are proposed as contributors to the incidence of cardiometabolic phenotypes (CMPs) with unhealthy metabolic status. This study analysed the association between dietary insulin load (DIL) and Dietary Insulin Index (DII) with CMPs in the AZAR cohort population. DESIGN This study was a cross-sectional analysis of the AZAR Cohort Study, beginning in 2014 and continuing to this date. SETTING The AZAR cohort is a part of an Iranian screening programme named the Persian cohort and involves participants living in the Shabestar region, Iran for at least 9 months. PARTICIPANTS A total of 15 006 participants agreed to partake in the study. We excluded participants with missing data (n=15), daily energy intake lower than 800 kcal (n=7) or higher than 8000 kcal (n=17), and cancer (n=85). Finally, 14 882 individuals remained. PRIMARY AND SECONDARY OUTCOME MEASURES The gathered information included the participants' demographic, dietary, anthropometric and physical activity data. RESULTS The frequency of DIL and DII significantly decreased from the first to fourth quartiles in metabolically unhealthy participants (p≤0.001). The mean values of DIL and DII were greater in metabolically healthy participants than in unhealthy ones (p<0.001). The results of the unadjusted model showed that the risks of unhealthy phenotypes in the fourth DIL quartile decreased by 0.21 (0.14-0.32) and 0.37 (0.33-0.43), respectively, compared with the first quartile. The same model showed the same risks for DII decreased by 0.18 (0.11-0.28) and 0.39 (0.34-0.45), respectively. The results in both genders were the same as all participants combined. CONCLUSIONS DII and DIL were correlated with a decreased OR of unhealthy phenotypes. We suggest the reason may be either a lifestyle change in metabolically unhealthy participants or elevated insulin secretion not being as detrimental as previously thought. Further studies can confirm these speculations.
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Affiliation(s)
- Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Seyed Sina Naghibi Irvani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Nahid Pourhashem
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
| | - Amir Mohammad Nourizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran (the Islamic Republic of)
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Choi HG, Kim HJ. Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women. Menopause 2023; 30:506-511. [PMID: 36730719 DOI: 10.1097/gme.0000000000002092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria. METHODS Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups. RESULTS The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group. CONCLUSIONS We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.
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Affiliation(s)
- Han-Gyo Choi
- From the Digestive Disease Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hye-Jin Kim
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
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Abstract
Nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity but around 10% to 20% of patients with NAFLD have normal body mass index, a condition referred to as lean or nonobese NAFLD. Although lean patients more often have milder liver disease, a proportion may nonetheless develop steatohepatitis and advanced liver fibrosis. Both genetic and environmental factors contribute to the development of NAFLD. Noninvasive tests have similarly good accuracy as initial assessments for lean NAFLD. Future studies should determine the most appropriate treatment in this special population.
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Affiliation(s)
- Ajay Duseja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Arka De
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vincent Wong
- Department of Medicine and Therapeutics, Medical Data Analytics Center, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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Tran T, Potteaux S. [Mild dyslipidemia accelerates tumor growth through expansion of immunosuppressive and pro-angiogenic myeloid cells]. Med Sci (Paris) 2023; 39:319-322. [PMID: 37094261 DOI: 10.1051/medsci/2023038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Affiliation(s)
- Thi Tran
- Université Paris Cité, Inserm U970-PARCC, Paris, France
| | - Stéphane Potteaux
- Université Paris Cité, Inserm U976 HIPI, Paris, France - Université de Reims Champagne Ardenne, IRMAIC EA 7509, Reims, France
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12
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Santillana N, Astudillo-Guerrero C, D’Espessailles A, Cruz G. White Adipose Tissue Dysfunction: Pathophysiology and Emergent Measurements. Nutrients 2023; 15:nu15071722. [PMID: 37049561 PMCID: PMC10096946 DOI: 10.3390/nu15071722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
White adipose tissue (AT) dysfunction plays an important role in the development of cardiometabolic alterations associated with obesity. AT dysfunction is characterized by the loss of the expansion capacity of the AT, an increment in adipocyte hypertrophy, and changes in the secretion profile of adipose cells, associated with accumulation of macrophages and inflammation. Since not all people with an excess of adiposity develop comorbidities, it is necessary to find simple tools that can evidence AT dysfunction and allow the detection of those people with the potential to develop metabolic alterations. This review focuses on the current pathophysiological mechanisms of white AT dysfunction and emerging measurements to assess its functionality.
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Affiliation(s)
- Natalia Santillana
- Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago 8380453, Chile
| | - Camila Astudillo-Guerrero
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile
- Programa de Doctorado en Ciencias Mención Neurociencia, Universidad de Valparaíso, Valparaíso 2360102, Chile
| | - Amanda D’Espessailles
- Instituto de Ciencias de la Salud, Universidad de O’Higgins, Rancagua 2820000, Chile
| | - Gonzalo Cruz
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile
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13
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Coral DE, Fernandez-Tajes J, Tsereteli N, Pomares-Millan H, Fitipaldi H, Mutie PM, Atabaki-Pasdar N, Kalamajski S, Poveda A, Miller-Fleming TW, Zhong X, Giordano GN, Pearson ER, Cox NJ, Franks PW. A phenome-wide comparative analysis of genetic discordance between obesity and type 2 diabetes. Nat Metab 2023; 5:237-247. [PMID: 36703017 PMCID: PMC9970876 DOI: 10.1038/s42255-022-00731-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/20/2022] [Indexed: 01/27/2023]
Abstract
Obesity and type 2 diabetes are causally related, yet there is considerable heterogeneity in the consequences of both conditions and the mechanisms of action are poorly defined. Here we show a genetic-driven approach defining two obesity profiles that convey highly concordant and discordant diabetogenic effects. We annotate and then compare association signals for these profiles across clinical and molecular phenotypic layers. Key differences are identified in a wide range of traits, including cardiovascular mortality, fat distribution, liver metabolism, blood pressure, specific lipid fractions and blood levels of proteins involved in extracellular matrix remodelling. We find marginal differences in abundance of Bacteroidetes and Firmicutes bacteria in the gut. Instrumental analyses reveal prominent causal roles for waist-to-hip ratio, blood pressure and cholesterol content of high-density lipoprotein particles in the development of diabetes in obesity. We prioritize 17 genes from the discordant signature that convey protection against type 2 diabetes in obesity, which may represent logical targets for precision medicine approaches.
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Affiliation(s)
- Daniel E Coral
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - Juan Fernandez-Tajes
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Neli Tsereteli
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Hugo Pomares-Millan
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Hugo Fitipaldi
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Pascal M Mutie
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Naeimeh Atabaki-Pasdar
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Sebastian Kalamajski
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Alaitz Poveda
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tyne W Miller-Fleming
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xue Zhong
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Giuseppe N Giordano
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ewan R Pearson
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Population Health and Genomics, University of Dundee, Dundee, UK
| | - Nancy J Cox
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Paul W Franks
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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14
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Liang Z, Zhang Y, Xu Y, Zhang X, Wang Y. Hesperidin inhibits tobacco smoke-induced pulmonary cell proliferation and EMT in mouse lung tissues via the p38 signaling pathway. Oncol Lett 2022; 25:30. [PMID: 36589667 PMCID: PMC9773313 DOI: 10.3892/ol.2022.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
Tobacco smoke (TS) is the major cause of lung cancer. The abnormal proliferation and epithelial-mesenchymal transition (EMT) of lung cells promote occurrence and development of lung cancer. The p38 pathway intervenes in this cancer development. Hesperidin also serves a role in human health and disease prevention. The roles of p38 in TS-mediated abnormal cell proliferation and EMT, and the hesperidin intervention thereof are not yet understood. In the present study, it was demonstrated that TS upregulated proliferating cell nuclear antigen, vimentin and N-cadherin expression, whereas it downregulated E-cadherin expression, as assessed using western blotting and reverse transcription-quantitative PCR. Furthermore, it was observed that inhibition of the p38 pathway inhibit TS-induced proliferation and EMT. Hesperidin treatment prevented the TS-induced activation of the p38 pathway, EMT and cell proliferation in mouse lungs. The findings of the present study may provide insights into the pathogenesis of TS-related lung cancer.
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Affiliation(s)
- Zhaofeng Liang
- Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China,Correspondence to: Professor Zhaofeng Liang, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu 212013, P.R. China, E-mail:
| | - Yue Zhang
- Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Yumeng Xu
- Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Xinyi Zhang
- Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Yanan Wang
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Suzhou, Jiangsu 215002, P.R. China,Dr Yanan Wang, Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, 16 Baita West Road, Suzhou, Jiangsu 215002, P.R. China, E-mail:
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15
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Fernández-Verdejo R, Galgani JE. Exploring the sequential accumulation of metabolic syndrome components in adults. Sci Rep 2022; 12:15925. [PMID: 36151232 PMCID: PMC9508087 DOI: 10.1038/s41598-022-19510-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components, regardless of their combination. The sequence through which these components accumulate may serve to identify underlying pathophysiological mechanisms and improve MetS treatment. We aimed to explore whether there is a more frequent sequence of accumulation of components in adults. The cross-sectional data of the National Health Survey of Chile 2016–2017 was analyzed. Subjects aged 18 to < 65 years, with body mass index ≥ 18.5 kg/m2, having all MetS components measured, and not under drug treatment were included (n = 1944, 60% women). MetS components were operationalized based on harmonized criteria: elevated waist circumference (≥ 91 cm for men, ≥ 83 cm for women), reduced high-density lipoprotein cholesterol (HDL-C; < 40 mg/dL for men, < 50 mg/dL for women), elevated triglycerides (≥ 150 mg/dL), elevated blood pressure (≥ 130 mmHg for systolic, or ≥ 85 mmHg for diastolic), and elevated glycemia (≥ 100 mg/dL). Subjects were grouped according to the number of components. Then, the prevalence of the observed combinations was determined. In subjects with one component, the most prevalent was waist circumference (56.7%). In subjects with two, the most prevalent combination was waist circumference and HDL-C (50.8%), while in subjects with three components was waist circumference, HDL-C, and triglycerides (54.0%). Finally, in subjects with four, the most prevalent combination was waist circumference, HDL-C, triglycerides, and blood pressure (40.8%). This pattern suggests that the most frequent accumulation sequence starts with abdominal obesity, followed by dyslipidemia, elevated blood pressure, and ultimately, dysglycemia. The factors that determine the sequence remain to be determined.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Avenida Pedro de Valdivia 1509, Providencia, Santiago, Chile.
| | - Jose E Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. .,Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Libertador Bernardo O'Higgins 340, Santiago, Chile.
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16
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Tran T, Lavillegrand JR, Lereverend C, Esposito B, Cartier L, Montabord M, Tran-Rajau J, Diedisheim M, Gruel N, Ouguerram K, Paolini L, Lenoir O, Pinteaux E, Brabencova E, Tanchot C, Urquia P, Lehmann-Che J, Le Naour R, Merrouche Y, Stockmann C, Mallat Z, Tedgui A, Ait-Oufella H, Tartour E, Potteaux S. Mild dyslipidemia accelerates tumorigenesis through expansion of Ly6C hi monocytes and differentiation to pro-angiogenic myeloid cells. Nat Commun 2022; 13:5399. [PMID: 36104342 PMCID: PMC9475043 DOI: 10.1038/s41467-022-33034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 08/24/2022] [Indexed: 11/08/2022] Open
Abstract
Cancer and cardiovascular disease (CVD) share common risk factors such as dyslipidemia, obesity and inflammation. However, the role of pro-atherogenic environment and its associated low-grade inflammation in tumor progression remains underexplored. Here we show that feeding C57BL/6J mice with a non-obesogenic high fat high cholesterol diet (HFHCD) for two weeks to induce mild dyslipidemia, increases the pool of circulating Ly6Chi monocytes available for initial melanoma development, in an IL-1β-dependent manner. Descendants of circulating myeloid cells, which accumulate in the tumor microenvironment of mice under HFHCD, heighten pro-angiogenic and immunosuppressive activities locally. Limiting myeloid cell accumulation or targeting VEGF-A production by myeloid cells decrease HFHCD-induced tumor growth acceleration. Reverting the HFHCD to a chow diet at the time of tumor implantation protects against tumor growth. Together, these data shed light on cross-disease communication between cardiovascular pathologies and cancer.
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Affiliation(s)
- Thi Tran
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | | | - Cedric Lereverend
- Université de Reims Champagne Ardenne, IRMAIC EA 7509, 51097, Reims, France
| | - Bruno Esposito
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Lucille Cartier
- Université de Reims Champagne Ardenne, IRMAIC EA 7509, 51097, Reims, France
- Département de Recherche, Institut Godinot, 51100, Reims, France
| | | | | | - Marc Diedisheim
- Service de diabétologie, Hôpital Cochin APHP. GlandOmics, Cheverny, Paris, France
| | - Nadège Gruel
- INSERM U830, Équipe Labellisée LNCC, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Centre, Institut Curie, 75005, Paris, France
- Department of Translational Research, Institut Curie Research Centre, Institut Curie, 75005, Paris, France
| | | | - Lea Paolini
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Olivia Lenoir
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Emmanuel Pinteaux
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Eva Brabencova
- Département de Recherche, Institut Godinot, 51100, Reims, France
| | - Corinne Tanchot
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Pauline Urquia
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | - Jacqueline Lehmann-Che
- Université Paris Cité, INSERM, U976 HIPI, F-75010, Paris, France
- Molecular Oncology Unit, Saint Louis Hospital, APHP, F-75010, Paris, France
| | - Richard Le Naour
- Université de Reims Champagne Ardenne, IRMAIC EA 7509, 51097, Reims, France
| | - Yacine Merrouche
- Université de Reims Champagne Ardenne, IRMAIC EA 7509, 51097, Reims, France
- Département de Recherche, Institut Godinot, 51100, Reims, France
| | - Christian Stockmann
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- University of Zurich, Institute of Anatomy, Zurich, Switzerland
- Comprehensive Cancer Center Zurich, Zurich, Switzerland
| | - Ziad Mallat
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Alain Tedgui
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
| | | | - Eric Tartour
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Equipe Labellisée Ligue Contre le Cancer, Paris, France
- AP-HP Hôpital Européen Georges Pompidou. Service d'immunologie, Paris, France
| | - Stephane Potteaux
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
- Université Paris Cité, INSERM, U976 HIPI, F-75010, Paris, France.
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17
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Yang L, Li X, Wang L, Xu S, Lou Y, Hu F. Metabolically obese phenotype and its dynamic change are associated with increased carotid intima-media thickness: Results from a cohort study. Nutr Metab Cardiovasc Dis 2022; 32:2238-2245. [PMID: 35850751 DOI: 10.1016/j.numecd.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/27/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS To examine associations between metabolically obese phenotypes or their changes and increased carotid intima-media thickness (CIMT). METHODS AND RESULTS This prospective cohort included 13,681 Chinese adults aged 20-80 years who completed follow-up health examination with carotid ultrasound and were divided according to metabolic and weight status: metabolically healthy and normal weight (MHNW); metabolically obese but normal weight (MONW); metabolically healthy but obese (MHO); metabolically abnormal and obese (MAO). Cox and logistic regression were used to evaluate the associations of the phenotypes or their changes with increased CIMT. During a mean follow-up of 33 months, 1927 participants developed increased CIMT. After adjusting for age, sex and potential biochemical confounders, MAO was significantly associated with increased CIMT (HR 1.22, 95% CI [1.07, 1.4]); the association remained significant in those 40 years or older. Compared with stable MHNW, increased CIMT risk was higher for stable MAO (OR 1.35 [1.16, 1.57]), transitional MAO from MONW (OR 1.44 [1.04, 1.97]), and transitional MHO from MHNW (OR 1.59 [1.10, 2.26]) in demographic adjusted models; only stable MAO remained significant in the multivariate adjusted model (OR 1.23 [1.05, 1.45]). CONCLUSION MAO significantly elevated the risk of increased CIMT. Stable MAO and obese transitions also promoted CIMT progression.
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Affiliation(s)
- Liping Yang
- Center for Chronic Disease Control, Nanshan, Shenzhen, PR China; Department of Nutrition, School of Public Health, Sun Yat-sen University, GuangZhou, PR China
| | - Xue Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, GuangZhou, PR China
| | - Li Wang
- Center for Chronic Disease Control, Nanshan, Shenzhen, PR China
| | - Shan Xu
- Center for Chronic Disease Control, Nanshan, Shenzhen, PR China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, PR China.
| | - Fulan Hu
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, PR China.
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18
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Wang Z, He Y, Li L, Zhang M, Ruan H, Zhu Y, Wei X, Wei J, Chen X, He S. New metabolic health definition might not be a reliable predictor for mortality in the nonobese Chinese population. BMC Public Health 2022; 22:1629. [PMID: 36038857 PMCID: PMC9422146 DOI: 10.1186/s12889-022-14062-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Recently, a new metabolic health (MH) definition was developed from NHANES-III. In the origin study, the definition may stratify mortality risks in people who are overweight or normal weight. We aimed to investigate the association between the new MH definition and all-cause mortality in a nonobese Chinese population. Methods The data were collected in 1992 and then again in 2007 from the same group of 1157 participants. The association between the new MH definition and all-cause mortality were analyzed by Cox regression models with overlap weighting according to propensity score (PS) as primary analysis. Results At baseline in 1992, 920 (79.5%) participants were categorized as MH, and 237 (20.5%) participants were categorized as metabolically unhealthy (MUH) based on this new definition. During a median follow-up of 15 years, all-cause mortality occurred in 17 (1.85%) participants in MH group and 13 (5.49%) in MUH group, respectively. In the crude sample, Kaplan–Meier analysis demonstrated a significantly higher all-cause mortality in MUH group when compared to MH group (log-rank p = 0.002), and MUH was significantly associated with increased all-cause mortality when compared to MH with HR at 3.04 (95% CI: 1.47–6.25, p = 0.003). However, Kaplan–Meier analysis with overlap weighting showed that the cumulative incidence of all-cause mortality was not significantly different between MH and MUH groups (adjusted p = 0.589). Furthermore, in the primary multivariable Cox analysis with overlap weighting, adjusted HR for all-cause mortality was 1.42 (95% CI: 0.49—4.17, p = 0.519) in MUH group in reference to MH group. Other additional PS analyses also showed the incidence of all-cause mortality was not significantly different between the two groups. Conclusion The new MH definition may be not appropriate for mortality risk stratification in non-obese Chinese people. Further investigations are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14062-3.
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Affiliation(s)
- Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yan He
- Department of Interventional Operating Room, Mianyang People's Hospital, Mianyang, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China.,Department of Cardiology, First People's Hospital, Longquanyi District, Chengdu, China
| | - Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China.,Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Ye Zhu
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xin Wei
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China.,Department of Cardiology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Jiafu Wei
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
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19
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Karra P, Winn M, Pauleck S, Bulsiewicz-Jacobsen A, Peterson L, Coletta A, Doherty J, Ulrich CM, Summers SA, Gunter M, Hardikar S, Playdon MC. Metabolic dysfunction and obesity-related cancer: Beyond obesity and metabolic syndrome. Obesity (Silver Spring) 2022; 30:1323-1334. [PMID: 35785479 PMCID: PMC9302704 DOI: 10.1002/oby.23444] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The metabolic dysfunction driven by obesity, including hyperglycemia and dyslipidemia, increases risk for developing at least 13 cancer types. The concept of "metabolic dysfunction" is often defined by meeting various combinations of criteria for metabolic syndrome. However, the lack of a unified definition of metabolic dysfunction makes it difficult to compare findings across studies. This review summarizes 129 studies that evaluated variable definitions of metabolic dysfunction in relation to obesity-related cancer risk and mortality after a cancer diagnosis. Strategies for metabolic dysfunction management are also discussed. METHODS A comprehensive search of relevant publications in MEDLINE (PubMed) and Google Scholar with review of references was conducted. RESULTS Metabolic dysfunction, defined as metabolic syndrome diagnosis or any number of metabolic syndrome criteria out of clinical range, inflammatory biomarkers, or markers of metabolic organ function, has been associated with risk for, and mortality from, colorectal, pancreatic, postmenopausal breast, and bladder cancers. Metabolic dysfunction associations with breast and colorectal cancer risk have been observed independently of BMI, with increased risk in individuals with metabolically unhealthy normal weight or overweight/obesity compared with metabolically healthy normal weight. CONCLUSION Metabolic dysfunction is a key risk factor for obesity-related cancer, regardless of obesity status. Nonetheless, a harmonized definition of metabolic dysfunction will further clarify the magnitude of the relationship across cancer types, enable better comparisons across studies, and further guide criteria for obesity-related cancer risk stratification.
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Affiliation(s)
- Prasoona Karra
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Maci Winn
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Svenja Pauleck
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | | | - Lacie Peterson
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Adriana Coletta
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer Doherty
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Cornelia M. Ulrich
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Scott A. Summers
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Sheetal Hardikar
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
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20
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Reynés B, Cifre M, Palou A, Oliver P. Perinatal Treatment with Leptin, but Not Celastrol, Protects from Metabolically Obese, Normal-Weight Phenotype in Rats. Nutrients 2022; 14:nu14112277. [PMID: 35684076 PMCID: PMC9183119 DOI: 10.3390/nu14112277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
Perinatal nutrition has a well-known influence on obesity susceptibility. We previously demonstrated the protective anti-obesity effects of perinatal leptin administration. Celastrol is a natural compound acting as a leptin sensitizer with anti-obesity effects when administered in adult animals. Here, we aimed to determine if perinatal treatment with leptin, celastrol, or their combination was able to improve metabolic health in animals fed an isocaloric high-fat (HF) diet. Leptin and/or celastrol or their vehicle were administered orally to rats during the suckling period. After weaning, animals were chronically pair-fed with an HF diet provided isocaloric to the intake of a normal-fat diet by control animals to avoid obesity. Isocaloric HF feeding in vehicle-treated animals resulted in metabolic features characteristic of the metabolically obese, normal-weight (MONW) phenotype, i.e., obesity-related disturbances without increased body weight. Leptin treatment prevented liver fat deposition and insulin resistance, induced greater insulin and leptin signaling capacity, decreased gene expression of orexigenic signals at the hypothalamic level, and induced browning in retroperitoneal adipose tissue. However, celastrol treatment did not provide any protective effect and resulted in greater size of the retroperitoneal adipose depot, higher circulating glucose and insulin levels, and decreased leptin sensitivity capacity in adipose tissue. The co-administration of leptin ameliorated the negative effects of celastrol on the retroperitoneal depot, inducing browning and decreasing its size. In conclusion, the perinatal administration of leptin, but not celastrol, provided protection against the consequences of dietary unbalances leading to an MONW phenotype in adulthood.
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Affiliation(s)
- Bàrbara Reynés
- Nutrigenomics, Biomarkers and Risk Evaluation Group, University of the Balearic Islands, 07122 Palma, Spain; (B.R.); (M.C.); (P.O.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
| | - Margalida Cifre
- Nutrigenomics, Biomarkers and Risk Evaluation Group, University of the Balearic Islands, 07122 Palma, Spain; (B.R.); (M.C.); (P.O.)
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Andreu Palou
- Nutrigenomics, Biomarkers and Risk Evaluation Group, University of the Balearic Islands, 07122 Palma, Spain; (B.R.); (M.C.); (P.O.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-971-173-170
| | - Paula Oliver
- Nutrigenomics, Biomarkers and Risk Evaluation Group, University of the Balearic Islands, 07122 Palma, Spain; (B.R.); (M.C.); (P.O.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Shi Y, Yu C, Hu L, Li M, Zhou W, Wang T, Zhu L, Bao H, Li P, Cheng X. Visceral adiposity index and sex differences in relation to peripheral artery disease in normal-weight adults with hypertension. Biol Sex Differ 2022; 13:22. [PMID: 35551654 PMCID: PMC9102597 DOI: 10.1186/s13293-022-00432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/27/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies on the relationship between the visceral adiposity index (VAI) and peripheral arterial disease (PAD) are limited. Therefore, this study explored the relationship between VAI and PAD in normal-weight patients with hypertension. METHODS A total of 6615 normal-weight patients with hypertension were included in the current study. The VAI, a simple index calculated using blood lipid and waist circumference (WC), can be used as a simple biomarker of body fat distribution. The outcome was PAD, which was defined as present when each side's ankle-brachial index (ABI) was ≤ 0.90. RESULTS A significant positive association was observed between VAI and PAD prevalence. For per unit increment in LnVAI, the adjusted odds ratios (ORs) of PAD for the total participants and males were 1.55 (95% CI 1.15-2.10) and 2.12 (95% CI 1.46-3.07), respectively. However, the VAI was not associated with PAD in female patients with hypertension (OR 1.28; 95% confidence interval [CI] 0.85-1.95). There was no interaction between sex and VAI (P for interaction = 0.128). Accordingly, in total participants, when VAI was assessed in quartiles and compared with quartile 1 (< 0.84), the PAD prevalence was higher than that of quartiles 2 (0.84 to < 1.36: OR 1.49; 95% CI 0.92-2.44), 3 (1.36 to < 2.25: OR 1.95; 95% CI 1.14-3.32), and 4 (≥ 2.25: OR 1.93; 95% CI 1.04-3.57). There were no significant interactions with the other confounders. CONCLUSION This study showed a positive association between VAI and PAD in normal-weight adults with hypertension among men but not among women.
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Affiliation(s)
- Yumeng Shi
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Chao Yu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China
| | - Minghui Li
- Department of Cardiovascular Medicine, Inner Mongolia People's Hospital, Hu He Hao Te Shi, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Tao Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China. .,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital, Nanchang of Jiangxi, China. .,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China.
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22
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Ding C, Shi Y, Li J, Li M, Hu L, Rao J, Liu L, Zhao P, Xie C, Zhan B, Zhou W, Wang T, Zhu L, Huang X, Bao H, Cheng X. Association of weight-adjusted-waist index with all-cause and cardiovascular mortality in China: A prospective cohort study. Nutr Metab Cardiovasc Dis 2022; 32:1210-1217. [PMID: 35277327 DOI: 10.1016/j.numecd.2022.01.033] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS As a new simple anthropometric index, the weight-adjusted-waist index (WWI) appears to be superior to body mass index (BMI) and waist circumference (WC) in assessing both muscle and fat mass. We aimed to explore the association of WWI with all-cause and cardiovascular mortality in southern China. METHODS AND RESULTS A total of 12,447 participants (mean age, 59.0 ± 13.3 years; 40.6% men) in Jiangxi Province from the China Hypertension Survey study were included. WWI was defined as WC divided by the square root of weight. The outcome was all-cause and cardiovascular mortality. During a median follow-up of 5.6 years, 838 all-cause deaths occurred, with 390 cardiovascular deaths. Overall, there was a nonlinear positive relationship of WWI with all-cause and cardiovascular mortality. Accordingly, compared with participants in quartiles 1-3 (<11.2 cm/√kg), a significant higher risk of all-cause mortality (HR: 1.36, 95% CI: 1.17, 1.58) and cardiovascular mortality (HR: 1.43, 95% CI: 1.15, 1.77) were found in quartile 4 (≥11.2 cm/√kg). Further adjustment for BMI and WC did not substantially alter the results. No significant interactions were found in any of the subgroups (sex, age, area, physical activity, current smoking, current alcohol drinking, hypertension, and stroke). CONCLUSION Higher WWI levels (≥11.2 cm/√kg) were associated with increased the risk of all-cause and cardiovascular mortality in southern China. These findings, if confirmed by further studies, suggested that WWI may serve as a simple and effective anthropometric index in clinical practice.
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Affiliation(s)
- Congcong Ding
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yumeng Shi
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Junpei Li
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Minghui Li
- Department of Cardiology, Inner Mongolia People's Hospital, Inner Mongolia, China
| | - Lihua Hu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jingan Rao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Liang Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Peixu Zhao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Chong Xie
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Biming Zhan
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China
| | - Xiao Huang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China.
| | - Huihui Bao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang of Jiangxi, China.
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Gatzios A, Rombaut M, Buyl K, De Kock J, Rodrigues RM, Rogiers V, Vanhaecke T, Boeckmans J. From NAFLD to MAFLD: Aligning Translational In Vitro Research to Clinical Insights. Biomedicines 2022; 10:biomedicines10010161. [PMID: 35052840 PMCID: PMC8773802 DOI: 10.3390/biomedicines10010161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
Although most same-stage non-alcoholic fatty liver disease (NAFLD) patients exhibit similar histologic sequelae, the underlying mechanisms appear to be highly heterogeneous. Therefore, it was recently proposed to redefine NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) in which other known causes of liver disease such as alcohol consumption or viral hepatitis do not need to be excluded. Revised nomenclature envisions speeding up and facilitating anti-MAFLD drug development by means of patient stratification whereby each subgroup would benefit from distinct pharmacological interventions. As human-based in vitro research fulfils an irrefutable step in drug development, action should be taken as well in this stadium of the translational path. Indeed, most established in vitro NAFLD models rely on short-term exposure to fatty acids and use lipid accumulation as a phenotypic benchmark. This general approach to a seemingly ambiguous disease such as NAFLD therefore no longer seems applicable. Human-based in vitro models that accurately reflect distinct disease subgroups of MAFLD should thus be adopted in early preclinical disease modeling and drug testing. In this review article, we outline considerations for setting up translational in vitro experiments in the MAFLD era and allude to potential strategies to implement MAFLD heterogeneity into an in vitro setting so as to better align early drug development with future clinical trial designs.
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Affiliation(s)
| | | | | | | | | | | | | | - Joost Boeckmans
- Correspondence: (A.G.); (J.B.); Tel.: +32-(0)-2-477-45-94 (A.G.)
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24
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Metabolic Obesity in People with Normal Body Weight (MONW)-Review of Diagnostic Criteria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020624. [PMID: 35055447 PMCID: PMC8776153 DOI: 10.3390/ijerph19020624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 12/12/2022]
Abstract
Disorders of metabolic obesity with normal body weight (MONW) are widely recognized risk factors for the development of cardiovascular diseases and type 2 diabetes. Despite this, MONW is not diagnosed in clinical practice. There is no consensus on the definition of MONW, and measuring the degree of insulin resistance or obesity among apparently healthy, non-obese patients is not widely applicable. The awareness of the relationship between metabolic disorders such as MONW and a higher risk of mortality from cardiovascular causes and other related diseases prompts the need for action to be taken aimed at creating appropriate diagnostic models that will allow for the effective detection of those with metabolic abnormalities among people with normal body weight. Such actions are decisive in the prevention and treatment of diseases. Therefore, the purpose of this article is to review the MONW diagnostic criteria used over the years.
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25
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Cai XT, Zhu Q, Liu SS, Wang MR, Wu T, Hong J, Hu JL, Li N. Associations Between the Metabolic Score for Insulin Resistance Index and the Risk of Type 2 Diabetes Mellitus Among Non-Obese Adults: Insights from a Population-Based Cohort Study. Int J Gen Med 2021; 14:7729-7740. [PMID: 34785931 PMCID: PMC8579827 DOI: 10.2147/ijgm.s336990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/04/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose The metabolic score for insulin resistance (METS-IR) index is an emerging surrogate predictor of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between the METS-IR index and the risk of T2DM in non-obese Japanese adults. Methods A total of 12,290 non-obese participants were selected from the NAGALA prospective cohort study conducted from 2004 to 2015. Cox proportional hazards models were used to assess the association between the baseline METS-IR index and risk of T2DM. Generalized additive models were used to identify nonlinear relationships. In addition, we performed subgroup analyses and interaction tests. Results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). Results During a median follow-up of 2050 days, 176 (1.43%) incident T2DM occurred. The fully adjusted HR (95% CI) for the incidence of T2DM in non-obese adults was 1.17 (HR=1.17, 95% CI: 1.09–1.27, P<0.001) for every 1-unit increase in the METS-IR index. The risk of developing T2DM increased with the quartile of change in the METS-IR index, after adjustment for multiple potential confounding, the HRs for the Q4 group versus the Q1 group was 4.01 (95% CI, 1.39–11.57). Generalized additive models also showed a cumulative increase in the risk of T2DM with increasing the METS-IR index. Time-dependent receiver operating curve suggested helpful discriminative power of the METS-IR index for T2DM. The C-statistics by the clinical risk factors significantly improve with the addition of the METS-IR index (from 0.862 to 0.875, P = 0.035); the discriminatory power and risk reclassification also appeared to be substantially better, with the category-free NRI of 0.216, and the IDI of 0.011. Conclusion The METS-IR index was a significant and independent predictor for future T2DM development in non-obese adults. The METS-IR index may have clinical significance in identifying groups at high risk of T2DM.
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Affiliation(s)
- Xin-Tian Cai
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.,Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Qing Zhu
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.,Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Sha-Sha Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Meng-Ru Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Ting Wu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Jun-Li Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
| | - Nanfang Li
- Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.,Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, Urumqi, Xinjiang, People's Republic of China
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Tsai SY, Chen HH, Hsu HY, Tsai MC, Hsu LY, Hwang LC, Chien KL, Lin CJ, Yeh TL. Obesity phenotypes and their relationships with atrial fibrillation. PeerJ 2021; 9:e12342. [PMID: 34760366 PMCID: PMC8557684 DOI: 10.7717/peerj.12342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022] Open
Abstract
Background This study assessed the associations of metabolic obesity phenotypes with the risk of atrial fibrillation (Afib). Methods This prospective cohort study categorized Taiwanese adults according to their body mass index (BMI) and metabolic health status at baseline. We assigned the participants to the underweight (BMI < 18.5 kg/m2), normal weight (BMI = 18.5-23.9 kg/m2), and overweight/obesity groups (BMI ≥ 24 kg/m2). Metabolically healthy was defined as absence of hypertension, diabetes, and hyperlipidemia and the presence of healthy metabolic profiles. Results In total, 5,742 adults were included. During a median follow-up of 13.7 years, 148 patients developed Afib. Compared to the metabolically healthy normal weight group, the risk of Afib was significantly higher than those in the metabolically unhealthy overweight/obesity (hazard ratio = 2.20, 95% confidence interval [1.12-4.33]) and metabolically unhealthy normal weight groups (HR = 2.64, 95% CI [1.34-5.17]). Additionally, the point estimate suggested a 1.97-fold greater risk among the metabolically healthy overweight/obesity group, although this difference was not significant given the wide confidence interval (HR = 1.97, 95% CI [0.80-4.86]). Conclusion Our results demonstrated the relationships of metabolic health and weight regarding the risk of Afib in Taiwanese adults. The Afib risk among metabolic and obesity phenotypes is associated with a metabolically unhealthy status. A trend toward a higher Afib risk with obesity among metabolically healthy subjects was observed. However, the result was not robust and it still suggested further study.
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Affiliation(s)
- Szu-Ying Tsai
- Department of Family Medicine, Taipei City Hospital, Zhongxing Branch, Taipei City, Taiwan.,Department of Family Medicine, Taipei MacKay Memorial Hospital, Taipei City, Taiwan
| | - Hsin-Hao Chen
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.,MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Hsin-Yin Hsu
- Department of Family Medicine, Taipei MacKay Memorial Hospital, Taipei City, Taiwan
| | - Ming-Chieh Tsai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei MacKay Memorial Hospital, Taipei City, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Lee-Ching Hwang
- Department of Family Medicine, Taipei MacKay Memorial Hospital, Taipei City, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chien-Ju Lin
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
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Pattern of Adiponectin, Osteocalcin, Irisin, FGF-21, and MCP-1 According to the Body Size Phenotype: Could They Be Markers of Metabolic Health in Mexican-Mestizo Middle-Aged Women? Metabolites 2021; 11:metabo11110771. [PMID: 34822430 PMCID: PMC8619823 DOI: 10.3390/metabo11110771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Variations in levels of some adipokines, myokines, osteokines, hepatokines and inflammatory cytokines contribute to abnormal glucose and lipid metabolism. The aim of this study was to determine the pattern of adiponectin, osteocalcin (OCN), irisin, FGF-21, and MCP-1 according to the body size phenotype of middle-aged women, and their associations with BMI, visceral adipose tissue (VAT), and HOMA-IR. A cross-sectional study in 265 women aged from 40 to 65 years was performed. The biochemical characteristics were evaluated in metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy obese, and metabolically unhealthy obese women. There was an association of OCN with BMI (r = -0.107; p = 0.047); adiponectin with BMI (r = -0.217; p = 0.001), insulin (r = -0.415; p = 0.0001), HOMA-IR (r = -0.429; p = 0.0001), and VAT (r = -0.134; p = 0.025); irisin with BMI (r = 0.604; p = 0.001), insulin (r = 0.446; p = 0.0001), HOMA-IR (r = 0.452; p = 0.0001), and VAT (r = 0.645; p = 0.0001); FGF-21 with insulin (r = -0.337; p= 0.030) and HOMA-IR (r = -0.341; p = 0.03); and MCP-1 with BMI (r = 0.481; p = 0.0001), VAT (r = 0.497; p = 0.001), insulin (r = 0.298; p= 0.001), and HOMA-IR (r = 0.255; p = 0.004). A multivariate analysis showed that an elevation of OCN (OR 1.4 (95%CI 1.06-1.81)) and a reduction of adiponectin (OR 0.9 (0.84-0.96)) were associated factors for a metabolic unhealthy phenotype in normal weight participants. Likewise, higher irisin (OR 1.007 (1.003-1.011)) and MCP-1 (1.044 (1.008-1.083)) were risk factors for a metabolic unhealthy phenotype in woman with obesity. OCN, adiponectin, irisin, FGF-21, and MCP-1 are associated with some metabolic parameters such as BMI, HOMA-IR, and VAT, and could be possible biomarkers of an unhealthy metabolic phenotype in middle-aged women.
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Zyśk B, Ostrowska L, Smarkusz-Zarzecka J. Salivary Adipokine and Cytokine Levels as Potential Markers for the Development of Obesity and Metabolic Disorders. Int J Mol Sci 2021; 22:ijms222111703. [PMID: 34769133 PMCID: PMC8584047 DOI: 10.3390/ijms222111703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 12/16/2022] Open
Abstract
Currently, the number of people suffering from obesity is increasing worldwide. In addition, the disease is affecting younger individuals. Therefore, it is essential to search for new diagnostic methods and markers for early assessment of the risk of obesity, metabolic disorders, and other comorbidities. The discovery of the secretory function of adipose tissue and coexistence of low-grade chronic inflammation with obesity set a new direction in this disease diagnosis using the assessment of the concentration of inflammatory markers secreted by adipose tissue. The aim of this review was to determine, based on previous findings, whether saliva can be useful in the diagnosis of obesity and its early metabolic complications and whether it can be an alternative diagnostic material to serum.
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Li J, Zhu J, Tan Z, Yu Y, Luo L, Zhou W, Zhu L, Wang T, Cao T, Liu L, Bao H, Huang X, Cheng X. Visceral adiposity index is associated with arterial stiffness in hypertensive adults with normal-weight: the china H-type hypertension registry study. Nutr Metab (Lond) 2021; 18:90. [PMID: 34627312 PMCID: PMC8502385 DOI: 10.1186/s12986-021-00617-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/09/2021] [Indexed: 01/24/2023] Open
Abstract
Background Limited information is available on arterial stiffness risk among hypertensive patients with metabolically abnormal but normal weight. Visceral adiposity index (VAI) is a novel indicator for visceral fat mass and metabolism, however, whether can be used to assessed arterial stiffness in a normal-weight population remains unclear. The goal of this study was to examine the independent association of VAI with arterial stiffness in normal-weight hypertensive patients. Methods 3258 participants recruited from the China H-type Hypertension Registry Study. VAI value was calculated using sex-specific equations. High arterial stiffness was defined as baPWV ≥ 18 m/s. Multivariable regression analysis was used to identify the association of VAI with baPWV and high arterial stiffness. Results Of participants, 50.5% (1644) were males, the mean age was 65.5 (SD, 9.1) years. Mean VAI and baPWV were 2.0 (SD, 2.3) and 18.2 (SD, 3.9) m/s, respectively. For each unit increase of lg VAI in multivariable regression analysis, there was a 1.05 m/s increase in baPWV (95% CI 0.67, 1.43) and a 2.13-fold increase in the risk of high arterial stiffness (95% CI 1.59, 2.86). In all models, the VAI was consistently and significantly associated with baPWV after adjustment for different confounders. High VAI levels were stably associated with baPWV in all subgroups. Conclusions We found positive association of VAI with baPWV and high arterial stiffness in normal-weight adults with hypertension. The establishment of this association could help the arterial stiffness risk stratification in normal-weight hypertensive populations, who are frequently overlooked in preventing cardiovascular disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00617-5.
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Affiliation(s)
- Junpei Li
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Jian Zhu
- Qiukou Health Center, Wuyuan, China
| | - Ziheng Tan
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Yun Yu
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Linfei Luo
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Wei Zhou
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Linjuan Zhu
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Tao Wang
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Tianyu Cao
- Biological Anthropology, University of California, Santa Barbara, California, USA
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Huihui Bao
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiology, Nanchang University Second Affiliated Hospital, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.
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Zeng Y, Li FF, Yuan SQ, Tang HK, Zhou JH, He QY, Baker JS, Dong YH, Yang YD. Prevalence of Hyperhomocysteinemia in China: An Updated Meta-Analysis. BIOLOGY 2021; 10:biology10100959. [PMID: 34681058 PMCID: PMC8533293 DOI: 10.3390/biology10100959] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 12/02/2022]
Abstract
Simple Summary Hyperhomocysteinemia has been defined as an elevated serum concentration of homocysteine exceeding 15 μmol/L and has been proven to play an important role in the pathogenesis of cerebrovascular disease. The prevalence of hyperhomocysteinemia in China has been outlined in a previous meta-analysis. Considering the key role of homocysteine in the process of vascular injury, more studies have been conducted to prevent hyperhomocysteinemia by nutritional supplements such as folic acid or other treatments. Additionally, studies have shown that the prevalence of hyperhomocysteinemia increases over time; therefore, it was necessary to provide an update from the previous meta-analysis on homocysteine status in China. This was needed to understand the prevalence, the trend in changes over time, and its determinants. The results highlight that the prevalence of hyperhomocysteinemia is increasing in China, especially among the elderly, men, and residents in the north, inland areas, and rural areas of China. Abstract We conducted a meta-analysis to systematically assess the prevalence of hyperhomocysteinemia (HHcy) in China, its change over time, and its determinants. Literature searches were conducted using English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, CBM, VIP, and Wanfang). The time ranges were from Jan 2014 to Mar 2021 in China. We adopted the random effects model to estimate the pooled positive rates of HHcy and corresponding 95% confidence intervals (95% CI). To find the sources of heterogeneity, we performed subgroup analysis and meta-regression. A total of 29 related articles were identified involving 338,660 participants with 128,147 HHcy cases. The estimated prevalence of HHcy in China was 37.2% (95% CI: 32.6–41.8%, I2 = 99.8%, p for heterogeneity < 0.001). The trend of HHcy prevalence was gradually upward over time, with increases during 2015–2016 (comparison to 2013–2014, p < 0.001), but steady between 2015–2016 and 2017–2018. Subgroup analysis showed that the prevalence was higher in the elderly over 55 years old, males, and residents in the north, inland, and rural China (for each comparison, p < 0.001). Meta-regression analysis revealed that age and area of study contributed to 42.3% of the heterogeneity between studies. The current meta-analysis provides strong evidence that the prevalence of HHcy is increasing in China, and varies substantially across different ages, genders, and geographic distribution. Accordingly, high-risk population groups should be focused on, and public health policies and strategies should be carried out to prevent and control HHcy in China.
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Affiliation(s)
- Yuan Zeng
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
| | - Fei-Fei Li
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China;
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China
| | - Shu-Qian Yuan
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
| | - Hao-Kai Tang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
| | - Jun-Hua Zhou
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
| | - Quan-Yuan He
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China;
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China
- Correspondence: (Y.-D.Y.); (J.S.B.); (Y.-H.D.)
| | - Yan-Hui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Correspondence: (Y.-D.Y.); (J.S.B.); (Y.-H.D.)
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China; (Y.Z.); (S.-Q.Y.); (H.-K.T.); (J.-H.Z.); (Q.-Y.H.)
- Correspondence: (Y.-D.Y.); (J.S.B.); (Y.-H.D.)
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Skeletal mass indices are inversely associated with metabolically unhealthy phenotype in overweight/obese and normal-weight men: a population-based cross-sectional study. Br J Nutr 2021; 126:501-509. [PMID: 33143771 DOI: 10.1017/s0007114520004262] [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: 11/05/2022]
Abstract
Muscle mass may play an important role in the metabolic profile of individuals with or without excess weight. Metabolic phenotypes classify individuals as healthy or unhealthy based on certain metabolic conditions. We investigated the association between skeletal mass indices (SMI) and the metabolically unhealthy phenotype in normal-weight and overweight/obese adults. A total of 660 adults aged 20 to 59 years were assessed by a population-based cross-sectional study. Muscle mass of the limbs or appendicular lean mass (ALM) adjusted for weight (SMIweight) and BMI (SMIBMI) was used to evaluate SMI. Logistic regression was employed to estimate the association between SMIweight, SMIBMI and metabolic phenotypes of normal-weight and overweight/obese individuals. Metabolically unhealthy individuals were older in both sexes. Metabolically unhealthy men had lower SMI values and higher fat percentage than metabolically healthy men. SMIweight was inversely associated with the metabolically unhealthy phenotype, both in normal-weight men (OR 0·49, 95 % CI 0·24, 0·99, P = 0·04) and in overweight/obese men (OR 0·32, 95 % CI 0·16, 0·64, P = 0·001). SMIBMI was inversely associated with the metabolically unhealthy phenotype in overweight/obese men (OR 0·36, 95 % CI 0·18, 0·72, P = 0·004), but not in normal-weight men (OR 0·70, 95 % CI 0·34, 1·43, P = 0·33). Among women, SMI showed no significant association with the phenotypes. In conclusion, the SMI are inversely associated with the metabolically unhealthy phenotype in men, especially among overweight/obese men.
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Li M, Hu L, Hu L, Huang X, Liu X, Zhou W, Wang T, Zhu L, Bao H, Cheng X. Visceral Adiposity Index Is Inversely Associated with Renal Function in Normal-Weight Adults with Hypertension: The China H-Type Hypertension Registry Study. J Nutr 2021; 151:1394-1400. [PMID: 33693869 DOI: 10.1093/jn/nxab022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/15/2020] [Accepted: 01/21/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Risk of chronic kidney disease (CKD) is higher in normal-weight metabolically unhealthy people, especially when combined with hypertension. In this context, whether the visceral adiposity index (VAI), which reflects body fat distribution and metabolism, can be used to identify the risk of CKD among normal-weight hypertensive patients is unclear. OBJECTIVES This study aimed to evaluate the association between VAI and renal function in normal-weight hypertensive patients. METHODS In this cross-sectional study, 8591 hypertensive patients with normal BMI from the China H-type Hypertension Registry Study were analyzed. The VAI was calculated with serum triglycerides, serum HDL cholesterol, waist circumference, and BMI. VAI was ln-transformed for analysis on account of the skewed distribution. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL · min-1 · 1.73 m-2. Multivariable linear and multivariable logistic regression analyses were performed to evaluate the association of VAI with eGFR and CKD. RESULTS The prevalence rate of CKD was 10.1%. Multivariable linear regression analyses showed that an elevated lnVAI reduced eGFR by 2.63 mL · min-1 · 1.73 m-2 (95% CI: -3.54, -1.72 mL · min-1 · 1.73 m-2). Multivariable logistic regression analysis showed that an elevated lnVAI was independently associated with the prevalence of CKD (OR: 1.59; 95% CI: 1.31, 1.93). As possible confounding factors were removed the association became greater. The higher the VAI was, the greater the decrease in eGFR and the higher the risk of CKD. No significant interactions were found in any of the subgroups (age, sex, physical activity, current smoking, current drinking, fasting glucose, LDL cholesterol, blood pressure, and antihypertensive drugs). CONCLUSIONS VAI, as a simple surrogate measure of visceral fat accumulation, is independently and inversely associated with renal function in normal-weight Chinese hypertensive adults.This trial was registered at chictr.org.cn as ChiCTR1800017274.
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Affiliation(s)
- Minghui Li
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Longlong Hu
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Xi Liu
- Cardiovascular Center, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Tao Wang
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
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Liu X, Wu Q, Yan G, Duan J, Chen Z, Yang P, Bragazzi NL, Lu Y, Yuan H. Cardiometabolic index: a new tool for screening the metabolically obese normal weight phenotype. J Endocrinol Invest 2021; 44:1253-1261. [PMID: 32909175 DOI: 10.1007/s40618-020-01417-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE People with the metabolically obese normal weight (MONW) phenotype are considered as an extremely high-risk group for unfavorable health consequences, but they are frequently undetected due to deceptive body mass index (BMI) and complex assessment. This study aimed to explore the clinical usefulness of cardiometabolic index (CMI) in identifying MONW individuals. METHODS This cross-sectional study involved a total of 47,683 normal-weight subjects aged ≥ 18 years. Participants underwent anthropometrics, routine biochemical tests, and questionnaires for a full evaluation of the metabolic profile. The odds ratio (OR) of CMI and MONW phenotype was determined by the Logistic regression models and the diagnostic accuracy of CMI was evaluated by the receiver operating characteristic (ROC) curve analysis. RESULTS The prevalence of MONW phenotype was 11.0%. After multivariate adjustment, the ORs for MONW in the highest compared with the lowest quartile of CMI was 71.20 (95% CI 55.19-91.86), and 1-SD increment of CMI brought a 54% additional risk. In ROC analysis, compared with BMI and waist circumference, CMI showed superior performance for identifying MONW individuals with an AUC of 0.853 (95% CI 0.847-0.860) in men and 0.912 (95% CI 0.906-0.918) in women, respectively. Moreover, CMI exhibited the highest diagnostic accuracy in younger age groups (aged 18-34 for men; aged 18-34 and 35-44 for women), in which AUCs surpassed 0.9 in both sexes. CONCLUSIONS CMI could be served as a valuable indicator to identify MONW phenotype of Chinese adults, particularly for young people.
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Affiliation(s)
- X Liu
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China
| | - Q Wu
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China
| | - G Yan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China
| | - J Duan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China
| | - Z Chen
- Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - P Yang
- Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - N L Bragazzi
- Centre for Disease Modelling, York University, Toronto, ON, Canada
| | - Y Lu
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China.
- Key Laboratory of Medical Information Research, Central South University, Changsha, Hunan, China.
- National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, Hunan, China.
| | - H Yuan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China.
- Key Laboratory of Medical Information Research, Central South University, Changsha, Hunan, China.
- National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Changsha, Hunan, China.
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Theodoro JMV, Martinez ODM, Grancieri M, Toledo RCL, Binoti ML, Martins AMD, Carvalho CWP, Lisboa PC, Martino HSD. Germinated millet flour (Pennisetum glaucum (L.) R. BR.) improves adipogenesis and glucose metabolism and maintains thyroid function in vivo. Food Funct 2021; 12:6083-6090. [PMID: 34047312 DOI: 10.1039/d0fo03388j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study investigated the effects of germinated millet flour on adipogenesis, insulin resistance, glucose tolerance and thyroid function in Wistar rats fed with a high-fat high-fructose diet (HFHF). The experiment was divided into two phases. Phase 1: control group, which received an AIN-93M diet (n = 10) and HFHF group (n = 20), which received a diet rich in saturated fat (31%) and fructose (20%), for eight weeks. Phase 2: intervention: the control group maintained the AIN-93M diet (n = 10) and the HFHF group was divided into two groups: the HFHF (n = 10) and the germinated millet group (n = 10), for 10 weeks. The germinated millet flour maintained (p > 0, 05) the plasma levels of thyroid hormones, increased (p < 0.05) the insulin receptor (INSR) mRNA expression, protein kinase B (AKT) mRNA expression and the phospho-AKT1 protein concentration, phosphofructokinase (PFK) mRNA, pyruvate kinase (PK) mRNA and activated protein kinase (AMPK) mRNA expression, and the brown adipose tissue and reduced (p < 0.05) the glucose triglyceride index (TyG), glucose, insulin, HOMA-IR and hypercorticosteronemia, compared to the HFHF group. These effects contributed to reduce the gluconeogenesis, hyperinsulinemia and adiposity. Thus, germinated millet flour is a good alternative for modulating the adipogenesis and glucose metabolism, without interfering with the thyroid hormones, in rats with an insulin resistance condition with a high-fat high-fructose diet.
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Affiliation(s)
| | | | - Mariana Grancieri
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG 36570900, Brazil.
| | | | - Mirella Lima Binoti
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG 36570900, Brazil.
| | - Amanda M Dias Martins
- Federal Rural University of Rio de Janeiro (UFRRJ), Department of Food Technology (DTA), 23890-000, Seropédica, RJ, Brazil
| | | | - Patrícia Cristina Lisboa
- Department of Physiological Sciences, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
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Fan L, Qiu J, Zhao Y, Yin T, Li X, Wang Q, Jing J, Zhang J, Wang F, Liu X, Liu L, Zhao Y, Zhang Y. The association between body composition and metabolically unhealthy profile of adults with normal weight in Northwest China. PLoS One 2021; 16:e0248782. [PMID: 33765000 PMCID: PMC7993598 DOI: 10.1371/journal.pone.0248782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/05/2021] [Indexed: 12/22/2022] Open
Abstract
Objective Related evidences of metabolically unhealthy profile of adults with normal weight are not well characterized in the Chinese population. This is because they cannot be effectively identified by regular measurements (such as body mass index [BMI]). To overcome this gap in literature, this study aimed at investigating the association between body composition and metabolically unhealthy profile in Chinese adults with normal weight. Methods A total of 5427 individuals with normal-weight were recruited from 15820 people living in Ningxia Hui Autonomous Region in Northwest China. Normal-weight was defined as a BMI of 18.5–23.9 kg/m2. Metabolically unhealthy profile was assessed by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Metabolically unhealthy normal-weight (MUHNW) profile was defined in individuals who had normal weight and at least two cardiometabolic risk factors. Generalized linear model was used to investigate the association between body composition measured by bioelectrical impedance and metabolically unhealthy profile in adults with normal-weight. Results The percentage of metabolically unhealthy profile was 35.86% in adults with normal weight. Different MUHNW distributions were found between males and females depending on age. The percentage of the MUHNW profile significantly increased in women after the age of 55, contrary to men. The association between body composition and MUHNW was affected by age and sex. The increased adiposity indices (fat mass index [FMI], visceral fat level [VFL], waist circumference [WCF]), and reduced skeletal muscle mass ratio [SMR] showed significant differences between MUHNW and metabolically healthy with normal weight (MHNW) (p < 0.05). Conclusion The distribution of MUHNW differed between ages and sexes. FMI, VFL, WCF and SMR could be responsible for the MUHNW adults, providing a new insight into the potential metabolic risks for the adults with normal weight in China. This directs us in the management of the MUHNW for their early prevention.
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Affiliation(s)
- Ling Fan
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Jiangwei Qiu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Yu Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Ting Yin
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Xiaoxia Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Qingan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Jinyun Jing
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Jiaxing Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Faxuan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Xiuying Liu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Lan Liu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
- * E-mail: (YZ); (YZ)
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China
- The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Yinchuan, Ningxia, China
- * E-mail: (YZ); (YZ)
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Gómez-Zorita S, Queralt M, Vicente MA, González M, Portillo MP. Metabolically healthy obesity and metabolically obese normal weight: a review. J Physiol Biochem 2021; 77:175-189. [PMID: 33704694 DOI: 10.1007/s13105-020-00781-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023]
Abstract
Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.
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Affiliation(s)
- Saioa Gómez-Zorita
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain. .,BIOARABA Health Research Institute, Vitoria, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain.
| | - Maite Queralt
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain
| | - Maria Angeles Vicente
- BIOARABA Health Research Institute, Vitoria, Spain.,Alava University Hospital (Osakidetza), Vitoria, Spain
| | - Marcela González
- Nutrition and Food Science Department, Faculty of Biochemistry and Biological Sciences, National University of Litoral and National Scientific and Technical Research Council (CONICET), 3000, Santa Fe, Argentina
| | - María P Portillo
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain.,BIOARABA Health Research Institute, Vitoria, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain
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Zhu L, Spence C, Yang WJ, Ma GX. The IDF Definition Is Better Suited for Screening Metabolic Syndrome and Estimating Risks of Diabetes in Asian American Adults: Evidence from NHANES 2011-2016. J Clin Med 2020; 9:jcm9123871. [PMID: 33260754 PMCID: PMC7759813 DOI: 10.3390/jcm9123871] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE extensive effort has been made to better define metabolic syndrome (MetS). Whether current definitions accurately diagnose MetS and predict risk of cardiovascular disease (CVD) or diabetes in diverse ethnic groups remains largely unknown. The objective of this study was to compare the prevalence of MetS and risk of CVD and diabetes among Asian American adults using two MetS definitions, one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and one by the International Diabetes Federation (IDF). METHODS we obtained a nationally representative sample of 2121 Asian American adults in the noninstitutionalized civilian population of the United States from the National Health and Nutrition Examination Survey (2011-2016). We computed age-adjusted, gender-specific MetS prevalence and each MetS component using ATP III and IDF definitions. RESULTS based on the IDF definition, MetS prevalence was 39.26% among Asian American men and 39.66% among Asian American women included in the study sample. Based on the ATP III definition, MetS prevalence in our sample was 39.38% among men and 36.11% among women. We found good concordance between the IDF and the ATP III definitions in identifying MetS in Asian American adults. Those with MetS defined only by the IDF definition had significantly higher body mass index (BMI) and waist circumference than those with MetS defined only by the ATP III definition. The IDF definition also better predicted elevated fasting insulin. CONCLUSIONS the IDF definition is more pertinent than the ATP III definition for screening and estimating risk of CVD and diabetes in Asian American adults. Future studies should examine differences in MetS prevalence across Asian ethnic groups to facilitate the development of culturally tailored strategies improve MetS prevention and detection in Asian Americans.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (W.J.Y.); (G.X.M.)
- Correspondence: ; Tel.: +1-215-707-4039
| | - Cody Spence
- Department of Sociology, College of Liberal Art, Temple University, Philadelphia, PA 19122, USA;
| | - Wei Jenny Yang
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (W.J.Y.); (G.X.M.)
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (W.J.Y.); (G.X.M.)
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Increased Stroke Risk in Metabolically Abnormal Normal Weight: a 10-Year Follow-up of 102,037 Participants in China. Transl Stroke Res 2020; 12:725-734. [PMID: 33089468 DOI: 10.1007/s12975-020-00866-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/16/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to investigate the risks of stroke in subjects with metabolically abnormal normal weight (MANW) in China. We recruited 102,037 participants from the Zhejiang Metabolic Syndrome Cohort and the Kailuan cohort. The mean years of follow-up were 9.9 years. General obesity was defined by body mass index (BMI) ≥ 28, overweight by BMI < 28 and ≥ 24, and normal weight by BMI < 24 and ≥ 18.5. Metabolic abnormality was defined as two or more abnormal components (elevated triglycerides, low high-density lipoprotein cholesterol, elevated systolic blood pressure or diastolic blood pressure, or use of antihypertensive drug therapy, elevated fasting plasma glucose, or antidiabetic treatment). A multiple Cox regression model was used to calculate hazard ratio (HR) and its 95% confidence interval (CI), adjusted by potential confounding factors. Overall HR of the risks in two cohorts was calculated by a meta-analysis. Compared with the subjects who were metabolically normal with normal weight (MNNW), the pooled HR for stroke in MANW subjects was 1.82 (95% CI, 1.59-2.07). The risks of stroke in MANW subjects were significantly lower than that in subjects with metabolically abnormal obesity (MAO), but higher than that in those with metabolically normal obesity (MNO) (P < 0.05). These associations remained in the subtypes of cerebral infarction and cerebral hemorrhage. In normal-weight subjects, the HR for stroke was significantly positively correlated with the number of abnormal metabolic components (Ptrend < 0.001). In brief, metabolic abnormality increased the risk of stroke irrespective of obesity status. MANW individuals showed a greater risk of stroke, and this risk was positively correlated with the number of abnormal metabolic components.
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Fernández-Verdejo R, Moya-Osorio JL, Fuentes-López E, Galgani JE. Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017. PLoS One 2020; 15:e0236451. [PMID: 32697789 PMCID: PMC7375524 DOI: 10.1371/journal.pone.0236451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Lifestyle habits associate with metabolic health in overall populations. Whether such association is similar among subjects with a different nutritional status has been less studied. We aimed to (i) determine the prevalence of metabolic phenotypes in Chile, and (ii) determine the association between lifestyle habits and metabolic health according to the nutritional status. METHODS The National Health Survey of Chile 2016-2017 was analyzed. A metabolically unhealthy phenotype was defined as manifesting ≥3 of the following risk factors: elevated blood pressure, elevated triglycerides, elevated glucose, elevated waist circumference, or reduced high-density lipoprotein cholesterol. Individuals manifesting <2 risk factors were considered as healthy. The nutritional status was defined as normal weight (18.5 to <25 kg/m2), overweight (25 to <30 kg/m2) or obesity (≥30 kg/m2). Questionnaires were used to estimate smoking habits, alcohol intake, sedentary behavior, moderate-vigorous physical activity, fruits/vegetables consumption, and fish/seafood consumption. The association (odds ratio [95%CI]) between lifestyle habits and metabolic health was determined within each nutritional status, adjusting for age, sex, BMI (in kg/m2), and education. RESULTS The prevalence of a metabolically unhealthy phenotype was 36% in the overall sample. Such a prevalence was 7%, 33% and 58% among subjects with normal weight, overweight and obesity, respectively. In subjects with normal weight, the highest quartile of fruits/vegetables consumption was associated with reduced odds of having a metabolically unhealthy phenotype (0.09 [0.01-0.48]). In subjects with obesity, the highest quartile of moderate-vigorous physical activity was associated with reduced odds of having a metabolically unhealthy phenotype (0.29 [0.09-0.91]). CONCLUSION One third of the Chilean population manifests an unhealthy phenotype. We identified associations between lifestyle habits and metabolic health that are specific to the nutritional status. Thus, emphasizing fruits/vegetables consumption in subjects with normal weight, and physical activity in subjects with obesity, may maximize the benefits of public health interventions.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | - José Luis Moya-Osorio
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose E. Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Zheng Q, Lin W, Liu C, Zhou Y, Chen T, Zhang L, Zhang X, Yu S, Wu Q, Jin Z, Zhu Y. Prevalence and epidemiological determinants of metabolically obese but normal-weight in Chinese population. BMC Public Health 2020; 20:487. [PMID: 32293373 PMCID: PMC7161294 DOI: 10.1186/s12889-020-08630-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/01/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is metabolic heterogeneity in normal-weight individuals, however, there has been limited research in the Chinese population. This study aimed to investigate the prevalence, distribution and epidemiological determinants of metabolically obese but normal-weight (MONW) in a Chinese population. METHODS A total of 17,876 normal-weight individuals were recruited from 37,815 individuals in Zhejiang province in southeastern China. Normal-weight was defined as a body mass index (BMI) of 18.5-23.9 kg/m2. Metabolically abnormal traits were assessed by metabolic syndrome criteria from the International Diabetes Federation (IDF) in 2015. MONW was defined as individuals who had at least two metabolically abnormal trait but normal weight. Multiple logistic regression was used to investigate MONW risk factors, adjusting for potential confounders. RESULTS The prevalence of metabolic abnormality was 34.1% in normal-weight individuals, and the overall prevalence of MONW was 16.1% in the general population. Different MONW distributions were found between men and women depending on age. Compared with women, men had a significantly higher MONW prevalence among those aged < 45 years old, and there was a lower prevalence for those aged ≥50 years old. Higher BMI or waist circumference (WC), central obesity, menopause, and family histories of hypertension, diabetes, and cardiovascular diseases, increased MONW risk. Higher education levels, regular alcohol drinking, and balanced or vegetarian food preferences reduced MONW risk. CONCLUSIONS Normal-weight individuals have metabolic heterogeneity in China. The MONW distribution between men and women depends on age. BMI, WC, dietary factors, and family history of chronic diseases, are associated with metabolic status.
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Affiliation(s)
- Qianqian Zheng
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Weihua Lin
- Hangzhou MetaWell Technology Co., Hangzhou, China
| | - Chengguo Liu
- Putuo District People's Hospital, Zhoushan, 316100, Zhejiang, China
| | - Yaohan Zhou
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Tianhui Chen
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang Province, China
| | - Liqun Zhang
- Putuo District People's Hospital, Zhoushan, 316100, Zhejiang, China
| | - Xuhui Zhang
- Hangzhou Center for Disease Control and Preventio, Hangzhou, 310051, Zhejiang, China
| | - Senhai Yu
- Daicun Town Community Health Service Center, Xiaoshan District, Hangzhou, Zhejiang, China
| | - Qiong Wu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Ziqi Jin
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
- Department of Respiratory Diseases, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, 310020, Zhejiang, China.
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Klitgaard HB, Kilbak JH, Nozawa EA, Seidel AV, Magkos F. Physiological and Lifestyle Traits of Metabolic Dysfunction in the Absence of Obesity. Curr Diab Rep 2020; 20:17. [PMID: 32232577 DOI: 10.1007/s11892-020-01302-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Individuals with metabolically unhealthy normal weight (MUNW) have an adverse cardiometabolic risk factor profile in the absence of excess body weight, and increased risk for diabetes and heart disease. We critically review some physiological traits and lifestyle characteristics of the MUNW phenotype. RECENT FINDINGS The prevalence of MUNW varies considerably around the world and among ethnicities, partly because of different definitions; on average, this phenotype affects about ~ 30% of normal weight persons globally. Most studies have recruited MUNW subjects who, although within the normal weight range, are significantly "more obese" than their metabolically healthy lean peers (greater body mass index or total body fat); hence one cannot ascertain whether observed differences are true traits of the MUNW phenotype of simply secondary to greater relative adiposity within the normal range. Carefully matched studies have indicated that MUNW can exist in the absence of excess total body fat. These subjects have a preferential accumulation of fat in the upper body (abdominal subcutaneous and visceral adipose tissues) and the liver, but not skeletal muscle; perhaps surprisingly, this predominantly "android" fat distribution does not translate into increased waist circumference. The MUNW phenotype is associated with lower aerobic fitness and muscle mass and strength, but whether this is simply due to inadequate regular physical activity is not entirely clear. Likewise, no consistent associations have been found between any dietary factors and the development of MUNW phenotype, but diet-induced modest weight loss facilitates its resolution. Delineating the mechanisms leading to metabolic dysfunction in the absence of increased body weight and body fat will likely reveal important targets for improving metabolic health and eventually for reducing the burden of cardiometabolic disease, not only in individuals with normal body weight but also in people with obesity.
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Affiliation(s)
- Hanna Bjørk Klitgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Hoffmann Kilbak
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Erica Arhnung Nozawa
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ann V Seidel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
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Esmaili H, Heshmat R, Ejtahed HS, Rastad H, Motlagh ME, Asayesh H, Jafarnejad M, Seif E, Qorbani M, Kelishadi R. Association of Serum 25-Hydroxyvitamin D Level With Metabolic Phenotypes of Obesity in Children and Adolescents: The CASPIAN-V Study. Front Endocrinol (Lausanne) 2020; 11:310. [PMID: 32612573 PMCID: PMC7308554 DOI: 10.3389/fendo.2020.00310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/23/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Different metabolic phenotypes of obesity are related to cardiometabolic risk factors in children and adolescents. Vitamin D, as one important factor, could be related to different subgroups of metabolic obesity and might affect metabolic disorders. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents. Methods: This nationwide cross-sectional study was conducted in the framework of the fifth survey of a national surveillance program, the CASPIAN study. Overall, 2,594 students aged 7-18 years were assessed for 25-hydroxyvitamin D status. Metabolic syndrome (MetS) was defined according to the ATP III criteria modified for the pediatric age group. Participants were classified into four metabolic phenotypes of obesity according to categories of the BMI and metabolic status: "metabolically healthy obese" (MHO), "metabolically non-healthy non-obese" (MNHNO), "metabolically non-healthy obese" (MNHO), and "metabolically healthy non-obese" (MHNO). Multinomial logistic regression analysis was performed for evaluating the association of 25-hydroxyvitamin D status with different metabolic phenotypes of obesity. Results: In this study, 85.2% of participants were classified as MHNO, 11.0 % as MHO, 2.5% as MNHNO, and 1.3% as MNHO. The frequency of hypovitaminosis D was more prevalent in MNHO (85.3%) than in other phenotypes (MHNO: 70%; MHO: 76.5%; MNHNO: 78.1%, respectively; p < 0.05). In the multivariate model, hypovitaminosis D significantly increased the odds of being MHO (OR: 1.46; 95% CI: 1.07-1.77) and MNHO (OR: 2.89; 1.05-8.31) compared to the healthy group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25-hydroxyvitamin D concentration, the odds of MNHNO and MNHO decreased significantly by 7% (OR: 0.93; 0.91-0.96) and 6% (OR: 0.94; 0.91-0.98) respectively. Conclusion: Our results support the hypothesis that 25-hydroxyvitamin D concentration is associated with metabolic obesity phenotypes. Longitudinal studies are necessary to assess the clinical impacts of this finding.
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Affiliation(s)
- Haleh Esmaili
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadith Rastad
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Marzieh Jafarnejad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Ehsan Seif
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Qorbani
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Roya Kelishadi
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Zhang S, Zhao M, Wang F, Liu J, Zheng H, Lei P. Relationship between normal weight obesity and mild cognitive impairment is reflected in cognitive-related genes in human peripheral blood mononuclear cells. Psychogeriatrics 2020; 20:35-43. [PMID: 30950168 DOI: 10.1111/psyg.12452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 01/31/2019] [Accepted: 03/06/2019] [Indexed: 01/12/2023]
Abstract
AIM Obesity contributes to the development of mild cognitive impairment, but the potential role of normal weight obesity in this disease has not been explored in humans. The aim of the study was to reveal the relationship between normal weight obesity and mild cognitive impairment in elderly individuals. METHODS This study consisted of 360 patients with amnestic mild cognitive impairment and 360 cognitively normal controls. Normal weight obesity was defined as having metabolic syndrome but a normal weight. Metabolic health meant having no metabolic syndrome. Reverse transcription quantitative real-time polymerase chain reaction was adopted to measure the messenger RNA expression of four cognitive-related genes (amyloid precursor protein, cyclic adenosine monophosphate-responsive element-binding protein 1, sortilin-related receptor 1, and synapsin I) in peripheral blood mononuclear cells. RESULTS Normal weight obesity was related to a higher risk of amnestic mild cognitive impairment (odds ratio = 3.14, 95% confidence interval: 2.13-4.60). In the patients, the expression of each gene in the peripheral blood mononuclear cells was linearly related to Mini-Mental State Examination and Montreal Cognitive Assessment scores (P < 0.05). The expression of these genes in the patients with metabolic health deviated from the normal levels found in the controls (P < 0.05), and the deviations were more significant in the patients with normal weight obesity (P < 0.05). CONCLUSION Normal weight obesity may be a potential risk factor for amnestic mild cognitive impairment in elderly. This relationship was reflected in the abnormal expression of several cognitive-related genes in peripheral blood mononuclear cells.
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Affiliation(s)
- Shishuang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Minghui Zhao
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Feng Wang
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
| | - Juan Liu
- Department of Ultrasound, Tianjin People's Hospital, Tianjin, China
| | - Hui Zheng
- Nankai Center for Disease Control and Prevention, Tianjin, China
| | - Ping Lei
- Department of Geriatrics, Tianjin Medical University General Hospital; Tianjin Geriatrics Institute, Tianjin, China
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The Relationship between Metabolically Healthy Obesity and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8081228. [PMID: 31443279 PMCID: PMC6723711 DOI: 10.3390/jcm8081228] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease (CVD) risk in individuals with metabolically healthy obesity (MHO) is unclear. We searched databases from inception to May 2019. Data were pooled using a random effects model. Newcastle-Ottawa Scale assessment was performed. Primary and secondary outcomes were CVD risk and all-cause mortality. Forty-three studies involving 4,822,205 cases were included. The median percentage of females, age and duration of follow-up was 52%, 49.9 years and 10.6 years, respectively. The mean Newcastle-Ottawa Scale score of the articles was 7.9 ± 1.0. Compared to individuals with a metabolically healthy normal weight, individuals with MHO had higher adjusted risk of CVD and all-cause mortality. We identified a significant linear dose-response relationship between body mass index (BMI) and CVD risk among metabolically healthy individuals (p < 0.001); every unit increase in BMI increased the CVD risk. Multivariate meta-regression analysis showed that an increased proportion of women and age resulted in the risk of CVD affected by MHO reduction (p = 0.014, p = 0.030, respectively). Age and sex explained the observed heterogeneity and reported the adjusted R2. MHO resulted in a significantly increased risk for CVD; therefore, long-term weight loss should be encouraged.
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Mirzababaei A, Djafarian K, Mozafari H, Shab-Bidar S. The long-term prognosis of heart diseases for different metabolic phenotypes: a systematic review and meta-analysis of prospective cohort studies. Endocrine 2019; 63:439-462. [PMID: 30671787 DOI: 10.1007/s12020-019-01840-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/03/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE This meta-analysis aimed to assess the association of different categories of weight and metabolic status with risk of heart diseases including myocardial infarction (MI), cardiovascular diseases (CVDs), and heart failure (HF). METHODS Data from relevant studies were identified systematically by searching PubMed and Scopus search engines up to 29 May 2018. Prospective studies were included in the analyses with metabolically healthy normal weight (MHNW) as the reference. Pooled RRs and 95% CI were calculated using random-effects or fixed-effect models when appropriate. Subgroup analysis was applied to define possible sources of heterogeneity. RESULTS Overall, 21 studies (n = 778,401 participants) were eligible for the present meta-analysis. Generally, the risk of CVDs for all metabolic phenotypes in metabolically unhealthy obese increased compared with the MHNW group. A significant positive association between all metabolic phenotypes and the risk of HF was also observed expect for MHOW (RR = 1.10, 95% CI: 0.60-2.00, P = 0.76) and MHO phenotypes (RR = 0.96, 95% CI: 0.25-3.77, P = 0.95). Moreover, MUHO phenotype was associated with greater risk of MI compared with the MHNW phenotype (RR = 1.82, 95% CI: 1.50-2.22, P < 0.001, respectively). CONCLUSIONS Our findings showed that all metabolically unhealthy phenotypes in different categories of weight were associated with increased incident of CVDs/HF and MI. Furthermore, healthy overweight and obese subjects had increased risk of CVDs.
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Affiliation(s)
- Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Student's Scientific Research Center, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hadis Mozafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Singh A, Zapata RC, Pezeshki A, Workentine ML, Chelikani PK. Host genetics and diet composition interact to modulate gut microbiota and predisposition to metabolic syndrome in spontaneously hypertensive stroke-prone rats. FASEB J 2019; 33:6748-6766. [PMID: 30821497 DOI: 10.1096/fj.201801627rrr] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Metabolic syndrome encompasses obesity, glucose intolerance, hypertension, and dyslipidemia; however, the interactions between diet and host physiology that predispose to metabolic syndrome are incompletely understood. Here, we explored the effects of a high-fat diet (HFD) on energy balance, gut microbiota, and risk factors of metabolic syndrome in spontaneously hypertensive stroke-prone (SHRSP) and Wistar-Kyoto (WKY) rats. We found that the SHRSP rats were hypertensive, hyperphagic, less sensitive to hypophagic effects of exendin-4, and expended more energy with diminished sensitivity to sympathetic blockade compared to WKY rats. Notably, key thermogenic markers in brown and retroperitoneal adipose tissues and skeletal muscle were up-regulated in SHRSP than WKY rats. Although HFD promoted weight gain, adiposity, glucose intolerance, hypertriglyceridemia, hepatic lipidosis, and hyperleptinemia in both SHRSP and WKY rats, the SHRSP rats weighed less but had comparable percent adiposity to WKY rats, which supports the use of HFD-fed SHRSP rats as a unique model for studying the metabolically obese normal weight (MONW) phenotype in humans. Despite distinct strain differences in gut microbiota composition, diet had a preponderant impact on gut flora with some of the taxa being strongly associated with key metabolic parameters. Together, we provide evidence that interactions between host genetics and diet modulate gut microbiota and predispose SHRSP rats to develop metabolic syndrome.-Singh, A., Zapata, R. C., Pezeshki, A., Workentine, M. L., Chelikani, P. K. Host genetics and diet composition interact to modulate gut microbiota and predisposition to metabolic syndrome in spontaneously hypertensive stroke-prone rats.
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Affiliation(s)
- Arashdeep Singh
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rizaldy C Zapata
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Adel Pezeshki
- Department of Animal and Food Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Matthew L Workentine
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Prasanth K Chelikani
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.,Gastrointestinal Research Group, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
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47
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Lee HY, Yang HK, Song HJ, Chang HJ, Kang JY, Lee SH, Han S, Kim YK. Metabolic health is more closely associated with decrease in lung function than obesity. PLoS One 2019; 14:e0209575. [PMID: 30673715 PMCID: PMC6343891 DOI: 10.1371/journal.pone.0209575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/08/2018] [Indexed: 01/21/2023] Open
Abstract
Objective Previous studies have evaluated the link between metabolic syndrome and obesity with impaired lung function, however findings have been controversial. We aimed to compare lung function among subjects with different metabolic health and obesity status. Methods Total 10,071 participants were evaluated at the Health Promotion Center in Seoul St. Mary’s Hospital between January 2012 and December 2014. Being metabolically healthy was defined as having fewer than three of the following risk factors: high blood pressure, high fasting blood glucose, high triglyceride, low high-density lipoprotein cholesterol and abdominal obesity. Obesity status was defined as body mass index (BMI) higher than 25 kg/m2. Analyses of pulmonary function were performed in four groups divided according to metabolic health and obesity: metabolically healthy non-obese (MHNO), metabolically health obese (MHO), metabolically unhealthy non-obese (MUHNO), and metabolically unhealthy obese (MUHO). Results Metabolically unhealthy subjects were more prone to decreased lung function compared with their metabolically healthy counterparts, regardless of obesity status. When multinomial logistic regression analysis was performed according to quartiles of forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) (% pred), after adjusting for age, sex, and smoking status, odds ratio (OR) for the lowest FVC and FEV1 (% pred) quartiles were significantly higher in MUHO subjects (1.788 [95% CI, 1.531–2.089] and 1.603 [95% CI, 1.367–1.881]) and lower in MHO subjects (0.768 [95% CI, 0.654–0.902] and 0.826 [95% CI, 0.700–0.976]) with MHNO group as the reference, when OR for highest FVC and FEV1 quartiles were considered as 1.0 Conclusion Metabolic health is more closely associated with impaired lung function than obesity.
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Affiliation(s)
- Hea Yon Lee
- Department of Health Promotion Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Kyung Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Jin Song
- Department of Health Promotion Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee Jae Chang
- Department of Health Promotion Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Young Kang
- Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Haak Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Solji Han
- Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Young Kyoon Kim
- Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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48
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Liu C, Wang C, Guan S, Liu H, Wu X, Zhang Z, Gu X, Zhang Y, Zhao Y, Tse LA, Fang X. The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria. Obes Facts 2019; 12:78-90. [PMID: 30814477 PMCID: PMC6465689 DOI: 10.1159/000495852] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/22/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Obesity-related disease risks may vary depending on whether the subject has metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). At least 5 definitions/criteria of obesity and metabolic disorders have been documented in the literature, yielding uncertainties in a reliable international comparison of obesity phenotype prevalence. This report aims to compare differences in MHO and MUO prevalence according to the 5 most frequently used definitions. METHODS A random sample of 4,757 adults aged 35 years and older (male 51.1%) was enrolled. Obesity was defined either according to body mass index or waist circumference, and the definitions of metabolic abnormalities were derived from 5 different criteria. RESULTS In MHO, the highest prevalence was obtained when using the homeostasis model assessment (HOMA) criteria (13.6%), followed by the Chinese Diabetes Society (11.4%), Adult Treatment Panel III (10.3%), Wildman (5.2%), and Karelis (4.2%) criteria; however, the MUO prevalence had an opposite trend to MHO prevalence. The magnitude of differences in the age-specific prevalence of MHO and MUO varied greatly and ranked in different orders. The proportion of insulin resistance for MHO and MUO individuals differed significantly regardless of which metabolic criterion was used. CONCLUSION The prevalence of MHO and MUO in the Chinese population varies according to different definitions of obesity and metabolic disorders.
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Affiliation(s)
- Chunxiao Liu
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chunxiu Wang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shaochen Guan
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hongjun Liu
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoguang Wu
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhongying Zhang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiang Gu
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yanlei Zhang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Zhao
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lap Ah Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- *Lap Ah Tse, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Sha Tin, Hong Kong (Hong Kong SAR), E-Mail
| | - Xianghua Fang
- Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China
- *Xianghua Fang, PhD, Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053 (China), E-Mail
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49
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Xu Y, Li H, Wang A, Su Z, Yang G, Luo Y, Tao L, Chen S, Wu S, Wang Y, Guo X. Association between the metabolically healthy obese phenotype and the risk of myocardial infarction: results from the Kailuan study. Eur J Endocrinol 2018; 179:343-352. [PMID: 30400019 DOI: 10.1530/eje-18-0356] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/06/2018] [Indexed: 12/13/2022]
Abstract
Objective This study aimed to determine if the metabolically healthy obese (MHO) is associated with an increased risk of myocardial infarction (MI) in Chinese population. Design The Kailuan study is a community-based prospective cohort study. Methods BMI and metabolic syndrome (MetS) were assessed in 91 866 participants without a history of MI or stroke. Participants were categorised into six mutually exclusive groups according to the BMI-MetS status: normal weight (BMI: ≤ 18.5to < 24.0 kg/m2) without MetS (MH-NW), normal weight with MetS (MUH-NW), overweight (BMI: ≤ 24.0to < 28.0 kg/m2) without MetS (MH-OW), overweight with MetS (MUH-OW), obese (BMI ≥ 28.0 kg/m2) without MetS (MHO) and obese with MetS (MUO). The hazard ratio (HR) with 95% CI was calculated for the incidence of MI using a multivariable Cox model. Results A total of 6745 (7.34%) individuals were classified as MHO. During a median 8-year follow-up, 1167 (1.27%) participants developed MI. The MHO group had an increased risk of MI (HR: 1.76, 95% CI: 1.37-2.25) in comparison with the MH-NW group after adjusting for potential confounding variables. After a similar adjustment, the risk of MI was significantly elevated in the MUH-NW (HR: 1.62, 95% CI: 1.28-2.05), MUH-OW (HR: 1.98, 95% CI: 1.67-2.35) and MUO group (HR: 2.06, 95% CI: 1.70-2.49). Conclusions MHO subjects showed a substantially higher risk of MI in comparison with MH-NW subjects. That said, even without measurable metabolic abnormalities, obesity was associated with a higher risk of MI.
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Affiliation(s)
- Yijie Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhaoping Su
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guang Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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50
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Almanza-Aguilera E, Brunius C, Bernal-Lopez MR, Garcia-Aloy M, Madrid-Gambin F, Tinahones FJ, Gómez-Huelgas R, Landberg R, Andres-Lacueva C. Impact in Plasma Metabolome as Effect of Lifestyle Intervention for Weight-Loss Reveals Metabolic Benefits in Metabolically Healthy Obese Women. J Proteome Res 2018; 17:2600-2610. [PMID: 29877711 DOI: 10.1021/acs.jproteome.8b00042] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Little is known regarding metabolic benefits of weight loss (WL) on the metabolically healthy obese (MHO) patients. We aimed to examine the impact of a lifestyle weight loss (LWL) treatment on the plasma metabolomic profile in MHO individuals. Plasma samples from 57 MHO women allocated to an intensive LWL treatment group (TG, hypocaloric Mediterranean diet and regular physical activity, n = 30) or to a control group (CG, general recommendations of a healthy diet and physical activity, n = 27) were analyzed using an untargeted 1H NMR metabolomics approach at baseline, after 3 months (intervention), and 12 months (follow-up). The impact of the LWL intervention on plasma metabolome was statistically significant at 3 months but not at follow-up and included higher levels of formate and phosphocreatine and lower levels of LDL/VLDL (signals) and trimethylamine in the TG. These metabolites were also correlated with WL. Higher myo-inositol, methylguanidine, and 3-hydroxybutyrate, and lower proline, were also found in the TG; higher levels of hippurate and asparagine, and lower levels of 2-hydroxybutyrate and creatine, were associated with WL. The current findings suggest that an intensive LWL treatment, and the consequent WL, leads to an improved plasma metabolic profile in MHO women through its impact on energy, amino acid, lipoprotein, and microbial metabolism.
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Affiliation(s)
- Enrique Almanza-Aguilera
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XaRTA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences , University of Barcelona , Avinguda Joan XXIII 27-31 , Barcelona 08028 , Spain.,CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) , Instituto de Salud Carlos III , Barcelona 08028 , Spain
| | - Carl Brunius
- Department of Food Science , Swedish University of Agricultural Sciences , Uppsala 750 07 , Sweden.,Food and Nutrition Division, Department of Biology and Biological Engineering , Chalmers University of Technology , Göteborg 412 58 , Sweden
| | - M Rosa Bernal-Lopez
- Internal Medicine Department, Biomedical Institute of Malaga (IBIMA) , Regional University Hospital of Malaga (Carlos Haya Hospital) , Málaga 29010 , Spain.,Ciber Fisiopatología de la Obesidad y Nutrición , Instituto de Salud Carlos III , Madrid 28029 , Spain
| | - Mar Garcia-Aloy
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XaRTA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences , University of Barcelona , Avinguda Joan XXIII 27-31 , Barcelona 08028 , Spain.,CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) , Instituto de Salud Carlos III , Barcelona 08028 , Spain
| | - Francisco Madrid-Gambin
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XaRTA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences , University of Barcelona , Avinguda Joan XXIII 27-31 , Barcelona 08028 , Spain.,CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) , Instituto de Salud Carlos III , Barcelona 08028 , Spain
| | - Francisco J Tinahones
- Ciber Fisiopatología de la Obesidad y Nutrición , Instituto de Salud Carlos III , Madrid 28029 , Spain.,Endocrinology and Nutrition Department, Biomedical Institute of Malaga (IBIMA) , Regional University Hospital of Malaga (Virgen de la Victoria Hospital) , Málaga 29010 , Spain
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Biomedical Institute of Malaga (IBIMA) , Regional University Hospital of Malaga (Carlos Haya Hospital) , Málaga 29010 , Spain.,Ciber Fisiopatología de la Obesidad y Nutrición , Instituto de Salud Carlos III , Madrid 28029 , Spain
| | - Rikard Landberg
- Department of Food Science , Swedish University of Agricultural Sciences , Uppsala 750 07 , Sweden.,Food and Nutrition Division, Department of Biology and Biological Engineering , Chalmers University of Technology , Göteborg 412 58 , Sweden
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Food Technology Reference Net (XaRTA), Nutrition and Food Safety Research Institute (INSA), Faculty of Pharmacy and Food Sciences , University of Barcelona , Avinguda Joan XXIII 27-31 , Barcelona 08028 , Spain.,CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) , Instituto de Salud Carlos III , Barcelona 08028 , Spain
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