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Hamed Riveros NF, García-Corredor L, Martínez-Solarte MA, González-Clavijo A. Effect of Bifidobacterium Intake on Body Weight and Body Fat in Overweight and Obese Adult Subjects: A Systematic Review and Meta-Analysis. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:519-531. [PMID: 38498828 DOI: 10.1080/27697061.2024.2320192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024]
Abstract
This systematic review aimed to assess the impact of Bifidobacterium genus probiotics on body weight and body composition parameters in overweight and obese individuals. A systematic search for randomized controlled trials was conducted in MEDLINE, EMBASE, LILACS, and Google Scholar databases until April 17, 2023. The inclusion criteria required the trials to involve Bifidobacterium genus probiotics interventions and the evaluation of obesity-related anthropometric and body composition outcomes in overweight or obese subjects. Studies were excluded when involving obese individuals with genetic syndromes or pregnant women, as well as probiotic mixture interventions. The revised Cochrane risk-of-bias tool for randomized trials was utilized to assess the quality of the included studies. A random-effects meta-analysis was performed using the mean difference between endpoint measurements and change from baseline for body mass index, body weight, body fat mass, body fat percentage, waist circumference, waist-to-hip ratio, and visceral fat area. From 1,527 retrieved reports, 11 studies (911 subjects) were included in this review. Bifidobacterium probiotics administration resulted in significant reductions in body fat mass (MD = -0.64 kg, 95% CI: -1.09, -0.18, p = 0.006), body fat percentage (MD = -0.64%, 95% CI: -1.18, -0.11, p = 0.02), waist circumference (MD = -1.39 cm, 95% CI: -1.99, -0.79, p < 0.00001), and visceral fat area (MD = -4.38 cm2, 95% CI: -7.24, -1.52, p = 0.003). No significant differences were observed for body mass index, body weight, or waist-to-hip ratio. This systematic review suggests that Bifidobacterium genus probiotics may contribute to managing overweight and obesity by reducing body fat mass, body fat percentage, waist circumference, and visceral fat area. Further research is required to understand strain and species interactions, optimal dosages, and effective delivery methods for probiotics in obesity management. This review was pre-registered under the PROSPERO record CRD42022370057.
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Affiliation(s)
| | - Lady García-Corredor
- Departamento de Ciencias Fisiológicas, Universidad Nacional de Colombia, Bogotá, Colombia
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Marina D, Buch‐Larsen K, Gillberg L, Andersen MA, Andersson M, Rasmussen ÅK, Schwarz P. Chemotherapy for post-menopausal women with early breast cancer seems not to result in clinically significant changes in thyroid function. Cancer Med 2024; 13:e70015. [PMID: 39108148 PMCID: PMC11303825 DOI: 10.1002/cam4.70015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVE Adjuvant chemotherapy is often indicated in patients diagnosed with early breast cancer (EBC). Among others, weight gain is one of the observed side effects of both chemotherapy and other cancer treatments; however, the mechanism is not well-described. In this study, we aimed to assess thyroid function before and shortly after the course of chemotherapy for EBC. METHODS This is a prospective cohort study of women diagnosed with EBC. The main outcome was the thyroid function and body weight before and after completing chemotherapy. Secondary outcomes were the presence of thyroid autoantibodies and treatment radiation dosage. We included 72 patients treated with adjuvant chemotherapy, whereas 59 patients also received supraclavicular locoregional radiotherapy. Triple-negative breast cancer (BC) patients receiving chemoimmunotherapy were excluded. RESULTS After the chemotherapy, we observed an increase in thyroid-stimulating hormone (p = 0.03) and a decrease in free-thyroxine (p = 0.0006), with no significant weight change. The prevalence of autoimmune thyroiditis was low. On average 3 months post-chemo, we found no statistically significant difference in the thyroid function of women treated versus not treated with supraclavicular locoregional radiotherapy. CONCLUSIONS Although statistically significant changes in thyroid hormones were observed, this study suggests no obvious clinically significant changes in thyroid function in women with early BC after the course of chemotherapy. The decrease in thyroid function was not related to autoimmunity, non-thyroidal illness, radiotherapy, or high-dose corticosteroids. Further studies with a longer follow-up of thyroid function after adjuvant chemotherapy and supraclavicular locoregional radiotherapy are needed.
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Affiliation(s)
- Djordje Marina
- Department of Endocrinology and MetabolismCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Kristian Buch‐Larsen
- Department of Endocrinology and MetabolismCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Linn Gillberg
- Department of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Mads Albrecht Andersen
- Department of OncologyCentre for Cancer and Organ Diseases, Copenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Michael Andersson
- Department of OncologyCentre for Cancer and Organ Diseases, Copenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Åse Krogh Rasmussen
- Department of Endocrinology and MetabolismCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
| | - Peter Schwarz
- Department of Endocrinology and MetabolismCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
- Faculty of Health SciencesUniversity of CopenhagenCopenhagenDenmark
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Zottola ZR, Geiger JT, Choo GE, Kedwai BJ, Balceniuk MD, Ellis JL, Doyle AJ, Newhall KA. Obese patients with CEAP (clinical, etiology, anatomy, pathophysiology) C2 and C3 disease show enhanced symptom improvement after endovenous thermal ablation. J Vasc Surg Venous Lymphat Disord 2024; 12:101873. [PMID: 38513798 DOI: 10.1016/j.jvsv.2024.101873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Endovenous thermal ablation (EVTA) is a prevalent treatment option for patients with severe venous disease. However, the decision to intervene for patients with less severe disease (CEAP [clinical, etiology, anatomy, pathophysiology] C2 and C3) is less clear and becomes further complicated for patients with obesity, a pathology known to increase venous disease symptom severity. Therefore, the objective of this study was to use the Society for Vascular Surgery Vascular Quality Initiative database to evaluate outcomes after EVTA in obese patients with CEAP C2 and C3 venous insufficiency. METHODS Using the Society for Vascular Surgery Vascular Quality Initiative database, we retrospectively analyzed the initial procedure of all patients with a CEAP clinical class of C2 or C3 who underwent EVTA from January 2015 to December 2021. Patients were grouped by obesity, defined as a body mass index of ≥30 kg/m2. The primary outcome was the change in venous clinical severity score (VCSS) from the procedure to the patient's initial follow-up. The secondary outcomes included the change in patient-reported outcomes at follow-up via the HASTI (heaviness, achiness, swelling, throbbing, itching) score, incidence of follow-up complications, and recanalization of treated veins. The change in the VCSS and HASTI score were analyzed using Student t tests, and complications and recanalization were assessed using the Fisher exact test. Significant outcomes were confirmed by multiple variable logistic regression. The remaining significant variables were then analyzed, with obesity categorized using the World Health Organization classification system to analyze how increasing obesity levels affect outcomes. RESULTS There were 8146 limbs that met the inclusion criteria, of which 5183 (63.6%) were classified as nonobese and 2963 (36.4%) as obese. Obesity showed no impact on improvement in the VCSS (-3.29 vs -3.35; P = .408). Obesity was found to be associated with a larger improvement in overall symptoms, as evidence by a greater improvement in the HASTI score (-7.24 vs -6.62; P < .001). Obese limbs showed a higher incidence of superficial phlebitis (1.5% vs 0.7%; P = .001), but no difference was found in recanalization or any other complication. CONCLUSIONS These data suggest that obese patients with CEAP clinical class C2 or C3 experience greater improvement in their perceived symptoms after EVTA with little difference in clinical improvement and complications compared with nonobese patients. Although obesity has been associated with increased severity of venous disease symptoms, obese patients are able to derive significant relief after treatment during the short term and may experience greater relief of symptoms than nonobese patients when treated at more mild disease presentations.
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Affiliation(s)
- Zachary R Zottola
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Joshua T Geiger
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Geena E Choo
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Baqir J Kedwai
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Mark D Balceniuk
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Jennifer L Ellis
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Adam J Doyle
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Karina A Newhall
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
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Webb J, Mach K, Gooch T, Reddy A, Anderson M, Scott J, Checketts J, Walker L, Hartwell M. Use of person-centered language in obesity-related publications across sports medicine journals: a systematic review of adherence to person-centered language guidelines in sports medicine. J Osteopath Med 2024; 124:307-314. [PMID: 38332743 DOI: 10.1515/jom-2023-0254] [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: 11/20/2023] [Accepted: 01/01/2024] [Indexed: 02/10/2024]
Abstract
CONTEXT Stigmatizing language or non-person-centered language (non-PCL) has been shown to impact patients negatively, especially in the case of obesity. This has led many associations, such as the American Medical Association (AMA) and the International Committee of Medical Journal Editors (ICMJE), to enact guidelines prohibiting the use of stigmatizing language in medical research. In 2018, the AMA adopted person-centered language (PCL) guidelines, including a specific obesity amendment to which all researchers should adhere. However, little research has been conducted to determine if these guidelines are being followed. OBJECTIVES Our primary objective was to determine if PCL guidelines specific to obesity have been properly followed in the sports medicine journals that are interacted with most frequently. METHODS We searched within PubMed for obesity-related articles between 2019 and 2022 published in the top 10 most-interacted sports medicine journals based on Google Metrics data. A predetermined list of stigmatizing and non-PCL terms/language was searched within each article. RESULTS A total of 198 articles were sampled, of which 58.6 % were found to be not compliant with PCL guidelines. The most common non-PCL terms were "obese" utilized in 49.5 % of articles, followed by "overweight" as the next most common stigmatizing term at 40.4 %. Stigmatizing labels such as "heavy, heavier, heaviness," "fat" as an adjective, and "morbid" appeared in articles but at a lower rate. CONCLUSIONS Our study shows that there is a severe lack of adherence to PCL guidelines in the most-interacted sports medicine journals. Negative associations between stigmatizing language and individuals with obesity will only persist if a greater effort is not made to change this. All journals, including the most prestigious ones, should adopt and execute PCL guidelines to prevent the spread of demeaning language in the medical community.
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Affiliation(s)
- Jason Webb
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Kaylee Mach
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Trey Gooch
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Arjun Reddy
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Michael Anderson
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Jeremy Scott
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Jake Checketts
- Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA
| | - Lance Walker
- Department of Physical Therapy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Schmerler J, Hussain N, Kurian SJ, Khanuja HS, Oni JK, Hegde V. Preoperative weight loss before total hip arthroplasty negatively impacts postoperative outcomes. ARTHROPLASTY 2024; 6:13. [PMID: 38561849 PMCID: PMC10986115 DOI: 10.1186/s42836-024-00237-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Obesity adversely impacts outcomes of total hip arthroplasty (THA), leading surgeons to impose body mass index cutoffs for patient eligibility and encourage preoperative weight loss. This study aimed to determine if preoperative weight loss impacts outcomes of THA in the general patient population and if it mitigates poor outcomes in obese patients. METHODS Patients who underwent THA from 2013-2020 were identified in the National Surgical Quality Improvement Program (NSQIP) database. Patients were stratified by weight loss of >10% of body weight over the preceding 6 months. We used multivariable linear and logistic regression models, adjusted for age, sex, race/ethnicity, and comorbidities, to examine the effect of significant preoperative weight loss on 30-day outcomes after THA in the general and obese patient populations. RESULTS In the overall population, patients who lost significant weight preoperatively had significantly increased length of stay, were more likely to have a non-home discharge, return to the operating room, or be readmitted, and were more likely to experience numerous medical complications. In the obese population, patients who lost significant weight preoperatively had significantly increased length of stay and were more likely to require a transfusion or experience any medical complication. DISCUSSION Rapid significant preoperative weight loss is not associated with improved postoperative outcomes after THA in the obese population and is associated with worse outcomes in the general population. Arthroplasty surgeons should balance these risks with the risks of obesity when advising patients about preoperative weight loss prior to THA. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jessica Schmerler
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA.
| | - Nauman Hussain
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA
| | - Shyam J Kurian
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA
| | - Harpal S Khanuja
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA
| | - Julius K Oni
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA
| | - Vishal Hegde
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD, 21287, USA
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Apaer S, Aizezi Z, Cao X, Wu J, Zhang Y, Tuersunmaimaiti A, Zhao J, Li T, Yang W, Tuxun T. Safety and Efficacy of LSG Versus LRYGB on Patients with Obesity: a Systematic Review and Meta-analysis from RCTs. Obes Surg 2024; 34:1138-1151. [PMID: 38351200 DOI: 10.1007/s11695-024-07076-w] [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: 10/02/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the two most frequently performed techniques in treating obesity and its related comorbidities. We aimed to compare the clinical efficacy and safety of LSG with LRYGB in terms of short- and mid-term outcomes of weight loss, obesity-related comorbidities, and post-operative complications via a meta-analysis of RCTs. METHODS Clinical comparative RCTs on LSG and LRYGB were searched through PubMed, MEDLINE, and Web of Science databases from inception to August 2022. Pooled outcomes from the selected studies were discussed by the random-effect meta-analysis method. Quality assessment and risk of bias for selected RCTs were implemented, and all the statistical analyses were performed. RESULTS Twenty studies, including 1270 patients, were enrolled. Meta-analysis results indicated the great superior efficacy of LRYGB to LSG in BMI loss at 6 (MD -1.35 kg/m2, 95% CI: -2.07 to -0.62, p = 0.0003), 12 months (MD -1.09 kg/m2, 95% CI: -1.86 to -0.33, p = 0.005), and 36 months (MD -1.47 kg/m2, 95% CI: -2.77 to -0.16, p = 0.03) as well as %EWL gaining at 36 months. Significantly higher remission rates of T2DM and dyslipidemia were achieved by LRYGB at 12 months. Besides, better improvements for T2DM-related and lipid biochemical parameters were found favoring LRYGB. However, LSG resulted in a lower post-operative complication rate and shorter operating time. CONCLUSIONS Present meta-analysis results suggested that LRYGB was superior to LSG concerning short- and mid-term weight loss, short-term T2DM remission efficacy, and related biochemical parameters. LSG is favored for obviously fewer complications and shorter operating time.
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Affiliation(s)
- Shadike Apaer
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zulifeiye Aizezi
- Department of Medical Affairs, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xinling Cao
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jing Wu
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yunfei Zhang
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Adudusalamu Tuersunmaimaiti
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jinming Zhao
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tao Li
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
| | - Tuerhongjiang Tuxun
- Department of Liver & Laparoscopic Surgery, Digestive & Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
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Wang L, Sun Y, Li Y, He L, Niu Y, Yan N. The association between trouble sleeping and obesity among the U.S. elderly from NHANES 2011-2014: A moderated mediation model of depressive symptoms and cognitive function. J Affect Disord 2024; 350:58-64. [PMID: 38220111 DOI: 10.1016/j.jad.2024.01.112] [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: 07/16/2023] [Revised: 12/08/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Studies have shown a close association between trouble sleeping and obesity in older adults. However, no studies have explored the underlying mechanism of this relationship. The present study was designed to evaluate the roles of depressive symptoms and cognitive function in the association between trouble sleeping and obesity in older American adults. METHODS A cross-sectional study with 2575 participants (≥60 years old) in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used for analysis. Obesity, depressive symptoms, and cognitive function (including Established Consortium for Word Learning in Alzheimer's Disease (CERAD-WL) (immediate learning and recall and delayed recall), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST)) were objectively measured, and trouble sleeping was assessed using a self-reported questionnaire. The moderated mediation analysis was conducted by Hayes' PROCESS macro. RESULTS Trouble sleeping was positively associated with obesity among older adults. Depressive symptoms partially and indirectly mediated this association, and DSST moderated the association between trouble sleeping and depressive symptoms. Trouble sleeping had a lower impact on depressive symptoms in older adults with higher cognitive function. LIMITATIONS The cross-sectional design prevents making causal inferences, and part of self-reported information was not objective enough. CONCLUSION Cognitive function moderated the mediation of depressive symptoms on the indirect, positive association between trouble sleeping and obesity; hence, incorporating methods to strengthen cognitive function and alleviate depressive symptoms may help weak the link between trouble sleeping and obesity among older adults.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan 750004, China
| | - Yanli Sun
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, China
| | - Yan Li
- The Center for Disease Control and Prevention of Yinchuan City, Yinchuan 750011, China
| | - Lin He
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan 750004, China.
| | - Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
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Wang J, Chehrehasa F, Moody H, Beecher K. Does neuroscience research change behaviour? A scoping review and case study in obesity neuroscience. Neurosci Biobehav Rev 2024; 159:105598. [PMID: 38401576 DOI: 10.1016/j.neubiorev.2024.105598] [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: 11/09/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
The language employed by researchers to define and discuss diseases can itself be a determinant of health. Despite this, the framing of diseases in medical research literature is largely unexplored. This scoping review examines a prevalent medical issue with social determinants influenced by the framing of its pathogenesis: obesity. Specifically, we compare the currently dominant framing of obesity as an addiction to food with the emerging frame of obesity developing from neuroinflammation. We triangulate both corpus linguistic and bibliometric analysis of the top 200 most engaging neuroscience journal articles discussing obesity that were published open access in the past 10 years. The constructed Neurobesity Corpus is available for public use. The scoping review analysis confirmed that neuroinflammation is an emerging way for obesity to be framed in medical research. Importantly, the articles analysed that discussed neuroinflammation were less likely to use crisis terminology, such as referring to an obesity "epidemic". We highlight a potential relationship between the adoption of addiction frames and the use of stigmatising language in medical research.
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Affiliation(s)
- Joshua Wang
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia.
| | - Fatemeh Chehrehasa
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia
| | - Hayley Moody
- Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia
| | - Kate Beecher
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Building 71/918 Royal Brisbane and Women's Hospital Campus, Herston, QLD 4029, Australia
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9
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Sethi I, Lam K, Sanicola C, Lee E, Tuppo C, Spaniolas K, Pryor AD. Efficacy of Bowel Regimen in Decreasing Postoperative Constipation in Bariatric Surgery Patients. Obes Surg 2024; 34:830-835. [PMID: 38285300 DOI: 10.1007/s11695-024-07073-z] [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: 11/09/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Postoperative constipation after bariatric surgery is a common complaint, decreasing patient quality of life. No literature exists examining the efficacy of a preoperative bowel regimen in reducing postoperative constipation in this cohort. This study aims explore the efficacy of a well-established bowel regimen, polyethylene glycol (PEG), in reducing constipation frequency and severity after bariatric surgery. METHODS This was a retrospective study of adult patients undergoing primary and revisional bariatric procedures. The use of PEG bowel prep for bariatric patients was introduced as an institutional quality improvement measure. Patients during the first 3 months after PEG implementation were surveyed for postoperative constipation. For the year after implementation, patients were followed for 30-day emergency room visits or hospitalization secondary to constipation. This cohort was compared to historical controls from the previous year. Student t-tests were used for statistical analysis. RESULTS During the 3-month exploratory phase, 28/49 (57.14%) patients fully completed the bowel regimen. In total, 0/56 (0%) patients reported preoperative constipation, and 5/28 (17.9%) patients reported constipation at the 3-week follow-up. In the 1 year post-implementation cohort, 2/234 (0.85%) patients had constipation-related occurrences at 30-day follow-up, compared to 8/219 patients (3.65%) in the historical cohort (p = 0.04). CONCLUSIONS The implementation of a PEG-based bowel regimen did not eliminate self-reported constipation. However, there were significant differences in rates of constipation-related ED visits and hospital readmissions, suggesting that the bowel regimen decreases rates of severe constipation. Finally, patient compliance was limited. Future work should aim towards increasing compliance.
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Affiliation(s)
- Ila Sethi
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11790, USA.
| | - Katherine Lam
- Department of Surgery, Westchester Medical Center, Valhalla, NY, 15095, USA
| | - Caroline Sanicola
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11790, USA
| | - Edmund Lee
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11790, USA
| | - Catherine Tuppo
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11790, USA
| | - Konstantinos Spaniolas
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11790, USA
| | - Aurora D Pryor
- Department of Surgery, Long Island Jewish Medical Center, Northwell Health, Queens, NY, 11040, USA
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Sampaio P, Waitzberg DL, Machado NM, de Miranda Torrinhas RSM, Fonseca DC, Ferreira BAM, Marques M, Barcelos S, Ishida RK, Guarda IFMS, de Moura EGH, Sakai P, Santo MA, Heymsfield SB, Corrêa-Giannella ML, Passadore MD, Sala P. Gastrointestinal genetic reprogramming of vitamin A metabolic pathways in response of Roux-en-Y gastric bypass. INT J VITAM NUTR RES 2024; 94:27-36. [PMID: 36164727 DOI: 10.1024/0300-9831/a000767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Roux-en-Y gastric bypass (RYGB) is one of the most performed bariatric surgical techniques. However, RYGB commonly results, as side effects, in nutritional deficiencies. This study aimed to examine changes in the expression of vitamin A pathway encoding genes in the gastrointestinal tract (GI) and to evaluate the potential mechanisms associated with hypovitaminosis A after RYGB. Intestinal biopsies were obtained through double-balloon endoscopy in 20 women with obesity (age 46.9±6.2 years; body mass index [BMI] 46.5±5.3 kg/m2 [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m2). Intestinal mucosal gene microarray analyses were performed in samples using a Human GeneChip 1.0 ST array (Affymetrix). Vitamin A intake was assessed from 7-day food records and serum retinol levels were evaluated by electrochemiluminescence immunoassay. Our results showed the following genes with significant downregulation (p≤0.05): LIPF (-0.60), NPC1L1 (-0.71), BCO1 (-0.45), and RBP4 (-0.13) in the duodenum; CD36 (-0.33), and ISX (-0.43) in the jejunum and BCO1 (-0.29) in the ileum. No significant changes in vitamin A intake were found (784±694 retinol equivalents [RE] pre-operative vs. 809±753 RE post-operative [mean±SD]). Although patients were routinely supplemented with 3500 international units IU/day (equivalent to 1050 μg RE/day) of oral retinol palmitate, serum concentrations were lower in the post-operative when compared to pre-operative period (0.35±0.14 μg/L vs. 0.52±0.33 μg/L, respectively - P=0.07), both within the normal range. After RYGB, the simultaneous change in expression of GI genes, may impair carotenoid metabolism in the enterocytes, formation of nascent chylomicrons and transport of retinol, resulting in lower availability of vitamin A.
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Affiliation(s)
- Priscilla Sampaio
- Centro Universitário São Camilo, São Paulo, Brazil
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | - Dan Linetzky Waitzberg
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | - Natasha Mendonça Machado
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | | | - Danielle C Fonseca
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | - Beatriz A M Ferreira
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | - Mariane Marques
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | - Samira Barcelos
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
| | | | | | | | - Paulo Sakai
- Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | | | | | - Maria Lúcia Corrêa-Giannella
- Laboratorio de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, University of São Paulo, Brazil
| | | | - Priscila Sala
- Centro Universitário São Camilo, São Paulo, Brazil
- Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil
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11
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Hao N, Bai X, Hu A, Zhao G, Chen Y, Zhao J, Ling Q, Li X, Cai C, Wang Q, Wang Z, Fang J. Assessing the Global, Regional, and National Impact of High Body Mass Index on Alzheimer's Disease and Other Dementias Between 1990 and 2019. J Alzheimers Dis 2024; 97:293-307. [PMID: 38043013 DOI: 10.3233/jad-230827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Obesity significantly increases Alzheimer's disease (AD) and dementia risk. Understanding the link between a high body mass index (BMI) and these conditions is crucial for effective management and prevention. OBJECTIVE We aimed to estimate the burden of AD and other dementias attributed to high BMI from 1990 to 2019 based on sex, age, and socio-demographic indicators (SDI) at global, regional, and national levels. METHODS We collected data on deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) from the 2019 Global Burden of Disease study for AD and dementia attributed to high BMI. We explored the correlation between SDI levels and ASDR. RESULTS In 2019, there were 198,476.2 deaths (95% UI: 32,695.4-593,366.4) and 3,159,912.4 DALYs (848,330.5-8,042,531) attributed to high BMI. Numbers of deaths, DALYs, ASMR, and ASDR increased since 1990. Females had higher deaths, ASMR, and ASDR than males. Mortality and DALYs rates increased with age. ASMR and ASDR increased across five SDI levels, with the highest rise in Low-middle SDI. High-income North America had the most deaths [30,993.9 (5,101.7-89,912.9)], while North Africa and the Middle East had the highest ASMR [4.61 (0.79-13.64)] and ASDR [72.56 (20.98-181.16)] in 2019. CONCLUSIONS The burden of AD and other dementias attributed to high BMI increased since 1990 globally and is still heaviest in developed regions. Females accounted predominantly for the burden than males. Timely measures are needed to against high BMI.
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Affiliation(s)
- Ning Hao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xue Bai
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - An Hu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Gaofeng Zhao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yansheng Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jianhe Zhao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qiong Ling
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiangyu Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuipu Cai
- College of Engineering, Shantou University, Shantou, China
| | - Qi Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhaojun Wang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jiansong Fang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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12
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Onghena L, Van Nieuwenhove Y, Demeulenaere L, Devisscher L, Verhelst X, Degroote H, Raevens S, Van Vlierberghe H, Lefere S, Geerts A. Patients hospitalized with alcohol-related liver disease and prior bariatric surgery are more prone to develop acute-on-chronic liver failure. Liver Int 2023; 43:2743-2751. [PMID: 37718533 DOI: 10.1111/liv.15726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND & AIMS Patients with a history of bariatric surgery (BS) are susceptible to developing alcohol use disorder. We and others have previously shown that these patients can develop severe alcohol-related liver disease (ARLD). Our aim was to describe the demographics, co-morbidities and mortality of a hospitalized population diagnosed with alcohol-related liver disease, in relation to BS. METHODS We included 299 patients hospitalized with ARLD at the Ghent University Hospital between 1 January 2018 and 31 December 2022. Clinical, biochemical and outcome data were retrospectively retrieved from the most recent hospitalization. Statistical analysis was performed using the t test, Mann-Whitney U and χ2 tests. RESULTS Thirteen per cent (39/299) of patients admitted with ARLD had a history of bariatric surgery, of whom 25 (64.1%) had undergone Roux-en-Y gastric bypass. Patients with a history of BS were predominantly female (76.9%), in contrast to the non-BS population (29.2%) (p < .0001), and despite being significantly younger (p < .0001) and had a similar survival (61.5% vs. 58.1%). Bariatric surgery and older age at diagnosis were both significantly associated with poorer transplant-free survival. The cause of death was acute-on-chronic liver failure in 73.3% of BS patients, compared to only 19.2% of those without a history of BS (p < .0001). The weekly amount of alcohol consumed (p = .012) and duration of use (p < .0001) were significantly lower/shorter in the BS population. CONCLUSIONS BS patients hospitalized with ARLD are predominantly younger women with a lower cumulative alcohol consumption compared to those without prior BS. BS impacted transplant-free survival, with ACLF as the predominant cause of death in these patients.
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Affiliation(s)
- Louis Onghena
- Department for Human Structure and Repair, Department of Gastrointestinal Surgery, Ghent University, Ghent, Belgium
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Yves Van Nieuwenhove
- Department for Human Structure and Repair, Department of Gastrointestinal Surgery, Ghent University, Ghent, Belgium
| | - Laurissa Demeulenaere
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Lindsey Devisscher
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Basic and Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
| | - Xavier Verhelst
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Helena Degroote
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Sarah Raevens
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Hans Van Vlierberghe
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Sander Lefere
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Anja Geerts
- Liver Research Center Ghent, Ghent University, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
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13
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Santos-Pereira M, Pereira SC, Rebelo I, Spadella MA, Oliveira PF, Alves MG. Decoding the Influence of Obesity on Prostate Cancer and Its Transgenerational Impact. Nutrients 2023; 15:4858. [PMID: 38068717 PMCID: PMC10707940 DOI: 10.3390/nu15234858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
In recent decades, the escalating prevalence of metabolic disorders, notably obesity and being overweight, has emerged as a pressing concern in public health. Projections for the future indicate a continual upward trajectory in obesity rates, primarily attributable to unhealthy dietary patterns and sedentary lifestyles. The ramifications of obesity extend beyond its visible manifestations, intricately weaving a web of hormonal dysregulation, chronic inflammation, and oxidative stress. This nexus of factors holds particular significance in the context of carcinogenesis, notably in the case of prostate cancer (PCa), which is a pervasive malignancy and a leading cause of mortality among men. A compelling hypothesis arises from the perspective of transgenerational inheritance, wherein genetic and epigenetic imprints associated with obesity may wield influence over the development of PCa. This review proposes a comprehensive exploration of the nuanced mechanisms through which obesity disrupts prostate homeostasis and serves as a catalyst for PCa initiation. Additionally, it delves into the intriguing interplay between the transgenerational transmission of both obesity-related traits and the predisposition to PCa. Drawing insights from a spectrum of sources, ranging from in vitro and animal model research to human studies, this review endeavors to discuss the intricate connections between obesity and PCa. However, the landscape remains partially obscured as the current state of knowledge unveils only fragments of the complex mechanisms linking these phenomena. As research advances, unraveling the associated factors and underlying mechanisms promises to unveil novel avenues for understanding and potentially mitigating the nexus between obesity and the development of PCa.
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Affiliation(s)
- Mariana Santos-Pereira
- iBiMED-Institute of Biomedicine and Department of Medical Science, University of Aveiro, 3810-193 Aveiro, Portugal;
- Endocrine and Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal;
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, 4099-002 Porto, Portugal
| | - Sara C. Pereira
- Endocrine and Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal;
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, 4099-002 Porto, Portugal
- LAQV-REQUIMTE and Department of Chemistry, Campus Universitario de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Irene Rebelo
- UCIBIO-REQUIMTE, Laboratory of Biochemistry, Department of Biologic Sciences, Pharmaceutical Faculty, University of Porto, 4050-313 Porto, Portugal;
| | - Maria A. Spadella
- Human Embryology Laboratory, Marília Medical School, Marília 17519-030, SP, Brazil;
| | - Pedro F. Oliveira
- LAQV-REQUIMTE and Department of Chemistry, Campus Universitario de Santiago, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Marco G. Alves
- iBiMED-Institute of Biomedicine and Department of Medical Science, University of Aveiro, 3810-193 Aveiro, Portugal;
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14
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Cerfoglio S, Lopomo NF, Capodaglio P, Scalona E, Monfrini R, Verme F, Galli M, Cimolin V. Assessment of an IMU-Based Experimental Set-Up for Upper Limb Motion in Obese Subjects. SENSORS (BASEL, SWITZERLAND) 2023; 23:9264. [PMID: 38005650 PMCID: PMC10674635 DOI: 10.3390/s23229264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
In recent years, wearable systems based on inertial sensors opened new perspectives for functional motor assessment with respect to the gold standard motion capture systems. The aim of this study was to validate an experimental set-up based on 17 body-worn inertial sensors (Awinda, Xsens, The Netherlands), addressing specific body segments with respect to the state-of-the art system (VICON, Oxford Metrics Ltd., Oxford, UK) to assess upper limb kinematics in obese, with respect to healthy subjects. Twenty-three obese and thirty healthy weight individuals were simultaneously acquainted with the two systems across a set of three tasks for upper limbs (i.e., frontal arm rise, lateral arm rise, and reaching). Root Mean Square error (RMSE) was computed to quantify the differences between the measurements provided by the systems in terms of range of motion (ROM), whilst their agreement was assessed via Pearson's correlation coefficient (PCC) and Bland-Altman (BA) plots. In addition, the signal waveforms were compared via one-dimensional statistical parametrical mapping (SPM) based on a paired t-test and a two-way ANOVA was applied on ROMs. The overall results partially confirmed the correlation and the agreement between the two systems, reporting only a moderate correlation for shoulder principal rotation angle in each task (r~0.40) and for elbow/flexion extension in obese subjects (r = 0.66), whilst no correlation was found for most non-principal rotation angles (r < 0.40). Across the performed tasks, an average RMSE of 34° and 26° was reported in obese and healthy controls, respectively. At the current state, the presence of bias limits the applicability of the inertial-based system in clinics; further research is intended in this context.
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Affiliation(s)
- Serena Cerfoglio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
| | - Nicola Francesco Lopomo
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, Italy; (N.F.L.); (R.M.)
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10126 Turin, Italy
| | - Emilia Scalona
- Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, 25123 Brescia, Italy;
| | - Riccardo Monfrini
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, Italy; (N.F.L.); (R.M.)
| | - Federica Verme
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; (S.C.); (M.G.); (V.C.)
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy;
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15
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Austin J, Wirtz A, Garrett M, Ferrell SC, Stephenson E, Gajjar S, Perloff S, Hartwell M. Associations of cesarean sections with comorbidities within the Pregnancy Risk Assessment Monitoring System. J Perinat Med 2023; 51:1025-1031. [PMID: 37203560 DOI: 10.1515/jpm-2023-0005] [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: 01/04/2023] [Accepted: 05/02/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Cesarean delivery (CD) is a common obstetrical procedure aimed at reducing maternal and infant morbidity and mortality in complicated pregnancies and medical emergencies yet carries potential complications. CD rates in the USA have increased over the years - likely associated with increased comorbidities. Thus, to expand the literature, our objective was to identify the likelihood of a woman having a CD when comorbidities - diabetes, high blood pressure (HBP), or depression - are present. METHODS We conducted a cross-sectional analysis of the 2019 Pregnancy Risk Assessment Monitoring System. Binary and multivariable logistic regression were used to calculate adjusted odds ratios (AORs) to determine associations between pre-existing and gestational comorbidities and CD among pregnant women. RESULTS Compared to those without a diagnosis, women with pre-existing diabetes (AOR: 1.69; CI: 1.54-1.86), pre-existing HBP (AOR: 1.58; CI: 1.46-1.69), and pre-existing depression (AOR: 1.14; CI 1.08-1.20; Table 2) were more likely to have a CD. Additionally, participants with gestational diabetes (AOR 1.43; CI 1.34-1.52), HBP (AOR 1.86; CI 1.76-1.95) and depression (AOR 1.13; CI 1.07-1.19) were also more likely to have a CD than those without comorbidities. CONCLUSIONS Higher rates of CD were found among individuals with a pre-existing or gestational diagnosis of diabetes, HBP, or depression than those without these diagnoses. With increasing rates of these conditions, it is likely that CD rates will continue their trajectory in the USA. Thus, professional organizations can have more impact by popularizing and making effective evidence-based guidelines for management.
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Affiliation(s)
- Jordyn Austin
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Alexis Wirtz
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Morgan Garrett
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Sydney C Ferrell
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Elise Stephenson
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Swapnil Gajjar
- Department of Industrial Engineering & Management, Oklahoma State University, Stillwater, OK, USA
| | - Spenser Perloff
- Department of Obstetrics and Gynecology, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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16
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Puliani G, Sbardella E, Cozzolino A, Sada V, Tozzi R, Andreoli C, Fiorelli M, Di Biasi C, Corallino D, Balla A, Paganini AM, Venneri MA, Lenzi A, Lubrano C, Isidori AM. Pituitary T1 signal intensity at magnetic resonance imaging is reduced in patients with obesity: results from the CHIASM study. Int J Obes (Lond) 2023; 47:948-955. [PMID: 37479795 PMCID: PMC10511316 DOI: 10.1038/s41366-023-01338-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 06/18/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Despite obesity being well known to be associated with several pituitary hormone imbalances, pituitary appearance in magnetic resonance imaging (MRI) in patients with obesity is understudied. OBJECTIVE To evaluate the pituitary volume and signal intensity at MRI in patients with obesity. METHODS This is a prospective study performed in an endocrine Italian referral center (ClinicalTrial.gov Identifier: NCT03458533). Sixty-nine patients with obesity (BMI > 30 kg/m2) and twenty-five subjects without obesity were enrolled. Thirty-three patients with obesity were re-evaluated after 3 years of diet and lifestyle changes, of whom 17 (51.5%) achieved a > 5% loss of their initial body weight, whereas the remaining 16 (48.5%) had maintained or gained weight. Evaluations included metabolic and hormone assessments, DEXA scan, and pituitary MRI. Pituitary signal intensity was quantified by measuring the pixel density using ImageJ software. RESULTS At baseline, no difference in pituitary volume was observed between the obese and non-obese cohorts. At the 3-year follow-up, pituitary volume was significantly reduced (p = 0.011) only in participants with stable-increased body weight. Furthermore, a significant difference was noted in the mean pituitary intensity of T1-weighted plain and contrast-enhanced sequences between the obese and non-obese cohorts at baseline (p = 0.006; p = 0.002), and a significant decrease in signal intensity was observed in the subgroup of participants who had not lost weight (p = 0.012; p = 0.017). Insulin-like growth factor-1 levels, following correction for BMI, were correlated with pituitary volume (p = 0.001) and intensity (p = 0.049), whereas morning cortisol levels were correlated with pituitary intensity (p = 0.007). The T1-weighted pituitary intensity was negatively correlated with truncal fat (p = 0.006) and fibrinogen (p = 0.018). CONCLUSIONS The CHIASM study describes a quantitative reduction in pituitary intensity in T1-weighted sequences in patients with obesity. These alterations could be explained by changes in the pituitary stromal tissue, correlated with low-grade inflammation.
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Affiliation(s)
- Giulia Puliani
- Oncological Endocrinology Unit, Regina Elena National Cancer Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Emilia Sbardella
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Alessia Cozzolino
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Valentina Sada
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Rossella Tozzi
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Chiara Andreoli
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Fiorelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Claudio Di Biasi
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Umberto I University Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Diletta Corallino
- Bariatric Surgery Unit, Department of General Surgery and Surgical Specialties "Paride Stefanini" Sapienza University of Rome, Umberto I University Hospital, Viale del Policlinico 155, 00161, Rome, Italy
| | - Andrea Balla
- Bariatric Surgery Unit, Department of General Surgery and Surgical Specialties "Paride Stefanini" Sapienza University of Rome, Umberto I University Hospital, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandro M Paganini
- Bariatric Surgery Unit, Department of General Surgery and Surgical Specialties "Paride Stefanini" Sapienza University of Rome, Umberto I University Hospital, Viale del Policlinico 155, 00161, Rome, Italy
| | - Mary Anna Venneri
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Carla Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
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Gonzalez-Becerra K, Barron-Cabrera E, Muñoz-Valle JF, Torres-Castillo N, Rivera-Valdes JJ, Rodriguez-Echevarria R, Martinez-Lopez E. A Balanced Dietary Ratio of n-6:n-3 Polyunsaturated Fatty Acids Exerts an Effect on Total Fatty Acid Profile in RBCs and Inflammatory Markers in Subjects with Obesity. Healthcare (Basel) 2023; 11:2333. [PMID: 37628530 PMCID: PMC10454033 DOI: 10.3390/healthcare11162333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
The n-3 polyunsaturated fatty acids (PUFAs) can reduce inflammatory markers and may therefore be useful in obesity management. The aim of this study was to analyze the effect of supplementation with n-3 PUFAs on total fatty acid profile in red blood cells (RBCs), as well as biochemical and inflammatory markers, in subjects with obesity. The study consisted in a randomized placebo-controlled, double-blind clinical trial involving 41 subjects with obesity during a 4-month follow-up. Individuals were randomly assigned to two groups: n-3 PUFA supplementation (1.5 g fish oil) and placebo (1.5 g sunflower oil). Anthropometric, biochemical, dietetic, cytokine and total fatty acid profiles in RBCs were measured. Both groups increased their PUFA intake and DHA incorporation in RBCs. However, the placebo group showed a reduction in serum IL-8 and MCP-1 at the end of the study. A multiple linear regression model adjusted by body fat mass and sex showed that an increase in DHA in RBCs decreased the serum IL-8 levels in both study groups at the end of the study. Our results highlight the role of dietary DHA and n-3 supplementation usefulness in exerting beneficial anti-inflammatory effects.
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Affiliation(s)
- Karina Gonzalez-Becerra
- Instituto de Investigación en Genética Molecular, Centro Universitario de la Ciénega, Universidad de Guadalajara, Av. Universidad 1115, Ocotlán 47810, Jalisco, Mexico;
| | - Elisa Barron-Cabrera
- Facultad de Ciencias de la Nutrición y Gastronomía, Universidad Autónoma Sinaloa, Av Cedros y Calle Sauces S/N, Culiacán 80010, Sinaloa, Mexico;
| | - Jose F. Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico
| | - Nathaly Torres-Castillo
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico; (N.T.-C.); (J.J.R.-V.); (R.R.-E.)
| | - Juan J. Rivera-Valdes
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico; (N.T.-C.); (J.J.R.-V.); (R.R.-E.)
| | - Roberto Rodriguez-Echevarria
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico; (N.T.-C.); (J.J.R.-V.); (R.R.-E.)
| | - Erika Martinez-Lopez
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico; (N.T.-C.); (J.J.R.-V.); (R.R.-E.)
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18
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Finn EB, Whang C, Hong PH, Costa SA, Callahan EA, Huang TTK. Strategies to improve the implementation of intensive lifestyle interventions for obesity. Front Public Health 2023; 11:1202545. [PMID: 37559739 PMCID: PMC10407556 DOI: 10.3389/fpubh.2023.1202545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/04/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Emily Benjamin Finn
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Christine Whang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Peter Houlin Hong
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Sergio A. Costa
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | | | - Terry T. -K. Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
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19
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Shenoy A, Schulman AR. Advances in endobariatrics: past, present, and future. Gastroenterol Rep (Oxf) 2023; 11:goad043. [PMID: 37483864 PMCID: PMC10361810 DOI: 10.1093/gastro/goad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
The obesity epidemic in the USA and worldwide is well documented and continues to grow. Endoscopic metabolic and bariatric therapies may offer a less invasive approach than surgical intervention. This article will review advances in endobariatrics over the last several decades, addressing the past and current state of bariatric and metabolic endoscopy. Food and Drug Administration-cleared devices and interventions currently under investigation are described including gastric devices, gastric remodeling procedures, small-bowel devices, duodenal ablation, as well as procedures to address weight regain after bariatric surgery. Future studies evaluating gastric and duodenal combination therapy, adjunctive pharmacotherapy, as well as individualized precision-health algorithms are underway.
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Affiliation(s)
- Abhishek Shenoy
- Corresponding author. Division of Gastroenterology, Department of Internal Medicine, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48105, USA. Tel: +1-908-3381691; Fax: +1-734-9365458;
| | - Allison R Schulman
- Division of Gastroenterology and Hepatology, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
- Department of Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
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20
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Seidel F, Fluiter K, Kleemann R, Worms N, van Nieuwkoop A, Caspers MPM, Grigoriadis N, Kiliaan AJ, Baas F, Michailidou I, Morrison MC. Ldlr-/-.Leiden mice develop neurodegeneration, age-dependent astrogliosis and obesity-induced changes in microglia immunophenotype which are partly reversed by complement component 5 neutralizing antibody. Front Cell Neurosci 2023; 17:1205261. [PMID: 37457817 PMCID: PMC10346859 DOI: 10.3389/fncel.2023.1205261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Obesity has been linked to vascular dysfunction, cognitive impairment and neurodegenerative diseases. However, experimental models that recapitulate brain pathology in relation to obesity and vascular dysfunction are still lacking. Methods In this study we performed the histological and histochemical characterization of brains from Ldlr-/-.Leiden mice, an established model for obesity and associated vascular disease. First, HFD-fed 18 week-old and 50 week-old Ldlr-/-.Leiden male mice were compared with age-matched C57BL/6J mice. We then assessed the effect of high-fat diet (HFD)-induced obesity on brain pathology in Ldlr-/-.Leiden mice and tested whether a treatment with an anti-complement component 5 antibody, a terminal complement pathway inhibitor recently shown to reduce vascular disease, can attenuate neurodegeneration and neuroinflammation. Histological analyses were complemented with Next Generation Sequencing (NGS) analyses of the hippocampus to unravel molecular pathways underlying brain histopathology. Results We show that chow-fed Ldlr-/-.Leiden mice have more severe neurodegeneration and show an age-dependent astrogliosis that is not observed in age-matched C57BL/6J controls. This was substantiated by pathway enrichment analysis using the NGS data which showed that oxidative phosphorylation, EIF2 signaling and mitochondrial dysfunction pathways, all associated with neurodegeneration, were significantly altered in the hippocampus of Ldlr-/-.Leiden mice compared with C57BL/6J controls. Obesity-inducing HFD-feeding did not aggravate neurodegeneration and astrogliosis in Ldlr-/-.Leiden mice. However, brains from HFD-fed Ldlr-/-.Leiden mice showed reduced IBA-1 immunoreactivity and increased CD68 immunoreactivity compared with chow-fed Ldlr-/-.Leiden mice, indicating alteration of microglial immunophenotype by HFD feeding. The systemic administration of an anti-C5 treatment partially restored the HFD effect on microglial immunophenotype. In addition, NGS data of hippocampi from Ldlr-/-.Leiden mice showed that HFD feeding affected multiple molecular pathways relative to chow-fed controls: HFD notably inactivated synaptogenesis and activated neuroinflammation pathways. The anti-C5 treatment restored the HFD-induced effect on molecular pathways to a large extent. Conclusion This study shows that the Ldlr-/-.Leiden mouse model is suitable to study brain histopathology and associated biological processes in a context of obesity and provides evidence of the potential therapeutic value of anti-complement therapy against obesity-induced neuroinflammation.
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Affiliation(s)
- Florine Seidel
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
- Department of Medical Imaging, Anatomy, Preclinical Imaging Center (PRIME), Radboud Alzheimer Center, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kees Fluiter
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Robert Kleemann
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Nicole Worms
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Anita van Nieuwkoop
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Martien P. M. Caspers
- Department of Microbiology and Systems Biology, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Nikolaos Grigoriadis
- Laboratory of Experimental Neurology and Neuroimmunology and the Multiple Sclerosis Center, 2 Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Amanda J. Kiliaan
- Department of Medical Imaging, Anatomy, Preclinical Imaging Center (PRIME), Radboud Alzheimer Center, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank Baas
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Iliana Michailidou
- Laboratory of Experimental Neurology and Neuroimmunology and the Multiple Sclerosis Center, 2 Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Martine C. Morrison
- Department of Metabolic Health Research, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, Netherlands
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21
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M TE, MA RH, B GV, ME FF, V M, F P, P BP, C S, A N, C GP, M L. Clinical and economic impact of COVID-19 on people with obesity in a Spanish cohort during the first pandemic peak. Front Endocrinol (Lausanne) 2023; 14:1146517. [PMID: 37342262 PMCID: PMC10278591 DOI: 10.3389/fendo.2023.1146517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction COVID-19 and obesity relationship has been extensively studied since the COVID-19 outbreak, proving obesity is a risk factor. This study aims to broaden the available information about this association and to evaluate the economic impact of obesity and the COVID-19 disease combination. Methods This retrospective study analyzed a sample of 3,402 patients admitted to a Spanish hospital with available body mass index (BMI) data. Results The prevalence of obesity was 33.4%. Patients with obesity showed a higher risk of hospitalization (OR 95% ConfidenceInterval [CI]=1.46; [1.24-1.73]; p < 0.001), which increased with the obesity degree (I: OR [95% CI]=1.28 [1.06-1.55], p =0.010; II: OR [95% CI]=1.58 [1.16-2.15], p =0.004; III: OR [95% CI] =2.09 [1.31-3.34], p =0.002). Patients with type III obesity had a significantly higher risk of intensive care unit (ICU) admission (OR [95% CI]= 3.30 [1.67-6.53]; p = 0.001) and invasive mechanical ventilation (IMV) need (OR [95% CI]= 3.98 [2.00-7.94]; p<0.001). The average cost per patient was remarkably higher in patients with obesity (p = 0.007), reaching an excess cost of 28.41% in the study cohort and rising to 56.5% in patients < 70 years. The average cost per patient increased significantly with the degree of obesity (p = 0.007). Discussion In conclusion, our results suggest a strong association between obesity and adverse COVID-19 outcomes and higher expenditures in patients with both conditions.
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Affiliation(s)
- Torrego-Ellacuría M
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Rubio-Herrera MA
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - González López-Valcárcel B
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fuentes-Ferrer ME
- Department of Preventive Medicine, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Martín V
- Department of Market Access and Public Affairs, Novo Nordisk Pharma, Sociedad Anónima (SA.), Madrid, Spain
| | - Poyato F
- Department of Clinical, Medical and Regulatory, Novo Nordisk Pharma, Sociedad Anònima (SA.), Madrid, Spain
| | - Barber-Pérez P
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Santucci C
- Department of Quantitative Methods for Economics and Management, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nuñez A
- Department of Critical Care, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - González-Pérez C
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Hospital Pharmacy, Hospital Clínico San Carlos, Instituto de Investigaciòn Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luaces M
- Innovation Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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22
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Geitgey DK, Lee M, Cottrill KA, Jaffe M, Pilcher W, Bhasin S, Randall J, Ross AJ, Salemi M, Castillo-Castrejon M, Kilgore MB, Brown AC, Boss JM, Johnston R, Fitzpatrick AM, Kemp ML, English R, Weaver E, Bagchi P, Walsh R, Scharer CD, Bhasin M, Chandler JD, Haynes KA, Wellberg EA, Henry CJ. The 'omics of obesity in B-cell acute lymphoblastic leukemia. J Natl Cancer Inst Monogr 2023; 2023:12-29. [PMID: 37139973 PMCID: PMC10157791 DOI: 10.1093/jncimonographs/lgad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
The obesity pandemic currently affects more than 70 million Americans and more than 650 million individuals worldwide. In addition to increasing susceptibility to pathogenic infections (eg, SARS-CoV-2), obesity promotes the development of many cancer subtypes and increases mortality rates in most cases. We and others have demonstrated that, in the context of B-cell acute lymphoblastic leukemia (B-ALL), adipocytes promote multidrug chemoresistance. Furthermore, others have demonstrated that B-ALL cells exposed to the adipocyte secretome alter their metabolic states to circumvent chemotherapy-mediated cytotoxicity. To better understand how adipocytes impact the function of human B-ALL cells, we used a multi-omic RNA-sequencing (single-cell and bulk transcriptomic) and mass spectroscopy (metabolomic and proteomic) approaches to define adipocyte-induced changes in normal and malignant B cells. These analyses revealed that the adipocyte secretome directly modulates programs in human B-ALL cells associated with metabolism, protection from oxidative stress, increased survival, B-cell development, and drivers of chemoresistance. Single-cell RNA sequencing analysis of mice on low- and high-fat diets revealed that obesity suppresses an immunologically active B-cell subpopulation and that the loss of this transcriptomic signature in patients with B-ALL is associated with poor survival outcomes. Analyses of sera and plasma samples from healthy donors and those with B-ALL revealed that obesity is associated with higher circulating levels of immunoglobulin-associated proteins, which support observations in obese mice of altered immunological homeostasis. In all, our multi-omics approach increases our understanding of pathways that may promote chemoresistance in human B-ALL and highlight a novel B-cell-specific signature in patients associated with survival outcomes.
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Affiliation(s)
- Delaney K Geitgey
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Miyoung Lee
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Kirsten A Cottrill
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Maya Jaffe
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - William Pilcher
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Swati Bhasin
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Jessica Randall
- Emory Integrated Computational Core, Emory University, Atlanta, GA, USA
| | - Anthony J Ross
- Riley Children’s Health, Indiana University Health, Indianapolis, IN, USA
| | - Michelle Salemi
- Proteomics Core Facility, University of California Davis Genome Center, Davis, 95616, CA
| | - Marisol Castillo-Castrejon
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew B Kilgore
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Ayjha C Brown
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Jeremy M Boss
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Rich Johnston
- Emory Integrated Computational Core, Emory University, Atlanta, GA, USA
| | - Anne M Fitzpatrick
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Melissa L Kemp
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Emory Integrated Proteomics Core, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Eric Weaver
- Shimadzu Scientific Instruments, Columbia, MD, USA
| | - Pritha Bagchi
- Emory Integrated Proteomics Core, Emory University School of Medicine, Atlanta, GA, USA
| | - Ryan Walsh
- Shimadzu Scientific Instruments, Columbia, MD, USA
| | - Christopher D Scharer
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Manoj Bhasin
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Joshua D Chandler
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Karmella A Haynes
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Elizabeth A Wellberg
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Curtis J Henry
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
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23
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Eoh KJ, Lee YJ, Nam EJ, Jung HI, Kim YT. Clinical Relevance of Vaginal Cuff Dehiscence after Minimally Invasive versus Open Hysterectomy. J Clin Med 2023; 12:3001. [PMID: 37109333 PMCID: PMC10142584 DOI: 10.3390/jcm12083001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to evaluate the clinical relevance of vaginal cuff dehiscence following a hysterectomy. Data were prospectively collected from all patients who underwent hysterectomies at a tertiary academic medical center between 2014 and 2018. The incidence and clinical factors of vaginal cuff dehiscence after minimally invasive versus open hysterectomy were compared. Vaginal cuff dehiscence occurred in 1.0% (95% confidence interval [95% CI], 0.7-1.3%) of women who underwent either form of hysterectomy. Among those who underwent open (n = 1458), laparoscopic (n = 3191), and robot-assisted (n = 423) hysterectomies, vaginal cuff dehiscence occurred in 15 (1.0%), 33 (1.0%), and 3 (0.7%) cases, respectively. No significant differences in cuff dehiscence occurrence were identified in patients who underwent various modes of hysterectomies. A multivariate logistic regression model was created using the variables indication for surgery and body mass index. Both variables were identified as independent risk factors for vaginal cuff dehiscence (odds ratio [OR]: 2.74; 95% CI, 1.51-4.98 and OR: 2.20; 95% CI, 1.09-4.41, respectively). The incidence of vaginal cuff dehiscence was exceedingly low in patients who underwent various modes of hysterectomies. The risk of cuff dehiscence was predominantly influenced by surgical indications and obesity. Thus, the different modes of hysterectomy do not influence the risk of vaginal cuff dehiscence.
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Affiliation(s)
- Kyung Jin Eoh
- Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Republic of Korea;
| | - Young Joo Lee
- Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (Y.J.L.); (E.J.N.)
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (Y.J.L.); (E.J.N.)
| | - Hye In Jung
- Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (Y.J.L.); (E.J.N.)
| | - Young Tae Kim
- Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; (Y.J.L.); (E.J.N.)
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24
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Di Martino A, Stefanini N, Brunello M, Bordini B, Pilla F, Geraci G, D’Agostino C, Ruta F, Faldini C. Is the Direct Anterior Approach for Total Hip Arthroplasty Effective in Obese Patients? Early Clinical and Radiographic Results from a Retrospective Comparative Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:769. [PMID: 37109727 PMCID: PMC10145216 DOI: 10.3390/medicina59040769] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Background and objectives: Total hip arthroplasty (THA) in obese patients (BMI > 30) is considered technically demanding, and it is associated with higher rates of general and specific complications including infections, component malpositioning, dislocation, and periprosthetic fractures. Classically, the Direct Anterior Approach (DAA) has been considered less suitable for performing THA surgery in the obese patient, but recent evidence produced by high-volume DAA THA surgeons suggests that DAA is suitable and effective in obese patients. At the authors' institution, DAA is currently the preferred approach for primary and revision THA surgery, accounting for over 90% of hip surgeries without specific patient selection. Therefore, the aim of the current study is to evaluate any difference in early clinical outcomes, perioperative complications, and implant positioning after primary THAs performed via DAA in patients who were divided according to BMI. Material and methods: This study is a retrospective review of 293 THA implants in 277 patients that were performed via DAA from 1 January 2016 to 20 May 2020. Patients were further divided according to BMI: 96 patients were normal weight (NW), 115 were overweight (OW), and 82 were obese (OB). All the procedures were performed by three expert surgeons. The mean follow-up was 6 months. Patients' data, American Society of Anesthesiologists (ASA) score, surgical time, days in rehab unit, pain at the second post-operative day recorded by using a Numerical Rating Scale (NRS), and number of blood transfusions were recorded from clinical charts and compared. Radiological evaluation of cup inclination and stem alignment was conducted on post-operative radiographs; intra- and post-operative complications at latest follow-up were recorded. Results: The average age at surgery of OB patients was significantly lower compared to NW and OW patients. The ASA score was significantly higher in OB patients compared to NW patients. Surgical time was slightly but significantly higher in OB patients (85 ± 21 min) compared to NW (79 ± 20 min, p = 0.05) and OW patients (79 ± 20 min, p = 0.029). Rehab unit discharge occurred significantly later for OB patients, averaging 8 ± 2 days compared to NW patients (7 ± 2 days, p = 0.012) and OW patients (7 ± 2 days; p = 0.032). No differences in the rate of early infections, number of blood transfusions, NRS pain at the second post-operative day, and day of post-operative stair climbing were found among the three groups. Acetabular cup inclination and stem alignment were similar among the three groups. The perioperative complication rate was 2.3%; that is, perioperative complication occurred in 7 out of 293 patients, with a significantly higher incidence of surgical revisions required in obese patients compared to the others. In fact, OB patients showed a higher revision rate (4.87%) compared to other groups, with 1.04% for NW and 0% for OW (p = 0.028, Chi-square test). Causes for revision in obese patients were aseptic loosening (2), dislocation (1), and clinically significant post-operative leg length discrepancy (1), with a revision rate of 4/82 (4.87%) during follow-up. Conclusions: THA performed via DAA in obese patients could be a solid choice of treatment, given the relatively low rate of complications and the satisfying clinical outcomes. However, surgical expertise on DAA and adequate instrumentation for this approach are required to optimise the outcomes.
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Affiliation(s)
- Alberto Di Martino
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Niccolò Stefanini
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Matteo Brunello
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Barbara Bordini
- Medical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Federico Pilla
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Giuseppe Geraci
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Claudio D’Agostino
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Federico Ruta
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Cesare Faldini
- I Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, 40136 Bologna, Italy
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Dixit U, He J, Whited M, Ellis JM, Zickgraf HF. Negative emotional eating patterns among American university students: A replication study. Appetite 2023; 186:106554. [PMID: 37030451 DOI: 10.1016/j.appet.2023.106554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
Emotional eating (EE) has been consistently associated with obesity, weight gain, and certain eating disorders (EDs). Given the cultural influence on food consumption and eating styles, comparison of EE patterns of individuals in culturally distinct nations (e.g., USA and China) could yield interesting differences in findings. However, given the increasing convergence in eating practices between the above-mentioned nations (e.g., higher reliance on outdoor eating at restaurants among Chinese adolescents), EE patterns might share significant similarities. The present study examined EE patterns of American college students and is a replication of the study done by He, Chen, Wu, Niu, and Fan (2020) on Chinese college students. Responses of 533 participants (60.4% women, 70.1% White, aged 18-52 (mean age = 18.75, SD = 1.35), mean self-reported body mass index = 24.22 kg/m2 and SD = 4.77) on the Adult Eating Behavior Questionnaire (Emotional overeating and emotional undereating subscales) were examined using Latent Class Analysis to identify specific patterns of EE. Participants also completed questionnaire measures of disordered eating and associated psychosocial impairment, depression, stress, and anxiety symptoms, and a measure of psychological flexibility. A solution with four classes emerged, i.e., emotional over- and undereating (18.3%), emotional overeating (18.2%), emotional undereating (27.8%), and non-emotional eating (35.7%). Current findings replicated and extended findings from He, Chen, et al. (2020) in that the emotional over- and undereating class exhibited the highest risks for depression, anxiety, stress, and psychosocial impairment due to disordered eating symptoms as well as lower psychological flexibility. Individuals who have difficulty with awareness and acceptance of their emotions appear to engage in the most problematic form of EE and could benefit from Dialectical behavior therapy and Acceptance and commitment therapy skills training.
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Murray JH, Burgio AL, Beretta M, Hargett SR, Harris TE, Olzomer E, Grams RJ, Garcia CJ, Li C, Salamoun JM, Hoehn KL, Santos WL. Oxadiazolopyridine Derivatives as Efficacious Mitochondrial Uncouplers in the Prevention of Diet-Induced Obesity. J Med Chem 2023; 66:3876-3895. [PMID: 36882080 PMCID: PMC10167758 DOI: 10.1021/acs.jmedchem.2c01573] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Small-molecule mitochondrial uncouplers are gaining recognition as potential therapeutics for metabolic diseases such as obesity, diabetes, and nonalcoholic steatohepatitis (NASH). Specifically, heterocycles derived from BAM15, a potent and mitochondria-selective uncoupler, have yielded promising preclinical candidates that are efficacious in animal models of obesity and NASH. In this study, we report the structure-activity relationship studies of 6-amino-[1,2,5]oxadiazolo[3,4-b]pyridin-5-ol derivatives. Using oxygen consumption rate as a readout of mitochondrial uncoupling, we established 5-hydroxyoxadiazolopyridines as mild uncouplers. In particular, SHM115, which contains a pentafluoro aniline, had an EC50 value of 17 μM and exhibited 75% oral bioavailability. SHM115 treatment increased the energy expenditure and lowered the body fat mass in two diet-induced obesity mouse models, including an obesity prevention model and an obesity reversal model. Taken together, our findings demonstrate the therapeutic potential of mild mitochondrial uncouplers for the prevention of diet-induced obesity.
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Affiliation(s)
- Jacob H Murray
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Ariel L Burgio
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Martina Beretta
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, New South Wales 2033, Australia
| | - Stefan R Hargett
- Department of Pharmacology, University of Virginia, Charlottesville, Virginia 22908, United States
| | - Thurl E Harris
- Department of Pharmacology, University of Virginia, Charlottesville, Virginia 22908, United States
| | - Ellen Olzomer
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, New South Wales 2033, Australia
| | - R Justin Grams
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Christopher J Garcia
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Catherine Li
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, New South Wales 2033, Australia
| | - Joseph M Salamoun
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Kyle L Hoehn
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, New South Wales 2033, Australia
- Department of Pharmacology, University of Virginia, Charlottesville, Virginia 22908, United States
| | - Webster L Santos
- Department of Chemistry and Virginia Tech Center for Drug Discovery, Virginia Tech, Blacksburg, Virginia 24061, United States
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Gaskell C, Sarada P, Aleem E, Bendriss G. Identifying lifestyle factors associated to co-morbidity of obesity and psychiatric disorders, a pilot study. Front Public Health 2023; 11:1132994. [PMID: 37206863 PMCID: PMC10188954 DOI: 10.3389/fpubh.2023.1132994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/13/2023] [Indexed: 05/21/2023] Open
Abstract
Obesity and psychiatric disorders are linked through a bidirectional association. Obesity rates have tripled globally in the past decades, and it is predicted that by 2025, one billion people will be affected by obesity, often with a co-morbidity such as depression. While this co-morbidity seems to be a global health issue, lifestyle factors associated to it differ between countries and are often attributed to more than one factor. Prior obesity studies were performed in Western populations; this is the first study that investigates lifestyle factors relating to obesity and mental health of the diverse population in Qatar, a country that has witnessed tremendous lifestyle change in a short time. In this pilot study, we surveyed 379 respondents to assess and compare the lifestyles of Qatar residents to the global population. However due to the high proportion of responses from the United Kingdom (UK) residents, we have made comparisons between Qatar residents and UK residents. We used chi-square analysis, spearman rank correlation and logistic regression to compare the lifestyle factors of individuals suffering from both increased BMI and mental health conditions. The types of food consumed, stress, exercise frequency and duration, alcohol and tobacco consumption, and sleep duration, were explored and results argue that different lifestyle factors can contribute to the same health condition, suggesting different mechanisms involved. We found that both groups reported similar sleep durations (p = 0.800), but that perception of sleep (p = 0.011), consumption of alcohol (p = 0.001), consumption of takeaway food (p = 0.007), and physical activity significantly varied between the groups (p = 0.0001). The study examined the predictors of comorbidity in Qatar as well as UK populations using multivariate logistic regression analysis. The result of the study showed no statistical association between comorbidity and the predictors drinking habit, smoking, physical activity, vegetable consumption, eat outs, and sleep perception for the Qatar population, and for the combined population. This study, however showed a significant association (p = 0.033) between sleep perception and comorbidity for the UK population. We conclude that further analysis is needed to understand the relationship between specific lifestyle factors and multimorbidity in each country.
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Affiliation(s)
| | | | - Eiman Aleem
- Biomedical Science, London South Bank University, London, United Kingdom
| | - Ghizlane Bendriss
- Premedical Division, Weill Cornell Medicine, Ar-Rayyan, Qatar
- *Correspondence: Ghizlane Bendriss,
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Leonardi B, Forte S, Natale G, Messina G, Rainone A, Opromolla G, Puca MA, Grande M, Martone M, Leone F, Fiorito R, Molino F, Liguori G, Russo F, Ferraro F, Pace MC, Molino A, Ferrante L, Forte M, Vicidomini G, Fiorelli A. One-lung ventilation in obese patients undergoing thoracoscopic lobectomy for lung cancer. Thorac Cancer 2022; 14:281-288. [PMID: 36479830 PMCID: PMC9870737 DOI: 10.1111/1759-7714.14747] [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: 10/08/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We evaluated the safety and feasibility of one-lung ventilation in obese patients undergoing thoracoscopic lobectomy and whether obesity affected peri- and postoperative outcomes. METHODS This was a retrospective single center study including consecutive patients undergoing thoracoscopic lobectomy between October 2019 and February 2022. Obese patients were statistically compared to a control group to evaluate any differences in relation to one-lung ventilation and peri- and postoperative outcomes. RESULTS Our study population included 111 patients; of these, 26 (23%) were included in the obese group, while 85 (77%) were included within the nonobese group. To obtain one-lung ventilation in nonobese patients, a double-lumen tube was more frequently used than a single-lumen tube with bronchial blocker (61% vs. 39%; p = 0.02), while in obese patients a single-lumen tube with bronchial blocker was used more than a double-lumen tube (81% vs. 19%, p = 0.001). Intergroup comparison showed that a double-lumen tube was the preferred method in nonobese patients, while a single-lumen tube with bronchial blockers was the strategy of choice in obese patients (p = 0.0002). Intubation time was longer in the obese group than in the nonobese group (94.0 ± 6.1 vs. 85.0 ± 7.0 s; p = 0.0004) and failure rate of first attempt at intubation was higher in the obese group (23% vs. 5%; p = 0.01). Obesity was not associated with increased intra-, peri- and postoperative complications and/or mortality. CONCLUSIONS One-lung ventilation is a feasible and safe procedure also in obese patients and obesity did not negatively affect peri- and postoperative outcomes after lung resection.
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Affiliation(s)
- Beatrice Leonardi
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | | | - Giovanni Natale
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Gaetana Messina
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Anna Rainone
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Giorgia Opromolla
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | | | - Mario Grande
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Mario Martone
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Francesco Leone
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Roberta Fiorito
- Anaestesiology UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Francesca Molino
- Anaestesiology UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | | | - Fara Russo
- Anaestesiology UnitVilla Malta HospitalSarnoItaly
| | - Fausto Ferraro
- Anaestesiology UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | | | | | - Luigi Ferrante
- Anaestesiology UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Mauro Forte
- Anaestesiology UnitUniversity of Campania Luigi VanvitelliNaplesItaly
| | | | - Alfonso Fiorelli
- Thoracic Surgery UnitUniversity of Campania Luigi VanvitelliNaplesItaly
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Obesity Classification of the Body Mass Index Does Not Predict Participation Restrictions at Work. J Occup Environ Med 2022; 64:e833-e838. [PMID: 36136664 DOI: 10.1097/jom.0000000000002712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective was to explore the differences of the three body mass index (BMI) obesity classes regarding sociodemographic data, medical and psychological well-being, but especially participation restrictions at work. METHODS A specialist in psychosomatic medicine reported on the health and occupational status of 190 patients (BMI >30), who were treated as inpatients in a psychosomatic rehabilitation unit. RESULTS Significant increases in severity or work limitations were found for higher BMI groups concerning metabolic, cardiologic, and orthopedic comorbidity. There were no differences regarding indicators of occupational participation. Independent of the obesity status, about three quarters were seen as fit for work. CONCLUSIONS The initial hypothesis is rejected, as no difference concerning objective parameters of work participation were found between the BMI classes. The data suggest that BMI class I to BMI class III do not allow predictions of the ability to work.
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Obesity in Latinx and White U.S. military veterans: prevalence, physical health, and functioning. J Psychiatr Res 2022; 155:163-170. [PMID: 36030571 DOI: 10.1016/j.jpsychires.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE While Latinx Americans in the general population are more likely to have obesity than non-Hispanic Whites, limited research has examined ethnic differences in obesity and its correlates among military veterans. To address this gap, we examined the prevalence, physical health and functional correlates of obesity in a population-based sample of Latinx and White U.S. military veterans. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of veterans. Bivariate and multivariate analyses were conducted to evaluate the relation between obesity, and health and functioning measures in Latinx and White veterans. RESULTS The prevalence of obesity was significantly higher among Latinx veterans (weighted 43.6% vs. 35.5%; odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.10-1.81). While obesity was associated with a greater number of medical conditions, reduced functioning, higher somatic symptoms, and insomnia severity in both Latinx and White veterans, these differences were more pronounced in Latinx relative to White veterans, with higher rates of arthritis, liver disease, diabetes, high blood pressure and cholesterol, heart attack, stroke, migraine, and physical disability, and greater physical, mental, and psychosocial dysfunction. CONCLUSION Obesity is more prevalent in Latinx than in White U.S. veterans, and the associated elevated health and functional impairments are more pronounced in Latinx veterans. Characterization of co-occurring physical and functioning problems among Latinx and White veterans with obesity may help inform ethnically-sensitive obesity prevention and treatment efforts in this population.
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The Association of Waist Circumference with the Prevalence and Survival of Digestive Tract Cancer in US Adults: A Population Study Based on Machine Learning Methods. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2492488. [PMID: 36245841 PMCID: PMC9562134 DOI: 10.1155/2022/2492488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022]
Abstract
Aims This paper aims to investigate the relationship of waist circumference (WC) with digestive tract cancer morbidity and mortality. Methods Based on the data from a nationally representative US population survey, we summarized the prevalence of digestive tract cancer and all-cause mortality of cancer patients across WC quartiles. Adjusted logistic regression and restricted spline curve were used to analyze WC and the prevalence of digestive tract cancer. Moreover, Cox regression and the Kaplan-Meier curve were applied to investigate the association of WC with all-cause mortality. We also attempted to make a model to predict cancer happening. Results This paper included a total of 34,041 participants, with digestive tract cancer observed in 265 (0.7%) individuals. WC was positively associated with digestive tract cancer morbidity after full adjustment of covariates (OR: 1.72 and 95% CI: 1.41-2.10). Also, individuals in the highest WC group had a higher risk of digestive tract cancer (Q4, OR: 2.71 and 95% CI: 1.48-5.00). Moreover, no significant association was observed in upper digestive cancer, and WC was associated with a longer survival time once diagnosed (hazard ratio (HR): 0.50 and 95% CI: 0.28-0.92). Finally, the model we made proved to be effective. Conclusion High WC is a risk factor for digestive tract cancer with or without adjusting for body mass index, especially those located in the lower digestive tract. However, once digestive tract cancer has been diagnosed, patients with higher WC showed better survival outcomes. Moreover, machine learning methods can be used to predict digestive tract cancer risk in the future.
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Su SC, Chien CY, Chen YC, Chiang CF, Lin FH, Kuo FC, Huang CL, Li PF, Liu JS, Lu CH, Ho LJ, Hsieh CH, Hung YJ, Shieh YS, Lee CH. PDIA4, a novel ER stress chaperone, modulates adiponectin expression and inflammation in adipose tissue. Biofactors 2022; 48:1060-1075. [PMID: 35674710 DOI: 10.1002/biof.1872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/15/2022] [Indexed: 12/13/2022]
Abstract
Increasing evidence supporting a causal link between obesity and endoplasmic reticulum (ER) stress in adipose tissue is being reported. Protein disulfide isomerase 4 (PDIA4) is a novel ER chaperone involved in the pancreatic β-cells pathogenesis in diabetes. However, the role of PDIA4 in obesity progression remains poorly understood. To assess the relationship between PDIA4, adiponectin, and metformin, we used the palmitate-induced inflammation in hypertrophic adipocytes and the high-fat diet-induced obesity mouse model. Our results revealed that palmitate-induced hypertrophic adipocytes exhibit obesity-associated conditions such as increased lipid accumulation, inflammation, and reduced glucose uptake. Pharmacological and genetic inhibition of PDIA4 significantly reverses these obesity-associated conditions in adipocytes. PDIA4 mechanistically promotes obesity progression via adiponectin downregulation. Furthermore, metformin modulates PDIA4 and adiponectin expression and improves obesity-associated conditions in both in vitro adipocytes and in vivo mouse models. Serum PDIA4 concentrations are also associated with body mass index, adiponectin, triglycerides, and inflammatory cytokines in humans. This is the first study demonstrating that PDIA4 modulates adipocytes by downregulating adiponectin. Moreover, metformin may serve as a potential therapeutic for preventing obesity via PDIA4-targeting.
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Affiliation(s)
- Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chu-Yen Chien
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Ying-Chen Chen
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Fu Chiang
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Luen Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Peng-Fei Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Li-Ju Ho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department and Graduate Institute of Biochemistry, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Shing Shieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
- Department and Graduate Institute of Biochemistry, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department and Graduate Institute of Biochemistry, National Defense Medical Center, Taipei, Taiwan
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Nnorom SO, Wilson LL. Breast Cancer in Black Women: Racial/Ethnic Disparities Affecting Survival. J Womens Health (Larchmt) 2022; 31:1255-1261. [PMID: 35230169 DOI: 10.1089/jwh.2021.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Breast cancer is the most common noncutaneous malignancy affecting women in the United States, with >245,000 cases diagnosed annually. Breast cancer mortality rates have continued to trend down in the past three decades, yet racial/ethnic disparities persist, with the worst mortality rates seen in Black women. Of note, when compared by race, this downward trend is also trailing in Black women. Survival after breast cancer is mainly driven by factors related to early detection and effective therapy. These factors can be grouped into "biological" such as age, genetic mutations, tumor characteristics; and "social" such as education, income, access to care. There have been studies attributing racial disparities solely to biological factors, and there are those attributing the disparities to social factors alone. Although the exact mechanism is unclear, a relationship between both factors as relates to racial disparities in breast cancer outcomes has been demonstrated. In this report, we review factors contributing to the increased morbidity and mortality for breast cancer in Black women and explore sociological relationships. Facing the worst poverty rates compared with other races, Black women are inevitably more likely to be uninsured, have limited access to quality education, and have fewer financial resources. The goal of this review was to elucidate the complex interplay between biological and social factors contributing to racial disparities in breast cancer outcomes. We conclude by emphasizing the need for interventions made at both local and national levels.
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Affiliation(s)
- Siobhan O Nnorom
- Clive O. Callender Health Sciences Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Lori L Wilson
- Clive O. Callender Health Sciences Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia, USA
- Division of Surgical Oncology, Department of Surgery, Howard University Hospital, Washington, District of Columbia, USA
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Lee M, Geitgey DK, Hamilton JAG, Boss JM, Scharer CD, Spangle JM, Haynes KA, Henry CJ. Adipocyte-mediated epigenomic instability in human T-ALL cells is cytotoxic and phenocopied by epigenetic-modifying drugs. Front Cell Dev Biol 2022; 10:909557. [PMID: 36060800 PMCID: PMC9438935 DOI: 10.3389/fcell.2022.909557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
The world’s population with obesity is reaching pandemic levels. If current trends continue, it is predicted that there will be 1.5 billion people with obesity by 2030. This projection is alarming due to the association of obesity with numerous diseases including cancer, with recent studies demonstrating a positive association with acute myeloid leukemia (AML) and B cell acute lymphoblastic leukemia (B-ALL). Interestingly, several epidemiological studies suggest the converse relationship may exist in patients with T cell acute lymphoblastic leukemia (T-ALL). To determine the relationship between obesity and T-ALL development, we employed the diet-induced obesity (DIO) murine model and cultured human T-ALL cells in adipocyte-conditioned media (ACM), bone marrow stromal cell-conditioned media, stromal conditioned media (SCM), and unconditioned media to determine the functional impact of increased adiposity on leukemia progression. Whereas only 20% of lean mice transplanted with T-ALL cells survived longer than 3 months post-inoculation, 50%–80% of obese mice with leukemia survived over this same period. Furthermore, culturing human T-ALL cells in ACM resulted in increased histone H3 acetylation (K9/K14/K18/K23/K27) and methylation (K4me3 and K27me3) posttranslational modifications (PTMs), which preceded accelerated cell cycle progression, DNA damage, and cell death. Adipocyte-mediated epigenetic changes in human T-ALL cells were recapitulated with the H3K27 demethylase inhibitor GSK-J4 and the pan-HDAC inhibitor vorinostat. These drugs were also highly cytotoxic to human T-ALL cells at low micromolar concentrations. In summary, our data support epidemiological studies demonstrating that adiposity suppresses T-ALL pathogenesis. We present data demonstrating that T-ALL cell death in adipose-rich microenvironments is induced by epigenetic modifications, which are not tolerated by leukemia cells. Similarly, GSK-J4 and vorinostat treatment induced epigenomic instability and cytotoxicity profiles that phenocopied the responses of human T-ALL cells to ACM, which provides additional support for the use of epigenetic modifying drugs as a treatment option for T-ALL.
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Affiliation(s)
- Miyoung Lee
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Delaney K. Geitgey
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Jamie A. G. Hamilton
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Jeremy M. Boss
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, United States
| | - Christopher D. Scharer
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, United States
| | - Jennifer M. Spangle
- Winship Cancer Institute, Atlanta, GA, United States
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, United States
| | - Karmella A. Haynes
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Curtis J. Henry
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA, United States
- Winship Cancer Institute, Atlanta, GA, United States
- *Correspondence: Curtis J. Henry,
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Ribeiro FM, Silva MA, Lyssa V, Marques G, Lima HK, Franco OL, Petriz B. The molecular signaling of exercise and obesity in the microbiota-gut-brain axis. Front Endocrinol (Lausanne) 2022; 13:927170. [PMID: 35966101 PMCID: PMC9365995 DOI: 10.3389/fendo.2022.927170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is one of the major pandemics of the 21st century. Due to its multifactorial etiology, its treatment requires several actions, including dietary intervention and physical exercise. Excessive fat accumulation leads to several health problems involving alteration in the gut-microbiota-brain axis. This axis is characterized by multiple biological systems generating a network that allows bidirectional communication between intestinal bacteria and brain. This mutual communication maintains the homeostasis of the gastrointestinal, central nervous and microbial systems of animals. Moreover, this axis involves inflammatory, neural, and endocrine mechanisms, contributes to obesity pathogenesis. The axis also acts in appetite and satiety control and synthesizing hormones that participate in gastrointestinal functions. Exercise is a nonpharmacologic agent commonly used to prevent and treat obesity and other chronic degenerative diseases. Besides increasing energy expenditure, exercise induces the synthesis and liberation of several muscle-derived myokines and neuroendocrine peptides such as neuropeptide Y, peptide YY, ghrelin, and leptin, which act directly on the gut-microbiota-brain axis. Thus, exercise may serve as a rebalancing agent of the gut-microbiota-brain axis under the stimulus of chronic low-grade inflammation induced by obesity. So far, there is little evidence of modification of the gut-brain axis as a whole, and this narrative review aims to address the molecular pathways through which exercise may act in the context of disorders of the gut-brain axis due to obesity.
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Affiliation(s)
- Filipe M. Ribeiro
- Post-Graduation Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil
- Center for Proteomic and Biochemical Analysis, Post-Graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
- Laboratory of Molecular Exercise Physiology - University Center of the Federal District - UDF, Brasilia, Brazil
| | - Maycon A. Silva
- Center for Proteomic and Biochemical Analysis, Post-Graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
| | - Victória Lyssa
- Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, University of Brasilia, Brasilia, Brazil
| | - Gabriel Marques
- Laboratory of Molecular Exercise Physiology - University Center of the Federal District - UDF, Brasilia, Brazil
| | - Henny K. Lima
- Center for Proteomic and Biochemical Analysis, Post-Graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
| | - Octavio L. Franco
- Post-Graduation Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil
- Center for Proteomic and Biochemical Analysis, Post-Graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
- S-Inova Biotech, Catholic University Dom Bosco, Biotechnology Program, Campo Grande, Brazil
| | - Bernardo Petriz
- Center for Proteomic and Biochemical Analysis, Post-Graduation in Genomic and Biotechnology Sciences, Catholic University of Brasilia, Brasília, Brazil
- Laboratory of Molecular Exercise Physiology - University Center of the Federal District - UDF, Brasilia, Brazil
- Postgraduate Program in Rehabilitation Sciences - University of Brasília, Brasília, Brazil
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A technology assisted precision ketogenic diet intervention for cardio-renal-metabolic health in overweight or obese adults: Protocol for a randomized controlled trial. Contemp Clin Trials 2022; 119:106845. [PMID: 35809772 DOI: 10.1016/j.cct.2022.106845] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 06/09/2022] [Accepted: 06/29/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The obesity epidemic is a public health concern, as it is associated with a variety of chronic conditions. The ketogenic diet has drawn much scientific and public attention. However, implementation is challenging and its effect on cardio-renal-metabolic health is inconclusive. This study will assess the feasibility, acceptability, and preliminary efficacy of a technology-assisted ketogenic diet on cardio-renal-metabolic health. METHODS This is a single center, 6-month, stratified, randomized controlled trial. A total of 60 overweight/obese adults (18+ years old) will be enrolled, including 20 without type 2 diabetes (T2D) and without chronic kidney disease (CKD); 20 with T2D, but without CKD; and 20 with early-stage CKD. Participants will be stratified based on health conditions and randomized into a ketogenic diet (n = 30) or a low-fat diet group (n = 30). Health education involving diet and physical activity will be delivered both digitally and in-person. Mobile and connected health technologies will be used to track lifestyle behaviors and health indicators, as well as provide weekly feedback. The primary outcome (weight) and the secondary outcomes (e.g., blood pressure, glycemic control, renal health) will be assessed with traditional measurements and metabolomics. DISCUSSION Mobile and connected health technologies provide new opportunities to improve chronic condition management, health education attendance, planned lifestyle changes and engagement, and health outcomes. The advancement of bioinformatics technology offers the possibility to profile and analyze omics data which may advance our understanding of the underlying mechanisms of intervention effects on health outcomes at the molecular level for personalized and precision lifestyle interventions.
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Jacoby H, Ross S, Sucandy I, Syblis C, Crespo K, Johnson L, Rosemurgy A. The Effect of Body Mass Index on Robotic Transhiatal Esophagectomy for Esophageal Adenocarcinoma. Am Surg 2022; 88:2204-2209. [PMID: 35694911 DOI: 10.1177/00031348221086786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Houlder K, Mocanu V, Verhoeff K, Marcil G, Birch DW, Karmali S, Switzer NJ. Trends, Outcomes, and Impact of Early Discharge Following Bariatric Surgery: a Retrospective MBSAQIP Analysis of 748,955 Patients. Obes Surg 2022; 32:2572-2581. [PMID: 35619047 DOI: 10.1007/s11695-022-06108-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Decreasing the length of stay following bariatric surgery can reduce pressure on hospitals and surgical costs and increase patient satisfaction. We examine trends in length of hospital stay following bariatric surgery and in post-operative complications. METHODS AND PROCEDURES The 2015-2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was used to compile patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy. Patients were categorized into either early discharge (within one day of surgery) or late discharge, and patient and non-patient factors were compared between the two groups. A multivariable logistic regression was carried out to determine predictive factors for early discharge. RESULTS We evaluated 748,955 patients, with 399,918 (53%) being discharged early. Patients discharged early were younger and had fewer associated medical problems. The rate of early discharge increased between 2015 and 2019 (42.1% in 2015 vs 62.0% in 2019), while complication rates decreased or were unchanged. Multivariable analysis revealed lower ASA classification (OR 1.07; CI 1.06-1.09; p < 0.0001) and operative year (2019 vs. 2015 OR 2.26; CI 2.22-2.29; p < 0.0001) to be independently associated with early discharge. Several factors including undergoing RYGB (OR 0.44 CI 0.44-0.45; p < 0.0001), and dialysis dependence (OR 0.50; CI 0.45-0.55; p < 0.0001) among others, were associated with reduced early discharge likelihood. CONCLUSIONS There is a trend in bariatric surgery towards the practice of early discharge, which is safe for patients. Further work is needed to develop a set of criteria to determine which patients are best suited for this practice.
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Affiliation(s)
- Kieryn Houlder
- Faculty of Medicine and Dentistry, University of Alberta, University of Alberta Hospital, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada.
| | - Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Kevin Verhoeff
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Gabriel Marcil
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Daniel W Birch
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Noah J Switzer
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
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Kujawska A, Kujawski S, Kozakiewicz M, Hajec W, Kwiatkowska M, Skierkowska N, Husejko J, Newton JL, Zalewski P, Kędziora-Kornatowska K. Adipokines Level and Cognitive Function-Disturbance in Homeostasis in Older People with Poorly Managed Hypertension: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116467. [PMID: 35682051 PMCID: PMC9180904 DOI: 10.3390/ijerph19116467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Aim: To explore the network relationship between cognitive function, depressive symptom intensity, body composition, proxies of cognitive reserve, trophic factor, adipokines and myokines, physical performance and blood pressure in a group of older people with poorly managed hypertension (PMHTN) compared to a normotensive (NTN) group. Materials and methods: History of hypertension and blood pressure level were examined in older participants. Thirty-one subjects diagnosed with PMHTN (history of hypertension diagnosis and values of sBP or dBP over 140/90 mmHg) and eighteen NTN (lack of history of hypertension and sBP and dBP lower than 140/90 mmHg) participated. Participants completed physical and cognitive function assessments: including the Mini–Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and its two subtests Delayed Recall (DR) and Verbal Fluency (VF) and Trail Making Test Part B (TMT B). Factors associated with cognitive functioning: age, years of education, cognitive and travel activity were assessed using a questionnaire. Visceral fat was determined by bioimpedance testing and gait velocity and agility assessed using an Up and Go test. To summarize the strength and direction (negative or positive) of a relationship between two variables, Spearman’s rank correlation coefficient was used. Then, network graphs were created to illustrate the relationship between variables. Node strength (number of edges per node), neighbourhood connectivity (the average connectivity of all the neighbours of a node), stress (the number of shortest paths passing through each node) were compared in network from PMHTN group to network from NTN group. Results: Neighbourhood connectivity and stress were significantly higher in of the PMHTN network compared to NTN (6.03 ± 1.5 vs. 4.23 ± 2.5, p = 0.005 and 118.21 ± 137.6 vs. 56.87 ± 101.5, p = 0.02, accordingly). Conclusion: In older subjects with poorly managed hypertension, dyshomeostasis was observed, compared to normotensive subjects.
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Affiliation(s)
- Agnieszka Kujawska
- Department of Human Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland
- Correspondence:
| | - Sławomir Kujawski
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Świętojańska 20, 85-077 Bydgoszcz, Poland; (S.K.); (P.Z.)
| | - Mariusz Kozakiewicz
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
| | - Weronika Hajec
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
| | - Małgorzata Kwiatkowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
| | - Natalia Skierkowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
| | - Jakub Husejko
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
| | - Julia L. Newton
- Population Health Sciences Institute, The Medical School, Newcastle University, Newcastle-Upon-Tyne NE2 4AX, UK;
| | - Paweł Zalewski
- Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun, Świętojańska 20, 85-077 Bydgoszcz, Poland; (S.K.); (P.Z.)
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Warsaw Medical University, 1b Banacha Street, 02-097 Warsaw, Poland
| | - Kornelia Kędziora-Kornatowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland; (M.K.); (W.H.); (M.K.); (N.S.); (J.H.); (K.K.-K.)
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Samaan JS, Srinivasan N, Mirocha J, Premkumar A, Toubat O, Qian E, Subramanyam C, Malik Y, Lee N, Sandhu K, Dobrowolsky A, Samakar K. Association of Postoperative Dieting, Exercise, Dietitian, and Surgeon Follow up With Bariatric Surgery Outcomes. Am Surg 2022; 88:2445-2450. [PMID: 35575161 DOI: 10.1177/00031348221101491] [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: 01/09/2023]
Abstract
Although postoperative diet modification, exercise, and regular dietitian and surgeon follow-up are often recommended after bariatric surgery (BS), their impact on weight loss is unclear. A Retrospective chart review was conducted for patients who received sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) between August 2000 and November 2017 with telephone follow-up. Multivariable logistic regression models were used for analyses. There were 514 patients included in our study. Most were female (76.3%), mean age was 46.9 years (Standard Deviation [SD] = 11.8), and mean weight loss was 11.6 (SD = 6.5) BMI points at a mean follow-up of 7 years (SD = 4.3). Current surgeon follow-up OR = 2.08 (P < .01) was positively associated with postoperative weight loss, while current dietitian follow-up=OR .41 (P < .01) was negatively associated. Current weight loss supplement use OR = .45 (P = .03) was associated with reduced willingness to undergo surgery again. Increasing preoperative BMI OR = 1.06 (P = .04) and increasing age OR = 1.04 (P = .02) were associated with improved quality of life (QoL) due to BS. Lack of surgeon follow-up and regular dietician consultation was associated with suboptimal weight loss after BS. Older age was positively associated with improved QoL, while current weight loss supplement use was associated with lower likelihood of undergoing surgery again, both independent of weight loss.
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Affiliation(s)
- Jamil S Samaan
- Department of Medicine, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nitin Srinivasan
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - James Mirocha
- Cedars-Sinai Medical Center, Biostatistics and Bioinformatics Research Center, Los Angeles, CA, USA
| | - Agnes Premkumar
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Omar Toubat
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Elaine Qian
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Chaitra Subramanyam
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Yousaf Malik
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Nayun Lee
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kulmeet Sandhu
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Adrian Dobrowolsky
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kamran Samakar
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Lustig RH, Collier D, Kassotis C, Roepke TA, Ji Kim M, Blanc E, Barouki R, Bansal A, Cave MC, Chatterjee S, Choudhury M, Gilbertson M, Lagadic-Gossmann D, Howard S, Lind L, Tomlinson CR, Vondracek J, Heindel JJ. Obesity I: Overview and molecular and biochemical mechanisms. Biochem Pharmacol 2022; 199:115012. [PMID: 35393120 PMCID: PMC9050949 DOI: 10.1016/j.bcp.2022.115012] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 02/06/2023]
Abstract
Obesity is a chronic, relapsing condition characterized by excess body fat. Its prevalence has increased globally since the 1970s, and the number of obese and overweight people is now greater than those underweight. Obesity is a multifactorial condition, and as such, many components contribute to its development and pathogenesis. This is the first of three companion reviews that consider obesity. This review focuses on the genetics, viruses, insulin resistance, inflammation, gut microbiome, and circadian rhythms that promote obesity, along with hormones, growth factors, and organs and tissues that control its development. It shows that the regulation of energy balance (intake vs. expenditure) relies on the interplay of a variety of hormones from adipose tissue, gastrointestinal tract, pancreas, liver, and brain. It details how integrating central neurotransmitters and peripheral metabolic signals (e.g., leptin, insulin, ghrelin, peptide YY3-36) is essential for controlling energy homeostasis and feeding behavior. It describes the distinct types of adipocytes and how fat cell development is controlled by hormones and growth factors acting via a variety of receptors, including peroxisome proliferator-activated receptor-gamma, retinoid X, insulin, estrogen, androgen, glucocorticoid, thyroid hormone, liver X, constitutive androstane, pregnane X, farnesoid, and aryl hydrocarbon receptors. Finally, it demonstrates that obesity likely has origins in utero. Understanding these biochemical drivers of adiposity and metabolic dysfunction throughout the life cycle lends plausibility and credence to the "obesogen hypothesis" (i.e., the importance of environmental chemicals that disrupt these receptors to promote adiposity or alter metabolism), elucidated more fully in the two companion reviews.
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Affiliation(s)
- Robert H Lustig
- Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, CA 94143, United States
| | - David Collier
- Brody School of Medicine, East Carolina University, Greenville, NC 27834, United States
| | - Christopher Kassotis
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, United States
| | - Troy A Roepke
- School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ 08901, United States
| | - Min Ji Kim
- Department of Biochemistry and Toxicology, University of Paris, INSERM U1224 (T3S), 75006 Paris, France
| | - Etienne Blanc
- Department of Biochemistry and Toxicology, University of Paris, INSERM U1224 (T3S), 75006 Paris, France
| | - Robert Barouki
- Department of Biochemistry and Toxicology, University of Paris, INSERM U1224 (T3S), 75006 Paris, France
| | - Amita Bansal
- College of Health & Medicine, Australian National University, Canberra, Australia
| | - Matthew C Cave
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY 40402, United States
| | - Saurabh Chatterjee
- Environmental Health and Disease Laboratory, University of South Carolina, Columbia, SC 29208, United States
| | - Mahua Choudhury
- College of Pharmacy, Texas A&M University, College Station, TX 77843, United States
| | - Michael Gilbertson
- Occupational and Environmental Health Research Group, University of Stirling, Stirling, Scotland, United Kingdom
| | - Dominique Lagadic-Gossmann
- Research Institute for Environmental and Occupational Health, University of Rennes, INSERM, EHESP, Rennes, France
| | - Sarah Howard
- Healthy Environment and Endocrine Disruptor Strategies, Commonweal, Bolinas, CA 92924, United States
| | - Lars Lind
- Department of Medical Sciences, University of Uppsala, Uppsala, Sweden
| | - Craig R Tomlinson
- Norris Cotton Cancer Center, Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, United States
| | - Jan Vondracek
- Department of Cytokinetics, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic
| | - Jerrold J Heindel
- Healthy Environment and Endocrine Disruptor Strategies, Commonweal, Bolinas, CA 92924, United States.
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Chandratre SR, Smith NJ, Walsh RW, Kindel T, Sundararajan SK, Joyce DL, Mohammed A. Isolated Left Ventricular Assist Device Implantation Produces Variable Changes to Patient Body Mass Index. Artif Organs 2022; 46:1597-1607. [PMID: 35261065 PMCID: PMC9256767 DOI: 10.1111/aor.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Body Mass Index (BMI) is an important consideration for transplant-eligible Left Ventricular Assist Device (LVAD) recipients. LVAD therapy's impact on BMI is unclear. We evaluated BMI changes in patients who underwent LVAD implantation. The association between these patients' BMI and transplant was studied. METHODS This was a retrospective cohort study of patients who underwent LVAD implantation between January 1, 2012-December 31, 2018 at our institution. Patients were stratified by preoperative BMI (kg/m2 ) into 4 groups: < 30, 30-34.9, 34.9-39.9, and ≥40. BMI data was collected at 12 and 6 months prior to implant, time of implantation, and 3- and 6- months post-implantation. RESULTS 107 patients underwent LVAD implantation at our institution. Data was available for 80 patients. Baseline characteristics included mean age 56.0 years, 69% male, and mean implant BMI 29.9 ± 6.8 kg/m2 . The mean BMI (kg/m2 ) with each of the BMI (kg/m2 ) groups <30, 30-34.9, 35-39.9, and ≥ 40 (n= 60, 25, 12, 10 respectively) was 25.1., 32.5, 36.8, and 43.8, respectively. There was no consistent pattern with weight change across differing implant BMIs. No patient with a BMI of <30 gained sufficient weight to impact transplant candidacy. 23% of patients with BMI of 30-34.9 kg/m2 , 60% of patients with a BMI 35-39.9 kg/m2 , and 87.5% of patients with a BMI of ≥40 had a 6-month BMI potentially affecting transplant. CONCLUSIONS Associated weight changes during LVAD support may significantly impact transplant candidacy. Higher BMI groups may benefit from multimodal and multidisciplinary targeted weight-loss interventions.
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Affiliation(s)
- Sonal R Chandratre
- Department of Pediatrics, Division of Pediatric Endocrinology, Aspirus Steven's Point Hospital, Aspirus Medical Group, Stevens Point, WI, USA
| | - Nathan J Smith
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Tammy Kindel
- Department of Surgery, Division of General Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sakthi K Sundararajan
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David L Joyce
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Asim Mohammed
- Department of Cardiovascular Disease, Lutheran Hospital, Fort Wayne, IN, USA
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Lee M, Hamilton JAG, Talekar GR, Ross AJ, Michael L, Rupji M, Dwivedi B, Raikar SS, Boss J, Scharer CD, Graham DK, DeRyckere D, Porter CC, Henry CJ. Obesity-induced galectin-9 is a therapeutic target in B-cell acute lymphoblastic leukemia. Nat Commun 2022; 13:1157. [PMID: 35241678 PMCID: PMC8894417 DOI: 10.1038/s41467-022-28839-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/11/2022] [Indexed: 12/25/2022] Open
Abstract
The incidence of obesity is rising with greater than 40% of the world’s population expected to be overweight or suffering from obesity by 2030. This is alarming because obesity increases mortality rates in patients with various cancer subtypes including leukemia. The survival differences between lean patients and patients with obesity are largely attributed to altered drug pharmacokinetics in patients receiving chemotherapy; whereas, the direct impact of an adipocyte-enriched microenvironment on cancer cells is rarely considered. Here we show that the adipocyte secretome upregulates the surface expression of Galectin-9 (GAL-9) on human B-acute lymphoblastic leukemia cells (B-ALL) which promotes chemoresistance. Antibody-mediated targeting of GAL-9 on B-ALL cells induces DNA damage, alters cell cycle progression, and promotes apoptosis in vitro and significantly extends the survival of obese but not lean mice with aggressive B-ALL. Our studies reveal that adipocyte-mediated upregulation of GAL-9 on B-ALL cells can be targeted with antibody-based therapies to overcome obesity-induced chemoresistance. Obesity has been reported to promote tumourigenesis and chemoresistance but the underlying mechanisms are not completely understood. Here, the authors show that adipocytes induce Galectin-9 (GAL-9) expression in B-acute lymphoblastic leukaemia (B-ALL) cells which leads to chemoresistance and antibody-mediated blockade of GAL-9 increases survival in preclinical B-ALL murine models.
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Affiliation(s)
- Miyoung Lee
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jamie A G Hamilton
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Ganesh R Talekar
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Anthony J Ross
- Riley Pediatric Cancer and Blood Diseases, Riley Children's Health, Indiana University School of Medicine, Indianapolis, Indiana, IN, USA
| | | | - Manali Rupji
- Bioinformatics and Biostatistics Shared Resource, Winship Cancer Institute, Atlanta, GA, USA
| | - Bhakti Dwivedi
- Bioinformatics and Biostatistics Shared Resource, Winship Cancer Institute, Atlanta, GA, USA
| | - Sunil S Raikar
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jeremy Boss
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher D Scharer
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA, USA
| | - Douglas K Graham
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Deborah DeRyckere
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Christopher C Porter
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Curtis J Henry
- Department of Pediatrics, Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
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Anti-obesity effects of heat-transformed green tea extract through the activation of adipose tissue thermogenesis. Nutr Metab (Lond) 2022; 19:14. [PMID: 35241108 PMCID: PMC8896087 DOI: 10.1186/s12986-022-00648-6] [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: 12/04/2021] [Accepted: 01/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Adipose tissue thermogenesis is a potential therapeutic target to increase energy expenditure and thereby combat obesity. The aim of the present study was to investigate the thermogenic and anti-obesity effects of heat-transformed green tea extract (HTGT) and enzymatically modified isoquercetin (EMIQ). Methods Immortalized brown pre-adipocytes and C3H10T1/2 cells were used for in vitro analyses. A high-fat diet (HFD)-induced obesity mouse model and CIDEA-reporter mice were used for in vivo experiments. The effects of HTGT and EMIQ on mitochondrial metabolism were evaluated by immunoblot, mitochondrial staining, and oxygen consumption rate analyses. In vivo anti-obesity effects of HTGT and EMIQ were measured using indirect calorimetry, body composition analyses, glucose tolerance tests, and histochemical analyses. Results Co-treatment with HTGT and EMIQ (50 μg/mL each) for 48 h increased brown adipocyte marker and mitochondrial protein levels (UCP1 and COXIV) in brown adipocytes by 2.9-fold, while the maximal and basal oxygen consumption rates increased by 1.57- and 1.39-fold, respectively. Consistently, HTGT and EMIQ treatment increased the fluorescence intensity of mitochondrial staining in C3H10T1/2 adipocytes by 1.68-fold. The combination of HTGT and EMIQ (100 mg/kg each) increased the expression levels of brown adipocyte markers and mitochondrial proteins in adipose tissue. Two weeks of HTGT and EMIQ treatment (100 mg/kg each) led to a loss of 3% body weight and 7.09% of body fat. Furthermore, the treatment increased energy expenditure by 8.95% and improved glucose tolerance in HFD-fed mice. Conclusions The current study demonstrated that HTGT and EMIQ have in vivo anti-obesity effects partly by increasing mitochondrial metabolism in adipocytes. Our findings suggest that a combination of HTGT and EMIQ is a promising therapeutic agent for the treatment of obesity and related metabolic diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12986-022-00648-6.
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Impact of Bariatric Surgery on Carotid Intima-Media Thickness in Patients with Morbid Obesity: a Prospective Study and Review of the Literature. Obes Surg 2022; 32:1563-1569. [PMID: 35237906 DOI: 10.1007/s11695-022-05976-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM One of the main causes of mortality among obese patients is cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is an independent predictor for atherosclerosis and risk of CVD, and has been demonstrated to be related with obesity. This study aimed to evaluate the effect of substantial weight loss after bariatric surgery on CIMT. METHODS This prospective study was performed on patients with morbid obesity and standard indications for bariatric surgery in a tertiary referral center in Iran. The mean CIMT values were assessed using B-mode ultrasonography before and 6 months after bariatric surgery. RESULTS A total of 32 patients (25 females, 7 males) with a mean age of 38.18 ± 1.18 years were enrolled. Body mass index (BMI) was significantly reduced from 43.66 ± 6.44 to 29.01 ± 2.56 kg/m2 during 6 months following surgery (p: 0.001). The mean CIMT values at 6 months after surgery were significantly lower than the baseline (0.53 ± 0.06 vs. 0.50 ± 0.08; p: 0.001). Along with a significant hypertension and metabolic syndrome remission, we observed considerable reduction in FBS (p: 0.019), cholesterol (p: 0.061), triglycerides (p: 0.001), and insulin levels (p: 0.001). Besides, liver stiffness was significantly decreased after surgery (6.15 ± 0.82 vs. 5.26 ± 0.83; p: 0.001). There was no statistically significant correlation between changes in quantitative variables and changes in CIMT. CONCLUSION Bariatric surgery results in significant reduction in CIMT, metabolic syndrome factors, and liver stiffness in patients with morbid obesity.
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Ewy MW, Patel A, Abdelmagid MG, Mohamed Elfadil O, Bonnes SL, Salonen BR, Hurt RT, Mundi MS. Plant-Based Diet: Is It as Good as an Animal-Based Diet When It Comes to Protein? Curr Nutr Rep 2022; 11:337-346. [DOI: 10.1007/s13668-022-00401-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 12/12/2022]
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Erichsen JM, Fadel JR, Reagan LP. Peripheral versus central insulin and leptin resistance: Role in metabolic disorders, cognition, and neuropsychiatric diseases. Neuropharmacology 2022; 203:108877. [PMID: 34762922 PMCID: PMC8642294 DOI: 10.1016/j.neuropharm.2021.108877] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/14/2021] [Accepted: 11/04/2021] [Indexed: 02/06/2023]
Abstract
Insulin and leptin are classically regarded as peptide hormones that play key roles in metabolism. In actuality, they serve several functions in both the periphery and central nervous system (CNS). Likewise, insulin and leptin resistance can occur both peripherally and centrally. Metabolic disorders such as diabetes and obesity share several key features including insulin and leptin resistance. While the peripheral effects of these disorders are well-known (i.e. cardiovascular disease, hypertension, stroke, dyslipidemia, etc.), the CNS complications of leptin and insulin resistance have come into sharper focus. Both preclinical and clinical findings have indicated that insulin and leptin resistance are associated with cognitive deficits and neuropsychiatric diseases such as depression. Importantly, these studies also suggest that these deficits in neuroplasticity can be reversed by restoration of insulin and leptin sensitivity. In view of these observations, this review will describe, in detail, the peripheral and central functions of insulin and leptin and explain the role of insulin and leptin resistance in various metabolic disorders, cognition, and neuropsychiatric diseases.
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Affiliation(s)
- Jennifer M Erichsen
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29208, USA.
| | - Jim R Fadel
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29208, USA
| | - Lawrence P Reagan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, 29208, USA; Columbia VA Health Care System, Columbia, SC, 29208, USA
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Mir IA, Soni R, Srivastav SK, Bhavya I, Dar WQ, Farooq MD, Chawla V, Nadeem M. Obesity as an Important Marker of the COVID-19 Pandemic. Cureus 2022; 14:e21403. [PMID: 35198310 PMCID: PMC8856632 DOI: 10.7759/cureus.21403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction: In December 2019, the emergence of the new coronavirus disease 2019 (COVID-19) began in Wuhan, China. Thereafter, the disease has been spreading rapidly across the world, with about 300 million registered cases worldwide, and the numbers are also exponentially increasing in India, with about 34 million registered cases by the end of 2021. Among the comorbidities, obesity may increase the risk of hospitalization due to COVID-19 infection as it is related to immune system dysfunction. Since the epidemiological picture of COVID-19 is changing very rapidly. Therefore, it is very important to discuss the pattern of clinical manifestation and association with comorbidities. Hence, we have conducted this observational study in one of the tertiary care centers in North India. Methods and Materials: We conducted a hospital-based prospective observational study in dedicated COVID-19 wards and ICU of a tertiary care center in North India with a sample size of 400 positive patients (males: 260, females: 140). We divided the patients in this study into three different age groups (less than 40 years, 40-60 years, and more than 60 years). The patients with age ≤ 18 years and BMI 18.5 kg/m2 were excluded from the study. Results: Out of these 400 patients, 55 (13.8%) developed severe COVID-19. There was a fewer number of patients who developed severe COVID-19 in the normal and over-weight group. Moreover, obese patients progressed to more severe cases (34.5%). This also shows that after adjusting for age, compared to the normal-weight group, those who were overweight had a 1.48-fold chance of developing severe COVID-19 (OR 1.48, P 0.0455), while those who were obese had a 1.73-fold chance of developing the disease (ORs 1.73, P 5 0.0652). Regarding gender distribution, the association appeared to be stronger in men than in women. After similar adjustment, the ORs for overweight and obese patients compared to normal-weight patients were 1.39 (p 0.5870) and 3.55 (p 0.0113) in females and 1.36 (0.5115) and 6.19 (0.0001) in males, respectively. Conclusion: Our study shows that obese patients with a BMI of greater than or equal to 27.5 are at higher risk of developing COVID-19 severity, especially in the male population. Moreover, severity may be related to other comorbid conditions. However, in our study, patients with chronic obstructive pulmonary disease (COPD) and GI/liver diseases were less obese, and severity was relatively low. So, the conclusion is that obese male patients with comorbidities are more likely to develop severe COVID-19 infection.
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Fu S, Zhou Q, Yuan L, Li Z, Chen Q. Effects of diet on obesity-related anthropometric characteristics in adults: a protocol for an umbrella review of meta-analyses of randomised controlled trials. BMJ Open 2022; 12:e050579. [PMID: 35027416 PMCID: PMC8762137 DOI: 10.1136/bmjopen-2021-050579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION There have been many meta-analyses of randomised controlled trials on the influence of different diets on obesity-related anthropometric characteristics in adults. However, whether diet interventions can effectively decrease obesity-related anthropometric characteristics remains unclear. The objective of this study is to summarise and synthesise the evidence on the effects of diet on obesity-related anthropometric characteristics in adults by an umbrella review of meta-analyses of randomised controlled trials. METHODS AND ANALYSIS We will first retrieve English articles only published before 15 December 2021 by searching PubMed, Embase and Web of Science. Only articles that are meta-analyses of randomised controlled trials will be included. Three researchers will independently screen the titles and abstracts of retrieved articles and check the data extracted from each eligible meta-analysis. In each meta-analysis, we will consider calculating the effect size of the mean difference of the effect of each diet on obesity-related anthropometric characteristics in adults using a random-effect model or a fixed-effect model according to heterogeneity. Study heterogeneity (Cochrane's Q and I2 statistics) and small-study effects (Egger's test or Begg's test) will be considered. Evidence of each effect size will be graded according to the NutriGrade scoring system. We will use AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews V.2) to assess the methodological quality of each meta-analysis. ETHICS AND DISSEMINATION This umbrella review will provide information on the effects of different diets on obesity-related anthropometric characteristics in adults. Ethical approval is not necessary for this study. We will publish the completed umbrella review and related data online. PROSPERO REGISTRATION NUMBER CRD42021232826.
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Affiliation(s)
- Shunlian Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qian Zhou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lijun Yuan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zinan Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qiu Chen
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Guo Z, Wu Y, Zhu L, Wang Y, Wang D, Sun X. PEX-168 improves insulin resistance, inflammatory response and adipokines in simple obese mice: a mechanistic exploration. BMC Endocr Disord 2021; 21:245. [PMID: 34923973 PMCID: PMC8686575 DOI: 10.1186/s12902-021-00908-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Polyethylene glycol loxenatide (PEX-168) is a new antidiabetic drug; as such, there are not yet any reports on its weight loss effect. Therefore, this trial was designed to investigate the effect of PEX-168 on simple obese mice. METHODS Thirty healthy male C57BL/6 mice were randomly selected and divided into a control group (NC) and an obesity model group. The high-fat diet-induced simple obesity mice were divided into a model control group (HF) and three intervention groups. The intervention groups were injected with different doses of PEX-168 intraperitoneally once a week for 12 weeks (low (LD), medium (MD) and high (HD)). Fasting blood glucose (FBG), body weight and food intake were measured from 1 to 12 weeks after PEX-168 injection. The serum insulin (INS), C-reactive protein (CRP), chemerin and omentin levels were measured after 12 weeks. RESULTS Compared with the HF group, the low dose of PEX-168 reduced the body weight of the mice in a short period of time (8 weeks), and the mice in the MD and HD groups showed a significant decrease in body weight (P < 0.05). The low dose of PEX-168 could effectively improve the blood glucose and homeostasis model assessment of insulin resistance (Homa-IR) of the mice (FBG P < 0.05 INS, Homa-IR P < 0.001), but there was no significant difference between different doses (P > 0.05). CRP levels in the MD and HD groups were significantly improved (P < 0.05). The levels of serum chemerin and omentin in the intervention groups were also significantly improved (P < 0.01), but there was no significant difference between the different doses (P > 0.05). CONCLUSIONS PEX-168 significantly reduced the body weight of simple obese mice and improved the insulin resistance. PEX-168 may regulate the expression of chemerin and omentin through its hypoglycaemic effect, and the weight-reducing effect of PEX-168 is unlikely to be the reason for the changes in both.
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Affiliation(s)
- Zeyuan Guo
- College of Nursing, Yangzhou University, Yangzhou, China
| | - Yuting Wu
- College of Nursing, Yangzhou University, Yangzhou, China
| | - Lihua Zhu
- Northern Jiangsu People's Hospital, Yangzhou, China
| | - Yong Wang
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
| | - Daorong Wang
- Northern Jiangsu People's Hospital, Yangzhou, China
- General Surgery Institute of Yangzhou, Yangzhou University, Yangzhou, China
- Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Xiaofang Sun
- College of Nursing, Yangzhou University, Yangzhou, China.
- Northern Jiangsu People's Hospital, Yangzhou, China.
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