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Hajmir MM, Shiraseb F, Hosseininasab D, Aali Y, Hosseini S, Mirzaei K. The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study. Front Nutr 2023; 10:1226162. [PMID: 38162517 PMCID: PMC10754978 DOI: 10.3389/fnut.2023.1226162] [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: 05/27/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Background Diet and inflammation both play important roles in the occurrence of obesity. We aimed to investigate the role of inflammation in the development of both metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals. Methods This cross-sectional study included 221 overweight and obese women aged 18-56 years. The study assessed the metabolic health phenotypes of the participants using the Karelis criterion score. Additionally, dietary intakes were evaluated using a 147-item semi-quantitative questionnaire and the NOVA classification system (comprising 37 food groups and beverages). The study also collected and analyzed the blood parameters, as well as biochemical and anthropometric indices, for all participants. Results Among the women included in the study, 22.9% had MHO phenotypes but 77.1% had MUHO phenotypes. A significant association between the third quartile of the NOVA classification system and the increased likelihood of having the MUHO phenotype was observed (OR = 1.40, 95% CI = 1.09-4.92, p = 0.04). Regarding the potential role of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) (p = 0.84), transforming growth factor-β (TGF-β) (p = 0.50), monocyte chemoattractant protein-1 (MCP-1) (p = 0.49), plasminogen activator inhibitor-1 (PAI-1) (p = 0.97), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.92) were found to be mediators. Conclusion We observed a significant positive association between ultra-processed food (UPF) consumption and the MUHO phenotype in overweight and obese women. This association appeared to be mediated by some inflammatory markers, such as hs-CRP, TGF-β, MCP-1, PAI-1, and HOMA-IR. Additional studies are needed to validate these findings.
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Affiliation(s)
- Mahya Mehri Hajmir
- Students’ Scientific Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Hosseininasab
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Yasaman Aali
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Hosseini
- School of Human Nutrition, McGill University, Quebec, QC, Canada
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Aisike G, Kuerbanjiang M, Muheyati D, Zaibibuli K, Lv MX, Han J. Correlation analysis of obesity phenotypes with leptin and adiponectin. Sci Rep 2023; 13:17718. [PMID: 37853077 PMCID: PMC10584881 DOI: 10.1038/s41598-023-43550-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023] Open
Abstract
Obesity can be categorized as metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). However, individuals with MHO are characterized by the absence of metabolic syndrome (MS) and appear to have lower inflammation levels compared to MUO. This study aimed to investigate the association of obesity phenotypes with leptin (LEP) and adiponectin (ADP). According to the inclusion and exclusion criteria, we selected 178 subjects from the previous cross-sectional survey. Based on the body mass index (BMI) and diagnostic criteria of MS, we divided the individuals into three groups, including healthy control group (HC group), metabolically healthy obesity group (MHO group) and metabolically unhealthy obesity group (MUO group). The concentrations of LEP and ADP in serum were measured, and the association of these two cytokines with different obesity phenotypes were subsequently analyzed. Compared to both the HC and MHO groups, the MUO group showed significantly higher BMI, waist circumference (WC), waist-hip ratio (WHR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (Homa-IR) and blood pressure (P < 0.05). In contrast, serum high-density lipoprotein cholesterol (HDL-C) was notably lower in the MUO group (P < 0.05). ADP was found to have a positive correlation with systolic blood pressure (SBP) and a negative correlation with FPG in the MHO group. In the MUO group, LEP demonstrated a positive correlation with fasting insulin (FINS) and Homa-IR, while ADP showed a positive correlation with TC and SBP. Linear regression analysis further indicated that SBP (β = 0.234, P = 0.043), TG (β = - 0.292, P = 0.001) and LDL-C (β = 0.626, P = 0.000) were independently correlated with ADP, and BMI (β = 0.398, P = 0.002) was independently correlated with LEP in obese individuals. In conclusion, ADP and LEP were closely related with glucose and lipid metabolism in obese individuals, these two cytokines might play critical roles in obesity-associated metabolic disorders.
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Affiliation(s)
- Guliqiekeran Aisike
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Maierheba Kuerbanjiang
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Dina Muheyati
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Kaibinuer Zaibibuli
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Mei-Xia Lv
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China
| | - Jia Han
- Department of Nutrition and Food Hygiene, College of Public Health, Xinjiang Medical University, Urumqi, 830011, China.
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Obesity during Pregnancy and SARS-CoV-2/COVID-19-Case Series of the Registry Study “COVID-19 Related Obstetric and Neonatal Outcome Study” (CRONOS-Network). J Clin Med 2023; 12:jcm12062089. [PMID: 36983091 PMCID: PMC10053603 DOI: 10.3390/jcm12062089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
(1) Background: Obesity is an increasing challenge in the care of pregnant women. The aim of our study was to investigate whether obesity is an independent risk factor for severe maternal and neonatal outcomes in pregnant women with COVID-19. (2) Methods: Data from the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was used to analyze the effect of obesity on selected individual and combined outcome parameters (3) Results: With 20.1%, the prevalence of obesity in the CRONOS registry exceeds the German background rate of 17.5%. Obese women showed significantly higher rates of GDM (20.4% vs. 7.6%; p < 0.001), hypertensive pregnancy disorders (6.2% vs. 2%; p = 0.004) and C-sections (50% vs. 34.5%; p < 0.001). BMI was revealed to be an individual risk factor for the severe combined pregnancy outcome (maternal death, stillbirth or preterm birth < 32 weeks) (OR 1.050, CI 1.005–1.097). (4) Conclusions: Maternal BMI is a predictor for the most severe outcome as maternal or neonatal death and preterm delivery <32 weeks of gestation. Unexpectedly, categorized obesity seems to have limited independent influence on the course and outcome of pregnancies with COVID infections.
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Shveid Gerson D, Gerson‐Cwilich R, Lara Torres CO, Chousleb de Kalach A, Ventura Gallegos JL, Badillo‐Garcia LE, Bargalló Rocha JE, Maffuz‐Aziz A, Sánchez Forgach ER, Castorena Roji G, Robles Vidal CD, Vargas‐Castillo A, Torres N, Tovar AR, Contreras Jarquín M, Gómez Osnaya JT, Zentella‐Dehesa A. Establishment of triple-negative breast cancer cells based on BMI: A novel model in the correlation between obesity and breast cancer. Front Oncol 2022; 12:988968. [PMID: 36591465 PMCID: PMC9795201 DOI: 10.3389/fonc.2022.988968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Obesity has been associated with an increased risk of biologically aggressive variants in breast cancer. Women with obesity often have tumors diagnosed at later stages of the disease, associated with a poorer prognosis and a different response to treatment. Human cell lines have been derived from specific subtypes of breast cancer and have served to define the cell physiology of corresponding breast cancer subtypes. However, there are no current cell lines for breast cancer specifically derived from patients with different BMIs. The availability of those breast cancer cell lines should allow to describe and unravel functional alterations linked to these comorbidities. Methods Cell cultures were established from tumor explants. Once generated, the triple negative subtype in a patient with obesity and a patient with a normal BMI were chosen for comparison. For cellular characterization, the following assays were conducted: proliferation assays, chemo - sensitivity assays for doxorubicin and paclitaxel, wound healing motility assays, matrix invasion assays, breast cancer cell growth to estradiol by chronic exposure to leptin, induction of endothelial permeability and tumorigenic potential in athymic mice with normo - versus hypercaloric diets with an evaluation of the epithelium - mesenchymal transformation proteins. Results Two different cell lines, were established from patients with breast cancer: DSG-BC1, with a BMI of 21.9 kg/m2 and DSG-BC2, with a BMI of 31.5 kg/m2. In vitro, these two cell lines show differential growth rates, motility, chemosensitivity, vascular permeability, response to leptin with an activation of the JAK2/STAT3/AKT signaling pathway. In vivo, they displayed distinct tumorigenic potential. In particular, DSG-BC2, presented higher tumorigenicity when implanted in mice fed with a hypercaloric diet. Discussion To our knowledge, these primary cultures are the first in vitro representation of both breast cancer and obesity. DSG - BC2 presented a more aggressive in vivo and in vitro phenotype. These results support the hypothesis that breast cancer generated in an obese metabolic state may represent a contrasting variant within the same disease. This new model will allow both further comprehension, functional studies and the analysis of altered molecular mechanisms under the comorbidity of obesity and breast cancer.
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Affiliation(s)
- Daniela Shveid Gerson
- Cancer Center, American British Cowdray (ABC) Medical Center, Mexico City, Mexico,*Correspondence: Daniela Shveid Gerson,
| | | | - Cesar Octavio Lara Torres
- Pathology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
| | | | - José Luis Ventura Gallegos
- Department of Genomic Medicine and Environmental Toxicology, Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis Ernesto Badillo‐Garcia
- Department of Genomic Medicine and Environmental Toxicology, Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Antonio Maffuz‐Aziz
- Cancer Center, American British Cowdray (ABC) Medical Center, Mexico City, Mexico
| | | | | | | | - Ariana Vargas‐Castillo
- Biochemistry Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico,Department of Nutrition Physiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
| | - Nimbe Torres
- Department of Nutrition Physiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
| | - Armando R. Tovar
- Department of Nutrition Physiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
| | - Mariela Contreras Jarquín
- Department of Genomic Medicine and Environmental Toxicology, Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Jesús Tenahuatzin Gómez Osnaya
- Department of Genomic Medicine and Environmental Toxicology, Institute of Biomedical Research, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Zentella‐Dehesa
- Cancer Center, American British Cowdray (ABC) Medical Center, Mexico City, Mexico,Biochemistry Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico
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Pourreza S, Mirzababaei A, Naeini F, Naghshi S, Mirzaei K. Association of dietary phytochemical index with metabolically unhealthy overweight/obesity phenotype among Iranian women: A cross-sectional study. Front Nutr 2022; 9:959341. [DOI: 10.3389/fnut.2022.959341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPhytochemicals have been recently studied as adjuvants for the treatment of obesity. No study has investigated the association of phytochemical-rich foods with metabolically unhealthy overweight/obesity phenotype (MUOW/O). This study aimed to determine the association of dietary phytochemical index (DPI) with MUOW/O based on Karelis criteria among Iranian female adults.MethodsIn this cross-sectional study, a total of 228 overweight and obese women aged 18–48 years were included. Anthropometric measurements were evaluated for all participants. A validated 147-item Food Frequency Questionnaire (FFQ) was used for dietary assessment. DPI was calculated as [dietary energy derived from phytochemical-rich foods (kcal)/total daily energy intake (kcal)] × 100. Participants’ body composition and biochemical parameters of Karelis criteria [triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, and high-sensitivity C-reactive protein (hs-CRP)] were determined.ResultsThe mean age of the study participants was 36.69 ± 9.20, and the mean DPI score was 26.23 ± 9.48 among participants with MUOW/O phenotype. After controlling for potential confounders, women in the highest tertile of DPI had lower odds for MUOW/O phenotype [odds ratio (OR): 0.23, 95% confidence interval (CI): 0.07–0.68, P = 0.008] compared to the lowest tertile. Among the components of Karelis criteria, homeostatic model assessment for insulin resistance (HOMA-IR) was significantly associated with MUOW/O phenotype in the fully adjusted model (OR: 0.29, 95% CI: 0.10–0.79, P = 0.01).ConclusionWe found a significant association between DPI and MUOW/O phenotype in Iranian women. Prospective studies are needed to confirm these findings.
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Khadem A, Shiraseb F, Mirzababaei A, Ghaffarian-Ensaf R, Mirzaei K. Association of Lifelines Diet Score (LLDS) and metabolically unhealthy overweight/obesity phenotypes in women: a cross-sectional study. BMC Womens Health 2022; 22:374. [PMID: 36096807 PMCID: PMC9469615 DOI: 10.1186/s12905-022-01957-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background Previous studies have shown the association of a number of dietary quality scores with metabolically phenotypes of obesity. Recently, the Lifelines Diet Score (LLDS), which is a fully food-based score based on the 2015 Dutch dietary guidelines and underlying international literature, has been proposed as a tool for assessing the quality of the diet. Therefore, this study was performed to investigate the association between LLDS and metabolically healthy/unhealthy overweight and obesity (MHO/MUHO) phenotypes. Methods This study was performed on 217 women, aged 18–48 years old. For each participant anthropometric values, biochemical test and body composition were evaluated by standard protocols and methods. The LLDS was determined based on 12 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. The metabolically healthy (MH) was evaluated using the Karelis criteria. Results Among the total participants in this study, 31.3% of the subjects were MHO while 68.7% were MUHO. After adjustment for potential confounding variables (age, energy intake, and physical activity), participants in highest LLDS tertile had a lower odds of MUHO compared with those in the lowest tertile (OR: 1.18; 95% CI: 0.23, 5.83; P-trend = 0.03). Also, after further adjustment with BMI, provided only small changes in "OR" and did not attenuate the significance (OR: 1.28; 95% CI: 0.23, 6.91; P-trend = 0.02). Conclusions The present evidence indicates that individuals with higher adherence to the LLDS had lower odds of metabolically unhealthy (MUH).
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Cobos-Palacios L, Ruiz-Moreno MI, Vilches-Perez A, Vargas-Candela A, Muñoz-Úbeda M, Benítez Porres J, Navarro-Sanz A, Lopez-Carmona MD, Sanz-Canovas J, Perez-Belmonte LM, Mancebo-Sevilla JJ, Gomez-Huelgas R, Bernal-Lopez MR. Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population. PLoS One 2022; 17:e0265362. [PMID: 35679338 PMCID: PMC9182320 DOI: 10.1371/journal.pone.0265362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/28/2022] [Indexed: 12/11/2022] Open
Abstract
Background and aims Obesity is linked to elevated levels of inflammatory serum markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFa). Adiponectin and resistin are adipokines related to obesity. It has been described that adipose tissue presents a high production and secretion of these diverse pro-inflammatory molecules, which may have local effects on the physiology of fat cells as well as systemic effects on other organs. Our aim was to evaluate the impact that lifestyle modifications, by following a Mediterranean Diet (MedDiet) program and physical activity (PA) training, would have on inflammatory biomarkers and adipokine profile in a Metabolically Healthy Obese (MHO) elderly population from Malaga (Andalusia, Spain). Subjetcs and methods Subjects aged ≥65 years (65 to 87 years old) with obesity (BMI ≥30 kg/m2) were included in this study if they met ≤1 of the following criteria: systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥ 85 mmHg; triglycerides ≥150 mg/dL; HDL-C <40mg/dL in men and <50mg/dL women; and fasting blood glucose ≥100mg/dL. Selected subjects underwent a personalized intensive lifestyle modification. Anthropometric measurements, PA, MedDiet adherence, analytical parameters, and inflammatory biomarkers were analyzed after 12 months of intervention. Results 166 MHO elderly subjects, 40 (24.1%) male and 126 (75.9%) female (p < 0.0001), aged 71.7±5.2 years old (65 to 87 years old) were included in the study. After 12 months of intervention, only the waist circumference was significantly reduced in all the population (-2.5 cm, p<0.0001), although weight and BMI were maintained. MedDiet adherence increased significantly (p<0.001), but all intensity levels of PA decreased significantly (p<0.001). Concerning inflammatory biomarkers, only TNFa serum increased their levels after the intervention (p<0.001). Regarding the adipokine profile, adiponectin concentrations experienced a significant increment (p<0.001); besides, resistin concentrations decreased significantly (p<0.001). In this sense, only TNFa, adiponectin, and resistin correlated with PA. Adiponectin also correlates with insulin, triglycerides and HDL-c in baseline conditions and after 12 months of intervention; CRP, IL-6, TNFa, adiponectin, and resistin concentrations correlated with anthropometric parameters and some intensities of PA. In addition, adiponectin levels correlates with insulin, triglycerides and HDL-c. In baseline conditions, resistin levels correlated positively with TNFa (p = 0.01) and CRP (p<0.0001) levels. TNFa and IL-6 correlated positively with CRP (p = 0.03 and p<0.0001, respectively). After 12 months of intervention, only IL-6 correlated positively with CRP (p = 0.006). In addition, adipokines levels correlated positively during the process of lifestyle modification. However, during this process, only IL-6 correlated positively with itself (p<0.0001) and with CRP (p = 0.03). Conclusion Healthy aging is a multifactorial biological process in which lifestyle is essential. The presence of obesity in elderly metabolically healthy population is not a problem necessarily. Elderly MHO population who eat a MedDiet and practice regularly PA are capable to modulate their production of inflammatory cytokines (CRP, IL-6, TNFa) and adipokines profile (adiponectin, resistin), preventing other metabolic disorders.
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Affiliation(s)
- Lidia Cobos-Palacios
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - María Isabel Ruiz-Moreno
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Alberto Vilches-Perez
- Department of Endocrinology and Nutrition, Instituto de Investigacion Biomedica de Malaga (IBIMA), University Hospital Virgen de la Victoria, Malaga, Spain
| | - Antonio Vargas-Candela
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Mónica Muñoz-Úbeda
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Javier Benítez Porres
- Physical Education and Sports Area, Faculty of Medicine, University of Malaga, Malaga, Spain
| | | | - María Dolores Lopez-Carmona
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Jaime Sanz-Canovas
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Luis M. Perez-Belmonte
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Juan José Mancebo-Sevilla
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
| | - Ricardo Gomez-Huelgas
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (MRBL); (RGH)
| | - María Rosa Bernal-Lopez
- Department of Internal Medicine, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga, Malaga, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (MRBL); (RGH)
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Bosco A, Dessì A, Zanza C, Pintus R, Fanos V. Resolvins' Obesity-Driven Deficiency: The Implications for Maternal-Fetal Health. Nutrients 2022; 14:nu14081662. [PMID: 35458224 PMCID: PMC9029397 DOI: 10.3390/nu14081662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/10/2022] Open
Abstract
Since pregnancy is already characterized by mild but significant inflammatory activity in physiological conditions, when complicated by obesity the probability of a persistent inflammatory state increases, with consequent multiple repercussions that add up to the complications associated with acute inflammation. In this context, the role of resolvins, specialized pro-resolving mediators (SPMs), deriving from omega-3 essential fatty acids, may be crucial. Indeed, differential production in numerous high-risk conditions associated with both childbirth and neonatal health, the correlation between maternal omega-3 intake and resolvin concentrations in maternal blood and at the placental level, and the high values found in breast milk in the first month of breastfeeding, are some of the most important hallmarks of these autacoids. In addition, a growing body of scientific evidence supports the lack of SPMs, at the level of immune-metabolic tissues, in the case of obesity. Furthermore, the obesity-related lack of SPMs seems to be decisive in the context of the current outbreak of COVID-19, as it appears to be one of the causes associated with the higher incidence of complications and negative outcomes of SARS-CoV-2 infection. The usefulness of metabolomics in this field appears clear, given that through the metabolome it is possible to observe the numerous and complex interactions between the mother, the placenta and the fetus in order to identify specific biomarkers useful in the prediction, diagnosis and monitoring of the various obstetric conditions. However, further investigations are needed in order to evaluate the possible use of some resolvins as biomarkers of maternal–fetal outcomes but also to establish adequate integration values in pregnant women with omega-3 fatty acids or with more active derivatives that guarantee optimal SPM production under risky conditions.
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Association of Periaortic Fat and Abdominal Visceral Fat with Coronary Artery Atherosclerosis in Chinese Middle Aged and Elderly Patients Undergoing Computed Tomography Coronary Angiography. Glob Heart 2021; 16:74. [PMID: 34900565 PMCID: PMC8533656 DOI: 10.5334/gh.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background and Aims: Coronary artery disease (CAD) is usually caused by atherosclerosis, which is associated with general obesity and stronger associations with localized ectopic fat depots have been reported. We measured body ectopic fat distribution in Chinese patients to determine the association with coronary artery atherosclerosis (CA). Methods: Patients undergoing coronary computed tomography angiography (CCTA) who agreed to participate in the study (n = 750, 50.4% men, mean age 64.8 years) had cardiovascular disease and risk assessment. Body ectopic fat depots were measured from CT and their association with CA, determined from CCTA, was evaluated by univariate and multivariate logistic regression models. Results: CAD with CA (CAD-CA) was present in 57.2% of participants with CAD of moderate/severe CA (CAD-msCA) present in 23.5% and both were significantly more frequent in men than in women. Overall, men had greater body mass index (BMI) but there was no difference in waist circumference (WC) between genders. However, significantly higher visceral adipose tissue (VAT) and periaortic fat volume (PAFV) were observed in men, whereas women had significantly higher abdominal subcutaneous adipose tissue (SAT). With increasing age, there was a significant decline in BMI, WC and SAT in men, but a significant increase of WC and VAT, PAFV and epicardial fat volume (EFV) in women. A high proportion of non-calcified plaques was observed in CAD-CA, 55.3% in CAD of minimal/mild CA (CAD-mmCA) with 38.7% exclusively non-calcified plaques, and 59.7% in CAD-msCA with multiple type plaques containing non-calcified ones. Multivariate logistic regression showed a significant association of PAFV with CAD-CA and CAD-msCA that was independent of general obesity and clinical risk factors, and independent of abdominal obesity in the highest PAFV quartile patients. VATA was associated with an increased prevalence of CAD-msCA in the patients in the upper 2 VATA quartiles that was independent of clinical risk factors and both general and abdominal obesity. Conclusions: We found age and gender differences of body ectopic fat distribution in Chinese patients with higher VAT and PAFV in men and higher SAT in women. With increased age, there was a decline of WC and SAT in men but not in women and an increase in WC, VAT and PAFV in women but not in men. PAFV was significantly associated with overall CAD-CA and CAD-msCA, while VAT was associated with CAD-msCA.
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Dzięgielewska-Gęsiak S, Wyszomirska K, Fatyga E, Wysocka E, Muc-Wierzgoń M. The role of oxidant-antioxidant markers and resistin in metabolic syndrome elderly individuals. Sci Prog 2021; 104:368504211006510. [PMID: 33913390 PMCID: PMC10364936 DOI: 10.1177/00368504211006510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In elderly, hormones and oxidant-antioxidant interplay are suggested to mediate biochemical balance between adipose tissue to other tissues. Thus the study attempts to explore metabolic traits, plasma resistin, and oxidant-antioxidant markers in metabolic syndrome (MetS) in comparison to non-metabolic syndrome (non-MetS) elderly individuals. A total of 541 healthy elderly Caucasians, with no acute and/or chronic disorders were invited. After taking into account inclusion/exclusion criteria's the MetS was defined as the presence of three out of five abnormal findings and allowed to divided groups into: non-metabolic syndrome, non-MetS (n = 25, median age 69.0 years), and newly diagnosed MetS (n = 29; median age 70.5 years) individuals. Glucose, plasma lipids, resistin (Res), thiobarbituric acid-reacting substances (TBARS), total antioxidant status (TAS), and Cu,Zn-superoxide dismutase (SOD-1) were measured. The MetS had higher resistin than non-MetS (p < 0.04). The linear correlation (all at p < 0.05) showed correlation for Res&triacylglycerols (R = 0.44), and for Res&diastolic blood pressure (R = -0.58) and for SOD-1&fasting glucose (R = -0.34) in MetS, while in the non-MetS group fasting glucose correlates with Res (R = 0.58) and with TAS (R = -0.43). The multiple regression analysis (alone and in combination) showed that independently from other factors resistin correlated positively with fasting glucose (β = 0.37; R = 0.58; R2 = 0.23; p < 0.01) in all investigated elderly participants. In the MetS resistin correlated negatively with diastolic blood pressure (β = -0.68; R = 0.80; R2 = 0.53; p = 0.0004) moreover in that group TAS correlated negatively with HDL-C (β = -0.71; R = 0.72; R2 = 0.37; p = 0.01). While age correlated negatively with systolic blood pressure (β = -0.60; R = 0.62; R2 = 0.14; p = 0.03) independently from other factors in the non-MetS group. Various metabolic factors contribute to maintain serum resistin and oxidant-antioxidant balance in the elderly people in the presence or absence of MetS. Resistin may serve as a predictor of MetS in the elderly, while strong antioxidant defense interactions in older individuals may indicate good health.
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Affiliation(s)
| | - Karolina Wyszomirska
- Department of Clinical Biochemistry and Laboratory Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Edyta Fatyga
- Department of Internal Medicine, Medical University of Silesia in Katowice, Bytom, Poland
| | - Ewa Wysocka
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
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11
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Zhang SS, Yang XJ, Ma QH, Xu Y, Chen X, Wang P, Pan CW. Leukocyte related parameters in older adults with metabolically healthy and unhealthy overweight or obesity. Sci Rep 2021; 11:4652. [PMID: 33633339 PMCID: PMC7907258 DOI: 10.1038/s41598-021-84367-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/27/2021] [Indexed: 11/18/2022] Open
Abstract
It remains unclear whether leukocyte-related parameters could be used as biomarkers to differentiate metabolically unhealthy overweight/obesity (MUO) from metabolically healthy overweight/obesity (MHO). We aimed to examine the differences in the distribution of leukocyte-related parameters between older adults with MHO and MUO and the correlations of leukocyte-related parameters with individual components of metabolic abnormality. In the Weitang Geriatric Diseases Study on older Chinese adults aged 60 years or above, 404 individuals with MHO and 480 with MUO contributed to the analysis. Overweight/obesity was defined as body mass index (BMI) of 25 kg/m2 or more. MHO and MUO were discriminated based on the Adult Treatment Panel III (ATP III) criteria. Leukocyte-related parameters were assessed using an automated hematology analyzer. All leukocyte-related parameters except monocytes were elevated in MUO group compared with MHO group (all P < 0.05). The prevalence of MUO increased by 24% with each 109/L increase of leukocytes after adjusting for confounders in the multiple-adjusted model (P < 0.01) and each unit elevation of other parameters except lymphocytes and monocytes were significantly associated with the presence of MUO (all P < 0.01). Trend tests revealed a linear trend for the association between MUO and all the leukocyte-related parameters (all P for trend < 0.05). Significant interactions between leukocyte-related parameters and sex on the presence of MUO were observed (all P value for interaction < 0.05). Higher leukocyte-related parameters were found in patients with MUO than those with MHO and were associated with higher prevalence of MUO which seems to be sex-dependent. Further studies are needed to see whether these parameters could be used as biomarkers for the screening or diagnosis for MUO in clinical or public health practice.
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Affiliation(s)
- Shan-Shan Zhang
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Xue-Jiao Yang
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Qing-Hua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, 215134, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Xing Chen
- Department of Children Health Care, Affiliated Suzhou Hospital of Nanjing Medical University, No.26, Dao Qian Road, Suzhou, 215000, China.
| | - Pei Wang
- Department of Health Economics, School of Public Health,, Fudan University, 130 Dong An Road, Shanghai, 200032, China. .,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, 200032, China.
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
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12
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Qu H, Song L, Zhang Y, Gao ZY, Shi DZ. The Effect of Prebiotic Products on Decreasing Adiposity Parameters in Overweight and Obese Individuals: A Systematic Review and Meta- Analysis. Curr Med Chem 2021; 28:419-431. [PMID: 31886746 DOI: 10.2174/0929867327666191230110128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/09/2019] [Accepted: 11/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Prebiotics are substrates selectively utilized by host microorganisms to confer health benefits. The potential of prebiotics to decrease body weight in overweight/obese individuals was suggested by some clinical and animal studies. However, these studies were based on relatively small sample sizes and the precise effects of prebiotic products have not yet been evaluated. Therefore, the present meta-analysis of Randomized Controlled Trials (RCTs) was designed to comprehensively assess the effects of prebiotic products on overweight and obese individuals. METHODS PubMed, EMBASE and Cochrane Library were searched to identify RCT investigating the effects of prebiotic products on overweight and obese individuals. We calculated the pooled weighted mean difference (WMD) to assess the effects of prebiotic products on Body Mass Index (BMI), body weight, fat mass and inflammatory biomarkers. RESULTS Twelve RCTs with a total of 535 overweight and obese individuals were enrolled. Compared with placebo, prebiotic products decreased C reactive protein (WMD, -1.06 mg/L; 95%CI, -1.72 to - 0.40; p=0.002), tumour necrosis factor-α(WMD, -0.64 pg/mL; 95%CI, -1.11 to -0.18; p=0.006) and other inflammatory markers, such as interleukin-1β,lipopolysaccharide (p<0.05); whereas no reductions in BMI (WMD, -0.20 kg/m2; 95%CI, -0.58 to 0.19; p=0.32), body weight (WMD, -0.51 kg; 95%CI, -1.18 to 0.16; p=0.14) and fat mass (WMD, 0.11 kg; 95%CI, -0.04 to 0.25; p=0.15) were observed. CONCLUSION In the present analysis, comprehensive evidence suggested that prebiotic products did not decrease adiposity parameters (BMI, body weight and body fat mass), but they could decrease the levels of systemic inflammatory biomarkers, implying adherence to prebiotic products might be a promising complementary approach to managing inflammatory states in overweight and obese individuals.
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Affiliation(s)
- Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Song
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhu-Ye Gao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Da-Zhuo Shi
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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13
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Shi R, Chen X, Lin H, Shen W, Xu X, Zhu B, Xu X, Ding Y, Wong FY, He N. Association of HIV infection with metabolic syndrome among normal or underweight young adults: evidence from the CHART cohort. Biosci Trends 2021; 14:450-456. [PMID: 33328394 DOI: 10.5582/bst.2020.03351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Metabolic syndrome (MS) is common among obese people. Little is known about the magnitude and characteristics of MS in people living with HIV (PLWH) in Asian countries in general and China in particular. Using baseline data collected between February 2017 through January 2020 from the Comparative HIV and Aging Research in Taizhou (CHART) cohort in China, we examined MS among 2,227 PLWH and 5,264 matched people without HIV, respectively. MS was defined using the criteria set forth by the International Diabetes Federation (IDF). Approximately 76.7% of PLWH had body mass index (BMI) < 24.0 kg/m2, significantly higher than people without HIV (50.3%). Among participants with BMI < 24.0 kg/m2, PLWH had a significantly higher prevalence of MS than people without HIV (20.6% vs. 14.5%; aOR: 1.41, 95% CI: 1.19-1.68) overall, and at an age of 18-29 (10.4% vs. 3.4%, aOR: 3.49, 95% CI: 1.99-6.11) and 30-44 years (17.3% vs. 8.5%, aOR: 2.03, 95% CI: 1.47-2.81), respectively. Among participants with BMI ≥ 24.0 kg/m2, MS prevalence was not significantly different between PLWH and people without HIV overall, but significantly lower in PLWH than people without HIV for those aged over 60 years (65.9% vs. 77.8%, aOR: 0.53, 95% CI: 0.32-0.88). Among PLWH, MS was significantly associated with older age and higher CD4 cell count, and with stavudine (d4T) use only in the group of BMI < 24.0 kg/m2. Our finding is indicative of a relatively higher risk for early onset of MS among HIV-infected young adults with lower BMI. Research is needed to elucidate the pathogenic mechanism for MS among PLWH.
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Affiliation(s)
- Ruizi Shi
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, Shanghai, China
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China
| | - Haijiang Lin
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China
| | - Xiaohui Xu
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Bowen Zhu
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xiaoyi Xu
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yingying Ding
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Frank Y Wong
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Center for Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, FL, U.S.A.,Department of Psychology, College of Social Sciences, University of Hawai'i at Mānoa, Honolulu, HI, U.S.A.,Department of Population Science, John D. Bower School of Population Health, University of Mississippi Medical Center, MS, U.S.A
| | - Na He
- School of Public Health, Fudan University, Shanghai, China; and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.,Key Laboratory of Health Technology Assessment of Ministry of Health, Fudan University, Shanghai, China
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14
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Ostrovskaya ЕV, Romantsova ТI, Gerasimov AN, Novoselova ТЕ. Metabolically healthy obesity: prevalence, phenotype characteristic, effectiveness of weight loss. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The goal was to study the prevalence of metabolically healthy obesity (MHO), the features of this phenotype compared with metabolically unhealthy obesity (MUHO), and the effect of weight loss on cardiometabolic risk factors in patients with MHO. Material and Methods — To assess the prevalence of MHO, 389 case histories of obese patients aged 18-60 were analyzed. Three types of MHO criteria were used: 1) the definitions of metabolic syndrome (MS) according to International Diabetes Federation (IDF), 2005; 2) the HOMA-IR index (<2.7); 3) Biobank Standardisation and Harmonisation for Research Excellence in the European Union (BioSHaRE-EU) criteria, 2013. The study included comparative analysis of the medical history, anthropometry, basic metabolic parameters, and adipocytokine levels in 44 patients with MHO (taking into account the MS definitions) and 33 women with MUHO initially and with a decrease in body mass (BM) by ≥5% after 6 months. Results — The MHO prevalence was: according to the definitions of MS – 38.6%, according to HOMA-IR index – 34.5%, in BioSHaRE-EU – 9.6%. All indicators of anthropometry, carbohydrate and lipid metabolism, including the HOMA-IR index, interleukin-6, and chemerin, as well as the duration of obesity in the MHO and MUHO groups significantly differed (p<0.05). After 6 months, MHO-patients who lost ≥5% BM from the initial value (63.6%) showed an increase of adiponectin, a decrease in waist circumference, HOMA-IR index, C-reactive protein (CRP), retinol-binding protein 4 (RBP-4), and chemerin (p<0.05). Conclusion — The MHO prevalence was maximal according to the MS definitions and minimal with BioSHaRE-EU criteria. The BM decrease in MHO is accompanied by a decrease in the content of proinflammatory adipocytokines and the HOMA-IR index, which determines the need to treat obesity regardless of the phenotype.
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15
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BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults: a cohort study. Public Health Nutr 2020; 24:4124-4131. [PMID: 32840191 DOI: 10.1017/s136898002000289x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. DESIGN Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. RESULTS Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. CONCLUSION BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.
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16
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Zhao RX, He Q, Sha S, Song J, Qin J, Liu P, Sun YJ, Sun L, Hou XG, Chen L. Increased AHR Transcripts Correlate With Pro-inflammatory T-Helper Lymphocytes Polarization in Both Metabolically Healthy Obesity and Type 2 Diabetic Patients. Front Immunol 2020; 11:1644. [PMID: 32849564 PMCID: PMC7406643 DOI: 10.3389/fimmu.2020.01644] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/19/2020] [Indexed: 12/25/2022] Open
Abstract
Aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor whose transcription activity is regulated by small compounds provided by diet, xenobiotics, and metabolism. It has been proven to be involved in energy homeostasis and inflammation in most recent years. Epidemiologically, exposure to xenobiotic AHR ligands contributes to obesity and type 2 diabetes (T2D). AHR is also the critical transcription factor determining the lineage commitment of pro-inflammatory Th17 and Th22 cells from naïve CD4+ T lymphocytes. It has been well-illustrated in animal models that IL-22, the major effector cytokine of Th17 and Th22 cells, played a major role in the interaction of metabolism and gut microbiota. But there were still missing links between gut microbiota, IL-22, and metabolism in humans. Our previous findings indicated that elevated circulating levels of IL-22 and frequencies of Th22 cells were associated with insulin resistance in both patients with obesity and T2D. Additionally, the hyperactive Th17 and Th22 cells phenotype also correlate with islets β-cell dysfunction in T2D. In this study, we made efforts to determine AHR expressions in peripheral blood mononuclear cells (PBMCs) from patients with T2D and metabolically healthy obesity (MHO). Correlation analyses were conducted to assess the possible link between AHR and the metabolic and inflammatory context. We revealed that mRNA expression of AHR was up-regulated and correlated with the percentage of Th17, Th22 as well as Th1 cells. Elevated plasma levels of IL-22 and IL-17 also correlated with increased AHR transcripts in PBMCs from both MHO and T2D patients. The transcription factor AHR may thus have a plausible role in the interaction between metabolism and pro-inflammatory status of patients in the development of obesity and T2D.
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MESH Headings
- Adult
- Basic Helix-Loop-Helix Transcription Factors/blood
- Basic Helix-Loop-Helix Transcription Factors/genetics
- Case-Control Studies
- Cell-Free Nucleic Acids/blood
- Cell-Free Nucleic Acids/genetics
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/immunology
- Female
- Humans
- Inflammation Mediators/blood
- Insulin-Secreting Cells/immunology
- Insulin-Secreting Cells/metabolism
- Interleukin-17/blood
- Interleukins/blood
- Male
- Middle Aged
- Obesity, Metabolically Benign/blood
- Obesity, Metabolically Benign/genetics
- Obesity, Metabolically Benign/immunology
- Phenotype
- RNA, Messenger/blood
- RNA, Messenger/genetics
- Receptors, Aryl Hydrocarbon/blood
- Receptors, Aryl Hydrocarbon/genetics
- T-Lymphocytes, Helper-Inducer/immunology
- T-Lymphocytes, Helper-Inducer/metabolism
- Th1 Cells/immunology
- Th1 Cells/metabolism
- Th17 Cells/immunology
- Th17 Cells/metabolism
- Up-Regulation
- Interleukin-22
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Affiliation(s)
- Ru-xing Zhao
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Qin He
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Sha Sha
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Jia Song
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Jun Qin
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Peng Liu
- Department of Internal Medicine, Affiliated Hospital of Shandong Huayuan Mining Co. Ltd, Taian, China
| | - Yu-jing Sun
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
| | - Lei Sun
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
| | - Xin-guo Hou
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
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Petrakis D, Margină D, Tsarouhas K, Tekos F, Stan M, Nikitovic D, Kouretas D, Spandidos DA, Tsatsakis A. Obesity ‑ a risk factor for increased COVID‑19 prevalence, severity and lethality (Review). Mol Med Rep 2020; 22:9-19. [PMID: 32377709 PMCID: PMC7248467 DOI: 10.3892/mmr.2020.11127] [Citation(s) in RCA: 224] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023] Open
Abstract
Coronaviruses (CoVs), enveloped positive-sense RNA viruses, are a group of viruses that cause infections in the human respiratory tract, which can be characterized clinically from mild to fatal. The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is the virus responsible. The global spread of COVID‑19 can be described as the worst pandemic in humanity in the last century. To date, COVID‑19 has infected more than 3,000,000 people worldwide and killed more than 200,000 people. All age groups can be infected from the virus, but more serious symptoms that can possibly result in death are observed in older people and those with underlying medical conditions such as cardiovascular and pulmonary disease. Novel data report more severe symptoms and even a negative prognosis for the obese patients. A growing body of evidence connects obesity with COVID‑19 and a number of mechanisms from immune system activity attenuation to chronic inflammation are implicated. Lipid peroxidation creates reactive lipid aldehydes which in a patient with metabolic disorder and COVID‑19 will affect its prognosis. Finally, pregnancy‑associated obesity needs to be studied further in connection to COVID‑19 as this infection could pose high risk both to pregnant women and the fetus.
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Affiliation(s)
- Demetrios Petrakis
- Laboratory of Toxicology, Medical School, University of Crete, 71409 Heraklion, Greece
| | - Denisa Margină
- ‘Carol Davila’ University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Biochemistry, 020956 Bucharest, Romania
| | | | - Fotios Tekos
- Department of Biochemistry-Biotechnology, University of Thessaly, 41500 Larissa, Greece
| | - Miriana Stan
- ‘Carol Davila’ University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Toxicology, 020956 Bucharest, Romania
| | - Dragana Nikitovic
- Laboratory of Histology-Embryology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Demetrios Kouretas
- Department of Biochemistry-Biotechnology, University of Thessaly, 41500 Larissa, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71110 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71409 Heraklion, Greece
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Sociodemographic and metabolic risk characteristics associated with metabolic weight categories in the Women's Health Initiative. Cardiovasc Endocrinol Metab 2020; 9:42-48. [PMID: 32537564 DOI: 10.1097/xce.0000000000000194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/22/2020] [Indexed: 11/26/2022]
Abstract
To identify sociodemographic and metabolic correlates of weight categories in postmenopausal women. Methods The Women's Health Initiative enrolled 161 808 postmenopausal women ages 50-79. We included those free of cardiovascular disease (CVD) and with CVD risk factors and biomarkers (n = 19 412). Normal weight was defined as a BMI ≥18.5 and <25 kg/m2 and waist circumference <88 cm and overweight/obesity as a BMI ≥25 kg/m2 or waist circumference ≥88 cm. Metabolically healthy was based on <2 and metabolically unhealthy ≥2 traits: triglycerides ≥150 mg/dl, systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥85 mmHg or antihypertensives or diuretics, fasting glucose ≥100 mg/dl or diabetes medication, and high-density lipoprotein cholesterol <50 mg/dl. Polytomous multinomial logistic regression with generalized link logit function provided the odds of metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO) according to demographic and risk factor measures. Results Among the 19 412 postmenopausal women, 2369 (12.2%) participants had prevalent diabetes. Advanced age was associated with an increased odds of MUHNW as compared with the MHNW after adjusting for covariates [odds ratio (OR) 1.04, P < 0.0001]. Black/African American ethnicity was associated with a decreased odds of MUHNW (OR 0.64, P < 0.0001) and MUHO (OR 0.77, P = 0.0004), while an increased odds for MHO (OR 1.50, P < 0.0001) as compared with White MHNW. Conclusions Advanced age and ethnicity are important indicators of metabolic weight categories among postmenopausal women.
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Alipour M, Rostami H, Parastouei K. Association between inflammatory obesity phenotypes, FTO-rs9939609, and cardiovascular risk factors in patients with type 2 diabetes. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:46. [PMID: 32765616 PMCID: PMC7377118 DOI: 10.4103/jrms.jrms_429_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/08/2019] [Accepted: 02/17/2020] [Indexed: 12/17/2022]
Abstract
Background The role of inflammatory states in cardiometabolic risks among patients with type 2 diabetes mellitus (T2DM) with similar degrees of obesity is unknown. The study aimed to compare cardiometabolic risk factors in inflammatory obesity phenotypes with regard to the role of the FTO rs9939609 gene polymorphism. Materials and Methods This study was performed on 155 patients with T2DM (77 men and 78 women) in Ahvaz, Iran. Participants were grouped into four groups based on the presence of obesity and inflammation (high-sensitivity C-reactive protein ≥3.9 mg/L): low inflammatory normal weight (LINW), high inflammatory normal weight (HINW), low inflammatory obese (LIO), and high inflammatory obese (HIO). The genotypes of FTO rs9939609, including homozygous carriers of the FTO risk allele (AA), heterozygous carriers (AT), and carrying no risk allele (TT), were studied. The cardiometabolic risk factors, including anthropometric status, hypertension, lipid and glycemic profile, and inflammatory markers, were evaluated. The waist-hip ratio (WHR), mean arterial pressure (MAP), and atherogenic index of plasma (AIP) were calculated. Results The patients in inflammatory groups (HINW and HIO) have significantly higher levels in AIP when compared to inflammatory healthy groups (LINW and LIO). No significant differences between any of the four group means were detected in WHR, blood pressure, MAP, glycemic status (fasting blood sugar and insulin), homeostatic model assessment, lipid profile (triglyceride, very low-density lipoprotein, high-density lipoprotein, low-density lipoprotein, and cholesterol), interleukin-6, and total antioxidant capacity. The most frequent of high-risk genotype (AA) of FTO rs9939609 was in HIO, LIO, HINW, and LINW. Conclusion T2DM patients with inflammatory condition have similar degree of increased atherogenic risk irrespective of obesity. The obesity-risk genotype AA of FTO gene was associated with an increased risk for inflammatory obesity in T2DM patients.
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Affiliation(s)
- Meysam Alipour
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hosein Rostami
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Karim Parastouei
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Almajwal AM, Alam I, Abulmeaty M, Razak S, Pawelec G, Alam W. Intake of dietary advanced glycation end products influences inflammatory markers, immune phenotypes, and antiradical capacity of healthy elderly in a little-studied population. Food Sci Nutr 2020; 8:1046-1057. [PMID: 32148813 PMCID: PMC7020308 DOI: 10.1002/fsn3.1389] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 12/04/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023] Open
Abstract
Dietary advanced glycation end products (dAGE) have profound negative effects on overall health, and their intake must be assessed. In this cross-sectional study, we investigated dAGE intake of 337 adult participants (180/157:M/F; age range 50-73 years). Data were collected on anthropometrics, body composition, dietary intake, selected blood biochemistry, immunological parameters, and antiradical capacity (50% hemolysis time; HT50). From the dietary data, dAGEs and phytochemical index (PI) were calculated. Mean BMI, % body fat (%BF), and fasting plasma glucose were all within the accepted normal range. Subjects with high dAGE intake had higher %BF, higher energy intake, and lower PI. They tended to have lower CD4/CD8 ratios and higher proportions of B cells and NK cells, but had significantly higher hs-CRP levels and lower HT50 values. Results on HT50 suggested that being >60 years of age enhanced dAGE-associated impairment of defense capacity in both those with low and high HT50 compared with those <60 years of age. Thus, overall dAGE consumption was high, but elderly participants had lower dAGE intake than younger adults. Indicators of nutritional status and immunological parameters of the subjects were found to be associated with dAGE intake, suggesting a potential impact on health.
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Affiliation(s)
- Ali Madi Almajwal
- Clinical Nutrition ProgramDepartment of Community Health SciencesCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
| | - Iftikhar Alam
- Clinical Nutrition ProgramDepartment of Community Health SciencesCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
- Department of Human Nutrition & DieteticsBacha Khan University CharsaddaCharsaddaPakistan
| | - Mahmoud Abulmeaty
- Clinical Nutrition ProgramDepartment of Community Health SciencesCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
| | - Suhail Razak
- Clinical Nutrition ProgramDepartment of Community Health SciencesCollege of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
| | - Graham Pawelec
- Department of ImmunologyUniversity of TübingenTübingenGermany
- Health Sciences North Research InstituteSudburyONCanada
| | - Wajid Alam
- Oral and Maxillofacial SurgeryKhyber College of DentistryPeshawarPakistan
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Efremov L, Lacruz ME, Tiller D, Medenwald D, Greiser KH, Kluttig A, Wienke A, Nuding S, Mikolajczyk R. Metabolically Healthy, but Obese Individuals and Associations with Echocardiographic Parameters and Inflammatory Biomarkers: Results from the CARLA Study. Diabetes Metab Syndr Obes 2020; 13:2653-2665. [PMID: 32821138 PMCID: PMC7419616 DOI: 10.2147/dmso.s263727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/02/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The research on heterogeneity among obese individuals has identified the metabolically healthy, but obese (MHO) phenotype as a distinct group that does not experience the typical cardiovascular-related diseases (CVD). It is unclear if this group differs with regard to preconditions for CVDs. Our aim was to assess differences in echocardiographic parameters and inflammatory biomarkers between MHO and metabolically healthy, normal weight individuals (MHNW). METHODS The analyses used data from 1412 elderly participants from a German population-based cohort study (CARLA), which collected detailed information on demographic, biochemical, and echocardiographic variables. Participants were subdivided into four groups (MHNW, MHO, MUNW (metabolically unhealthy, normal weight) and MUO (metabolically unhealthy, obese)) based on BMI≥30 kg/m2 (obese or normal weight) and presence of components of the metabolic syndrome. The clinical characteristics of the 4 groups were compared with ANOVA or Chi-Square test, in addition to two linear regression models for 16 echocardiographic parameters. The difference in inflammatory biomarkers (hsCRP, IL-6 and sTNF-RI) between the groups was examined with a multinomial logistic regression model. RESULTS The MHO individuals were on average 64.2±8.4 years old, with a higher proportion of women (71.6%), low percentage of smokers, larger waist circumference (109.3±10.5 cm vs 89.1±10.8 cm, p<0.0001) and higher odds ratios for hsCRP, IL-6 and sTNF-RI compared to MHNW individuals. Linear regression models revealed greater left atrial (LA) diameter (2.73 (95% CI: 1.35-4.11) mm), LA volume (7.86 (95% CI: 2.88-12.83) mL), and left ventricular mass index (LVMI) (11.82 (95% CI: 4.43-19.22) g/m1.7) in the MHO group compared to the MHNW group. CONCLUSION The MHO phenotype is associated with echocardiographic markers of cardiac remodeling (LA diameter, volume and LVMI) and higher odds ratios for inflammatory biomarkers.
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Affiliation(s)
- Ljupcho Efremov
- Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Daniel Tiller
- IT Department, Data Integration Center, University Hospital Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Daniel Medenwald
- Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Karin Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Sebastian Nuding
- Department of Internal Medicine III, University Hospital Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Correspondence: Rafael Mikolajczyk Institute of Medical Epidemiology, Biostatistics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, Halle (Saale)06112, Germany Email
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Obesity survival paradox in cancer patients: Results from the Physical Frailty in older adult cancer patients (PF-EC) study. Clin Nutr 2019; 38:2806-2812. [DOI: 10.1016/j.clnu.2018.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 11/28/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022]
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Gao L, Wang L, Yang H, Pan H, Gong F, Zhu H. MC4R Single Nucleotide Polymorphisms Were Associated with Metabolically Healthy and Unhealthy Obesity in Chinese Northern Han Populations. Int J Endocrinol 2019; 2019:4328909. [PMID: 31781208 PMCID: PMC6875380 DOI: 10.1155/2019/4328909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/05/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022] Open
Abstract
Melanocortin-4 receptor (MC4R) has been reported to be associated with the risk of obesity, and metabolically unhealthy obese (MUHO) patients tend to have a greater risk of cardiovascular complications than metabolically healthy obese (MHO) patients. Therefore, we aimed to study single nucleotide polymorphisms (SNPs) in the MC4R gene associated with metabolically healthy and unhealthy obesity in Chinese Northern Han populations. A total of 1100 Chinese Northern Han subjects were recruited and divided into four groups according to the criteria of the Adult Treatment Panel-III (ATP-III) and World Health Organization (WHO): MUHO (n = 300), MHO (n = 196), metabolic unhealthy normal weight (MUH-NW) (n = 303), and metabolic healthy normal weight (MH-NW) (n = 301). DNA samples were extracted, and six SNPs of the MC4R gene, including rs2331841, rs656710, rs17782313, rs571312, rs12970134, and rs11872992, were genotyped with the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) method. Among the six SNPs of the MC4R gene, rs2331841 (A/G) was the most significant and could account for 0.9% of obesity etiology. Compared with the normal weight group, rs2331841 of the MC4R gene was associated with obesity (P=0.032). The obesity risk of subjects with the AG genotype in the rs2331841 site was 82% higher than the risk of those with the GG genotype (β = 0.60, OR = 1.82, P=0.030). After adjusting for sex and age, the frequency of the A allele in the rs2331841 site was higher in the MUHO group than in the MH-NW group (27.9% vs. 21.1%, respectively, OR = 1.49, 95% CI 1.14-1.96, P=0.005) and in the MUHO group than in the MHO group (27.9% vs. 22.3%, respectively, OR = 1.39, 95% CI 1.02-1.92, P=0.039). Among the three genotypes of rs2331841, the subjects with the AA/AG genotype had higher diastolic blood pressure (DBP) than those with the GG genotype. Our data first suggest that SNPs in the rs2331841 site of the MC4R gene are closely related to obesity and its related metabolic disorders in Chinese Northern Han populations. The participants with an A allele of rs2331841 had a higher risk of obesity and MUHO than other participants.
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Affiliation(s)
- Luying Gao
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Linjie Wang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Fengying Gong
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
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Crotti G, Gianfagna F, Bonaccio M, Di Castelnuovo A, Costanzo S, Persichillo M, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Body Mass Index and Mortality in Elderly Subjects from the Moli-Sani Study: A Possible Mediation by Low-Grade Inflammation? Immunol Invest 2018; 47:774-789. [PMID: 30422032 DOI: 10.1080/08820139.2018.1538237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The association between obesity and mortality in the elderly remains controversial. To test the association between BMI and mortality, with the hypothesis of a mediation by low-grade inflammation (LGI), a prospective study design (median follow-up 7.8 years) was used on a sample of 4,970 elderly subjects (age ≥ 65 years) from the Moli-sani Study cohort. The association between BMI categories and overall or cause-specific mortality (hazard ratio, HR) was calculated by multivariable Cox regression. Dose-response relationship was tested using restricted cubic splines. Interaction between BMI and LGI, assessed through high-sensitivity C-reactive protein (hs-CRP) and INFLA-score, was also tested. In comparison with normal-weight, overweight was significantly associated with a 20% (adjusted HR = 0.80; 95%CI 0.67-0.95) reduced risk of total mortality, while severe obesity (BMI > 40) with an increased risk (HR = 1.81; 95%CI 1.13-2.93). Cubic spline curves showed a U-shaped relationship between BMI and total mortality (p value for nonlinear relationship = 0.001). Similar results were found for cardio-cerebrovascular and other causes mortality. Hs-CRP and INFLA-score were associated with an increased risk of total mortality in adjusted analyses. Mediation analysis did not show any effect of LGI on the association between BMI and mortality. However, after stratification for LGI under or below the population median, greater LGI increased the risk of mortality in obese elderly more than expected (p for interaction = 0.04). A U-shaped association between BMI and mortality was observed in Italian elderly subjects. While the association was independent of LGI levels, there was a significant interaction between BMI and LGI in increasing mortality risk in obese elderly individuals.
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Affiliation(s)
- Giacomo Crotti
- a Research Center on Public Health, Department of Medicine and Surgery , University of Milano-Bicocca , Monza , Italy
| | - Francesco Gianfagna
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy.,c Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery , University of Insubria , Varese , Italy
| | - Marialaura Bonaccio
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Simona Costanzo
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Amalia De Curtis
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | - Chiara Cerletti
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | | | - Giovanni de Gaetano
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy
| | - Licia Iacoviello
- b Department of Epidemiology and Prevention , IRCCS Neuromed , Pozzilli (IS) , Italy.,c Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery , University of Insubria , Varese , Italy
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Rasaei N, Mirzababaei A, Arghavani H, Tajik S, Keshavarz SA, Yekaninejad MS, Imani H, Mirzaei K. A comparison of the sensitivity and specificity of anthropometric measurements to predict unhealthy metabolic phenotype in overweight and obese women. Diabetes Metab Syndr 2018; 12:1147-1153. [PMID: 30017504 DOI: 10.1016/j.dsx.2018.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/29/2018] [Indexed: 01/22/2023]
Abstract
AIM Metabolically Healthy Obese (MHO) is called to obese people that their insulin sensitivity, lipid profiles and inflammatory profiles are favorable, and there are no signs of hypertension and cardio-metabolic diseases. The metabolically unhealthy obese (MUHO) is the opposite. A Body Shape Index (ABSI) is a marker to identifying abdominal obesity that is derived from weight, height and waist circumference (WC). Several studies have reported ABSI is associated with diabetes, metabolic syndrome, hypertension and higher mortality rate. MATERIALS AND METHODS A total of 305 overweight and obese women were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. Blood samples were obtained. The usual food intake of evaluated through the use of a semi-quantitative food frequency questionnaire. RESULTS The results of this study revealed that there is a significant relationship between ABSI and MHO and MUHO (p = 0.04) and area under the ROC curve was 0.60. Also there is a significant relationship between BMI, fat mass index (FMI), free fat mass index (FFMI), neck circumference (NC), WC, fat mass (FM) and metabolic healthy status (MHS). The largest area under the ROC curve belonged to NC, WC, FM and BMI (0.66). CONCLUSION The findings of this study suggest that there is a significant relationship between ABSI, BMI, FMI, FFMI, NC, WC, FM and MHS. The largest area under the ROC curve was related to the NC, WC, FM and BMI not ABSI, that means NC, WC, FM and BMI have maximum sensitivity and specificity.
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Affiliation(s)
- Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hana Arghavani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Somayeh Tajik
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyed Ali Keshavarz
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Imani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Fate of the metabolically healthy obese-is this term a misnomer? A study from the Clinical Practice Research Datalink. Int J Obes (Lond) 2018; 43:1093-1101. [PMID: 29777229 DOI: 10.1038/s41366-018-0096-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 03/06/2018] [Accepted: 04/02/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The metabolically healthy obese (MHO) phenotype may express typical characteristics on long-term follow-up. Little is known about the initiation of this phenotypes and its future stability. AIM The Clinical Practice Research Datalink (CPRD) is a large-scale primary care database. The aim of this study was to assess the stability of, and evaluate the factors associated with a transition into an unhealthy outcome in, a MHO population in the UK. METHODS The CPRD was interrogated for a diagnosis of 'obesity' and cross-referenced with a body mass index (BMI) ≥35 kg/m2; participants were further classified as MH using a clinical diagnostic code or a relative therapeutic code. A hazard cox regression univariate and multivariate analysis evaluated the time to transition for independent variables. RESULTS There were 231,399 patients with a recorded BMI of 35 kg/m2 or greater. Incomplete records were eliminated and follow-up limited to 300 months, the cohort was reduced to 180,560 patients. The prevalence of MHO within the obese population from the CPRD was 128,191/180,560 (71%). MHO individuals, who were of male gender (hazard ratio (HR) 1.23 (1.21-1.25), p = < 0.01), older age group (HR 3.93 (3.82-4.04), p = < 0.01), BMI of 50-60 kg/m2 at baseline (HR 1.32(1.26-1.38), p = 0.01), smokers (HR 1.07(1.05-1.09), p = < 0.01) and regionally from North West England (HR 1.15(1.09-1.21), p = < 0.01) were more prone to an unhealthy transition (to develop comorbidities). Overall, of those MH at baseline, 71,485/128,191(55.8%) remained healthy on follow-up, with a mean follow-up of 113.5 (standard deviations (SD) 78.6) months or 9.4 (SD 6.6) years. CONCLUSIONS From this unique large data set, there is a greater prevalence of MHO individuals in the UK population than in published literature elsewhere. Female gender, younger age group, and lower initial weight and BMI were found to be significant predictors of sustained metabolic health in this cohort. However, there remains a steady progressive transition from a healthy baseline over the years.
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Talbot CPJ, Plat J, Joris PJ, Konings M, Kusters YHAM, Schalkwijk CG, Ritsch A, Mensink RP. HDL cholesterol efflux capacity and cholesteryl ester transfer are associated with body mass, but are not changed by diet-induced weight loss: A randomized trial in abdominally obese men. Atherosclerosis 2018; 274:23-28. [PMID: 29747087 DOI: 10.1016/j.atherosclerosis.2018.04.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/04/2018] [Accepted: 04/24/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Obesity is associated with a lower HDL-mediated cholesterol efflux from macrophages and a higher CETP (cholesteryl ester transfer protein) activity, but effects of weight loss are not clear. In addition, associations with visceral and subcutaneous adipose tissue are not known. We therefore investigated effects of diet-induced weight loss on HDL-mediated cholesterol efflux and cholesterol ester (CE) transfer in abdominally obese men. Differences between normal-weight and abdominally obese men were also examined. METHODS Twenty-five apparently healthy, normal-weight men (waist circumference: <94 cm) and 52 abdominally obese men (waist circumference: 102-110 cm) were included. Abdominally obese subjects were randomly allocated to a dietary weight-loss intervention group or a no-weight loss control group. Individuals from the intervention group followed a very-low-calorie diet for 6 weeks to obtain a waist circumference below 102 cm, followed by a 2-week weight-stable period. Cholesterol efflux was measured in BODIPY-labeled murine J774 macrophages. CE transfer was measured by quantifying the transfer of CE from radiolabeled exogenous HDL to apoB-containing lipoproteins. RESULTS Cholesterol efflux capacity was 9 percentage point (pp) lower in abdominally obese than in normal-weight men (p≤0.001), while CE transfer was 5 pp higher (p≤0.01). Diet-induced weight-loss of 10.3 kg did not change cholesterol efflux and CE transfer. In addition, stepwise regression analysis did not suggest that the different fat depots are differently related to efflux capacity and CE transfer. CONCLUSIONS After a 2-week weight-stable period, dietary weight loss of 10 kg did not improve ABCA1-mediated cholesterol efflux and CE transfer in abdominally obese men.
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Affiliation(s)
- Charlotte P J Talbot
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Peter J Joris
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Maurice Konings
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Yvo H A M Kusters
- Department of Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM (School for Cardiovascular Diseases), Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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den Hartigh LJ, Gao Z, Goodspeed L, Wang S, Das AK, Burant CF, Chait A, Blaser MJ. Obese Mice Losing Weight Due to trans-10,cis-12 Conjugated Linoleic Acid Supplementation or Food Restriction Harbor Distinct Gut Microbiota. J Nutr 2018; 148:562-572. [PMID: 29659960 PMCID: PMC6251681 DOI: 10.1093/jn/nxy011] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/28/2017] [Accepted: 01/09/2018] [Indexed: 12/28/2022] Open
Abstract
Background trans-10,cis-12 Conjugated linoleic acid (t10,c12-CLA) is a dietary supplement that promotes weight loss by increasing fat oxidation and energy expenditure. We previously reported that in the absence of t10,c12-CLA, mice forced to lose equivalent body weight by food restriction (FR) do not exhibit increases in fat oxidation or energy expenditure but have improved glucose metabolism, consistent with FR as a metabolically healthy weight-loss method. Objective Because diet is a primary determinant of gut bacterial populations, we hypothesized that the disparate metabolic effects accompanying weight loss from t10,c12-CLA or FR could be related to altered intestinal microbiota. Methods Ten-week-old male LDL receptor-deficient (Ldlr-/-) mice were fed a high-fat, high-sucrose diet (HFHS; 36% lard fat, 36.2% sucrose + 0.15% cholesterol) for 12 wk (baseline), then switched to the HFHS diet alone (obese control), HFHS + 1% c9,t11-CLA (obese fatty acid control), HFHS + 1% t10,c12-CLA (weight-loss-inducing fatty acid), or HFHS + FR (weight-loss control group with 75-85% ad libitum HFHS food intake) for a further 8 wk. Fecal microbial content, short-chain fatty acids (butyrate, acetate), tissue CLA concentrations, and intestinal nutrient transporter expression were quantified. Results Mice fed t10,c12-CLA or assigned to FR lost 14.5% of baseline body weight. t10,c12-CLA-fed mice had elevated concentrations of fecal butyrate (2-fold) and plasma acetate (1.5-fold) compared with HFHS-fed controls. Fecal α diversity decreased by 7.6-14% in all groups. Butyrivibrio and Roseburia, butyrate-producing microbes, were enriched over time by t10,c12-CLA. By comparing with each control group, we also identified bacterial genera significantly enriched in the t10,c12-CLA recipients, including Lactobacillus, Actinobacteria, and the newly identified Ileibacterium valens of the Allobaculum genus, whereas other taxa were enriched by FR, including Clostridiales and Bacteroides. Conclusion Modalities resulting in equivalent weight loss but with divergent metabolic effects are associated with compositional differences in the mouse intestinal microbiota.
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Affiliation(s)
- Laura J den Hartigh
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Zhan Gao
- Department of Medicine, New York University School of Medicine, New York, NY
| | - Leela Goodspeed
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Shari Wang
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Arun K Das
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Charles F Burant
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Alan Chait
- Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Martin J Blaser
- Department of Medicine, New York University School of Medicine, New York, NY
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Lake JE, Li X, Palella FJ, Erlandson KM, Wiley D, Kingsley L, Jacobson LP, Brown TT. Metabolic health across the BMI spectrum in HIV-infected and HIV-uninfected men. AIDS 2018; 32:49-57. [PMID: 28926404 PMCID: PMC5718950 DOI: 10.1097/qad.0000000000001651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES In the general population, metabolic health often declines as BMI increases. However, some obese individuals maintain metabolic health. HIV and antiretroviral therapy have been associated with metabolic disturbances. We hypothesized that HIV-infected (HIV) men on suppressive antiretroviral therapy experience less metabolic health than HIV-uninfected (HIV) men across all BMI categories. DESIGN/METHODS In a cross-sectional analysis of 1018 HIV and 1092 HIV men enrolled in the multicenter AIDS cohort study, Poisson regression with robust variance determined associations between HIV serostatus and metabolic health prevalence (defined as meeting ≤2 of 5 National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria), adjusting for age, race, BMI category, smoking, and hepatitis C virus infection status. RESULTS HIV men were younger (54 vs. 59 years) and had lower median BMI (25 vs. 27 kg/m). Nonobese HIV men had lower metabolic health prevalence than HIV men (BMI ≤25 kg/m: 80 vs. 94%, P < 0.001; BMI 25-29 kg/m: 64 vs. 71%, P = 0.05), but metabolic health prevalence among obese men did not differ by HIV serostatus (BMI 30-34 kg/m: 35 vs. 39%, P = 0.48; BMI ≥35 kg/m: 27 vs. 25%, P = 0.79). In the adjusted model, nonobese HIV men were less likely to demonstrate metabolic health than nonobese HIV men. Among HIV men, per year darunavir, zidovudine, and stavudine use were associated with lower metabolic health likelihood. CONCLUSION Metabolically healthy obesity prevalence does not differ by HIV serostatus. However, among nonobese men, HIV infection is associated with lower metabolic health prevalence, with associations between lack of metabolic health and darunavir and thymidine analog nucleoside reverse transcriptase inhibitor exposure observed.
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Affiliation(s)
- Jordan E Lake
- McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas
| | - Xiuhong Li
- Johns Hopkins University, Baltimore, Maryland
| | - Frank J Palella
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Neves JS, Guerreiro V, Carvalho D, Serrão R, Sarmento A, Freitas P. Metabolically Healthy or Metabolically Unhealthy Obese HIV-Infected Patients: Mostly a Matter of Age? Front Endocrinol (Lausanne) 2018; 9:681. [PMID: 30505292 PMCID: PMC6250744 DOI: 10.3389/fendo.2018.00681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/30/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Life expectancy of HIV-infected patients has increased with antiretroviral treatment (ART). Chronic diseases associated with aging, including metabolic and cardiovascular diseases are becoming more prevalent in this population. We aimed to evaluate the association of obesity and aging with cardiometabolic comorbidities and metabolic health status among patients with HIV infection. Methods: We evaluated 580 HIV-1 infected patients (71.7% male, mean age of 47.7 ± 11.5 years). We analyzed the association of age and obesity (defined by and by central obesity) with gender, duration of HIV infection, and ART, anthropometric parameters, cardiometabolic comorbidities, Framingham risk score (FRS), blood pressure, lipid profile, uric acid, liver biochemical tests, and glycemic profile. Furthermore, we analyzed the above-mentioned associations according to the category and central obesity into the metabolically healthy (MH) and unhealthy (MUH) categories. To evaluate the association of anthropometric parameters with cardiometabolic comorbidities, we performed unadjusted and adjusted logistic regression models. Results: The prevalence of excessive weight and cardiometabolic comorbidities increased with age. Patients with normal weight were younger and there was a higher proportion of female patients in the obesity group. The prevalence of hypertension and metabolic syndrome were higher among patients who were overweight or with obesity. The FRS was higher among patients with obesity. The proportion of MUH patients was higher among patients with excessive weight and central obesity. MUH patients had more cardiometabolic comorbidities and a higher FRS. In the normal weight group, MUH patients were older, and in the obesity group they were more likely to be male. The anthropometric parameter most associated with metabolic syndrome was waist circumference and that most associated with hypertension was waist-to-height ratio. The anthropometric parameter most associated with diabetes and FRS was waist-to-hip ratio. Conclusion: Patients with HIV present a high prevalence of obesity and related comorbidities. Ageing significantly contributes to metabolic dysfunction in this population. The proportion of MUH patients is higher among groups with excessive weight and central obesity, with those patients presenting a higher cardiovascular risk. Our results highlight the importance of evaluating and addressing obesity in patients with HIV, as well as metabolic comorbidities and cardiovascular risk.
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Affiliation(s)
- João Sérgio Neves
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- *Correspondence: João Sérgio Neves
| | - Vanessa Guerreiro
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
- Faculdade de Medicina, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Rosário Serrão
- Faculdade de Medicina, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Infectious Diseases Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - António Sarmento
- Infectious Diseases Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Paula Freitas
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
- Faculdade de Medicina, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Ostrovskaya EV, Romantsova TI, Gerasimov AN, Novoselova TE. The prevalence of metabolically healthy obesity according to the sample of the Moscow region. OBESITY AND METABOLISM 2017. [DOI: 10.14341/omet2017451-56] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction. Obesity is a major factor for cardiometabolic risk. However, there is a category of obese patients without disorders of lipid, carbohydrate metabolism and cardiovascular disease metabolically healthy obese (MHO).
Aim. Our goal was to investigate the prevalence and characteristics of this phenotype compared to patients with metabolic syndrome (MS).
Materials and methods. To evaluate the prevalence of the MHO phenotype we analyzed 389 medical records of females aged 1860 years with obesity. Three types of MHO criteria were used: 1) HOMA index (2.7); 2) IDF-criteria of metabolic syndrome, 2005; 3) the BioSHaRE-EU 2013 criteria (obese patients without any symptoms of MS). We conducted a comparative analysis of anthropometry, status of lipid and carbohydrate metabolism, the functional state of the liver.
Results. The MHO prevalence was: 34.5% according to HOMA index, according to the definitions of MS 2005 38.6%, in BioSHaRE-EU 9.6%. In groups of MHO and MS dyslipidemia was observed in 27.3 and 49.5% (p0.05), hypertension in 25% and 71.6% (p0.05), steatogepatosis in 47.7% vs 51.3% (p0.05) of observations, respectively. Among comorbidities the gynecological pathology was most prevalent - 50.8 and 61.4% (p0.05), disorders of carbohydrate metabolism differed significantly in frequency- 6.82 and 39.1% of patients (p0.05). Patients with MHO had a shorter duration of the existence of obesity than MS (18.7 vs. 24 years) (p=0.0004) and less likely to have attempted to reduce weight 85.8% and 91.6%. Average BMI, waist circumference, hip circumference, fasting glucose, total cholesterol, insulin basal, basal C-peptide, HOMA index in groups of MHO and MS differed significantly (p0.05). Median ALT was 20 and 23.2 U/l, AST 20 and 23 U/l, triglycerides 1.1 and 1.8 mmol/l, high-density lipoprotein 1.4 and 1.1 mmol/l, respectively.
Conclusions. The MHO prevalence was maximal according to the MS definitions from 2005, and minimal with BioSHaRE-EU criteria. The main analyzed indicators differed significantly in groups MHO and MS. Longer obesity existence in the MS group may suggest an instability of MHO phenotype over time.
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Doustmohamadian S, Serahati S, Barzin M, Keihani S, Azizi F, Hosseinpanah F. Risk of all-cause mortality in abdominal obesity phenotypes: Tehran Lipid and Glucose Study. Nutr Metab Cardiovasc Dis 2017; 27:241-248. [PMID: 28139376 DOI: 10.1016/j.numecd.2016.11.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM Long-term health risks in the so-called "healthy obesity" phenotypes remain controversial. Also it is unknown if "metabolically healthy abdominal obese" (MHAO) phenotype is at increased risk of all-cause mortality compared to their non-abdominally obese counterparts. In this study we assessed the risk of all-cause mortality in different abdominal obesity phenotypes. METHODS AND RESULTS In this large population-based cohort, 8804 participants (aged ≥ 30 years), from the Tehran Lipid and Glucose Study (TLGS) were enrolled and followed for a median of 12.0 (8.7-12.5) years. Abdominal obesity was defined using national waist circumference (WC) cut-off points of ≥89 cm for men and ≥91 cm for women. Metabolic health was defined as ≤1 components of metabolic syndrome (excluding WC), using the Joint Interim Statement (JIS) definition. Baseline prevalence of MHAO phenotype was 12.8% in the whole population and 23.4% in those with abdominal obesity. A total of 540 all-cause death occurred during the follow-up. After multivariate adjustment, all-cause mortality risk in MHAO phenotype was not significantly increased compared to "metabolically healthy non abdominal obese" (MHNAO) as the reference group (HR: 1.35, CI: 0.89-2.03). CONCLUSION Our results indicate that MHAO individuals were not at higher risk for all-cause mortality over a median of 12 years follow-up. However, considering inadequate power of our analysis for fully adjusted model, larger studies with more follow-ups are needed.
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Affiliation(s)
- S Doustmohamadian
- School of Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - S Serahati
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - M Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - S Keihani
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - F Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
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Kanagasabai T, Dhanoa R, Kuk JL, Ardern CI. Association between Sleep Habits and Metabolically Healthy Obesity in Adults: A Cross-Sectional Study. J Obes 2017; 2017:5272984. [PMID: 28367325 PMCID: PMC5358440 DOI: 10.1155/2017/5272984] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/15/2017] [Indexed: 02/06/2023] Open
Abstract
Higher body mass index (BMI) increases the risk of cardiometabolic diseases, but nearly a third of the people living with obesity (BMI: ≥30 kg/m2) are metabolically healthy (MHO). Extreme sleep durations and poor sleep quality are associated with higher bodyweight and cardiometabolic dysfunction, but the full extent to which sleep habits may help differentiate those with MHO versus metabolically abnormal obesity (MAO) is not yet known. Data from the U.S. National Health and Nutritional Examination Survey 2005-08 was used (BMI: ≥30 kg/m2; ≥20 y; N = 1,777). The absence of metabolic syndrome was used to define MHO. Those with MHO tended to be younger, female, Non-Hispanic Black, never smokers, more physically active, and with less physician diagnosed sleep disorders than MAO. Neither sleep duration nor overall sleep quality was related to MHO in crude or multivariable adjusted analyses; however, reporting "almost always" to having trouble falling asleep (OR (95% CI): 0.40 (0.20-0.78)), waking up during the night (0.38 (0.17-0.85)), feeling unrested during the day (0.35 (0.18-0.70)), and feeling overly sleepy during the day (0.35 (0.17-0.75)) was related to lower odds of MHO. Selected sleep quality factors, but not sleep quantity or overall sleep quality, are associated with the MHO phenotype.
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Affiliation(s)
| | - Ramandeep Dhanoa
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Jennifer L. Kuk
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Chris I. Ardern
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
- *Chris I. Ardern:
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Abstract
The percentage of older obese adults is on the rise. Many clinicians underestimate the health consequences of obesity in the elderly, citing scarce evidence and concerns that weight loss might be detrimental to the health of older adults. Although overweight and obese elders are not at the same risk for morbidity and mortality as younger individuals, quality of life and function are adversely impacted. Weight loss plans in the elderly should include aerobic activities as well as balance and resistance activities to maintain optimal physical function.
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Affiliation(s)
- Virginia B Kalish
- Department of Family Medicine, National Capital Consortium Family Medicine Residency, Fort Belvoir Community Hospital, 9300 Dewitt Loop, Fort Belvoir, VA 22060, USA.
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Jamar G, Caranti DA, de Cassia Cesar H, Masquio DCL, Bandoni DH, Pisani LP. Leptin as a cardiovascular risk marker in metabolically healthy obese: Hyperleptinemia in metabolically healthy obese. Appetite 2016; 108:477-482. [PMID: 27838444 DOI: 10.1016/j.appet.2016.11.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/07/2016] [Accepted: 11/08/2016] [Indexed: 12/21/2022]
Abstract
Adipokines contribute to the inflammatory process which can lead to obesity-associated cardiometabolic complications. Metabolically healthy obese individuals seem to be protected or more resistant to develop these complications and it is intriguing why some individuals develop comorbidities and others do not. Thus, we questioned whether the differences between metabolically healthy and unhealthy obese relied on the alterations in metabolic profile, characterized by serum leptin and adiponectin. A total of 142 obese adults were divided into 2 groups - metabolically healthy obese (MHO) or unhealthy obese (MUO) - and they were evaluated for anthropometric measures, body composition, blood pressure, dietary intakes and plasma levels of leptin and adiponectin. Leptin/adiponectin ratio (L/A) was calculated. Age, BMI and blood pressure were higher in the MUO. No differences in anthropometric measurements, body composition, dietary intake and dietary quality were observed between groups. Leptin were significantly higher in the MUO (53.07 ± 34.56 versus 36.27 ± 24.02 ng/ml in the MHO, r < 0.04). The logistic regression analysis demonstrated that leptin was an important factor associated with not being healthy, independent of age, body weight and BMI. There were no differences between groups for adiponectin and L/A. Leptin correlated positively with body weight (r = 0.25, r < 0.05), BMI (r = 0.38, r < 0.05) and BF (r = 0.74, r < 0.05), and negatively with FFM (r = -0.74, r < 0.05). Our findings suggest that leptin is an important cardiovascular disease marker to obese population and can contribute to evaluate metabolic risks in these individuals.
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Affiliation(s)
- Giovana Jamar
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil
| | - Danielle Arisa Caranti
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil; Departamento de Biociências, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil
| | - Helena de Cassia Cesar
- Departamento de Biociências, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil
| | | | - Daniel Henrique Bandoni
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil; Departamento de Saúde, Clínica e Instituições, Universidade Federal de São Paulo - UNIFESP, Santos SP, Brazil
| | - Luciana Pellegrini Pisani
- Programa de Pós-graduação Interdisciplinar em Ciências da Saúde, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil; Departamento de Biociências, Universidade Federal de São Paulo - UNIFESP, Santos, SP, Brazil.
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Briffa JF, Grinfeld E, Jenkin KA, Mathai ML, Poronnik P, McAinch AJ, Hryciw DH. Diet induced obesity in rats reduces NHE3 and Na(+) /K(+) -ATPase expression in the kidney. Clin Exp Pharmacol Physiol 2016; 42:1118-26. [PMID: 26173747 DOI: 10.1111/1440-1681.12452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/25/2015] [Accepted: 07/01/2015] [Indexed: 01/25/2023]
Abstract
The consumption of a high fat diet (HFD) is associated with proteinuria and altered sodium handling and excretion, which can lead to kidney disease. In the proximal tubule, the Na(+) /H(+) Exchanger 3 (NHE3) is responsible for normal protein reabsorption and the reabsorption of approximately 70% of the renal sodium load. It is the Na(+) /K(+) -ATPase that provides the driving force for the reabsorption of sodium and its exit across the basolateral membrane. This study investigates the effects that consumption of a HFD for 12 weeks has on NHE3 and Na(+) /K(+) -ATPase expression in the kidney. Western blot analysis identified a significant reduction in NHE3 and its modulator, phosphorylated protein kinase B, in renal lysate from obese rats. In the obese rats, a reduction in NHE3 expression in the proximal tubule may impact on the acidification of endosomes which are responsible for albumin uptake, suggesting a key role for the exchanger in protein endocytosis in obesity. Western blot analysis identified a reduction in Na(+) /K(+) -ATPase which could also potentially impact on albumin uptake and sodium reabsorption. This study demonstrates that consumption of a HFD for 12 weeks reduces renal NHE3 and Na(+) /K(+) -ATPase expression, an effect that may contribute to the albuminuria associated with obesity. Furthermore the reduction in these transporters is not likely to contribute to the reduced sodium excretion in obesity. These data highlight a potential link between NHE3 and Na(+) /K(+) -ATPase in the pathophysiological changes in renal protein handling observed in obesity.
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Affiliation(s)
- J F Briffa
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia.,Department of Physiology, The University of Melbourne, Parkville, Victoria, Australia
| | - E Grinfeld
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - K A Jenkin
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - M L Mathai
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - P Poronnik
- Department of Physiology, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - A J McAinch
- Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, St Albans, Victoria, Australia
| | - D H Hryciw
- Department of Physiology, The University of Melbourne, Parkville, Victoria, Australia
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Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res 2016; 118:1752-70. [DOI: 10.1161/circresaha.115.306883] [Citation(s) in RCA: 578] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/11/2016] [Indexed: 12/20/2022]
Abstract
The prevalence of obesity has increased worldwide over the past few decades. In 2013, the prevalence of obesity exceeded the 50% of the adult population in some countries from Oceania, North Africa, and Middle East. Lower but still alarmingly high prevalence was observed in North America (≈30%) and in Western Europe (≈20%). These figures are of serious concern because of the strong link between obesity and disease. In the present review, we summarize the current evidence on the relationship of obesity with cardiovascular disease (CVD), discussing how both the degree and the duration of obesity affect CVD. Although in the general population, obesity and, especially, severe obesity are consistently and strongly related with higher risk of CVD incidence and mortality, the one-size-fits-all approach should not be used with obesity. There are relevant factors largely affecting the CVD prognosis of obese individuals. In this context, we thoroughly discuss important concepts such as the fat-but-fit paradigm, the metabolically healthy but obese (MHO) phenotype and the obesity paradox in patients with CVD. About the MHO phenotype and its CVD prognosis, available data have provided mixed findings, what could be partially because of the adjustment or not for key confounders such as cardiorespiratory fitness, and to the lack of consensus on the MHO definition. In the present review, we propose a scientifically based harmonized definition of MHO, which will hopefully contribute to more comparable data in the future and a better understanding on the MHO subgroup and its CVD prognosis.
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Affiliation(s)
- Francisco B. Ortega
- From the PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain (F.B.O.); Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden (F.B.O.); Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA (C.J.L.); and
| | - Carl J. Lavie
- From the PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain (F.B.O.); Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden (F.B.O.); Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA (C.J.L.); and
| | - Steven N. Blair
- From the PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain (F.B.O.); Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden (F.B.O.); Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA (C.J.L.); and
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Clark DO, Unroe KT, Xu H, Keith NR, Callahan CM, Tu W. Sex and Race Differences in the Relationship between Obesity and C-Reactive Protein. Ethn Dis 2016; 26:197-204. [PMID: 27103770 DOI: 10.18865/ed.26.2.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
C-reactive protein (CRP) is a risk factor for cardiovascular disease and mortality; it is known to be positively associated with obesity but there is some evidence that this association differs by race or sex. We used nationally representative data of adults aged >50 years to investigate sex and race modifiers of the associations between obesity and CRP in non-Hispanic White males (n=3,517) and females (n=4,658), and non-Hispanic Black males (n=464) and females (n=826). Using multiple linear regression models with the natural logarithm of CRP as the dependent variable, we sequentially included body mass index (BMI), a body shape index (ABSI), and socioeconomic, health and health behavior covariates in the model. The association between BMI and CRP was significantly stronger in females than males. Obese White females had mean CRP values slightly above 3 mg/liter (vs 2 for White males) and Black females had mean CRP values >4 mg/liter (vs 3 for Black males). More than 50% of Black females in the United States have obesity. Continued research into racial and sex differences in the relationship between obesity, inflammation, and health risks may ultimately lead to more personalized weight loss recommendations.
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Affiliation(s)
- Daniel O Clark
- Indiana University Center for Aging Research, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana
| | - Kathleen T Unroe
- Indiana University Center for Aging Research, Indianapolis, Indiana
| | - Huiping Xu
- Department of Biostatistics, Indiana University
| | | | | | - Wanzhu Tu
- Department of Biostatistics, Indiana University
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Silva-Palacios A, Königsberg M, Zazueta C. Nrf2 signaling and redox homeostasis in the aging heart: A potential target to prevent cardiovascular diseases? Ageing Res Rev 2016; 26:81-95. [PMID: 26732035 DOI: 10.1016/j.arr.2015.12.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
Aging process is often accompanied with a high incidence of cardiovascular diseases (CVD) due to the synergistic effects of age-related changes in heart morphology/function and prolonged exposure to injurious effects of CVD risk factors. Oxidative stress, considered a hallmark of aging, is also an important feature in pathologies that predispose to CVD development, like hypertension, diabetes and obesity. Approaches directed to prevent the occurrence of CVD during aging have been explored both in experimental models and in controlled clinical trials, in order to improve health span, reduce hospitalizations and increase life quality during elderly. In this review we discuss oxidative stress role as a main risk factor that relates CVD with aging. As well as interventions that aim to reduce oxidative stress by supplementing with exogenous antioxidants. In particular, strategies of improving the endogenous antioxidant defenses through activating the nuclear factor related-2 factor (Nrf2) pathway; one of the best studied molecules in cellular redox homeostasis and a master regulator of the antioxidant and phase II detoxification response.
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Eckel N, Meidtner K, Kalle-Uhlmann T, Stefan N, Schulze MB. Metabolically healthy obesity and cardiovascular events: A systematic review and meta-analysis. Eur J Prev Cardiol 2015; 23:956-66. [PMID: 26701871 DOI: 10.1177/2047487315623884] [Citation(s) in RCA: 256] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/03/2015] [Indexed: 11/17/2022]
Abstract
AIMS Previous studies have provided inconsistent results about the cardiovascular risks for participants with metabolically healthy obesity (MHO). These uncertainties might partly reflect the lack of a uniform definition of MHO. We conducted a systematic review and meta-analysis to examine whether there is a suitable approach that identifies obese participants who are not at an increased risk of cardiovascular events compared with healthy normal-weight participants. METHODS AND RESULTS Twenty-two prospective studies were eligible for the meta-analysis. Using random-effect models, pooled relative risks (RRs) were calculated for the combined effects of obesity with the presence or absence of metabolic syndrome, insulin resistance, hypertension, diabetes, hyperlipidaemia and any of these metabolic factors. Participants with MHO defined by the absence of metabolic syndrome were at increased risk for cardiovascular events compared with healthy normal-weight participants (pooled RR 1.45, 95% confidence interval (CI) 1.20-1.70), but had lower risks than unhealthy normal-weight (RR 2.07, 95% CI 1.62-2.65) and obese (RR 2.31, 95% CI 1.99-2.69) participants. The risk associated with participants who had MHO was particularly high over the long term. Similar risk estimates were observed when MHO was defined by other approaches. CONCLUSIONS None of the approaches clearly identified an obese subgroup not at increased risk of cardiovascular events compared with normal-weight healthy participants. A benign obese phenotype might be defined by strict definitions, but insufficient studies exist to support this. More research is needed to better define MHO.
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Affiliation(s)
- Nathalie Eckel
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Germany German Center for Diabetes Research, Germany
| | - Karina Meidtner
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Germany
| | | | - Norbert Stefan
- German Center for Diabetes Research, Germany Institute of Diabetes Research and Metabolic Diseases of the Helmholtz Center München at the University of Tübingen, Germany Department of Internal Medicine IV, University Hospital of Tübingen, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Germany German Center for Diabetes Research, Germany
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Kiesswetter E, Schrader E, Diekmann R, Sieber CC, Volkert D. Varying Associations Between Body Mass Index and Physical and Cognitive Function in Three Samples of Older Adults Living in Different Settings. J Gerontol A Biol Sci Med Sci 2015; 70:1255-61. [PMID: 25910844 DOI: 10.1093/gerona/glv048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 03/25/2015] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The study investigates variations in the associations between body mass index (BMI) and (a) physical and (b) cognitive function across three samples of older adults living in different settings, and moreover determines if the association between BMI and physical function is confounded by cognitive abilities. METHODS One hundred ninety-five patients of a geriatric day hospital, 322 persons receiving home care (HC), and 183 nursing home (NH) residents were examined regarding BMI, cognitive (Mini-Mental State Examination), and physical function (Barthel Index for activities of daily living). Differences in Mini-Mental State Examination and activities of daily living scores between BMI groups (<22, 22-<25, 25-<30, 30-<35, ≥35kg/m(2)) were tested by analysis of covariance considering relevant confounders. RESULTS Activities of daily living and Mini-Mental State Examination impairments increased from the geriatric day hospital over the HC to the NH sample, whereas prevalence rates of obesity and severe obesity (35%, 33%, 25%) decreased. In geriatric day hospital patients cognitive and physical function did not differ between BMI groups. In the HC and NH samples, cognitive abilities were highest in obese and severely obese subjects. Unadjusted mean activities of daily living scores differed between BMI groups in HC receivers (51.6±32.2, 61.8±26.1, 67.5±28.3, 72.0±23.4, 66.2±24.2, p = .002) and NH residents (35.6±28.6, 48.1±25.7, 39.9±28.7, 50.8±24.0, 57.1±28.2, p = .029). In both samples significance was lost after adjustment indicating cognitive function as dominant confounder. CONCLUSIONS In older adults the associations between BMI and physical and cognitive function were dependent on the health and care status corresponding to the setting. In the HC and the NH samples, cognitive status, as measured by the Mini-Mental State Examination, emerged as an important confounder within the association between BMI and physical function.
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Affiliation(s)
- Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
| | - Eva Schrader
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Rebecca Diekmann
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. Department for Geriatric Medicine, Carl von Ossietzky Universität Oldenburg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
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Lang PO, Trivalle C, Vogel T, Proust J, Papazyan JP, Dramé M. Determination of Cutoff Values for DEXA-Based Body Composition Measurements for Determining Metabolic and Cardiovascular Health. Biores Open Access 2015; 4:16-25. [PMID: 26309779 PMCID: PMC4497664 DOI: 10.1089/biores.2014.0056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The two components of the body weight (i.e., fat mass and muscle mass) appeared to be of high interest to consider in predicting metabolic health related risks. We aimed to determine cutoff values for fat mass index (FMI) and muscle mass index (MMI), FM/MM, and BMI for metabolic and cardiovascular health. This study was a cross-sectional analysis study conducted in a center of preventive medicine. It included 616 consecutive outpatients: mean age was 56.0±10.0 years (74.6% aged ≥50), and 61.4% were female. Fat and muscle mass were obtained with dual energy X-ray absorptiometry scan analyses. Metabolically unhealthy individuals were defined as people with biological features of dyslipidemia, hyperuricemia, diabetes, and/or hepatitis steatosis. Documented hypertension and/or atherosclerosis of at least one major artery defined individuals with cardiovascular complications. Receiver-operating characteristic curve analysis revealed that the cutoff values for MMI, FMI, and FM/MM were respectively 18.8kg/m2 (sensitivity [Se]=58%; specificity [Sp]=59%), 5.5kg/m2 (Se=61%; Sp=62%), and 0.31 (Se=62%; Sp=62%) in men; and 14.1kg/m2 (Se=52%; Sp=54%), 5.5kg/m2 (Se=65%; Sp=67%), 0.39 (Se=73%; Sp=73%) in women for predicting metabolic health. Values were 19.3kg/m2 (Se=58%; Sp=59%), 7.0kg/m2 (Se=61%; Sp=62%) and 0.49 (Se=62%; Sp=62%) in men; and 15.7kg/m2 (Se=58%; Sp=59%), 6.4kg/m2 (Se=61%; Sp=62%) and 0.35 (Se=62%; Sp=62%) in women for cardiovascular complications. Whatever the outcomes considered, the Youden indexes for BMI values were systematically below 25 kg/m2, except for cardiovascular complications in men, where the threshold for the best Se/Sp was 25.7 kg/m2. These cutoff values for FMI, MMI, and FM/MM could be of practical value for the clinical evaluation of a deficit in MM with or without excess of FM. They complement the classical concept of BMI in a more qualitative manner and extend the analysis of its impact on health outcomes to all BMI categories.
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Affiliation(s)
- Pierre-Olivier Lang
- Health and Wellbeing Academy, Anglia Ruskin University , Cambridge, United Kingdom . ; Nescens Centre of Preventive Medicine, Clinic of Genolier , Genolier, Switzerland
| | - Christophe Trivalle
- Pôle Gériatrie, Hôpitaux Universitaires de Paris-Sud , Hôpital Paul Brousse, Assistance-Publique Hôpitaux de Paris, Villejuif, France
| | - Thomas Vogel
- Pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg , Strasbourg, France
| | - Jacques Proust
- Nescens Centre of Preventive Medicine, Clinic of Genolier , Genolier, Switzerland
| | | | - Moustapha Dramé
- Department of Research and Innovation, Hôpitaux Universitaires de Reims , Reims, France . ; Faculty of Medicine, University of Reins-Champagne-Ardenne , Reins, France
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Deletion of serum amyloid A3 improves high fat high sucrose diet-induced adipose tissue inflammation and hyperlipidemia in female mice. PLoS One 2014; 9:e108564. [PMID: 25251243 PMCID: PMC4177399 DOI: 10.1371/journal.pone.0108564] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/22/2014] [Indexed: 12/17/2022] Open
Abstract
Serum amyloid A (SAA) increases in response to acute inflammatory stimuli and is modestly and chronically elevated in obesity. SAA3, an inducible form of SAA, is highly expressed in adipose tissue in obese mice where it promotes monocyte chemotaxis, providing a mechanism for the macrophage accumulation that occurs with adipose tissue expansion in obesity. Humans do not express functional SAA3 protein, but instead express SAA1 and SAA2 in hepatic as well as extrahepatic tissues, making it difficult to distinguish between liver and adipose tissue-specific SAA effects. SAA3 does not circulate in plasma, but may exert local effects that impact systemic inflammation. We tested the hypothesis that SAA3 contributes to chronic systemic inflammation and adipose tissue macrophage accumulation in obesity using mice deficient for Saa3 (Saa3(-/-)). Mice were rendered obese by feeding a pro-inflammatory high fat, high sucrose diet with added cholesterol (HFHSC). Both male and female Saa3(-/-) mice gained less weight on the HFHSC diet compared to Saa3(+/+) littermate controls, with no differences in body composition or resting metabolism. Female Saa3(-/-) mice, but not males, had reduced HFHSC diet-induced adipose tissue inflammation and macrophage content. Both male and female Saa3(-/-) mice had reduced liver Saa1 and Saa2 expression in association with reduced plasma SAA. Additionally, female Saa3(-/-) mice, but not males, showed improved plasma cholesterol, triglycerides, and lipoprotein profiles, with no changes in glucose metabolism. Taken together, these results suggest that the absence of Saa3 attenuates liver-specific SAA (i.e., SAA1/2) secretion into plasma and blunts weight gain induced by an obesogenic diet. Furthermore, adipose tissue-specific inflammation and macrophage accumulation are attenuated in female Saa3(-/-) mice, suggesting a novel sexually dimorphic role for this protein. These results also suggest that Saa3 influences liver-specific SAA1/2 expression, and that SAA3 could play a larger role in the acute phase response than previously thought.
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Lang PO, Trivalle C, Vogel T, Proust J, Papazian JP. Markers of metabolic and cardiovascular health in adults: Comparative analysis of DEXA-based body composition components and BMI categories. J Cardiol 2014; 65:42-9. [PMID: 24794756 DOI: 10.1016/j.jjcc.2014.03.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/26/2014] [Accepted: 03/14/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To investigate how body composition components fit body mass index (BMI) categories and whether they could be considered as markers of metabolic and cardiovascular health. DESIGN Prospective study. SETTING A center for preventive medicine. PARTICIPANTS Six hundred and sixteen consecutive outpatients: mean age of 56.0±10.0 years; 74.6% aged ≥50 years and 61.4% were females. MEASUREMENTS Fat mass (FM) and muscle mass (MM) were obtained by dual energy X-ray absorptiometry analyses. Metabolically unhealthy individuals were defined as people with biological features of dyslipidemia, hyperuricemia, diabetes, and/or hepatitis steatosis. Documented hypertension and/or atherosclerosis of one major artery, at least, defined individuals with cardiovascular complications. RESULTS According to BMI categories, 45.8% of the sample was of normal weight, while 19.2% and 16.5% were classified as overweight and obese. A total of 78.0% and 86.3% of overweight and obese individuals were metabolically unhealthy respectively, 46.8% and 52.6% of subjects classified into normal and underweight BMI categories were also diagnosed. Cardiovascular complications mainly concerned the two highest BMI groups (78.2%). In multifactorial analyses the overweight and obese BMI categories were predictive of health outcomes [respectively, odds ratio (OR)=8.05, 95% confidence interval (CI): 4.23-12.07 and 5.74, 95% CI: 3.41-8.98]. FM and MM indexes were significantly associated with metabolic (OR=1.30, 95% CI: 1.19-1.47; and 0.84, 95% CI: 0.78-0.91) and cardiovascular (OR=1.22, 95% CI: 1.13-1.32; and 0.72, 95% CI: 0.65-0.80) health respectively, and FM/MM (respectively, OR=15.45, 95% CI: 11.77-20.17; and 16.61, 95% CI: 10.49-21.33) as well. CONCLUSION Our findings suggest that FM and MM readouts are important measurements of nutritional status and they extend the analysis of its impact on health outcomes to all BMI categories. Moreover, they highlight the interest of measuring body composition in medical check-ups to predict metabolic and cardiovascular diseases.
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Affiliation(s)
- Pierre-Olivier Lang
- Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield, UK; Nescens Centre of Preventive Medicine, Clinic of Genolier, Genolier, Switzerland.
| | - Christophe Trivalle
- Pôle Gériatrie, Hôpitaux Universitaires de Paris-Sud, Hôpital Paul Brousse, Assistance-Publique Hôpitaux de Paris, Villejuif, France
| | - Thomas Vogel
- Pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jacques Proust
- Nescens Centre of Preventive Medicine, Clinic of Genolier, Genolier, Switzerland
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Brinkley TE, Leng X, Chughtai HL, Nicklas BJ, Kritchevsky SB, Ding J, Kitzman DW, Hundley WG. Periaortic fat and cardiovascular risk: a comparison of high-risk older adults and age-matched healthy controls. Int J Obes (Lond) 2014; 38:1397-402. [PMID: 24525960 PMCID: PMC4143481 DOI: 10.1038/ijo.2014.29] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/05/2014] [Accepted: 02/10/2014] [Indexed: 02/07/2023]
Abstract
Objective Fat accumulation around the heart and aorta may impact cardiovascular (CV) health. The purpose of this study was to conduct a systematic investigation to examine potential associations of these fat depots with risk factors for CV events, which has not been done before. Methods Pericardial fat, periaortic fat around the ascending aorta (AA), descending aorta (DA) and aortic arch, and abdominal subcutaneous and visceral fat were measured by MRI in older adults with (n=385, 69±8 years, 52% female) and without (n=50, 69±8 years, 58% female) risk factors for a CV event. Results Individuals with CV risk factors exhibited greater fat volumes across all fat depots compared to those without risk factors. In analysis of covariance accounting for age, gender, race/ethnicity, diabetes, hypertension, coronary artery disease, smoking, and BMI, individuals with risk factors possessed higher epicardial, pericardial, AA, DA, and abdominal visceral fat (p<0.05). When matched one-to-one on age, gender, race/ethnicity, and BMI, AA and DA fat were higher in those with versus without CV risk factors (p<0.01). Conclusions Older adults with a high risk for CV events have greater periaortic fat than low-risk adults, even after accounting for BMI. More studies are needed to determine whether greater periaortic fat predicts future CV events.
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Affiliation(s)
- T E Brinkley
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - X Leng
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - H L Chughtai
- Section on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - B J Nicklas
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - S B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - J Ding
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
| | - D W Kitzman
- Section on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - W G Hundley
- Section on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Roberson LL, Aneni EC, Maziak W, Agatston A, Feldman T, Rouseff M, Tran T, Blaha MJ, Santos RD, Sposito A, Al-Mallah MH, Blankstein R, Budoff MJ, Nasir K. Beyond BMI: The "Metabolically healthy obese" phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic review. BMC Public Health 2014; 14:14. [PMID: 24400816 PMCID: PMC3890499 DOI: 10.1186/1471-2458-14-14] [Citation(s) in RCA: 215] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 12/10/2013] [Indexed: 12/31/2022] Open
Abstract
Background A subgroup has emerged within the obese that do not display the typical metabolic disorders associated with obesity and are hypothesized to have lower risk of complications. The purpose of this review was to analyze the literature which has examined the burden of cardiovascular disease (CVD) and all-cause mortality in the metabolically healthy obese (MHO) population. Methods Pubmed, Cochrane Library, and Web of Science were searched from their inception until December 2012. Studies were included which clearly defined the MHO group (using either insulin sensitivity and/or components of metabolic syndrome AND obesity) and its association with either all cause mortality, CVD mortality, incident CVD, and/or subclinical CVD. Results A total of 20 studies were identified; 15 cohort and 5 cross-sectional. Eight studies used the NCEP Adult Treatment Panel III definition of metabolic syndrome to define “metabolically healthy”, while another nine used insulin resistance. Seven studies assessed all-cause mortality, seven assessed CVD mortality, and nine assessed incident CVD. MHO was found to be significantly associated with all-cause mortality in two studies (30%), CVD mortality in one study (14%), and incident CVD in three studies (33%). Of the six studies which examined subclinical disease, four (67%) showed significantly higher mean common carotid artery intima media thickness (CCA-IMT), coronary artery calcium (CAC), or other subclinical CVD markers in the MHO as compared to their MHNW counterparts. Conclusions MHO is an important, emerging phenotype with a CVD risk between healthy, normal weight and unhealthy, obese individuals. Successful work towards a universally accepted definition of MHO would improve (and simplify) future studies and aid inter-study comparisons. Usefulness of a definition inclusive of insulin sensitivity and stricter criteria for metabolic syndrome components as well as the potential addition of markers of fatty liver and inflammation should be explored. Clinicians should be hesitant to reassure patients that the metabolically benign phenotype is safe, as increased risk cardiovascular disease and death have been shown.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Khurram Nasir
- Center for Prevention and Wellness Research, Baptist Health Medical Group, Michigan Ave Suite 500, Miami Beach, Florida.
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Yi LC, Neves ALS, Areia M, Neves JMO, Souza TPD, Caranti DA. Influencia do indice de massa corporal no equilibrio e na configuracao plantar em obesos adultos. REV BRAS MED ESPORTE 2014. [DOI: 10.1590/s1517-86922014000100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: A obesidade é uma doença crônica degenerativa multifatorial que pode levar a alterações do sistema musculoesquelético, como mudança do centro de gravidade e sobrecarga mecânica sobre os membros inferiores. OBJETIVOS: Correlacionar o índice de massa corporal (IMC) com o equilíbrio corporal e verificar associação entre o IMC e a configuração plantar. MÉTODOS: Foram avaliados 30 obesos, de ambos os gêneros, com IMC maior ou igual a 30 Kg/m². Inicialmente, os voluntários foram submetidos às avaliações de medidas antropométricas a fim de calcular o valor do IMC. Em seguida, foram submetidos ao teste de equilíbrio corporal estático Balance Error Scoring System (BESS) e a plantigrafia para a identificação da impressão plantar. Por meio do método de Viladot, os voluntários foram classificados em grupos: pé plano (GPP), pé cavo (GPC) e pé neutro (GPN). A correlação entre as variáveis IMC e BESS foi calculada por meio do coeficiente de correlação linear de Pearson e associação entre o IMC e a configuração plantar foi realizada por meio da análise de variância (Anova). Para todas as análises, nível de significância considerado foi p < 0,05. RESULTADOS: Os valores da correlação entre o IMC e o BESS foram r = - 0,1 e p = 0,59. Os valores da associação do IMC entre GPN - GPP; GPN - GPC; GPP - GPC foram respectivamente: p = 0,76; p = 0,001; p = 0,07. CONCLUSÃO: O índice de massa corporal de adultos obesos não influencia o equilíbrio corporal, porém influencia na configuração plantar.
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Lang PO, Mahmoudi R, Novella JL, Tardieu E, Bertholon LA, Nazeyrollas P, Blanchard F, Jolly D, Dramé M. Is obesity a marker of robustness in vulnerable hospitalized aged populations? Prospective, multicenter cohort study of 1 306 acutely ill patients. J Nutr Health Aging 2014; 18:66-74. [PMID: 24402392 DOI: 10.1007/s12603-013-0352-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The "obesity paradox" is poorly understood in vulnerable older hospitalized populations. OBJECTIVES To prospectively analyze the impact of body mass index (BMI) and comorbidities on early (6-week), one- and two-year mortality. DESIGN Prospective multicenter study with a two-year follow-up of old patients participating in the SAFES cohort study. SETTINGS Nine university hospitals in France. PARTICIPANTS Patients aged 75 or older hospitalized in medical divisions through the emergency department. MEASUREMENT Inpatients' characteristics were obtained through a comprehensive geriatric assessment of inpatients, conducted in the first week of hospitalization. All-cause mortalities at 6-week, one- and two-year were determined using bivariable and multivariable Cox proportional hazard model. RESULTS The SAFES cohort included 1,306 patients, aged 85±6 years, with a majority of women (65%). One- and two-year mortality were inversely associated with BMI ≥30 kg/m2 while early mortality was not, and positively associated with age, burden of comorbidities, walking disorders, level of dependency and presence of a dementia syndrome. Survival rates between patients in low (< 18.0 kg/m2) and intermediate (18-24.9 and 25-29.9 kg/m2) BMI categories were not significant. CONCLUSION While our findings seem to confirm the reality of the "obesity paradox" in vulnerable older hospitalized population, the exact understanding of underlying mechanisms and even the truthfulness of this paradoxical relationship are still fraught with considerable methodological, epidemiological and metabolic challenges.
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Affiliation(s)
- P-O Lang
- Pierre Olivier Lang, MD, MPH, PD, PhD. Nescens Centre of Preventive Medicine, Clinic of Genolier, Route du Muids, 3, CH-1272 Genolier, Switzerland, Phone: + 412236693 09 - fax: + 4122 36693 49-E-mail:
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Eglit T, Ringmets I, Lember M. Obesity, high-molecular-weight (HMW) adiponectin, and metabolic risk factors: prevalence and gender-specific associations in Estonia. PLoS One 2013; 8:e73273. [PMID: 24039900 PMCID: PMC3767784 DOI: 10.1371/journal.pone.0073273] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 07/19/2013] [Indexed: 02/06/2023] Open
Abstract
Background The metabolic consequences of obesity are associated with an imbalance of adipocytokines, e.g. adiponectin. However, some obese subjects remain metabolically healthy and have adiponectin levels similar to normal body weight subjects. Current estimates of the prevalence of obesity in Estonia have relied only on self-report data. Objectives To estimate the prevalence of obesity in Estonia, to test for associations between HMW adiponectin and metabolic risk factors and to test if HMW adiponectin levels differentiate metabolically healthy and metabolically unhealthy subjects. Methods We conducted a population-based cross-sectional multicentre study to gather history, examination and blood test results for 495 subjects aged 20–74. Metabolically healthy subjects were free from hypertension, dyslipidaemia, impaired glucose regulation and insulin resistance. Metabolically unhealthy subjects had at least one of these four metabolic abnormalities. Results The prevalence of obesity was 29% in men and 34% in women. HMW adiponectin was positively correlated with HDL cholesterol and negatively correlated with triglycerides, obesity, insulin resistance and blood glucose. This effect was driven by metabolically unhealthy subjects in men, but by both metabolically healthy and metabolically unhealthy subjects in women. Metabolically healthy women had higher HMW adiponectin levels than metabolically unhealthy women. 12% of all obese subjects were metabolically healthy, and their HMW adiponectin levels were similar to normal weight subjects. Conclusions Obesity is more prevalent in Estonian adults than previously thought. HMW adiponectin levels were associated with various metabolic risk factors in metabolically healthy women but not in metabolically healthy men. For both genders, HMW adiponectin differentiates metabolically healthy obese subjects from metabolically unhealthy obese subjects.
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Affiliation(s)
- Triin Eglit
- Department of Internal Medicine, University of Tartu and Tartu University Hospital, Tartu, Estonia
- * E-mail:
| | - Inge Ringmets
- Department of Public Health, University of Tartu, Tartu, Estonia
| | - Margus Lember
- Department of Internal Medicine, University of Tartu and Tartu University Hospital, Tartu, Estonia
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Abstract
Obesity is associated with increased risk of developing metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) leading to higher all-cause mortality. However accumulating evidence suggests that not all obese subjects are at increased cardiometabolic risk and that the "metabolically healthy obese" (MHO) phenotype may exist in the absence of metabolic abnormalities. Despite the knowledge of the existence of obese metabolic phenotypes for some time now there is no standard set of criteria to define metabolic health, thus impacting on the accurate estimation of the prevalence of the MHO phenotype and making comparability between studies difficult. Furthermore prospective studies tracking the development of cardiometabolic disease and mortality in MHO have also produced conflicting results. Limited data regards the determinants of the MHO phenotype exist, particularly in relation to dietary and lifestyle behaviours. In light of the current obesity epidemic it is clear that current "one size fits all" approaches to tackle obesity are largely unsuccessful. Whether dietary, lifestyle and/or therapeutic interventions based on stratification of obese individuals according to their metabolic health phenotype are more effective remains to be seen, with limited and conflicting data available so far. This review will present the current state of the art including the epidemiology of MHO and its definitions, what factors may be important in determining metabolic health status and finally, some potential implications of the MHO phenotype in the context of obesity diagnosis, interventions and treatment.
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Affiliation(s)
- Catherine M Phillips
- HRB Centre for Diet and Health Research, Department of Epidemiology and Public Health, Room 4.033, Western Gateway Building, University College Cork, Cork, Ireland,
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