Sitagliptin Alleviates Obesity in Immature Mice by Inhibiting Oxidative Stress and Inflammation

To investigate the impact of Sitagliptin against obesity and the underlying mechanism. Obese immature mice were treated with 10, 30, and 90 mg/kg Sitagliptin, respectively. The body weights were recorded and the level of serum biochemical indexes were detected. The visceral fat ratio of each mouse was determined. The pathological change in adipose tissues was determined by HE staining, while F4/80 and CD206 levels in adipose tissues were determined by the immunohistochemical analysis. Lipid formation was evaluated by Oil red O staining assay. RAW264.7 cells were stimulated using oxLDL, followed by being incubated with different concentrations of Sitagliptin. The release of ADPN, IL-6, IL-1β, TNF-α, and the activity of SOD, was measured by ELISA assay. Western blotting was applied to determine adipsin, Nrf2, Keap1, and HO-1 protein levels. ROS level was checked using the DCFH-DA assay. RT-PCR assay was utilized to detect the mRNA levels of IL-6, IL-1β, TNF-α, Nrf2, Keap1, and HO-1. The body weight gain, infiltration of multinucleated cells, enlarged size of adipocytes, increased lipid accumulation, elevated visceral fat ratio, declined ADPN level, upregulated adipsin, and disordered serum biochemical indexes in obese immature mice were statistically significantly reversed by Sitagliptin. Excessive release of inflammatory factors and upregulated F4/80 and CD206 were observed in obese immature mice, which were statistically significantly repressed by Sitagliptin. Furthermore, the elevated MDA level, increased SOD activity, and inhibited Nrf2 pathway in obese immature mice were significantly reversed by Sitagliptin. In oxLDL stimulated RAW264.7 cells, increased release of inflammatory factors, ROS, and MDA, elevated SOD activity, and inactivated Nrf2 pathway were observed, which were statistically significantly abolished by the treatment of Sitagliptin. Sitagliptin alleviated obesity in immature mice by inhibiting inflammation and oxidative stress.

Association between Dietary Behavior and Overweight and Obesity among Chinese Students: A Cross-Sectional Study

OBJECTIVES

To investigate the prevalence of overweight and obesity among Ningbo students and explore the association between students' dietary behavior and overweight and obesity.

MATERIALS AND METHODS

A total of 7299 students were recruited, including 3755 males and 3544 females. A questionnaire on student health status and influencing factors was used to investigate dietary behavior. Logistic regression analysis investigated the relationship between dietary behavior and overweight and obesity. Age, gender, area, grade, sleep duration, and physical activity were adjusted in the multivariate regression models.

RESULTS

This study revealed that the prevalence of overweight and obesity in Ningbo students was 16.14% and 9.88%, respectively. The logistic regression analysis results showed that regular consumption of sugary beverages was associated with a higher risk of being overweight (OR = 1.256, 95% CI: 1.023-1.542, p = 0.029). The research indicated that skipping breakfast was considered a risk factor for obesity (OR = 2.102, 95% CI: 1.087-4.065, p = 0.027). After adjusting for age, gender, area, and grade and continuing to adjust for sleep duration and physical activity, the results showed that consuming fried food at least once a day increased the risk of obesity (OR = 1.494, 95% CI: 1.050-2.125, p = 0.026; OR = 1.516, 95% CI: 1.065-2.158, p = 0.021, respectively). This study found that the frequency of breakfast and the consumption of fried food, fresh vegetables, and fruits were not significantly associated with being overweight (p > 0.05).

CONCLUSIONS

This study indicated that dietary behavior was related to overweight and obesity among Ningbo students. Further studies and more government support are required to confirm this study's findings and address the current overweight/obesity problems.

First morning voided urinary gonadotropins in children: verification of method performance and establishment of reference intervals

OBJECTIVES

Urinary luteinizing hormone (uLH) and urinary follicle-stimulating hormone (uFSH) have been shown to be useful screening and management tools for children with central precocious puberty. However, studies on uLH and uFSH reference intervals are scarce. Therefore, we aimed to establish reference intervals for uLH and uFSH, according to age, sex, and pubertal status in apparently healthy children aged 6-11 years.

METHODS

We performed detection capability, precision, accuracy by recovery, linearity, agreement analysis, and stability testing to analyze the method performance of uLH and uFSH. The Clinical Laboratory Standards Institute's C28-A3 criteria was used to establish the reference intervals.

RESULTS

Both uLH and uFSH were stable at 4 °C for 52.6 h and 64.8 days, respectively. The total imprecision of uFSH is within the manufacturer's claim, while the total imprecision of uLH remained within tolerable bias. Both uLH and uFSH could be measured with acceptable detection capability. The recovery rates of the hormones were 87.6-98.8% and 102.8-103.4%, respectively, and therefore within acceptable limits. There were significant correlations between the serum and urine concentrations (LH: r=0.91, p<0.001; FSH: r=0.90, p<0.001). The reference intervals of uLH and uFSH were established according to age, sex, and pubertal status.

CONCLUSIONS

We established reference intervals for uLH and uFSH based on age, sex and pubertal status to provide a non-invasive clinical screening tool for precocious puberty in children aged 6-11 years.

Comparison of the effects of different growth standards on infants in Urban Shanghai: a cluster-randomized controlled trial

BACKGROUND

The Shanghai growth standards are higher than World Health Organization (WHO) growth standards, which may influence the feeding practices of the caregivers and increase the risk of overweight in these infants. This study aimed to compare the effects of different growth standards on childhood obesity in Shanghai metropolitan area.

METHODS

This was a cluster-randomized controlled trial conducted in 2 downtown areas with 19 community health service centers in Shanghai from November 2013 to December 2015. Randomization was done at the level of the community. Infants (health newborns) were assessed and monitored by the Shanghai growth standards (S-group) and the 2006 WHO growth standards (W-group), respectively. Measurements were taken at 1.0, 2.0, 4.0, 6.0, 9.0 and 12.0 months of age during follow-up period. Based on the values of length and weight measurements, according to the group's growth standards, doctors provided the caregivers with corresponding clinical consultation. Changes in weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for length z-score (WLZ) between 2 groups were assessed using mixed regression models. Overweight was compared between 2 group at all follow-up measurements.

RESULTS

A total of 6509 infants (52.1% were boys) were in the W-group, and 8510 infants (51.4% were boys) were in the S-group. The overweight ratios between two groups were distinct at 9 months of age (3.4% in W-group and 4.3% in S-group) and 12 months of age (2.2% in W-group and 3.8% in S-group), and the differences were statistically significant (P = 0.020 and P < 0.001, respectively). Compared to W-group, the increase in WAZ (coefficient = 0.04, P = 0.004) and WLZ (coefficient = 0.09, P < 0.001) were significantly greater, and the LAZ was lower (coefficient = -0.04, P = 0.047) in S-group (W-group values were used as reference in mixed regression models).

CONCLUSION

Compared to the Shanghai growth standards, the adoption of WHO 2006 growth standards would reduce the risk of infant overweight in Shanghai metropolitan area up to 1 year of age.

TRIAL REGISTRATION NUMBER

ChiCTR1800015371, http://www.chictr.org.cn/ Chinese Clinical Trial Registry.

Prenatal determinants of childhood obesity: a review of risk factors 1

Childhood obesity is a predictor of adult obesity and has its roots in the pre-pregnancy or pregnancy period. This review presents an overview of the prenatal risk factors for childhood obesity, which were categorized into 2 groups: biological risk factors (maternal pre-pregnancy body mass index, gestational weight gain, diabetes in pregnancy, and caesarean section), and environmental and behavioural risk factors (maternal smoking and exposure to obesogens, maternal dietary patterns, maternal intestinal microbiome and antibiotics exposure, and maternal psychosocial stress). Identifying modifiable predisposing prenatal factors for obesity will inform further development of inventions to prevent obesity over the life course, and future directions for research and intervention are discussed.

The effects of economic development and built environment on diabetes in CHINA

Background

With rapid economy growth, the prevalence of obesity, and related chronic diseases, has increased greatly. Although this has been widely recognized, little attention has been paid to the influence of built environment and economic growth, particularly for developing countries. The main purpose of this study is to investigate the potential relationship between the prevalence of diabetes and the built environment while considering the effects of socioeconomic change in China.

Methods

Three nationally representative samples are constructed and employed mainly based on various sources of data, such as the China National Nutrition and Health Survey, World Health Organization, and China Health and Retirement Longitudinal Survey in 2013. The explanatory variables representing the built environment and influential factors include the health outcomes, economic indicators, local health facilities, regional dummies, and demographic features. OLS, robust regressions, and a set of binary choice models are used to estimate the possible relationship.

Results

It is suggested that the prevalence of diabetes is associated with both the broader built environment and individual economic factors in China. China’s sharp economic growth in the recent decades has greatly increased the prevalence of obesity and diabetes, when also considering other influential factors.

Conclusions

Although the results can not specify causal mechanism, some useful results can be clearly discovered and subsequently a few important policy implications can be provided for the sustainable and healthy development of China’s urban planning or built environment.

Time trends and factors in body mass index and obesity among children in China: 1997-2011

BACKGROUND

Research on the shift in children's body mass index (BMI) distribution is limited and conditional mean models used in the previous research have limitations in capturing cross-distribution variations in effects. The objectives are to analyze the shift in Chinese children's BMI distribution and to test the associations between BMI distribution and other factors.

METHODS

We analyzed data collected from children 7 to 17 years old from the China Health and Nutrition Survey (CHNS) conducted in 1997, 2000, 2004, 2006, 2009 and 2011, from 2814 participants with 6799 observations. Longitudinal quantile regression (QR) was used to explore the effect of several factors on BMI trends in 2015.

RESULTS

The BMI curves shift to the right in boys and girls, with the distributions becoming wider, indicating a higher proportion of children have become overweight. The 5th, 15th, 50th, 85th and 95th BMI percentile curves all shifted upward from 1997 to 2011, and the higher percentiles had greater increases. The prevalence of overweight and obesity increased in boys and girls between 1997 and 2011, from 6.5 to 15.5% in boys and from 4.6 to 10.4% in girls. Energy intake and parents' BMI levels had a positive association with children's BMI. Per capita income was positively associated with changes in BMI only at the upper percentiles of the BMI distributions in boys. Increased physical activity (PA) was associated with decreased BMI in girls.

CONCLUSIONS

Children in China are becoming increasingly overweight. Energy intake, parental BMI, PA and early menarche age in girls are associated with elevated BMI in children.

A clinical trial evaluating the laryngeal mask airway-Supreme in obese children during general anesthesia

INTRODUCTION

The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure.

MATERIAL AND METHODS

After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group. Endotracheal intubation was performed under direct vision laryngoscopy. In the LMA group, a size-3 LMA-Supreme was placed and a stomach tube inserted via the drainage tube of the mask. Cardiovascular and respiratory parameters, time taken for placement, placement attempts, time to removal of the endotracheal tube/LMA, length of stay in the post-anesthesia care unit (PACU), and complications were recorded.

RESULTS

Insertion time was significantly longer (p < 0.001) in the LMA-Supreme group than in the endotracheal intubation group. Peak airway pressure was significantly higher, and pulmonary compliance and PACU stay time lower in the LMA-Supreme group. No significant differences between endotracheal intubation and the LMA-Supreme were seen in other parameters, except for a higher incidence of coughing in the endotracheal intubation group.

CONCLUSIONS

The LMA-Supreme can be easily inserted and effectively used for airway management in obese children undergoing minor surgery.

The Long-Term Public Health Benefits of Breastfeeding

Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer.

Development and evaluation of a food environment survey in three urban environments of Kunming, China

BACKGROUND

Given the rapid pace of urbanization and Westernization and the increasing prevalence of obesity, there is a need for research to better understand the influence of the built environment on overweight and obesity in world's developing regions. Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China.

METHODS

We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city.

RESULTS

273 food establishments (163 restaurants and 110 stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food restaurants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity. Depending on the cutoff used, 19% to 36% of male and 10% to 22% of female 16-year old adolescents were found to be overweight.

CONCLUSIONS

The prevalence of overweight Chinese adolescents, and the food environments they are exposed to, deserve immediate attention. To our knowledge, these are the first food environment surveys developed specifically to assess changing food availability, accessibility, and pricing in China. These instruments may be useful in future systematic longitudinal assessments of the changing food environment and its health impact in China.

Is body size associated with ovarian cancer in southern Chinese women?

PURPOSE

To investigate the association between risk of ovarian cancer and body size among southern Chinese women.

METHODS

A hospital-based case-control study was undertaken in Guangzhou, Guangdong Province, from 2006 to 2008. Participants were 500 incident ovarian cancer patients and 500 controls, with a mean age of 59 years. Information on adult height and weight was obtained via face-to-face interview using a structured questionnaire. Logistic regression analyses were performed to assess the association between anthropometric factors and the ovarian cancer risk.

RESULTS

Compared with women having body weight ≤50 kg and body mass index (BMI) <18.5 kg/m(2), the adjusted odds ratios (ORs) of ovarian cancer were 1.84 (95 % confidence interval (CI) 1.34-2.54) and 1.77 (95 % CI 1.04-3.02) in those women who had body weight >55 kg and BMI ≥23 kg/m(2), respectively. Significant dose-response relationships were also observed for both weight and BMI (p < 0.01). Body height was not significantly associated with ovarian cancer risk.

CONCLUSION

Body weight and BMI were associated with increased risk of ovarian cancer in southern Chinese women.