1
|
Cruz KJC, de Oliveira ARS, Fontenelle LC, Morais JBS, de Sousa Melo SR, Dos Santos LR, de Sousa TGV, de Freitas ST, Henriques GS, Bordin S, Maia CSC, de Oliveira FE, Costa CHN, de Matos Neto EM, do Nascimento Marreiro D. Relationship Between Zinc, Selenium, and Magnesium Status and Markers of Metabolically Healthy and Unhealthy Obesity Phenotypes. Biol Trace Elem Res 2024; 202:3449-3464. [PMID: 37957519 DOI: 10.1007/s12011-023-03938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Our objective was to investigate the relationship between zinc, selenium, and magnesium status and markers of metabolically healthy and unhealthy obesity phenotypes. This was a cross-sectional study with 140 women: metabolically healthy obese women (n = 35), metabolically unhealthy obese women (n = 28), and normal-weight women (n = 77). We have calculated the body mass index, waist-hip ratio, waist-height ratio and some adiposity indices. Additionally, we evaluated endocrine-metabolic parameters and estimated the dietary intake of energy, macronutrients, zinc, selenium, and magnesium. The mineral concentrations in plasma, erythrocytes, and urine were assessed. In obese patients, there was a significant decrease in dietary zinc, selenium, and magnesium intake per kilogram of body weight, as well as lower mineral concentrations in both plasma and erythrocytes. Additionally, these patients exhibited higher urinary mineral levels compared to the control group, regardless of whether they had healthy or unhealthy phenotypes. We observed a significant correlation between deficiencies in zinc, selenium, and magnesium and obesity-associated metabolic disorders, including dyslipidemias and redox status disturbances. This study highlights a connection between deficiencies in zinc, selenium, and magnesium and metabolic disorders linked to obesity, including dyslipidemias, alterations in redox status, and thyroid hormonal dysfunction.
Collapse
Affiliation(s)
- Kyria Jayanne Clímaco Cruz
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Ana Raquel Soares de Oliveira
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Larissa Cristina Fontenelle
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Jennifer Beatriz Silva Morais
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Stéfany Rodrigues de Sousa Melo
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Loanne Rocha Dos Santos
- Postgraduate Program in Food and Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | | | | | - Gilberto Simeone Henriques
- School of Nursing, Federal University of Minas Gerais, 6627 Pres. Antônio Carlos Ave. Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Emídio Marques de Matos Neto
- Department of Physical Education, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| | - Dilina do Nascimento Marreiro
- Department of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Ininga, Teresina, Piaui, Brazil
| |
Collapse
|
2
|
Li L, Zhou Z, Fang J, Liu D, Deng C, Chen Y, Ahasan Z, Zhu W, Cai K. The characterization of metabolic changes in adipose tissues and muscles due to different exercise intensities by Dixon in healthy young men. Eur J Radiol 2024; 177:111559. [PMID: 38865759 DOI: 10.1016/j.ejrad.2024.111559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE To delineate the alterations in adipose and muscle tissue composition and functionality among healthy young men across varying exercise intensities, which help to elucidate the impact of exercise intensity on weight management and inform fitness planning. METHOD 3D Dixon MRI scans were performed on the neck and supraclavicular area in 10 high-intensity exercises (HIE) athletes, 20 moderate intensity exercises (MIE) athletes and 19 low-intensity exercises non-athlete male controls (NCM). Twelve imaging parameters, including the total volume of muscle, white adipose tissue (WAT), brown adipose tissue (BAT), and the mean fat-water fraction (FWF) within these tissues. Additionally, ratios of BAT or WAT to total fat (BATr or WATr) and the proportions of muscle, BAT, or WAT to total tissue volume (Musp, BATp, and WATp) were calculated. Parameters were compared across groups and correlated with Body Mass Index (BMI), waistline, and hipline. RESULTS The HIE group exhibited the highest total muscle (totalMUS) and brown adipose tissue (totalBAT) volumes among the three groups. Conversely, the NCM group had significantly higher fwfFAT and fwfBAT values. The MUSp was higher in the HIE and MIE groups compared to NCM, while the BATp and WATp were lower. Furthermore, the BATr in HIE and MIE groups were higher than NCM group while the WATr were lower. Significant linear relationships were observed between totalBAT, totalWAT, MUSp, BATr, fwfFAT, and BMI, waistline (P < 0.05) across all groups. CONCLUSIONS MIE is sufficient for the purpose of weight control, While HIE helps to further increase the muscle mass. All three physical indexes were significantly associated with the image parameters, with waistline emerging as the most effective indicator for detecting metabolic changes across all groups.
Collapse
Affiliation(s)
- Li Li
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Zhiguo Zhou
- Orthopedics Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, HUST, Wuhan, China.
| | - Jicheng Fang
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Dong Liu
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Chenghu Deng
- Department of Physical Education, Wuhan University of Technology, Wuhan, China
| | - Yong Chen
- Endocrinology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Zoheb Ahasan
- Radiology Department, Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Wenzhen Zhu
- Radiology Department, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Kejia Cai
- Radiology Department, Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Bioengineering Department, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| |
Collapse
|
3
|
Blanco Anesto J, Nicolau J. [Changes in weight, body composition, metabolic parameters and vitamin D in subjects with grade 3 and 4 obesity treated with liraglutide 3 mg]. NUTR HOSP 2024. [PMID: 39037190 DOI: 10.20960/nh.05267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION grade 3 and 4 obesity is a chronic and progressive disease. Liraglutide 3 mg could be an effective adjuvant therapy in these subjects. OBJECTIVES to evaluate changes in weight loss, body composition, metabolic parameters and vitamin D levels in subjects with grade 3 and 4 obesity treated for 8 months with liraglutide 3 mg. METHODS a total of 67 subjects with a BMI ≥ 40 kg/m2 had anthropometric parameters, body composition, metabolic parameters and vitamin D levels determined at baseline and after 8 months of treatment with liraglutide 3 mg. RESULTS a significant reduction in weight, BMI and abdominal circumference was evident after 8 months of treatment with liraglutide (p < 0.001), with a mean percentage of weight loss of 13.04 % and a mean weight loss of 14.99 kg at the end of the intervention. The final body composition data showed a significant improvement in the percentage of fat and fat mass (kg) (p < 0.001). The average loss of muscle mass was 2.02 kg (p = 0.213). The healthy visceral fat index (VGI) (< 13) increased to 67.17 % (p < 0.001) at 8 months. There was a significant reduction in blood pressure (p < 0.001) and an improvement in the biochemical variables studied. There was a significant increase in 25-OH vitamin D (p < 0.001) at the end of the intervention. CONCLUSIONS Treatment with liraglutide was safe and effective in patients with obesity with a positive impact on weight loss, vitamin D levels and other cardiovascular risk factors.
Collapse
|
4
|
Ishii H, Yamada H, Sato R, Hayashi W, Nakamura D, Sugita S, Tazaki T, Takashio O, Inamoto A, Iwanami A. Obesity-associated factors in psychiatric outpatients: A multicenter questionnaire survey. Neuropsychopharmacol Rep 2024. [PMID: 39010283 DOI: 10.1002/npr2.12465] [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: 05/21/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
The prevalence of obesity is increasing worldwide, resulting in various health issues such as hypertension, dyslipidemia, diabetes mellitus, heart disease, and a lower life expectancy. Importantly, several psychiatric disorders and the use of psychotropic medications have been linked to obesity, and the possible risk factors need further investigation. This study examined the prevalence of obesity and its associated factors using a self-administered questionnaire. Participants were recruited from three outpatient clinics and individuals who met one or more of the ICD-10 F0-F9, G4 diagnoses were included. In total, 1384 participants completed the questionnaire about their lifestyle. Statistical analysis compared the demographic and clinical characteristics of the individuals who were obese (Body Mass Index: BMI ≥25) and those who were non-obese (BMI <25). The results revealed that the factors associated with obesity in psychiatric outpatients were being male, prolonged treatment duration, eating out frequently, and use of both second- and first-generation antipsychotics. The study emphasized the importance of closely monitoring BMI in individuals with multiple obesity-related factors.
Collapse
Affiliation(s)
- Hiroki Ishii
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Hiroki Yamada
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
- Shinrin Koen Mental Clinic, Namekawa-cho, Hiki-gun, Saitama, Japan
| | - Ryotaro Sato
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Wakaho Hayashi
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Dan Nakamura
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Shutaro Sugita
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Taro Tazaki
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Osamu Takashio
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Atsuko Inamoto
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
| | - Akira Iwanami
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| |
Collapse
|
5
|
Savulescu-Fiedler I, Mihalcea R, Dragosloveanu S, Scheau C, Baz RO, Caruntu A, Scheau AE, Caruntu C, Benea SN. The Interplay between Obesity and Inflammation. Life (Basel) 2024; 14:856. [PMID: 39063610 PMCID: PMC11277997 DOI: 10.3390/life14070856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Obesity is an important condition affecting the quality of life of numerous patients and increasing their associated risk for multiple diseases, including tumors and immune-mediated disorders. Inflammation appears to play a major role in the development of obesity and represents a central point for the activity of cellular and humoral components in the adipose tissue. Macrophages play a key role as the main cellular component of the adipose tissue regulating the chronic inflammation and modulating the secretion and differentiation of various pro- and anti-inflammatory cytokines. Inflammation also involves a series of signaling pathways that might represent the focus for new therapies and interventions. Weight loss is essential in decreasing cardiometabolic risks and the degree of associated inflammation; however, the latter can persist for long after the excess weight is lost, and can involve changes in macrophage phenotypes that can ensure the metabolic adjustment. A clear understanding of the pathophysiological processes in the adipose tissue and the interplay between obesity and chronic inflammation can lead to a better understanding of the development of comorbidities and may ensure future targets for the treatment of obesity.
Collapse
Affiliation(s)
- Ilinca Savulescu-Fiedler
- Department of Internal Medicine, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, 030167 Bucharest, Romania
| | - Razvan Mihalcea
- Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, 030167 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
- Department of Orthopaedics and Traumatology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania (C.C.)
- Department of Radiology and Medical Imaging, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 030167 Bucharest, Romania
| | - Radu Octavian Baz
- Clinical Laboratory of Radiology and Medical Imaging, “Sf. Apostol Andrei” County Emergency Hospital, 900591 Constanta, Romania
- Department of Radiology and Medical Imaging, Faculty of Medicine, “Ovidius” University, 900527 Constanta, Romania
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania (C.C.)
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Serban Nicolae Benea
- Department of Infectious Diseases, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Prof. Dr. Matei Balș” National Institute for Infectious Diseases, 021105 Bucharest, Romania
| |
Collapse
|
6
|
Miller CK. Medical Nutrition Therapy: Still Relevant in the Era of Pharmacotherapy for Obesity Care. J Acad Nutr Diet 2024:S2212-2672(24)00516-1. [PMID: 38936770 DOI: 10.1016/j.jand.2024.06.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/03/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Affiliation(s)
- Carla K Miller
- School of Public Health, Indiana University-Bloomington, Bloomington, Indiana.
| |
Collapse
|
7
|
Sims A, Long DL, Tiwari HK, Cui J, Long DM, Brown TM, Smith MJ, Levitan EB. Population-average mediation analysis for zero-inflated count outcomes. Stat Med 2024; 43:2547-2559. [PMID: 38637330 DOI: 10.1002/sim.10085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/07/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
Mediation analysis is an increasingly popular statistical method for explaining causal pathways to inform intervention. While methods have increased, there is still a dearth of robust mediation methods for count outcomes with excess zeroes. Current mediation methods addressing this issue are computationally intensive, biased, or challenging to interpret. To overcome these limitations, we propose a new mediation methodology for zero-inflated count outcomes using the marginalized zero-inflated Poisson (MZIP) model and the counterfactual approach to mediation. This novel work gives population-average mediation effects whose variance can be estimated rapidly via delta method. This methodology is extended to cases with exposure-mediator interactions. We apply this novel methodology to explore if diabetes diagnosis can explain BMI differences in healthcare utilization and test model performance via simulations comparing the proposed MZIP method to existing zero-inflated and Poisson methods. We find that our proposed method minimizes bias and computation time compared to alternative approaches while allowing for straight-forward interpretations.
Collapse
Affiliation(s)
- Andrew Sims
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - D Leann Long
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Hemant K Tiwari
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jinhong Cui
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Dustin M Long
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Biostatistics and Data Science, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Todd M Brown
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa J Smith
- Department of Biostatistics, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Emily B Levitan
- Department of Epidemiology, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
8
|
Chen HW, Liu K, Cao BF, Zhong Q, Zhou R, Li LH, Wang SA, Wei YF, Liu HM, Wu XB. Combined associations of visceral adipose tissue and adherence to a Mediterranean lifestyle with T2D and diabetic microvascular complications among individuals with prediabetes. Cardiovasc Diabetol 2024; 23:201. [PMID: 38867282 PMCID: PMC11170917 DOI: 10.1186/s12933-024-02284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND It's unclear if excess visceral adipose tissue (VAT) mass in individuals with prediabetes can be countered by adherence to a Mediterranean lifestyle (MEDLIFE). We aimed to examine VAT mass, MEDLIFE adherence, and their impact on type 2 diabetes (T2D) and diabetic microvascular complications (DMC) in individuals with prediabetes. METHODS 11,267 individuals with prediabetes from the UK Biobank cohort were included. VAT mass was predicted using a non-linear model, and adherence to the MEDLIFE was evaluated using the 25-item MEDLIFE index, encompassing categories such as "Mediterranean food consumption," "Mediterranean dietary habits," and "Physical activity, rest, social habits, and conviviality." Both VAT and MEDLIFE were categorized into quartiles, resulting in 16 combinations. Incident cases of T2D and related DMC were identified through clinical records. Cox proportional-hazards regression models were employed to examine associations, adjusting for potential confounding factors. RESULTS Over a median follow-up of 13.77 years, we observed 1408 incident cases of T2D and 714 cases of any DMC. High adherence to the MEDLIFE, compared to the lowest quartile, reduced a 16% risk of incident T2D (HR: 0.84, 95% CI: 0.71-0.98) and 31% for incident DMC (0.69, 0.56-0.86). Conversely, compared to the lowest quartile of VAT, the highest quartile increased the risk of T2D (5.95, 4.72-7.49) and incident any DMC (1.79, 1.36-2.35). We observed an inverse dose-response relationship between MEDLIFE and T2D/DMC, and a dose-response relationship between VAT and all outcomes (P for trend < 0.05). Restricted cubic spline analysis confirmed a nearly linear dose-response pattern across all associations. Compared to individuals with the lowest MEDLIFE quartile and highest VAT quartile, those with the lowest T2D risk had the lowest VAT and highest MEDLIFE (0.12, 0.08-0.19). High MEDLIFE was linked to reduced T2D risk across all VAT categories, except in those with the highest VAT quartile. Similar trends were seen for DMC. CONCLUSION High adherence to MEDLIFE reduced T2D and MDC risk in individuals with prediabetes, while high VAT mass increases it, but MEDLIFE adherence may offset VAT's risk partly. The Mediterranean lifestyle's adaptability to diverse populations suggests promise for preventing T2D.
Collapse
Affiliation(s)
- Hao-Wen Chen
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Kuan Liu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Bi-Fei Cao
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Liang-Hua Li
- Public Health Division, Hospital of Zhongluotan Town, Baiyun District, Guangzhou, 510515, China
| | - Shi-Ao Wang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Yan-Fei Wei
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China
| | - Hua-Min Liu
- Department of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, No. 1063-No. 1023, Shatai South Road, Baiyun District, Guangzhou, 510515, China.
| |
Collapse
|
9
|
Tzoulis P, Baldeweg SE. Semaglutide for weight loss: unanswered questions. Front Endocrinol (Lausanne) 2024; 15:1382814. [PMID: 38904050 PMCID: PMC11188346 DOI: 10.3389/fendo.2024.1382814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Affiliation(s)
- Ploutarchos Tzoulis
- Department of Metabolism & Experimental Therapeutics, Division of Medicine, University College London, London, United Kingdom
| | | |
Collapse
|
10
|
Minuzzi RK, Petry C, Souza Dos Santos F, Semmelmann AL, Bassols GF, Pereira-Lima JFS. The Role of Hypogonadism in the Body Composition of Obese Men in the Preoperative Period of Bariatric Surgery. Endocr Pract 2024; 30:551-557. [PMID: 38641213 DOI: 10.1016/j.eprac.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE To describe clinical characteristics, hormonal profile and body composition of obese men in preoperative of bariatric surgery. METHODS Cross-sectional, population-based study. Patients evaluated from June 2019 to December 2021 in 2 obesity referral centers. Patients underwent clinical evaluation, androgen deficiency screening using Androgen Deficiency in the Aging Male questionnaire, hormonal profile and body composition assessment through body mass index (BMI), body fat percentage (FM-%) and mass (FM-kg) measured by electrical bioimpedance and dual energy x-ray absorptiometry. To characterize hypogonadism, 2 cut-off points were considered: TT <264 ng/dL and TT <164 ng/dL. RESULTS Thirty patients were included, mean age 35.6 ± 8.8 years, mean weight 129.4 ± 14.0 kg and mean BMI 42.3 ± 4.7 kg/m2. Dyslipidemia was the most prevalent comorbidity. Considering TT <264 ng/dL, 22 patients (73%) had hypogonadism. The mean TT in hypogonadal men was 198.9 + 68.7 ng/dL and in eugonadal men 357.0 + 59.5 ng/dl (P < .001). Using TT <164 ng/dL, 7 patients (23%) had hypogonadism. The mean TT in hypogonadal patients was 116.6 + 28.9 ng/dL and in eugonadal patients 279.0 + 75.0 ng/dL (P < .001). In Androgen Deficiency in the Aging Male questionnaire, 93.3% had positive screening, with no significant difference between groups. There was no statistically significant difference in body composition between groups when using TT <264 ng/dL as the hypogonadism cutoff. Considering hypogonadism TT <164 ng/dL, hypogonadal patients had significantly higher values of weight (139.0 × 126.5 kg P = .036), BMI (46.1 × 41.2 kg/m2P = .014), FM-% (48.0 × 42.8% P = .010) and FM-kg (66.3 × 53.9 kg P = .007) than eugonadal patients. CONCLUSION Hypogonadism was identified in at least 23% of patients. Considering TT below the lower limit of normality for characterization of hypogonadism, we identified a significant worsening in body composition parameters.
Collapse
Affiliation(s)
- Ricardo Kunde Minuzzi
- Graduate Program of Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Carolina Petry
- Graduate Program of Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Santa Casa of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Felipe Souza Dos Santos
- Graduate Program of Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Lucia Semmelmann
- Clinoson Clinic, Diagnostic Imaging, Porto Alegre, Brazil; Radiologist, Head of the Densitometry and Body Composition Sector, Porto Alegre, Brazil
| | | | - Julia Fernanda Semmelmann Pereira-Lima
- Graduate Program of Pathology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Santa Casa of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
11
|
Perez-Leighton C, Kerr B, Scherer PE, Baudrand R, Cortés V. The interplay between leptin, glucocorticoids, and GLP1 regulates food intake and feeding behaviour. Biol Rev Camb Philos Soc 2024; 99:653-674. [PMID: 38072002 DOI: 10.1111/brv.13039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 05/09/2024]
Abstract
Nutritional, endocrine, and neurological signals converge in multiple brain centres to control feeding behaviour and food intake as part of the allostatic regulation of energy balance. Among the several neuroendocrine systems involved, the leptin, glucocorticoid, and glucagon-like peptide 1 (GLP1) systems have been extensively researched. Leptin is at the top hierarchical level since its complete absence is sufficient to trigger severe hyperphagia. Glucocorticoids are key regulators of the energy balance adaptation to stress and their sustained excess leads to excessive adiposity and metabolic perturbations. GLP1 participates in metabolic adaptation to food intake, regulating insulin secretion and satiety by parallel central and peripheral signalling systems. Herein, we review the brain and peripheral targets of these three hormone systems that integrate to regulate food intake, feeding behaviour, and metabolic homeostasis. We examine the functional relationships between leptin, glucocorticoids, and GLP1 at the central and peripheral levels, including the cross-regulation of their circulating levels and their cooperative or antagonistic actions at different brain centres. The pathophysiological roles of these neuroendocrine systems in dysregulated intake are explored in the two extremes of body adiposity - obesity and lipodystrophy - and eating behaviour disorders.
Collapse
Affiliation(s)
- Claudio Perez-Leighton
- Departmento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, 830024, Chile
| | - Bredford Kerr
- Centro de Biología Celular y Biomedicina-CEBICEM, Facultad de Medicina y Ciencia, Universidad San Sebastián, Carmen Sylva 2444, Providencia, Santiago, Chile
| | - Philipp E Scherer
- Touchstone Diabetes Center, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - René Baudrand
- Departmento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, 830024, Chile
- Centro Translacional de Endocrinología (CETREN), Facultad de Medicina, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, 830024, Chile
| | - Víctor Cortés
- Departmento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, 830024, Chile
| |
Collapse
|
12
|
Martins BC, da Silva Ribeiro M, Teixeira AVS, Peixoto TC, Lisboa PC, Martins FF, Souza-Mello V, Daleprane JB. Consumption of interesterified palm oil leads inflammation of white adipose tissue and triggers metabolic disturbances in mice on a high-fat diet. Sci Rep 2024; 14:12530. [PMID: 38822155 PMCID: PMC11143230 DOI: 10.1038/s41598-024-63488-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/29/2024] [Indexed: 06/02/2024] Open
Abstract
Growing obesity is linked to shifts in dietary patterns, particularly the increased intake of ultra-processed high-fat foods. This study aimed to evaluate the effects of interesterified palm oil consumption on glucose homeostasis, adipose tissue remodeling, and hepatic lipogenesis in C57BL/6 mice fed a high-fat diet. Sixty C57BL/6 mice were divided into four groups (n = 15): the control group (C) fed a standard diet (4% soybean oil), the high-fat group (HF) (23.8% lard), the high palm oil fat group (HFP) (23.8% palm oil), and the high interesterified palm fat group (HFI) (23.8% interesterified palm oil) for 8 weeks (all groups received 50% energy from lipids). The HFI group exhibited higher body mass than the HF group (+ 11%, P < 0.05), which was attributed to an increased percentage of fat mass. Plasma concentrations of IL-6, insulin, and HOMA-IR were also elevated in the HFI group. Both the HFP and HFI groups showed hypertrophied adipocytes and pancreatic islets, increased alpha and beta cell masses, hepatic steatosis, low expression of genes related to beta-oxidation, and upregulated lipogenesis. In conclusion, the consumption of interesterified palm oil alters inflammatory and glucose profiles.
Collapse
Affiliation(s)
- Bruna Cadete Martins
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Mayara da Silva Ribeiro
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Ananda Vitoria Silva Teixeira
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Thamara Cherem Peixoto
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Patrícia Cristina Lisboa
- Laboratory of Endocrine Physiology, Department of Physiological Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, 20551-030, Brazil
| | - Fabiane Ferreira Martins
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Department of Morphology, Federal University of Rio Grande Do Norte, Rio Grande do Norte, Brazil
| | - Vanessa Souza-Mello
- Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Biomedical Center, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Julio Beltrame Daleprane
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| |
Collapse
|
13
|
Hu L, Han X, Chen M, Zhang T. Association of waist circumference and BMI with premature death in young and middle-aged population. Front Public Health 2024; 12:1389766. [PMID: 38873315 PMCID: PMC11169795 DOI: 10.3389/fpubh.2024.1389766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Premature death is a global health indicator, significantly impacted by obesity, especially in young and middle-aged population. Both body mass index (BMI) and waist circumference (WC) assess obesity, with WC specifically indicating central obesity and showing a stronger relationship with mortality. However, despite known associations between BMI and premature death, as well as the well-recognized correlation between WC and adverse health outcomes, the specific relationship between WC and premature death remains unclear. Therefore, focusing on young and middle-aged individuals, this study aimed to reliably estimate independent and combined associations between WC, BMI and premature death, thereby providing causal evidence to support strategies for obesity management. Methods This study involved 49,217 subjects aged 18-50 years in the United States from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Independent and combined associations between WC and BMI with premature death across sex and age stratum were examined by Cox regression. Survey weighting and inverse probability weighting (IPW) were further considered to control selection and confounding bias. Robustness assessment has been conducted on both NHANES and China Health and Retirement Longitudinal Study (CHARLS) data. Results A linear and positive relationship between WC and all-cause premature death was found in both males and females, with adjusted HRs of 1.019 (95%CI = 1.004-1.034) and 1.065 (95%CI = 1.039-1.091), respectively. Nonlinear relationships were found with respect to BMI and all-cause premature death. For females aged 36-50 with a BMI below 28.6 kg/m2, the risk of premature death decreased as BMI increased, indicated by adjusted HRs of 0.856 (95%CI = 0.790-0.927). Joint analysis showed among people living with obesity, a larger WC increased premature death risk (HR = 1.924, 95%CI = 1.444-2.564). Discussion WC and BMI exhibited prominent associations with premature death in young and middle-aged population. Maintaining an appropriate WC and BMI bears significant implications for preventing premature death.
Collapse
Affiliation(s)
| | | | | | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
14
|
Liu M, Zhu Y, Wang F. Does chili pepper consumption affect BMI and obesity risk? A cross-sectional analysis. Front Nutr 2024; 11:1410256. [PMID: 38887506 PMCID: PMC11182340 DOI: 10.3389/fnut.2024.1410256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024] Open
Abstract
Background The effects of chili intake on overweight and obesity have attracted significant interest in recent years. This study aimed to investigate the correlation between chili consumption frequency, body mass index (BMI), and obesity prevalence in the American population. Methods Data from participants in National Health and Nutrition Examination Survey (NHANES) 2003-2006 were collected. We enrolled 6,138 participants with complete information on chili intake and BMI in this cross-sectional study. Multivariate logistic regression and sensitivity analyses were conducted to explore the relationship between chili intake frequency and BMI and obesity. Subgroup analyses and interaction tests were employed to assess the stability of the observed correlation. Results Increased chili consumption frequency was linked to higher BMI values and a greater prevalence of obesity. Compared to the non-consumption group, the highest frequency group had a multivariate-adjusted β of 0.71 (95% CI: 0.05, 1.38) for BMI and an OR of 1.55 (95% CI: 1.22, 1.97) for obesity in the fully adjusted model. This positive association between chili intake frequency and obesity was more pronounced in females and older adults (≥ 60 years old). Conclusion Our findings suggest a positive association between chili intake frequency and BMI and obesity in United States adults, suggesting that controlling chili intake frequency could potentially contribute to improved weight management in the general population.
Collapse
Affiliation(s)
- Mengxue Liu
- Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yihao Zhu
- Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Fei Wang
- Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
15
|
Han J, Chen Y, Xu X, Li Q, Xiang X, Shen J, Ma X. Development of Recombinant High-Density Lipoprotein Platform with Innate Adipose Tissue-Targeting Abilities for Regional Fat Reduction. ACS NANO 2024; 18:13635-13651. [PMID: 38753978 DOI: 10.1021/acsnano.4c00403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
As an escalating public health issue, obesity and overweight conditions are predispositions to various diseases and are exacerbated by concurrent chronic inflammation. Nonetheless, extant antiobesity pharmaceuticals (quercetin, capsaicin, catecholamine, etc.) manifest constrained efficacy alongside systemic toxic effects. Effective therapeutic approaches that selectively target adipose tissue, thereby enhancing local energy expenditure, surmounting the limitations of prevailing antiobesity modalities are highly expected. In this context, we developed a temperature-sensitive hydrogel loaded with recombinant high-density lipoprotein (rHDL) to achieve targeted delivery of resveratrol, an adipose browning activator, to adipose tissue. rHDL exhibits self-regulation on fat cell metabolism and demonstrates natural targeting toward scavenger receptor class B type I (SR-BI), which is highly expressed by fat cells, thereby achieving a synergistic effect for the treatment of obesity. Additionally, the dispersion of rHDL@Res in temperature-sensitive hydrogels, coupled with the regulation of their degradation and drug release rate, facilitated sustainable drug release at local adipose tissues over an extended period. Following 24 days' treatment regimen, obese mice exhibited improved metabolic status, resulting in a reduction of 68.2% of their inguinal white adipose tissue (ingWAT). Specifically, rHDL@Res/gel facilitated the conversion of fatty acids to phospholipids (PA, PC), expediting fat mobilization, mitigating triglyceride accumulation, and therefore facilitating adipose tissue reduction. Furthermore, rHDL@Res/gel demonstrated efficacy in attenuating obesity-induced inflammation and fostering angiogenesis in ingWAT. Collectively, this engineered local fat reduction platform demonstrated heightened effectiveness and safety through simultaneously targeting adipocytes, promoting WAT browning, regulating lipid metabolism, and controlling inflammation, showing promise for adipose-targeted therapy.
Collapse
Affiliation(s)
- Junhua Han
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Yingxian Chen
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Xiaolong Xu
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Qingmeng Li
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Xin Xiang
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Jianzhong Shen
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
| | - Xiaowei Ma
- National Key Laboratory of Veterinary Public Health and Safety, Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing 100193, P. R. China
- Sanya Institute of China Agricultural University, Sanya, Hainan 572025, P. R. China
| |
Collapse
|
16
|
Rogers RJ, Doherty M, Jones D, Jakicic JM, Church TS. Impact of a digital employer-based weight loss program on individuals age 65 or older. FRONTIERS IN AGING 2024; 5:1337418. [PMID: 38841343 PMCID: PMC11150599 DOI: 10.3389/fragi.2024.1337418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/25/2024] [Indexed: 06/07/2024]
Abstract
Introduction Older adults are not protected from obesity, which has been linked to frailty, cognitive impairment, and other aging-related factors. Intensive lifestyle interventions have been shown to be effective for weight loss in older adults; however, these have typically been highly intensive and less feasible for dissemination. This analysis describes weight loss in a large-scale, commercially available, digital intervention in a subset of older adults. Methods Older adults (N = 20,443, males = 6,238; females = 14,205) between 65 and 85 years of age with overweight (43.3%) or obesity (46.7%) participated in an online, self-directed weight loss program. Behavioral-based content was delivered through weekly video lessons within an online platform that included weight and physical activity tracking, an online community, a reference library, and access to coaching support. Self-reported measures taken at the time of entry into the program were used for this analysis (demographics, height, body weight, and health status). Weight was reported across weeks of engagement in the curriculum. Results The average weight loss was -3.15 kg (95% CI: [-3.20, -3.11]) at 15.5 weeks. Weight loss was significantly greater in male individuals (-3.79 kg [95% CI: -3.89, -3.71]) versus female individuals (-2.87 kg [95% CI: -2.94, -2.82]) (p < 0.001), with a similar engagement in curriculum weeks. Percent weight loss was statistically significant for all age categories (p < 0.05) and self-reported health conditions (p < 0.05). Discussion Short-term weight loss was observed in older adults exposed to a low-touch, self-guided, and digital behavioral-based weight loss program. Weight loss was also observed even in the presence of various chronic health conditions.
Collapse
Affiliation(s)
- Renee J. Rogers
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, KS, United States
- Wondr Health, Dallas, TX, United States
| | | | | | - John M. Jakicic
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, KS, United States
| | | |
Collapse
|
17
|
Harvanek ZM, Kudinova AY, Wong SA, Xu K, Brick L, Daniels TE, Marsit C, Burt A, Sinha R, Tyrka AR. Childhood adversity, accelerated GrimAge, and associated health consequences. J Behav Med 2024:10.1007/s10865-024-00496-0. [PMID: 38762606 DOI: 10.1007/s10865-024-00496-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/01/2024] [Indexed: 05/20/2024]
Abstract
Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects.
Collapse
Affiliation(s)
- Zachary M Harvanek
- Department of Psychiatry, Yale University, New Haven, CT, USA.
- Yale Stress Center, Yale University, New Haven, CT, USA.
| | - Anastacia Y Kudinova
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Bradley Hospital, Providence, RI, USA
| | - Samantha A Wong
- New York University Grossman School of Medicine, New York, USA
| | - Ke Xu
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychiatry, Connecticut Veteran Healthcare System, West Haven, CT, USA
| | - Leslie Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Teresa E Daniels
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Bradley Hospital, Providence, RI, USA
- Initiative for Stress, Trauma, and Resilience, Alpert Medical School of Brown University, Providence, RI, USA
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| | - Carmen Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amber Burt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Yale Stress Center, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
| | - Audrey R Tyrka
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Initiative for Stress, Trauma, and Resilience, Alpert Medical School of Brown University, Providence, RI, USA
- Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
| |
Collapse
|
18
|
Basolo A, Bechi Genzano S, Vitti J, Salvetti G, Gilio D, Ceccarini G, Scartabelli G, Lippi C, Bellini R, Mancini R, D'Imporzano S, Moretto C, Angeli V, Troiani D, Fierabracci P, Jaccheri R, Calderone A, Poma AM, Chiovato L, Saponati G, Santini F. Efficacy of multivitamin support following bariatric surgery in patients with obesity: a prospective observational study. Eat Weight Disord 2024; 29:34. [PMID: 38714632 PMCID: PMC11076347 DOI: 10.1007/s40519-024-01655-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/02/2024] [Indexed: 05/10/2024] Open
Abstract
PURPOSE Bariatric surgery (BS), an effective treatment for severe obesity and its comorbidities, may result in micronutrient and vitamin deficiencies. This monocentric prospective observational study aimed at evaluating the efficacy of a specifically designed vitamin/mineral formula (Bariatrifast, BIOITALIA S.r.l., Italy) for preventing and treating micronutrient deficiencies in patients submitted to BS. METHODS Twenty patients with severe obesity (mean weight and BMI: 123.5 kg (range 88-174) and 43.3 kg/m2 (range 37-54) respectively) underwent BS (10 vertical sleeve gastrectomy VSG, 10 Roux-en-Y gastric bypass, RYGB). The mean age was 49.9 years (range 27-68). After a presurgical visit (V0), follow-up visits were performed at 1, 3, 6 and 12 months after surgery (V1-V4). Recorded data included weight, height and BMI. A complete blood count, measurement of ferritin, folic acid, vitamin B12, ionized calcium, 25 OH vitamin D, parathyroid hormone (PTH) were obtained. Following BS, patients started the daily oral multivitamin and mineral supplement. RESULTS All patients achieved a significant weight loss (mean - 34.7 ± 11.8 kg). No deficiencies of various vitamins/micronutrients were detected during the entire study period. The serum concentrations of vitamin B12, 25-OH Vitamin D and folic acid increased over the follow-up period compared with V0 (mean increase 243 ng/L, 23 µg /L, 8 µg/L, respectively). Compared to RYGB, patients who underwent sleeve gastrectomy showed higher levels of 25-OH vitamin D at V2, V3 and V4 (all p < 0.05), and higher levels of Vitamin B12 and folic acid at V4 (p < 0.05 and p < 0.005, respectively). No adverse events were reported. CONCLUSION Following VSG or RYGB, Bariatrifast administration was associated with normal values of essential micronutrients, and it was well-tolerated without evidence of gastrointestinal side effects. Clinical Trial Registration ClinicalTrials.gov, identifiers NCT06152965.
Collapse
Affiliation(s)
- Alessio Basolo
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Susanna Bechi Genzano
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Jacopo Vitti
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Guido Salvetti
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Donatella Gilio
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Giovanni Ceccarini
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Giovanna Scartabelli
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Chita Lippi
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Rosario Bellini
- Bariatric Surgery Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Rudi Mancini
- Bariatric Surgery Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | | | - Carlo Moretto
- Bariatric Surgery Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Valentina Angeli
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Daniela Troiani
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Paola Fierabracci
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Roberta Jaccheri
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Alba Calderone
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy
| | - Anello M Poma
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56100, Pisa, Italy
| | - Luca Chiovato
- Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, PV, Italy
| | | | - Ferruccio Santini
- Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, 56124, Pisa, Italy.
- University of Pisa, Pisa, Italy.
| |
Collapse
|
19
|
Hao M, Lv Y, Liu S, Guo W. The New Challenge of Obesity - Obesity-Associated Nephropathy. Diabetes Metab Syndr Obes 2024; 17:1957-1971. [PMID: 38737387 PMCID: PMC11086398 DOI: 10.2147/dmso.s433649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/28/2024] [Indexed: 05/14/2024] Open
Abstract
In recent years, obesity has become one of the major diseases that affect human health and consume human health resources, especially when it causes comorbidities such as hypertension, diabetes, cardiovascular disease and kidney disease. Many studies have demonstrated that obesity is associated with the development of chronic kidney disease and can exacerbate the progression of end-stage renal disease. This review described the mechanisms associated with the development of obesity-associated nephropathy and the current relevant therapeutic modalities, with the aim of finding new therapeutic targets for obesity-associated nephropathy. The mechanisms of obesity-induced renal injury include, in addition to the traditional alterations in renal hemodynamics, the involvement of various mechanisms such as macrophage infiltration in adipose tissue, alterations in adipokines (leptin and adiponectin), and ectopic deposition of lipids. At present, there is no "point-to-point" treatment for obesity-induced kidney injury. The renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-dependent glucose transporter 2 (SGLT-2) inhibitors and bariatric surgery described in this review can reduce urinary protein to varying degrees and delay the progression of kidney disease. In addition, recent studies on the therapeutic effects of intestinal flora on obesity may reduce the incidence of obesity-related kidney disease from the perspective of primary prevention. Both of these interventions have their own advantages and disadvantages, so the continuous search for the mechanism of obesity-induced related kidney disease will be extremely helpful for the future treatment of obesity-related kidney disease.
Collapse
Affiliation(s)
- Mengjin Hao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China
- Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, 272000, People’s Republic of China
| | - You Lv
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China
| | - Siyuan Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China
| | - Weiying Guo
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China
| |
Collapse
|
20
|
Sarzani R, Landolfo M, Di Pentima C, Ortensi B, Falcioni P, Sabbatini L, Massacesi A, Rampino I, Spannella F, Giulietti F. Adipocentric origin of the common cardiometabolic complications of obesity in the young up to the very old: pathophysiology and new therapeutic opportunities. Front Med (Lausanne) 2024; 11:1365183. [PMID: 38654832 PMCID: PMC11037084 DOI: 10.3389/fmed.2024.1365183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Obesity is a multifactorial chronic disease characterized by an excess of adipose tissue, affecting people of all ages. In the last 40 years, the incidence of overweight and obesity almost tripled worldwide. The accumulation of "visceral" adipose tissue increases with aging, leading to several cardio-metabolic consequences: from increased blood pressure to overt arterial hypertension, from insulin-resistance to overt type 2 diabetes mellitus (T2DM), dyslipidemia, chronic kidney disease (CKD), and obstructive sleep apnea. The increasing use of innovative drugs, namely glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i), is changing the management of obesity and its related cardiovascular complications significantly. These drugs, first considered only for T2DM treatment, are now used in overweight patients with visceral adiposity or obese patients, as obesity is no longer just a risk factor but a critical condition at the basis of common metabolic, cardiovascular, and renal diseases. An adipocentric vision and approach should become the cornerstone of visceral overweight and obesity integrated management and treatment, reducing and avoiding the onset of obesity-related multiple risk factors and their clinical complications. According to recent progress in basic and clinical research on adiposity, this narrative review aims to contribute to a novel clinical approach focusing on pathophysiological and therapeutic insights.
Collapse
Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Matteo Landolfo
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Chiara Di Pentima
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
| | - Beatrice Ortensi
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Paolo Falcioni
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Lucia Sabbatini
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Adriano Massacesi
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Ilaria Rampino
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
- Centre for Obesity, Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, European Society of Hypertension (ESH) “Hypertension Excellence Centre”, Società Italiana per lo Studio dell'Aterosclerosi (SISA) LIPIGEN Centre, IRCCS INRCA, Ancona, Italy
| |
Collapse
|
21
|
Sochacka K, Kotowska A, Lachowicz-Wiśniewska S. The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity-Interdependent Mechanisms/Co-Occurrence. Nutrients 2024; 16:1039. [PMID: 38613071 PMCID: PMC11013804 DOI: 10.3390/nu16071039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Obesity and depression are interdependent pathological disorders with strong inflammatory effects commonly found worldwide. They determine the health status of the population and cause key problems in terms of morbidity and mortality. The role of gut microbiota and its composition in the treatment of obesity and psychological factors is increasingly emphasized. Published research suggests that prebiotic, probiotic, or symbiotic preparations can effectively intervene in obesity treatment and mood-dysregulation alleviation. Thus, this literature review aims to highlight the role of intestinal microbiota in treating depression and obesity. An additional purpose is to indicate probiotics, including psychobiotics and prebiotics, potentially beneficial in supporting the treatment of these two diseases.
Collapse
Affiliation(s)
- Klaudia Sochacka
- Faculty of Medicine and Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Agata Kotowska
- Department of Social Policy, Institute of Sociological Sciences, College of Social Sciences, University of Rzeszow, 35-310 Rzeszow, Poland;
| | | |
Collapse
|
22
|
Di Fusco SA, Mocini E, Gori M, Iacoviello M, Bilato C, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists position paper-obesity in adults: a clinical primer. Eur Heart J Suppl 2024; 26:ii221-ii235. [PMID: 38784672 PMCID: PMC11110455 DOI: 10.1093/eurheartjsupp/suae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient-clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.
Collapse
Affiliation(s)
- Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mauro Gori
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Iacoviello
- S.C. Di Cardiologia Universitaria-Utic Policlinico Riuniti, Foggia, Italy
| | - Claudio Bilato
- U.O.C. Cardiologia, Dipartimento di Medicina Cardiovascolare, Ospedali dell’Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Marco Corda
- S.C. Cardiologia e UTIC, Dipartimento Cardiovascolare, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Leonardo De Luca
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Giovanna Geraci
- U.O. Cardiologia, P.O. Sant’Antonio Abate, ASP Trapani, Erice, TP, Italy
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Milli
- Cardiologia Firenze 1 (Ospedali S. Maria Nuova e Nuovo San Giovanni di Dio), Azienda USL Toscana Centro, Firenze, Italy
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia—IRCCS, Reggio Emilia, Italy
| | - Vittorio Pascale
- SOC di Cardiologia-UTIC-Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero ‘Pugliese’, Azienda Ospedaliero-Universitaria ‘Renato Dulbecco’, Catanzaro, Italy
| | - Carmine Riccio
- Dipartimento Cardio-Vascolare, U.O.S.D. Follow-up del Paziente Post-Acuto, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | | | - Emanuele Tizzani
- Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli, TO, Italy
| | - Domenico Gabrielli
- Fondazione per il Tuo cuore—Heart Care Foundation, Firenze, Italy
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Massimo Grimaldi
- U.O.C. Cardiologia-UTIC, Ospedale Miulli, Acquaviva delle Fonti, BA, Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| |
Collapse
|
23
|
Juul-Hindsgaul N, Alalwani Z, Boylan AM, Hartmann-Boyce J, Nunan D. Defining success in adult obesity management: A systematic review and framework synthesis of clinical practice guidelines. Clin Obes 2024; 14:e12631. [PMID: 38320758 DOI: 10.1111/cob.12631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/18/2023] [Accepted: 11/16/2023] [Indexed: 03/16/2024]
Abstract
Obesity is a chronic and complex disease affecting millions of people worldwide. Currently, there is no standard definition of success for the management of obesity. We set out to complete a synthesis of clinical practice guidelines for obesity management for adult populations, aiming to provide both a quantitative descriptive and qualitative analysis of definitions of success in clinical practice guidelines. An electronic search retrieved 4477 references. Sixteen clinical practice guidelines were included after screening and full-text review. We coded definitions of success 147 times across the included guidelines. No standard or explicit definition of success was identified in the guidelines but rather success was implicitly defined. We developed three themes describing how success was defined in the clinical practice guidelines: Knowledge-based decision making; management of expectations; and the perception of control. The review reinforced that success is an inherently subjective and complex concept. Defining success is limited by existing studies that focus on weight loss and would benefit from additional research on different outcomes. Equally, the relationship between people living with obesity and their clinicians should be further explored to understand how defining success is controlled, discussed and framed in a clinical setting.
Collapse
Affiliation(s)
- Nicole Juul-Hindsgaul
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Zahra Alalwani
- Department for Continuing Education, University of Oxford, Oxford, UK
| | - Anne-Marie Boylan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jamie Hartmann-Boyce
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David Nunan
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
24
|
de Oliveira E Silva AM, Pereira RO, Oliveira AKDS, Harris FS, de Melo ILP, Almeida-Souza TH, Yoshime LT, Dos Santos Melo C, Lopes Dos Santos J, de Andrade-Wartha ERS, Cogliati B, Granato D, Mancini-Filho J. Ameliorative effects of aqueous extract from rosemary on oxidative stress and inflammation pathways caused by a high-fat diet in C57BL/6 mice. Appl Physiol Nutr Metab 2024; 49:459-472. [PMID: 38048548 DOI: 10.1139/apnm-2023-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Rosemary is an herb exhibits biological properties, attenuates inflammation, oxidative stress, and improves lipid profile. Here, we evaluated the effects of rosemary aqueous extract (RE) on mice fed with a high-fat diet (HFD). Male C57BL/6 mice were administered a control diet or HFD for 10 weeks. The treated groups received RE in the diet at different concentrations: 25, 250, and 500 mg/100 g. After 10 weeks, serum concentrations of glucose, lipid, insulin, leptin, adiponectin, and cytokines were evaluated and the oxygen radical absorbance capacity was determined. Histological analysis was performed to determine the concentrations of triacylglycerides (TG), total cholesterol, cytokines, and antioxidant enzymes as well as the expression of genes involved in lipid metabolism, oxidative stress, and inflammation. The dietary RE ameliorated HFD-induced weight gain, adipose tissue weight, glucose intolerance, and insulin, leptin, and free fatty acid levels. Reduction in hepatic TG deposition was observed. The levels of inflammatory cytokines decreased, and the expression of genes involved in lipid metabolism increased. RE mitigated oxidative stress and reduced the production of reactive oxygen species in HepG2 and 3T3-L1 cells. Therefore, RE is a potential therapeutic agent for the prevention of inflammation and oxidative stress outcomes associated with obesity.
Collapse
Affiliation(s)
- Ana Mara de Oliveira E Silva
- Nutrition Sciences Graduate Program, Federal University of Sergipe (UFS), São Cristóvão, Sergipe, Brazil
- Health Sciences Graduate Program, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Raquel Oliveira Pereira
- Health Sciences Graduate Program, Federal University of Sergipe (UFS), Aracaju, Sergipe, Brazil
| | | | - Fernanda Santana Harris
- Department of Food and Experimental Nutrition, Laboratory of Lipids, Faculty of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Illana Louise Pereira de Melo
- Department of Food and Experimental Nutrition, Laboratory of Lipids, Faculty of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | | | - Luciana Tedesco Yoshime
- Department of Food and Experimental Nutrition, Laboratory of Lipids, Faculty of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Caroline Dos Santos Melo
- Nutrition Sciences Graduate Program, Federal University of Sergipe (UFS), São Cristóvão, Sergipe, Brazil
| | - Jymmys Lopes Dos Santos
- Department of Morphology, Federal University of Sergipe (UFS), São Cristóvão, Sergipe, Brazil
| | | | - Bruno Cogliati
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Daniel Granato
- Department of Biological Sciences, Faculty of Science and Engineering, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Jorge Mancini-Filho
- Department of Food and Experimental Nutrition, Laboratory of Lipids, Faculty of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| |
Collapse
|
25
|
Barbagallo F, Cucinella L, Tiranini L, Chedraui P, Calogero AE, Nappi RE. Obesity and sexual health: focus on postmenopausal women. Climacteric 2024; 27:122-136. [PMID: 38251874 DOI: 10.1080/13697137.2024.2302429] [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: 09/03/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Menopause is a cardiometabolic transition with many women experiencing weight gain and redistribution of body fat. Hormonal changes may affect also several dimensions of well-being, including sexual function, with a high rate of female sexual dysfunction (FSD), which displays a multifactorial etiology. The most important biological factors range from chronic low-grade inflammation, associated with hypertrophic adipocytes that may translate into endothelial dysfunction and compromised blood flow through the genitourinary system, to insulin resistance and other neuroendocrine mechanisms targeting the sexual response. Psychosocial factors include poor body image, mood disorders, low self-esteem and life satisfaction, as well as partner's health and quality of relationship, and social stigma. Even unhealthy lifestyle, chronic conditions and putative weight-promoting medications may play a role. The aim of the present narrative review is to update and summarize the state of the art on the link between obesity and FSD in postmenopausal women, pointing to the paucity of high-quality studies and the need for further research with validated end points to assess both biomarkers of obesity and FSD. In addition, we provide general information on the diagnosis and treatment of FSD at menopause with a focus on dietary interventions, physical activity, anti-obesity drugs and bariatric surgery.
Collapse
Affiliation(s)
- F Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - L Cucinella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| | - L Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - P Chedraui
- Escuela de Posgrados en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - R E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| |
Collapse
|
26
|
Lu D, Yuan Z, Guo X, Zhu L, Zhang F, Li X, Wang W, Lin H, Luo J. Efficacy and safety of intragastric expandable oral capsules in adults with overweight or obesity: A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab 2024; 26:1224-1233. [PMID: 38253466 DOI: 10.1111/dom.15418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]
Abstract
AIM This trial assessed the efficacy and safety of 2.24 g intragastric expandable capsules twice per day versus placebo for weight management in adults with overweight or obesity. METHODS This double-blind, placebo-controlled study included adults with a body mass index of at least 24 kg/m2 and no more than 40 kg/m2 . In total, 280 participants were recruited from six hospitals in China and were assigned in a 1:1 ratio to receive 2.24 g oral intragastric expandable capsules or placebo for 24 weeks. Coprimary endpoints were the percentage change in body weight from baseline and the rate of weight reduction of ≥5%, assessed using both the full analysis set and per protocol set. RESULTS At baseline, the mean body weight was 81.8 kg, and the mean body mass index was 29.4 kg/m2 . The mean body weight change at week 24 was -4.9% with intragastric expandable capsules versus -1.9% with placebo [estimated treatment difference (ETD) -3.0%, 95% confidence interval (CI) -4.1 to -1.9; p < .001] using the full analysis set and -6.1% versus -2.5% (ETD -3.6%, 95% CI -5.0 to -2.3; p < .001), respectively, using the per protocol set. The percentage of participants who had weight loss exceeding 5% was 45.0% in the intragastric expandable capsule group versus 19.7% in the placebo group (ETD 25.3%, 95% CI 14.7-35.9; p < .001) in the full analysis set and 55.9% versus 26.2% (ETD 29.6%, 95% CI 17.1-42.2; p < .001), respectively, in the per protocol set. Waist circumference significantly decreased at week 24 (intragastric expandable capsules vs. placebo: -5.6 ± 8.3 cm vs. -2.9 ± 4.8 cm; p = .003). The most common adverse events associated with the use of intragastric expandable capsules were gastrointestinal disorders (intragastric expandable capsule vs. placebo, 25.0% vs. 21.9%), and most were mild and transient. CONCLUSIONS In this 24-week trial including participants with overweight or obesity, 2.24 g of intragastric expandable capsules twice daily led to a clinically meaningful reduction in body weight compared with placebo.
Collapse
Affiliation(s)
- Difei Lu
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Zhenfang Yuan
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Liyong Zhu
- Department of Gastrointestinal Surgery, Xiangya Third Hospital of Central South University, Changsha, China
| | - Fan Zhang
- Department of Endocrinology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xuejun Li
- Department of Endocrinology, Xiamen University First Affiliation Hospital, Xiamen, China
| | - Wenbo Wang
- Department of Endocrinology, Peking University Shougang Hospital, Beijing, China
| | - Huandong Lin
- Department of Endocrinology, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Jingnan Luo
- Junion Therapeutics (Xiamen) Co. Ltd, Xiamen, China
| |
Collapse
|
27
|
Wu X, Wang C, Lv D, Chen B, Wu Y, Wu X, Yang Y, Cui J, Xu W, Yang H, Song L, He W, Zhang Y, Guan H, Xie F, Xie W, Shang Q, Zhao Z, Li X. Associations between Chinese visceral adiposity index and risks of all-cause and cause-specific mortality: A population-based cohort study. Diabetes Obes Metab 2024; 26:1264-1272. [PMID: 38164799 DOI: 10.1111/dom.15424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
AIM To determine the associations between the Chinese visceral adiposity index (CVAI) and the risks of all-cause and cause-specific mortality. MATERIALS AND METHODS A total of 3 916 214 Chinese adults were enrolled in a nationwide population cohort covering all 31 provinces of mainland China. The CVAI was calculated based on age, body mass index, waist circumference, and triglyceride and high-density lipoprotein cholesterol concentrations. We used a Cox proportional hazards regression model to determine the hazard ratios and 95% confidence intervals (CIs) for risk of mortality associated with different CVAI levels. RESULTS The median follow-up duration was 3.8 years. A total of 86 158 deaths (34 867 cardiovascular disease [CVD] deaths, 29 884 cancer deaths, and 21 407 deaths due to other causes) were identified. In general, after adjusting for potential confounding factors, a U-shaped relationship between CVAI and all-cause mortality was observed by restricted cubic spline (RCS). Compared with participants in CVAI quartile 1, those in CVAI quartile 4 had a 23.0% (95% CI 20.0%-25.0%) lower risk of cancer death, but a 23.0% (95% CI 19.0-27.0) higher risk of CVD death. In subgroup analysis, a J-shaped and inverted U-shaped relationship for all-cause mortality and cancer mortality was observed in the group aged < 60 years. CONCLUSIONS The CVAI, an accessible indicator reflecting visceral obesity among Chinese adults, has predictive value for all-cause, CVD, and cancer mortality risks. Moreover, the CVAI carries significance in the field of health economics and secondary prevention. In the future, it could be used for early screening purposes.
Collapse
Affiliation(s)
- Xiaoyan Wu
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Chunqi Wang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Deliang Lv
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Bowang Chen
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Wu
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaobing Wu
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yang Yang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianlan Cui
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Xu
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Yang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lijuan Song
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenyan He
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Zhang
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyun Guan
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Fengzhu Xie
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Wei Xie
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Qinggang Shang
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Zhiguang Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Central China Sub-center of the National Center for Cardiovascular Diseases, Zhengzhou, China
- Shenzhen Center for Cardiovascular Diseases, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| |
Collapse
|
28
|
Lee Y, Sang H, Kim S, Choi DA, Rhee SY. Weight Management Health Note, a Mobile Health Platform for Obesity Management Developed by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2024; 33:1-10. [PMID: 38281733 PMCID: PMC11000511 DOI: 10.7570/jomes23074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024] Open
Abstract
The Weight Management Health Note application, developed by the Korean Society for the Study of Obesity (KSSO), was designed to assist individuals in weight management and enhance overall well-being. The Committee of IT-Convergence Treatment of Metabolic Syndrome of the KSSO designed this application. Committee members reviewed and supervised the application's underlying driving algorithms and scientific rationale. A healthcare-specific application developer subsequently finalized the application. This application encompasses a myriad of features, including a comprehensive food diary, an exercise tracker, and tailor-made lifestyle recommendations aligned with individual needs and aspirations. Moreover, it facilitates connections within a community of like-minded individuals endeavoring to manage their weight, fostering mutual support and motivation. Importantly, the application is rich in evidence-based health content curated by the KSSO, ensuring users access accurate information for effective obesity management. Looking ahead, the KSSO is committed to orchestrating diverse academic research endeavors linked to this application and refining its functionalities through continuous feedback from users. The KSSO aspires for this application to serve as a valuable resource for individuals striving to manage their health and enhance their quality of life.
Collapse
Affiliation(s)
- Yujung Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Hyunji Sang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Sunyoung Kim
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | | | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
| |
Collapse
|
29
|
Reges O, Test T, Dicker D, Karpati T. Association of Waist Circumference and Body Mass Index Deciles Ratio with All-Cause Mortality: Findings from the National Health and Nutrition Examination Survey. Nutrients 2024; 16:961. [PMID: 38612995 PMCID: PMC11013628 DOI: 10.3390/nu16070961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Given the importance and continued interest in finding a simple, accessible, and universal measure which reflects both general and abdominal adiposity, this study tested for an association of the ratio of WC decile to BMI decile (WC-d/BMI-d) with all-cause mortality. Individuals aged 18-79 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2007 to 2018 were included in the analysis. WC and BMI deciles were defined separately for males and females, while WC-d/BMI-d was calculated for each individual. The association of WC-d/BMI-d with mortality was assessed using logistic models for the total study population, and then again after stratification by sex, ethnicity, morbidity level, and BMI categories. Positive associations between WC-d/BMI-d and mortality were demonstrated for the total study population (adjusted OR = 1.545, 95%CI: 1.369-1.722) and within different sub-groups, including the population with a normal BMI level (adjusted OR = 1.32, 95%CI: 1.13-1.50). WC-d/BMI-d increased with age, with ~40 years representing a critical time point when WC-d surpasses BMI-d, with a sharper incline for males as compared to females. WC-d/BMI-d was significantly associated with all-cause mortality amongst NHANES American adults; thus, measurements of WC and its integration with BMI in this metric should be considered in clinical practice.
Collapse
Affiliation(s)
- Orna Reges
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 6209804, Israel
| | - Tsafnat Test
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
- Clalit Health Services, Southern District, Yerucham 8050315, Israel
| | - Dror Dicker
- Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva 4937211, Israel
- Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Tomas Karpati
- Department of Digital Technologies in Medicine, Holon Institute of Technology, Holon 5810201, Israel;
| |
Collapse
|
30
|
Vilarrasa N, Salvador J, Poyato F, Rubio-Herrera MÁ. Does the Prevalence of Obesity in the Different Regions of Spain Influence the Attitudes, Perception, and Barriers to Its Treatment? Obes Facts 2024; 17:264-273. [PMID: 38493779 PMCID: PMC11149964 DOI: 10.1159/000538257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The differences in the prevalence of obesity between the various regions of Spain, partly attributed to socioeconomic differences, may influence the approach to this disease. The aim of this study was to compare differences in attitudes, perception, and barriers to the treatment of obesity between people with obesity (PwO) and health care professionals (HCPs), between the different regions of Spain. METHODS Sub-analysis of the ACTION-IO Spain study, which included 1,500 PwO and 306 HCP, was performed to identify differences in PwQ and HCPs belonging to regions with high prevalence of obesity (>16%, n = 9 regions, high prevalence of obesity [HPO] group) and low prevalence of obesity (<16%, n = 8 regions, low prevalence of obesity [LPO] group) (self-reported data), according to the 2017 National Health Survey of Spain. STATISTICS comparison of proportions (χ2). RESULTS A total of 746 PwO belonged to HPO and 754 to LPO group. The PwO in HPO group were younger, had lower income, a lower level of higher education, higher unemployment rate, and fewer comorbidities. Obesity was considered a chronic disease to a higher extent in HPO compared to LPO group (62 vs. 56%), but this difference was not statistically significant. The PwO in HPO group discussed less with the HCPs about their excess weight (57 vs. 70%), did not feel motivated to lose weight in a higher percentage (26 vs. 18%), and felt less emotionally supported (16 vs. 24%). In HPO group, the preference for unhealthy food (51 vs. 36%), and the costs of healthy eating, anti-obesity drugs and bariatric surgery were perceived barriers to losing weight. A higher proportion of PwO in HPO group considered that exercise (58 vs. 40%) was more effective for achieving weight loss. In contrast, LPO group considered diet more effective (48 vs. 32%). HCPs in HPO group felt more motivated to treat obesity (83 vs. 68%) and a higher proportion (14 vs. 5%) identified the economic burden as one of the main reasons why PwO do not start conversations to lose weight. CONCLUSIONS There is less concern and conversation about excess weight in PwO in regions with a higher prevalence of obesity, with socioeconomic limitations being one of the main perceived barriers to treatment.
Collapse
Affiliation(s)
- Nuria Vilarrasa
- Department of Endocrinology, Diabetes and Nutrition, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Javier Salvador
- Faculty of Medicine, University of Navarra, Pamplona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Madrid, Spain
| | | | - Miguel Ángel Rubio-Herrera
- Department of Endocrinology and Nutrition, San Carlos Clinical Hospital and Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
31
|
Bayram F, Sonmez A, Kiyici S, Akbas F, Yetgin MK, Yazici D, Cingi A, Sargin M, Unal S, Iseri C, Mahmutoglu FS, Yumuk VD. Expert Opinion on the Utility of Telemedicine in Obesity Care: Recommendations on a Hybrid Multidisciplinary Integrated Care Follow-Up Algorithm. Curr Obes Rep 2024; 13:167-182. [PMID: 38172478 DOI: 10.1007/s13679-023-00541-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW The proposed expert opinion was prepared by a panel of obesity and law specialists from Turkey to review the utility of telemedicine in obesity care and to provide a guidance document with recommendations on a hybrid multidisciplinary integrated care follow-up algorithm and the legislation governing telemedicine practice to assist obesity specialists in practicing the telemedicine. RECENT FINDINGS The efficacy and feasibility of telemedicine interventions in supporting obesity management programs even during pandemics confirm that obesity is a particularly well-suited field for telemedicine, emphasizing the strong likelihood of continued utilization of telemedicine in obesity management, beyond the pandemic period. Telemedicine has great potential to address several barriers to ongoing weight-management care, such as challenges of access to specialized care, cost, and time limitations as well as patient adherence to treatment. However, telemedicine practice should complement rather than replace the in-person visits which are unique in building rapport and offering social support. Accordingly, the participating experts recommend the use of a hybrid integrated care model in the management of obesity, with the use of telemedicine, as an adjunct to in-person visits, to enable the provision of suggested intensive obesity management via frequent visits by a multidisciplinary team of obesity specialists. Further research addressing the utility of telemedicine in terms of optimal modality and duration for successful long-term obesity management outcomes is necessary to develop specific guidelines on telemedicine practice. In addition, the legislation governing the norms and protocols on confidentiality, privacy, access, and liability needs to be improved.
Collapse
Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Ankara Guven Hospital, Ankara, Turkey
| | - Sinem Kiyici
- Department of Endocrinology and Metabolism, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Feray Akbas
- Department of Internal Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Meral Kucuk Yetgin
- Department of Coaching Education, Sport Health Sciences, Marmara University Faculty of Sports Science, Istanbul, Turkey
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Koc University Faculty of Medicine, Istanbul, Turkey
| | - Asim Cingi
- Department of General Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Sargin
- Department of Family Medicine, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Seniz Unal
- Private Clinical Psychology Office, Istanbul, Turkey
| | - Ceren Iseri
- Department of Internal Medicine, Nutrition Science, Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Fatih Selami Mahmutoglu
- Department of Criminal Law and Criminal Procedure Law, Turkish-German University Faculty of Law, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Department of Endocrinology and Metabolism, Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
| |
Collapse
|
32
|
Owodunni OP, Courville EN, Peter-Okaka U, Ricks CB, Schmidt MH, Bowers CA. Multiplicative effect of frailty and obesity on postoperative mortality following spine surgery: a deep dive into the frailty, obesity, and Clavien-Dindo dynamic. Int J Obes (Lond) 2024; 48:360-369. [PMID: 38110501 DOI: 10.1038/s41366-023-01423-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND/OBJECTIVES Obesity is a global health challenge that affects a large proportion of adults worldwide. Obesity and frailty pose considerable health risks due to their potential to interact and amplify one another's negative effects. Therefore, we sought to compare the discriminatory thresholds of the risk analysis index (RAI), 5-factor modified frailty index (m-FI-5) and patient age for the primary endpoint of postoperative mortality. SUBJECTS/METHODS We included spine surgery patients ≥18 years old, from the American College of Surgeons National Quality Improvement program database from 2012-2020, that were classified as obese. We performed receiver operating characteristic curve analysis to compare the discrimination threshold of RAI, mFI-5, and patient age for postoperative mortality. Proportional hazards risk-adjusted regressions were performed, and Hazard ratios and corresponding 95% Confidence intervals (CI) are reported. RESULTS Overall, there were 149 163 patients evaluated, and in the ROC analysis for postoperative mortality, RAI showed superior discrimination C-statistic 0.793 (95%CI: 0.773-0.813), compared to mFI-5 C-statistic 0.671 (95%CI 0.650-0.691), and patient age C-statistic 0.686 (95%CI 0.666-0.707). Risk-adjusted analyses were performed, and the RAI had a stepwise increasing effect size across frailty strata: typical patients HR 2.55 (95%CI 2.03-3.19), frail patients HR 3.48 (95%CI 2.49-4.86), and very frail patients HR 4.90 (95%CI 2.87-8.37). We found increasing postoperative mortality effect sizes within Clavein-Dindo complication strata, consistent across obesity categories, exponentially increasing with frailty, and multiplicatively enhanced within CD, frailty and obesity strata. CONCLUSION In this study of 149 163 patients classified as obese and undergoing spine procedures in an international prospective surgical database, the RAI demonstrated superior discrimination compared to the mFI-5 and patient age in predicting postoperative mortality risk. The deleterious effects of frailty and obesity were synergistic as their combined effect predicted worse outcomes.
Collapse
Affiliation(s)
- Oluwafemi P Owodunni
- Department of Emergency Medicine, University of New Mexico Hospital, Albuquerque, NM, USA.
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, USA.
| | - Evan N Courville
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, USA
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, NM, USA
| | - Uchenna Peter-Okaka
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, USA
| | - Christian B Ricks
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, NM, USA
| | - Meic H Schmidt
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, NM, USA
| | - Christian A Bowers
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, USA
| |
Collapse
|
33
|
Lewis KH, Gudzune KA, Ard JD. Phentermine in the Modern Era of Obesity Pharmacotherapy: Does It Still Have a Role in Treatment? Curr Obes Rep 2024; 13:132-140. [PMID: 38172485 DOI: 10.1007/s13679-023-00546-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW This review provides an overview of the history, mechanism of action, and expected treatment effects of the anti-obesity medication (AOM), phentermine. It also includes a summary of recent research and practical guidance for prescribing clinicians. RECENT FINDINGS Recent research on phentermine is sparse and consists primarily of observational studies with methodologic limitations. These studies suggest that phentermine use is associated with clinically significant weight loss in adults and that the medication is generally well tolerated. Large-scale observational studies evaluating phentermine's safety have not identified an increased risk of cardiovascular events or elevations in blood pressure. There is no data to support the notion that phentermine is addictive. Although it remains the most commonly prescribed AOM in the USA, phentermine has little rigorous research to support its efficacy and safety in long-term treatment, which creates a dilemma with guideline-recommended chronic use of AOMs. While we await forthcoming conclusive data on this front, clinicians may consider using phentermine long-term in selected patients, if such prescribing is consistent with local regulatory statutes.
Collapse
Affiliation(s)
- Kristina H Lewis
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27101, USA.
| | - Kimberly A Gudzune
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy & Management, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Jamy D Ard
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27101, USA
| |
Collapse
|
34
|
Zhang L, Chen S, Cao X, Yu J, Yang Z, Abdelrahman Z, Yang G, Wang L, Zhang X, Zhu Y, Wu S, Liu Z. Trajectories of Body Mass Index and Waist Circumference in Relation to the Risk of Cardiac Arrhythmia: A Prospective Cohort Study. Nutrients 2024; 16:704. [PMID: 38474832 DOI: 10.3390/nu16050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/14/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The aim of the current study was to explore the trajectories, variabilities, and cumulative exposures of body mass index (BMI) and waist circumference (WC) with cardiac arrhythmia (CA) risks. METHODS In total, 35,739 adults from the Kailuan study were included. BMI and WC were measured repeatedly during the 2006-2010 waves. CA was identified via electrocardiogram diagnosis. BMI and WC trajectories were fitted using a group-based trajectory model. The associations were estimated using Cox proportional hazards models. RESULTS We identified four stable trajectories for BMI and WC, respectively. Neither the BMI trajectories nor the baseline BMI values were associated with the risk of CA. Compared to the low-stable WC group, participants in the high-stable WC group had a higher risk of CA (hazard ratio (HR) = 1.40, 95% confidence interval (CI): 1.06, 1.86). Interestingly, the cumulative exposures of BMI and WC instead of their variabilities were associated with the risk of CA. In the stratified analyses, the positive associations of the high-stable WC group with the risk of CA were found in females only (HR = 1.98, 95% CI: 1.02, 3.83). CONCLUSIONS A high-stable WC trajectory is associated with a higher risk of CA among Chinese female adults, underscoring the potential of WC rather than BMI to identify adults who are at risk.
Collapse
Affiliation(s)
- Liming Zhang
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Hebei United University, Tangshan 063000, China
| | - Xingqi Cao
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiening Yu
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Zhenqing Yang
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Zeinab Abdelrahman
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Gan Yang
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Liang Wang
- Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX 76711, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Hebei United University, Tangshan 063000, China
| | - Zuyun Liu
- Second Affiliated Hospital, and School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China
| |
Collapse
|
35
|
Wachiraphansakul N, Vongchaiudomchoke T, Manosroi W, Nochaiwong S. Comparative effectiveness of glucagon-like peptide-1 receptor agonists on body composition and anthropometric indices: A protocol for a systematic review and network meta-analysis of randomized controlled trials. PLoS One 2024; 19:e0297488. [PMID: 38408098 PMCID: PMC10896528 DOI: 10.1371/journal.pone.0297488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/05/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To date, no studies have addressed the comparative efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RAs) therapy on body composition and anthropometric indices among adult overweight or obese patients with or without type 2 diabetes. To provide evidence-based recommendations, we will conduct a traditional pairwise and network meta-analysis of all available randomized clinical trials that evaluated the effects of GLP1-RAs interventions for adult overweight or obese patients with or without type 2 diabetes. METHODS AND DESIGN Electronic databases, including Medline, Embase, PubMed, Cochrane Library (CENTRAL), Scopus, and CINAHL, will be searched from inception without language restriction. Grey literature will be searched, including Google Scholar, ongoing clinical trial registries, and preprint reports. Reference lists of included trials, relevant major endocrinology scientific meetings, and manual hand searches from key general medicine and obesity and endocrinology journals will also be browsed. Two authors will screen, select, extract, appraise the risk of bias, and rate the evidence findings. Any disagreement will be resolved through team discussion. Based on a random-effects model, we will employ a two-step approach of traditional pairwise meta-analysis and network meta-analysis for quantitative synthesis. The pooled effect estimates using a frequentist approach with 95% confidence intervals for continuous endpoints will be expressed as the standardized mean difference, whereas odds ratios will be used for categorical endpoints. The quality of included trials will be evaluated using the Cochrane risk-of-bias version 2 assessment tool. Certainty of evidence for each outcome will be assessed using the modified confidence in network meta-analysis approach and the Grading of Recommended Assessment, Development, and Evaluation approach. The magnitude of the effect size, prediction intervals, surface under the cumulative ranking curve values, and certainty of evidence will be incorporated to draw evidence-based conclusions. CONCLUSION This systematic review and network meta-analysis will summarize the comparative efficacy of GLP1-RAs therapy on body composition and anthropometric indices. Evidence identified from this review will promote the rational use of interventions for adult overweight or obese patients with or without type 2 diabetes and will serve as an important step for evidence-based practice within this area. TRIAL REGISTRATION PROSPERO registration number: CRD42023458228.
Collapse
Affiliation(s)
| | | | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surapon Nochaiwong
- Pharmacoepidemiology and Statistical Research Center (PESRC), Chiang Mai University, Chiang Mai, Thailand
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
36
|
Chen M, Miao G, Huo Z, Peng H, Wen X, Anton S, Zhang D, Hu G, Brock R, Brantley PJ, Zhao J. Longitudinal Profiling of Fasting Plasma Metabolome in Response to Weight-Loss Interventions in Patients with Morbid Obesity. Metabolites 2024; 14:116. [PMID: 38393008 PMCID: PMC10890440 DOI: 10.3390/metabo14020116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/02/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
It is well recognized that patients with severe obesity exhibit remarkable heterogeneity in response to different types of weight-loss interventions. Those who undergo Roux-en-Y gastric bypass (RYGB) usually exhibit more favorable glycemic outcomes than those who receive adjustable gastric banding (BAND) or intensive medical intervention (IMI). The molecular mechanisms behind these observations, however, remain largely unknown. To identify the plasma metabolites associated with differential glycemic outcomes induced by weight-loss intervention, we studied 75 patients with severe obesity (25 each in RYGB, BAND, or IMI). Using untargeted metabolomics, we repeatedly measured 364 metabolites in plasma samples at baseline and 1-year after intervention. Linear regression was used to examine whether baseline metabolites or changes in metabolites are associated with differential glycemic outcomes in response to different types of weight-loss intervention, adjusting for sex, baseline age, and BMI as well as weight loss. Network analyses were performed to identify differential metabolic pathways involved in the observed associations. After correction for multiple testing (q < 0.05), 33 (RYGB vs. IMI) and 28 (RYGB vs. BAND) baseline metabolites were associated with changes in fasting plasma glucose (FPG) or glycated hemoglobin (HbA1c). Longitudinal changes in 38 (RYGB vs. IMI) and 38 metabolites (RYGB vs. BAND) were significantly associated with changes in FPG or HbA1c. The identified metabolites are enriched in pathways involved in the biosynthesis of aminoacyl-tRNA and branched-chain amino acids. Weight-loss intervention evokes extensive changes in plasma metabolites, and the altered metabolome may underlie the differential glycemic outcomes in response to different types of weight-loss intervention, independent of weight loss itself.
Collapse
Affiliation(s)
- Mingjing Chen
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32603, USA
| | - Guanhong Miao
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32603, USA
| | - Zhiguang Huo
- Department of Biostatistics, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32603, USA
| | - Hao Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Soochow University, Suzhou 215123, China
| | - Xiaoxiao Wen
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32603, USA
| | - Stephen Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32603, USA
| | - Dachuan Zhang
- Department of Biostatistics, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Ricky Brock
- Behavioral Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Phillip J Brantley
- Behavioral Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32603, USA
| |
Collapse
|
37
|
Sanchez-Lastra MA, Ding D, Del Pozo Cruz B, Dalene KE, Ayán C, Ekelund U, Tarp J. Joint associations of device-measured physical activity and abdominal obesity with incident cardiovascular disease: a prospective cohort study. Br J Sports Med 2024; 58:196-203. [PMID: 37940366 PMCID: PMC10894840 DOI: 10.1136/bjsports-2023-107252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To examine the joint associations between physical activity and abdominal obesity with the risk of cardiovascular disease (CVD) events. METHODS We included 70 830 UK Biobank participants (mean age±SD=61.6 ± 7.9 years; 56.4% women) with physical activity measured by wrist-worn accelerometers and without major chronic diseases. Participants were jointly categorised into six groups based on their physical activity level (tertiles of total volume and specific intensity levels) and presence or absence of abdominal obesity based on measured waist circumference. Associations with incident CVD (fatal and non-fatal events) were determined using proportional subdistribution hazard models with multivariable adjustment. RESULTS After excluding events during the first 2 years of follow-up, participants were followed for a median of 6.8 years, during which 2795 CVD events were recorded. Compared with the low abdominal adiposity and highest tertile of physical activity, abdominal obesity was associated with higher risk of incident CVD, especially in those with low levels of vigorous-intensity physical activity (HR 1.42, 95% CI 1.22 to 1.64). Approximately 500 min per week of moderate-to-vigorous intensity and approximately 30-35 min of vigorous-intensity physical activity offset the association of abdominal obesity and the risk of having a CVD event. CONCLUSION Physical activity equivalent to approximately 30-35 min of vigorous intensity per week appears to offset the association between abdominal obesity and incident CVD. About 15 times more physical activity of at least moderate intensity is needed to achieve similar results.
Collapse
Affiliation(s)
- Miguel Adriano Sanchez-Lastra
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Special Didactics, University of Vigo Faculty of Education and Sports Sciences, Pontevedra, Spain
- Wellness and Movement Research Group (WellMove), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Ding Ding
- Prevention Research Collaboration, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Camperdown, New South Wales, Australia
| | - Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark Centre for Active and Healthy Ageing, Odense, Denmark
- University of Cadiz Faculty of Education Sciences, Puerto Real, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz Puerta del Mar University Hospital, Cádiz, Spain
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Carlos Ayán
- Department of Special Didactics, University of Vigo Faculty of Education and Sports Sciences, Pontevedra, Spain
- Wellness and Movement Research Group (WellMove), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Jakob Tarp
- Department of Clinical Epidemiology, Aarhus University & University Hospital, Aarhus, Denmark
| |
Collapse
|
38
|
Ahmed N, Asif S, Arfan M, Mahmood Q, Islam A, Gatasheh MK, Zia M. Synthesis and Characterization of Short α and β-Mixed Peptides with Excellent Anti-Lipase Activities. Molecules 2024; 29:765. [PMID: 38398517 PMCID: PMC10892623 DOI: 10.3390/molecules29040765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Obesity is a source of significant pathologies and deadly diseases, including heart disease, diabetes, and cancer. One of the most intriguing strategies in the hunt for new anti-obesity medications is the inhibition of pancreatic lipase (PL). This study presents a novel application of short α and β-mixed peptides as pancreatic lipase inhibitors. These peptides were synthesized in the solution phase and characterized using FTIR and 1H-NMR. L-proline is present in a high percentage of natural anti-lipase peptides and was used as a β-amino acid in this study to enhance anti-lipase activity and proteolytic stability. Moreover, L-α-proline was converted to β-amino acid derivatives using the Arndt-Eistert method with the advantage of stereo control at the α-carbon. The synthesized peptides with anti-lipase activity are N-Boc-β-Pro-Gly-OBz (93%), N-Boc-O-Bz-Tyr-β-Pro-β-Pro-Gly-OBz (92%), N-Boc-O-Bz-Tyr-β-Pro-COOH (91%), N-Boc-Phe-β-Pro-OCH3 (90%), and N-Boc-O-Bz-Tyr-β-Pro-OCH3 (89%). These peptides may function as lead molecules for further modification to more significant molecules, which can help control obesity.
Collapse
Grants
- RSP2024R393 King Saud University
- 9ebfe58b5d63cfdf,0fc4036025155e1a,3a852f3e85a2433b,ffc04817768e29d8,1eae9545a3244bed,db5d8742b53a782c,fc9of098bf237c77,8ce5883758852285 Qaiser Mahmood
- 0bb1baa309ebdbb0,6a5aa5d7ed313e53,61843063f3444df7,58875d947b81e726,615b239e803be0b0,45e50be7ef0245f1,c5d9a4fe383b609e,0ceab0ce3ca2061e Amjad Islam
Collapse
Affiliation(s)
- Naeem Ahmed
- Department of Chemistry, School of Natural Sciences, National University of Sciences and Technology, Islamabad 44000, Pakistan;
| | - Sabahat Asif
- Department of Chemistry and Chemical Engineering, Syed Babar Ali School of Science and Engineering, Lahore University of Management Sciences (LUMS), Lahore 54792, Pakistan;
| | - Muhammad Arfan
- Department of Chemistry, School of Natural Sciences, National University of Sciences and Technology, Islamabad 44000, Pakistan;
| | - Qaiser Mahmood
- Chemistry and Chemical Engineering Guangdong Laboratory, Shantou 515031, China;
| | - Amjad Islam
- Key Laboratory for Preparation and Application of Ordered Structured Materials of Guangdong Province, College of Chemistry and Chemical Engineering, Shantou University, Shantou 515063, China;
| | - Mansour K. Gatasheh
- Department of Biochemistry, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia;
| | - Muhammad Zia
- Department of Biotechnology, Quaid-i-Azam University, Islamabad 45320, Pakistan;
| |
Collapse
|
39
|
Pinto TAM, Saito HPA, Nourani CL, Ataide EC, Boin IFSF, Lourenco GJ, Lima CSP. Clinicopathological Aspects and Inflammation-Immune Markers in Alcohol and/or Hepatitis C Virus-Induced Hepatocellular Carcinoma Patients Treated With Sorafenib. Gastroenterology Res 2024; 17:23-31. [PMID: 38463146 PMCID: PMC10923249 DOI: 10.14740/gr1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/06/2024] [Indexed: 03/12/2024] Open
Abstract
Background Tyrosine kinase inhibitors have been used to treat hepatocellular carcinoma (HCC), but the outcomes of patients under treatment vary. Since the roles of clinicopathological aspects and markers of chronic inflammation/immune homeostasis in the outcome of HCC patients treated with sorafenib are still unclear, these were the aims of this study. Methods Patients with alcohol-induced and/or hepatitis C virus (HCV)-induced HCC (n = 182) uniformly treated with sorafenib were included in the study. Baseline clinicopathological aspects of patients were computed from the medical records. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII) were obtained from the hematological exam performed before the administration of sorafenib. Overall survival (OS) was analyzed using Kaplan-Meier probabilities, log-rank test, and univariate and multivariate Cox proportional hazard ratio (HR) analyses. Results In multivariate analysis, alpha-foetoprotein (AFP) level and Child-Pugh score were predictors of OS. Patients with AFP levels higher than 157 ng/mL and Child-Pugh B or C had 1.40 (95% confidence interval (CI): 1.03 - 1.91, P = 0.03) and 1.64 (95% CI: 1.07 - 2.52, P = 0.02) more chances of evolving to death than the remaining patients, respectively. NLR, PLR, LMR, SIRI, and SII did not alter the OS of HCC patients. Conclusions AFP level and Child-Pugh score act as independent prognostic factors in patients with alcohol and/or HCV-induced HCC treated with sorafenib, but markers of chronic inflammation/immune homeostasis seem not to alter the outcome of patients with HCC induced by alcohol and/or HCV.
Collapse
Affiliation(s)
- Thiago Alexandre Martins Pinto
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Helena Paes Almeida Saito
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Carolina Lopes Nourani
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Elaine Cristina Ataide
- Department of Surgery, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | | | - Gustavo Jacob Lourenco
- Laboratory of Cancer Genetics; School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Carmen Silvia Passos Lima
- Clinical Oncology Service, Department of Anesthesiology, Oncology, and Radiology, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
- Laboratory of Cancer Genetics; School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil
| |
Collapse
|
40
|
Domingo E, Marques P, Francisco V, Piqueras L, Sanz MJ. Targeting systemic inflammation in metabolic disorders. A therapeutic candidate for the prevention of cardiovascular diseases? Pharmacol Res 2024; 200:107058. [PMID: 38218355 DOI: 10.1016/j.phrs.2024.107058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
Cardiovascular disease (CVD) remains the leading cause of death and disability worldwide. While many factors can contribute to CVD, atherosclerosis is the cardinal underlying pathology, and its development is associated with several metabolic risk factors including dyslipidemia and obesity. Recent studies have definitively demonstrated a link between low-grade systemic inflammation and two relevant metabolic abnormalities: hypercholesterolemia and obesity. Interestingly, both metabolic disorders are also associated with endothelial dysfunction/activation, a proinflammatory and prothrombotic phenotype of the endothelium that involves leukocyte infiltration into the arterial wall, one of the earliest stages of atherogenesis. This article reviews the current literature on the intricate relationship between hypercholesterolemia and obesity and the associated systemic inflammation and endothelial dysfunction, and discusses the effectiveness of present, emerging and in-development pharmacological therapies used to treat these metabolic disorders with a focus on their effects on the associated systemic inflammatory state and cardiovascular risk.
Collapse
Affiliation(s)
- Elena Domingo
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Patrice Marques
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Vera Francisco
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Valencia, Spain
| | - Laura Piqueras
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; CIBERDEM, Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute (ISCIII), Spain.
| | - Maria-Jesus Sanz
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; CIBERDEM, Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute (ISCIII), Spain.
| |
Collapse
|
41
|
de Cuevillas B, Lubrecht J, Navas-Carretero S, Vreugdenhil A, Martinez JA. Sleep duration is associated with liver steatosis in children depending on body adiposity. Eur J Pediatr 2024; 183:779-789. [PMID: 38001309 PMCID: PMC10912132 DOI: 10.1007/s00431-023-05332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
Sleep is a factor associated with overweight/obesity risk, wherein interactions with fatty liver should be ascertained. The aim of this cross-sectional study was to analyze the possible relationships of sleep with liver health and whether this interplay is related to body adiposity distribution in children and adolescents. Anthropometric, clinical, and biochemical measurements were performed in children and adolescents (2-18 years old) with overweight/obesity (n = 854). Body fat distribution was clinically assessed, and several hepatic markers, including hepatic steatosis index, were calculated. Sleep time mediation (hours/day) in the relationship between the hepatic steatosis index and body fat distribution was investigated. Differences among diverse fatty liver disease scores were found between children with overweight or obesity (p < 0.05). Linear regression models showed associations between hepatic steatosis index and lifestyle markers (p < 0.001). Hepatic steatosis index was higher (about + 15%) in children with obesity compared to overweight (p < 0.001). Pear-shaped body fat distribution may seemingly play a more detrimental role on liver fat deposition. The association between sleep time and hepatic steatosis index was dependent on body mass index z-score. Post hoc analyses showed that 39% of the relationship of body fat distribution on hepatic steatosis index may be explained by sleep time. Conclusion: An association of sleep time in the relationship between body fat distribution and hepatic steatosis index was observed in children and adolescents with overweight/obesity, which can be relevant in the prevention and treatment of excessive adiposity between 2 and 18 years old. CLINICAL TRIAL NCT04805762. Import: As part of a healthy lifestyle, sleep duration might be a modifiable factor in the management of fatty liver disease in children. WHAT IS KNOWN • Sleep is an influential factor of overweight and obesity in children. • Excessive adiposity is associated with liver status in children and adolescents. WHAT IS NEW • Sleep time plays a role in the relationship between body fat distribution and liver disease. • Monitoring sleep pattern may be beneficial in the treatment of hepatic steatosis in children with excessive body weight.
Collapse
Affiliation(s)
- Begoña de Cuevillas
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain.
| | - Judith Lubrecht
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Santiago Navas-Carretero
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Health Research Institute of Navarra, Pamplona, Spain
| | - Anita Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - J Alfredo Martinez
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition Program, Research Institute On Food and Health Sciences IMDEA Food, CSIC-UAM, Madrid, Spain
- Centro de Medicina y Endocrinología, Universidad de Valladolid, Valladolid, Spain
| |
Collapse
|
42
|
Márquez Álvarez CDM, Gómez-Crisóstomo NP, De la Cruz-Hernández EN, El-Hafidi M, Pedraza-Chaverri J, Medina-Campos ON, Martínez-Abundis E. Chronic consumption of imbalance diets high in sucrose or fat induces abdominal obesity with different pattern of metabolic disturbances and lost in Langerhans cells population. Life Sci 2024; 336:122305. [PMID: 38030061 DOI: 10.1016/j.lfs.2023.122305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
AIM Obesity is a worldwide health issue, associated with development of type 2 Diabetes Mellitus. The aim of this study is to analyze the effect of consumption of two hypercaloric diets on metabolic disturbance and beta cells damage. MAIN METHODS Male Wistar rats were subjected to twelve months consumption of three diets: a Control balanced diet (CTD, carbohydrates 58 %, proteins 29 %, lipids 13 %) and two hypercaloric diets, high in sucrose (HSD, carbohydrates 68 %, proteins 22 %, lipids 10 %) or high in fat (HFD, carbohydrates 31 %, proteins 14 %, lipids 55 %). Serum levels of glucose, triglycerides and free fatty acids were measured after zoometric parameters determination. Antioxidant enzymes activity and oxidative stress-marker were measured in pancreas tissue among histological analysis of Langerhans islets. KEY FINDINGS Although diets were hypercaloric, the amount of food consumed by rats decreased, resulting in an equal caloric consumption. The HSD induced hypertriglyceridemia and hyperglycemia with higher levels in free fatty acids (FFA, lipotoxicity); whereas HFD did not increased neither the triglycerides nor FFA, nevertheless the loss of islets' cell was larger. Both diets induced obesity with hyperglycemia and significant reduction in Langerhans islets size. SIGNIFICANCE Our results demonstrate that consumption of HSD induces more significant metabolic disturbances that HFD, although both generated pancreas damage; as well hypercaloric diet consumption is not indispensable to becoming obese; the chronic consumption of unbalanced diets (rich in carbohydrates or lipids) may lead to abdominal obesity with metabolic and functional disturbances, although the total amount of calories are similar.
Collapse
Affiliation(s)
- Corazón de María Márquez Álvarez
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Nancy P Gómez-Crisóstomo
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Erick N De la Cruz-Hernández
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico
| | - Mohammed El-Hafidi
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, 14080 CDMX, Mexico
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Omar Noel Medina-Campos
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Eduardo Martínez-Abundis
- Laboratorio de Investigación en Enfermedades Metabólicas e Infecciosas, División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, C.P. 86650 Comalcalco, Tabasco, Mexico.
| |
Collapse
|
43
|
Dote-Montero M, Merchan-Ramirez E, Oses M, Echarte J, Clavero-Jimeno A, Alcantara J, Camacho-Cardenosa A, Cupeiro R, Rodríguez-Miranda MDLN, López-Vázquez A, Amaro-Gahete FJ, González Cejudo MT, Martin-Olmedo JJ, Molina-Fernandez M, García Pérez PV, Contreras-Bolívar V, Muñoz-Garach A, Andreo-López MC, Carneiro-Barrera A, Miranda-Ferrúa E, Zugasti A, Petrina E, Álvarez de Eulate N, Goñi E, Ribelles MJ, Brugos CA, Izquierdo C, Fernández-Puggioni V, Galbete A, Villanueva A, Medrano M, Alfaro-Magallanes VM, Muñoz-Torres M, Martín-Rodríguez JL, Idoate F, Cabeza R, Ruiz JR, Labayen I. Efficacy of different 8 h time-restricted eating schedules on visceral adipose tissue and cardiometabolic health: A study protocol. Nutr Metab Cardiovasc Dis 2024; 34:177-187. [PMID: 37949715 DOI: 10.1016/j.numecd.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIMS To investigate the efficacy and feasibility of three different 8 h time-restricted eating (TRE) schedules (i.e., early, late, and self-selected) compared to each other and to a usual-care (UC) intervention on visceral adipose tissue (VAT) and cardiometabolic health in men and women. METHODS AND RESULTS Anticipated 208 adults (50% women) aged 30-60 years, with overweight/obesity (25 ≤ BMI<40 kg/m2) and with mild metabolic impairments will be recruited for this parallel-group, multicenter randomized controlled trial. Participants will be randomly allocated (1:1:1:1) to one of four groups for 12 weeks: UC, early TRE, late TRE or self-selected TRE. The UC group will maintain their habitual eating window and receive, as well as the TRE groups, healthy lifestyle education for weight management. The early TRE group will start eating not later than 10:00, and the late TRE group not before 13:00. The self-selected TRE group will select an 8 h eating window before the intervention and maintain it over the intervention. The primary outcome is changes in VAT, whereas secondary outcomes include body composition and cardiometabolic risk factors. CONCLUSION This study will determine whether the timing of the eating window during TRE impacts its efficacy on VAT, body composition and cardiometabolic risk factors and provide insights about its feasibility.
Collapse
Affiliation(s)
- Manuel Dote-Montero
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain.
| | - Elisa Merchan-Ramirez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Maddi Oses
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Jon Echarte
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Antonio Clavero-Jimeno
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Jma Alcantara
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Alba Camacho-Cardenosa
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Rocío Cupeiro
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | | | - Alejandro López-Vázquez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Francisco J Amaro-Gahete
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Juan J Martin-Olmedo
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Marcos Molina-Fernandez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Victoria Contreras-Bolívar
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
| | - Araceli Muñoz-Garach
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María C Andreo-López
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
| | | | - Emiliano Miranda-Ferrúa
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Zugasti
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Navarra, Pamplona, Spain
| | - Estrella Petrina
- Servicio de Radiología, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Elena Goñi
- Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
| | - María Jesús Ribelles
- Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Claudia Izquierdo
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Victoria Fernández-Puggioni
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Arkaitz Galbete
- Universidad Pública de Navarra-Navarrabiomed-Hospital Universitario de Navarra, Redissec, Instituto de Investigacion Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Arantxa Villanueva
- Smart Cities Institute, Public University of Navarre, Pamplona, Spain; Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - María Medrano
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Víctor Manuel Alfaro-Magallanes
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain; LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain; Department of Medicine, University of Granada, 18016 Granada, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | | | - Rafael Cabeza
- Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Idoia Labayen
- Institute for Sustainability & Food Chain Innovation, Department of Health Sciences, Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigación Biomédica en Red: Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| |
Collapse
|
44
|
Georgoulis M, Damigou E, Chrysohoou C, Barkas F, Kravvariti E, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos DB. Increased body weight and central adiposity markers are positively associated with the 20-year incidence of cardiovascular disease: The ATTICA epidemiological study (2002-2022). Nutr Res 2024; 121:1-15. [PMID: 37995411 DOI: 10.1016/j.nutres.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Abstract
Increased adiposity predisposes to cardiovascular disease (CVD). We hypothesized that the presence of obesity would be positively associated with CVD risk, and that the co-presence of central obesity would modify/enhance this association. This was a prospective study (2002-2022) among 1845 Greek adults (mean age, 44.8 ± 13.5 years; men, 49.8%). At baseline, the presence of overweight/obesity was assessed via body mass index (BMI), whereas central obesity was defined as waist circumference ≥102/88 cm, waist-to-hip-ratio ≥0.95/0.80, or waist-to-height-ratio ≥0.50 in men/women. BMI was reevaluated at 10 years and longitudinal BMI trajectories (2002-2012) were identified. CVD incidence was recorded at 20 years (ratio of new cases to the number of participants assessed). Compared with participants with normal weight at baseline, those with obesity exhibited a 27% higher 20-year CVD risk after adjustment for age, sex, lifestyle habits, and medical status (hazard ratio, 1.271; 95% confidence interval, 1.012-1.597). In similar multiadjusted models, compared with participants who were always non-overweight/obese, those who were always overweight/obese exhibited a 40% higher 20-year CVD risk (hazard ratio, 1.403; 95% confidence interval, 1.018-1.936). Additional control for high-sensitivity C-reactive protein attenuated the associations. In the combined baseline body weight classification analysis, CVD incidence was the lowest in participants with normal weight without central obesity, moderate in those with overweight/obesity without central obesity, and highest in those with normal weight and central obesity and overweight/obesity and central obesity (P < .001). Obesity leads to increased CVD risk, partly mediated by inflammation. The combination of BMI with simple measures of abdominal adiposity is superior for CVD risk screening.
Collapse
Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece.
| |
Collapse
|
45
|
Palamarchuk OS, Leshko MM, Klushyn VO, Feketa VP. A differentiated approach to the diagnosis of overweight and obesity in children based on bioimpedance analysis of body composition. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:402-408. [PMID: 38691779 DOI: 10.36740/wlek202403105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Aim: The current study introduces a novel diagnostic algorithm employing bioimpedance analysis to comprehensively evaluate body composition in children, assessing fat content, skeletal muscle content, and fat distribution. PATIENTS AND METHODS Materials and Methods: Bioelectrical impedance measurements were obtained using the TANITA MC-780 MA analyzer. Indicators such as body weight, BMI, total fat content, absolute limb muscle mass, skeletal muscle strength, and waist-to-hip ratio (WHR) were assessed. A sample of 101 children aged 9 to 14 were studied using the proposed algorithm, refining BMI-based classifications. RESULTS Results: The algorithm comprises three steps, categorizing children based on fat content, presence of sarcopenia, and central fat distribution. It identified diverse somatotypes within the groups classified by BMI. Notably, it revealed prognostically unfavorable somatotypes, such as sarcopenic obesity with central fat distribution, highlighting potential health risks. Current BMI-centric diagnoses may misclassify cardiometabolic risks, making early detection challenging. The algorithm enables a detailed evaluation, unmasking metabolically unfavorable conditions like sarcopenic obesity. The incorporation of functional tests, such as a standardized hand-grip test, enhances diagnostic accuracy. The proposed WHR indicator for characterizing fat distribution provides a practical method for determining somatotypes in children. CONCLUSION Conclusions: This comprehensive algorithm offers an alternative to BMI-based classifications, enabling early detection of obesity and associated risks. Further validation through large-scale epidemiological studies is essential to establish correlations between somatotypes and cardiometabolic risks, fostering a more nuanced and individualized approach to pediatric obesity management.
Collapse
|
46
|
Gregory JM, Kraft G, Dalla Man C, Slaughter JC, Scott MF, Hastings JR, Edgerton DS, Moore MC, Cherrington AD. A high-fat and fructose diet in dogs mirrors insulin resistance and β-cell dysfunction characteristic of impaired glucose tolerance in humans. PLoS One 2023; 18:e0296400. [PMID: 38134122 PMCID: PMC10745172 DOI: 10.1371/journal.pone.0296400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
This study examined the impact of a hypercaloric high-fat high-fructose diet (HFFD) in dogs as a potential model for human impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). The HFFD not only led to weight gain but also triggered metabolic alterations akin to the precursors of human T2DM, notably insulin resistance and β-cell dysfunction. Following the HFFD intervention, the dogs exhibited a 50% decrease in insulin sensitivity within the first four weeks, paralleling observations in the progression from normal to IGT in humans. Calculations of the insulinogenic index using both insulin and C-peptide measurements during oral glucose tolerance tests revealed a significant and sustained decrease in early-phase insulin release, with partial compensation in the later phase, predominantly stemming from reduced hepatic insulin clearance. In addition, the Disposition Index, representing the β-cell's capacity to compensate for diminished insulin sensitivity, fell dramatically. These results confirm that a HFFD can instigate metabolic changes in dogs akin to the early stages of progression to T2DM in humans. The study underscores the potential of using dogs subjected to a HFFD as a model organism for studying human IGT and T2DM.
Collapse
Affiliation(s)
- Justin M Gregory
- Ian Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Guillaume Kraft
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| | - Chiara Dalla Man
- Department of Information Engineering, University of Padova, Padova, Italy
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Melanie F Scott
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| | - Jon R Hastings
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| | - Dale S Edgerton
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| | - Mary C Moore
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| | - Alan D Cherrington
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN United States of America
| |
Collapse
|
47
|
Li Y, Miao Y, Tan J, Zhang Q. Association of modifiable risk factors with obstructive sleep apnea: a Mendelian randomization study. Aging (Albany NY) 2023; 15:14039-14065. [PMID: 38085646 PMCID: PMC10756101 DOI: 10.18632/aging.205288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/16/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The risk factors involved in obstructive sleep apnea (OSA) have not been clearly identified yet. We attempted to systematically investigate genetically predicted modifiable risk factors and lifestyle behaviors associated with OSA. METHODS The association between 34 risk factors and OSA was evaluated using the two-sample Mendelian randomization (MR). Genetic variants for risk factors were acquired from European-descent genome-wide studies. Data sources for OSA were extracted from FinnGen study with 16,761 cases and 201,194 controls. The primary analysis chosen was the inverse-variance weighted method. RESULTS MR analyses provide evidence of genetically predicted poor overall health rating (odds ratio (OR), 2.82; 95% confidence interval (CI), 1.95-4.08), nap during day (OR, 2.01; 95% CI, 1.37-2.93), high body mass index (BMI) (OR, 1.14; 95% CI, 1.09-1.19), increased body fat mass (OR, 1.83; 95% CI, 1.83-2.05), elevated body water mass (OR, 1.50; 95% CI, 1.31-1.70) and hypertension (OR, 1.81; 95% CI, 1.34-2.45) were associated with higher OSA risk, while high education level (OR, 0.55; 95% CI, 0.40-0.75) correlated with reduced OSA risk. Suggestive evidence was obtained for smoking and waist-to-hip ratio (WHR) with higher OSA odds, and vigorous physical activity, and HDL cholesterol with lower OSA odds. After adjusting for BMI using multivariable MR analysis, the effects of smoking, WHR, vigorous physical activity, and HDL-cholesterol were fully attenuated. CONCLUSIONS This MR study indicates that overall health rating, nap during day, BMI, body fat mass, body water mass, hypertension, and education are causally associated with the risk of OSA, which means that these modifiable risk factors are key targets for OSA prevention.
Collapse
Affiliation(s)
- Ye Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Yuyang Miao
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Jin Tan
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
- Tianjin Geriatrics Institute, Tianjin 300052, China
| |
Collapse
|
48
|
Hartson KR, King KM, O'Neal C, Brown AA, Olajuyigbe T, Elmore S, Perez A. Testing the Effects of Two Field-to-Fork Programs on the Nutritional Outcomes of Elementary School Students From Diverse and Lower-Income Communities. J Sch Nurs 2023; 39:444-455. [PMID: 34351238 DOI: 10.1177/10598405211036892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N = 264) and the Field-to-Fork After-school Club (N = 56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar's and Wilcoxon signed rank tests. The proportion of students knowing how to cook a vegetable rich recipe increased with both programs (Multi-visit Program p < .001; After-school Club p = .002). Vegetable consumption increased with the After-school Club (p = .002). Farm-to-school programming can increase knowledge of cooking vegetable rich recipes and vegetable intake among elementary school students from diverse, urban, and lower-income communities.
Collapse
Affiliation(s)
| | - Kristi M King
- Department of Health and Sports Sciences, Student Activity Center-East (SAC-E) 105G, Louisville, KY, USA
| | - Carol O'Neal
- Department of Health and Sports Sciences, Student Activity Center-East (SAC-E) 105G, Louisville, KY, USA
| | - Aishia A Brown
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | | | - Shakeyrah Elmore
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | | |
Collapse
|
49
|
Yu H, Armstrong N, Pavela G, Kaiser K. Sex and Race Differences in Obesity-Related Genetic Susceptibility and Risk of Cardiometabolic Disease in Older US Adults. JAMA Netw Open 2023; 6:e2347171. [PMID: 38064210 PMCID: PMC10709778 DOI: 10.1001/jamanetworkopen.2023.47171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/29/2023] [Indexed: 12/18/2023] Open
Abstract
Importance The fat mass and obesity-associated gene (FTO) is associated with obesity phenotypes, but the association is inconsistent across populations. Within-population differences may explain some of the variability observed. Objective To investigate sex differences in the association between FTO single-nucleotide variants (SNVs) and obesity traits among self-identified non-Hispanic Black and non-Hispanic White US adults, to examine whether the SNVs were associated with cardiometabolic diseases, and to evaluate whether obesity mediated the association between FTO SNVs and cardiometabolic diseases. Design, Setting, and Participants This cross-sectional study used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a US population-based cohort study with available genetic data (assayed in 2018) and phenotypic data at baseline (enrolled 2003-2007). Participants were aged 45 to 98 years at baseline. Data were analyzed from October 2021 to October 2022. Exposures Eleven SNVs in the FTO gene present among both Black and White participants. Main Outcomes and Measures Objectively measured obesity indicators (body mass index and waist-to-height ratio), objectively measured and/or self-reported cardiometabolic diseases (hypertension, stroke history, heart disease, and diabetes), and self-reported social-economic and psychosocial status. Results A total of 10 447 participants (mean [SD] age, 64.4 [9.7] years; 5276 [55.8%] women; 8743 [83.7%] Black and 1704 [16.3%] White) were included. In the White group, 11 FTO SNVs were significantly associated with obesity, hypertension, and diabetes using linear models (eg, body mass index: β = 0.536; 95% CI, 0.197-0.875), but none of the FTO SNVs were associated with obesity traits in the Black group. White males had a higher risk of obesity while White females had a higher risk of hypertension and diabetes. However, 1 FTO SNV (rs1121980) was associated with a direct increase in the risk of heart disease in Black participants not mediated by obesity (c' = 0.145 [SE, 0.0517]; P = .01). Conclusions and Relevance In this cross-sectional study of obesity phenotypes and their association with cardiometabolic diseases, the tested FTO SNVs reflected sex differences in White participants. Different patterns of associations were observed among self-identified Black participants. Therefore, these results could inform future work discovering risk alleles or risk scores unique to Black individuals or further investigating genetic risk in all US residents.
Collapse
Affiliation(s)
- Hairui Yu
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham
- Department of Family and Community Medicine, School of Medicine, University of Alabama at Birmingham
| | - Nicole Armstrong
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Greg Pavela
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham
| | - Kathryn Kaiser
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham
| |
Collapse
|
50
|
Ali Ibrahim AI, Mendoza B, Stanford FC, Malhotra S. Real-World Experience of the Efficacy and Safety of Phentermine Use in Adolescents: A Case Series. Child Obes 2023; 19:535-540. [PMID: 36576420 DOI: 10.1089/chi.2022.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Pharmacotherapy has emerged as a practical option for weight management in pediatrics. This study aims to assess the effectiveness and safety of phentermine use in pediatric patients with obesity. Methods: We performed a retrospective single-center analysis of patients younger than or equal to 18 years of age, over 10 years, who underwent phentermine treatment and recommended lifestyle changes. We evaluated efficacy by the change in the percent of the 95th percentile for BMI (%BMIp95). We deemed a 5% decrease in %BMIp95 as a favorable outcome. Results: We identified 30 pediatric patients who were treated with phentermine. The cohort was primarily female, 63% white, with a mean (standard deviation) baseline age of 15.63 (1.97) years. The average duration of treatment was 10 months, with a period ranging from 2 weeks to 2 years. The average %BMIp95 at the start of treatment was 137%, and that at the time of analysis was 122%, with a mean reduction of 15%. Five patients, 17%, experienced side effects that resolved after dose reduction or discontinuing phentermine. Conclusions: Phentermine monotherapy is an effective and safe means for weight loss in pediatric patients when combined with lifestyle interventions. Twenty-one of 30 (70%) patients achieved at least a 5% decrease in %BMIp95 within a mean duration of treatment of 10 months. We noted no severe adverse events.
Collapse
Affiliation(s)
- Awab I Ali Ibrahim
- Pediatric Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Fatima Cody Stanford
- Pediatric Endocrinology, MGH Weight Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Nutrition Obesity Research Center at Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sonali Malhotra
- Pediatric Endocrinology, MGH Weight Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Rhythm Pharmaceuticals, Boston, MA, USA
| |
Collapse
|