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Gong J, Liu F, Peng Y, Wang P, Si C, Wang X, Zhou H, Gu J, Qin A, Song F. Sex disparity in the association between metabolic-anthropometric phenotypes and risk of obesity-related cancer: a prospective cohort study. BMC Med 2024; 22:355. [PMID: 39218868 PMCID: PMC11367774 DOI: 10.1186/s12916-024-03592-9] [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] [Received: 01/02/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Sex disparity between metabolic-obesity (defined by body mass index, BMI) phenotypes and obesity-related cancer (ORC) remains unknown. Considering BMI reflecting overall obesity but not fat distribution, we aimed to systematically assess the association of our newly proposed metabolic-anthropometric phenotypes with risk of overall and site-specific ORC by sex. METHODS A total of 141,579 men (mean age: 56.37 years, mean follow-up time: 12.04 years) and 131,047 women (mean age: 56.22 years, mean follow up time: 11.82 years) from the UK Biobank was included, and designated as metabolic-anthropometric phenotypes based on metabolic status (metabolically healthy/unhealthy), BMI (non-obesity/obesity) and body shape (pear/slim/apple/wide). The sex-specific association of different phenotypes with overall and site-specific ORC was assessed by hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression models. RESULTS We found metabolically unhealthy and/or obesity phenotypes conveyed a higher risk in men than in women for overall ORC and colorectal cancer compared with metabolically healthy non-obesity phenotype (Pinteraction < 0.05). Of note, metabolically healthy obesity phenotype contributed to increased risks of most ORC in men (HRs: 1.58 ~ 2.91), but only correlated with higher risks of endometrial (HR = 1.89, 95% CI: 1.54-2.32) and postmenopausal breast cancers (HR = 1.17, 95% CI: 1.05-1.31) in women. Similarly, even under metabolically healthy, men carrying apple and wide shapes phenotypes (metabolically healthy apple/wide and metabolically healthy non-obesity apple/wide) suffered an increased risk of ORC (mainly colorectal, liver, gastric cardia, and renal cancers, HRs: 1.20 ~ 3.81) in comparison with pear shape or non-obesity pear shape. CONCLUSIONS There was a significant sex disparity between metabolic-anthropometric phenotypes and ORC risk. We advised future ORC prevention and control worth taking body shape and sex disparity into account.
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Affiliation(s)
- Jianxiao Gong
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Fubin Liu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Yu Peng
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Changyu Si
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Xixuan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Huijun Zhou
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Jiale Gu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Ailing Qin
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China
| | - Fangfang Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Major Diseases in the Population, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, 300060, China.
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Abildgaard J, Bang AK, Nordkap L, Priskorn L, Jørgensen N. The influence of body composition on the response to dynamic stimulation of the endocrine pituitary-testis axis. Int J Obes (Lond) 2024; 48:1216-1222. [PMID: 38609526 PMCID: PMC11347364 DOI: 10.1038/s41366-024-01518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Testosterone treatment is generally not recommended in men with obesity induced low serum testosterone. However, distinguishing this condition from overt testosterone deficiency in men with obesity where treatment should be initiated is a diagnostic challenge and tools to differentiate these conditions are scarce but could be of important clinical relevance. OBJECTIVES To investigate the association between body composition and dynamic responses of the pituitary-testis axis in men. METHODS Single-center cross-sectional study including 112 healthy men. Participants went through a full biochemical assessment of the pituitary-testis axis, and dynamic stimulatory tests of luteinizing hormone (LH) secretion (gonadotropin-releasing hormone (GnRH)-test) and testosterone secretion (choriogonadotropin (hCG)-test). A subset (N = 78) further had a DXA-scan performed. RESULTS A higher body mass index (BMI) was associated with lower basal serum LH (BU = -0.44, 95% CI: -0.88--0.01, p = 0.04). The GnRH-stimulated LH increase was not significantly associated with BMI (BU = -0.10, 95% CI: -0.72-0.51, p = 0.74). Furthermore, a high BMI was associated with low basal testosterone (BU -0.02, 95% CI: -0.03--0.02, p < 0.001), and free testosterone (BU -15.0, 95% CI: -19.9--10.0, p < 0.001) and men with overweight and obesity had significantly lower testosterone (9%, p = 0.003 and 24%, p < 0.001) and free testosterone (25%, p = 0.006 and 50%, p < 0.001) concentrations compared to men with normal weight. The HCG-stimulated testosterone increase was significantly less dependent on BMI compared to the influence of BMI on basal testosterone concentrations (p = 0.04 for the interaction). CONCLUSIONS Dynamic sex hormone responses following pituitary-testis axis stimulation were less dependent on BMI, compared to the influence of BMI on basal hormone concentrations and could potentially assist clinical decision making in patients with obesity suspected of testosterone deficiency.
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Affiliation(s)
- Julie Abildgaard
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Kirstine Bang
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Loa Nordkap
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lærke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Sardar MB, Raza M, Fayyaz A, Nadir MA, Nadeem ZA, Babar M. Environmental Heavy Metal Exposure and Associated Cardiovascular Diseases in Light of the Triglyceride Glucose Index. Cardiovasc Toxicol 2024:10.1007/s12012-024-09913-x. [PMID: 39212843 DOI: 10.1007/s12012-024-09913-x] [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: 05/20/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
Cardiovascular diseases (CVD), primarily ischemic heart disease and stroke, remain leading global health burdens. Environmental risk factors have a major role in the development of CVD, particularly exposure to heavy metals. The Triglyceride Glucose Index (TyG), a measure of insulin resistance and CVD risk, is the primary focus of this study, which summarizes the most recent findings on the effects of lead (Pb), arsenic (As), and cadmium (Cd) on CVD risk. A higher risk of CVD is correlated with an elevated TyG index, which has been linked to insulin resistance. Exposure to Cd is associated with disturbance of lipid metabolism and oxidative stress, which increases the risk of CVD and TyG. Exposure reduces insulin secretion and signaling, which raises the TyG index and causes dyslipidemia. Pb exposure increases the risk of CVD and TyG index via causing oxidative stress and pancreatic β-cell destruction. These results highlight the need of reducing heavy metal exposure by lifestyle and environmental modifications in order to lower the risk of CVD. To comprehend the mechanisms and create practical management plans for health hazards associated with heavy metals, more study is required.
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Affiliation(s)
- Muhammad Bilal Sardar
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan.
| | - Mohsin Raza
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Ammara Fayyaz
- Department of Medicine, Central Park Medical College, Lahore, Pakistan
| | - Muhammad Asfandyar Nadir
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Zain Ali Nadeem
- Department of Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore, 54700, Pakistan
| | - Muhammad Babar
- Department of Medicine, Social Security Hospital, Faisalabad, Pakistan
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Lefebvre C, Tiffay A, Breemeersch CE, Dreux V, Bôle-Feysot C, Guérin C, Breton J, Maximin E, Monnoye M, Déchelotte P, Douard V, Goichon A, Coëffier M. Sex-dependent effects of a high fat diet on metabolic disorders, intestinal barrier function and gut microbiota in mouse. Sci Rep 2024; 14:19835. [PMID: 39191839 DOI: 10.1038/s41598-024-70931-4] [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: 01/30/2024] [Accepted: 08/22/2024] [Indexed: 08/29/2024] Open
Abstract
Obesity is often associated with sex-dependent metabolic complications, in which altered intestinal barrier function and gut microbiota contribute. We aimed to characterize in mice the sex-dependent effects of a high fat diet on these parameters. Male and female C57BL/6 mice received a standard (SD) or high fat diet (HFD; 60% kcal from fat) during 14 weeks (W14). Body composition, glucose tolerance, insulin sensitivity, intestinal permeability, colonic expression of 44 genes encoding factors involved in inflammatory response and gut barrier function, cecal microbiota, plasma adipokines and white adipose tissue response have been assessed. Both male and female HFD mice exhibited an increase of body weight and fat mass gain and glucose intolerance compared to SD mice. However, only male HFD mice tended to develop insulin resistance associated to increased Tnfα and Ccl2 mRNA expression in perigonadal adipose tissue. By contrast, only female HFD mice showed significant intestinal hyperpermeability that was associated with more markedly altered colonic inflammatory response. Cecal microbiota richness was markedly reduced in both sexes (Observed species) with sex-dependent modifications at the phyla or family level, e.g. decreased relative abundance of Bacillota and Lachnospiraceae in females, increased of Bacteroidaceae in males. Interestingly, some of these microbiota alterations were correlated with peripheral metabolic and inflammatory markers. In conclusions, male and female mice exhibit different responses to a high fat diet with specific changes of gut microbiota, intestinal barrier function, colonic and white adipose tissue inflammation, metabolic markers and body weight gain. The underlying mechanisms should be deciphered in further investigations.
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Affiliation(s)
- Candice Lefebvre
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Adam Tiffay
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Charles-Edward Breemeersch
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Virginie Dreux
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Christine Bôle-Feysot
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Charlène Guérin
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Jonathan Breton
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Elise Maximin
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, Domaine de Vilvert, 78350, Jouy-en-Josas, France
| | - Magali Monnoye
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, Domaine de Vilvert, 78350, Jouy-en-Josas, France
| | - Pierre Déchelotte
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
- Department of Nutrition, CHU Rouen, 76000, Rouen, France
| | - Véronique Douard
- INRAE, AgroParisTech, Micalis Institute, Université Paris-Saclay, Domaine de Vilvert, 78350, Jouy-en-Josas, France
| | - Alexis Goichon
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France
| | - Moïse Coëffier
- Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", UFR Santé, 22 Boulevard Gambetta, 76000, Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), Univ Rouen Normandie, 76000, Rouen, France.
- Department of Nutrition, CHU Rouen, 76000, Rouen, France.
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5
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Hu C, Wang S, Lin H, Wan Q, Zheng R, Zhu Y, Li M, Xu Y, Xu M, Zheng J, Chen L, Zeng T, Hu R, Ye Z, Shi L, Su Q, Chen Y, Yu X, Yan L, Wang T, Zhao Z, Qin G, Chen G, Dai M, Zhang D, Tang X, Gao Z, Shen F, Gu X, Luo Z, Qin Y, Chen L, Hou X, Huo Y, Li Q, Wang G, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Zhao J, Mu Y, Lai S, Li D, Ning G, Wang W, Hu W, Bi Y, Lu J. Body size, insulin sensitivity, metabolic health and risk of cardiovascular disease in Chinese adults: Insights from the China Cardiometabolic Disease and Cancer Cohort (4C) study. Diabetes Obes Metab 2024; 26:2176-2187. [PMID: 38419419 DOI: 10.1111/dom.15525] [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: 12/27/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
AIMS To assess the excess risk of cardiovascular disease (CVD) associated with different criteria for metabolic health, and the interplay of body size, insulin sensitivity and metabolic health with CVD risk. MATERIALS AND METHODS We conducted a prospective study involving 115 638 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Metabolic health was defined using three different definitions: (1) insulin sensitivity defined by homeostatic model assessment of insulin resistance index; (2) absence of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria; and (3) simultaneous absence of metabolic abnormalities (diabetes, hypertension, dyslipidaemia). The primary endpoint was a composite of incident CVD events comprising the first occurrence of myocardial infarction, stroke, heart failure, or cardiovascular death. RESULTS During a mean 3.61-year follow-up period, obese individuals with insulin sensitivity (multivariable-adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.37-2.08), or without metabolic syndrome (HR 1.46, 95% CI 1.13-1.89) still exhibited increased CVD risks, when compared to their normal-weight counterparts. Otherwise, those with obesity but simultaneous absence of metabolic abnormalities demonstrated similar CVD risk compared to normal-weight individuals (HR 0.91, 95% CI 0.53-1.59). CVD risk increased with the number of abnormalities across body mass index categories, regardless of insulin sensitivity. CONCLUSIONS This study emphasizes the need for refined definitions of metabolic health and advocates for meticulous screening for metabolic abnormalities to reduce cardiovascular risks, even in individuals with normal weight and insulin sensitivity.
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Affiliation(s)
- Chunyan Hu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Qin Wan
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yuanyue Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jie Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Xulei Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xuejiang Gu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Xinguo Hou
- Qilu Hospital of Shandong University, Jinan, China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Guixia Wang
- The First Hospital of Jilin University, Changchun, China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiajun Zhao
- Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Shenghan Lai
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Weiguo Hu
- Department of Geriatrics, Medical Center on Aging, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
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6
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Lyu L, Wang X, Xu J, Liu Z, He Y, Zhu W, Lin L, Hao B, Liu H. Association between triglyceride glucose-body mass index and long-term adverse outcomes of heart failure patients with coronary heart disease. Cardiovasc Diabetol 2024; 23:162. [PMID: 38724999 PMCID: PMC11080126 DOI: 10.1186/s12933-024-02213-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/25/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The triglyceride glucose-body mass index (TyG-BMI) is recognized as a reliable surrogate for evaluating insulin resistance and an effective predictor of cardiovascular disease. However, the link between TyG-BMI index and adverse outcomes in heart failure (HF) patients remains unclear. This study examines the correlation of the TyG-BMI index with long-term adverse outcomes in HF patients with coronary heart disease (CHD). METHODS This single-center, prospective cohort study included 823 HF patients with CHD. The TyG-BMI index was calculated as follows: ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI. To explore the association between the TyG-BMI index and the occurrences of all-cause mortality and HF rehospitalization, we utilized multivariate Cox regression models and restricted cubic splines with threshold analysis. RESULTS Over a follow-up period of 9.4 years, 425 patients died, and 484 were rehospitalized due to HF. Threshold analysis revealed a significant reverse "J"-shaped relationship between the TyG-BMI index and all-cause mortality, indicating a decreased risk of all-cause mortality with higher TyG-BMI index values below 240.0 (adjusted model: HR 0.90, 95% CI 0.86-0.93; Log-likelihood ratio p = 0.003). A distinct "U"-shaped nonlinear relationship was observed with HF rehospitalization, with the inflection point at 228.56 (adjusted model: below: HR 0.95, 95% CI 0.91-0.98; above: HR 1.08, 95% CI 1.03-1.13; Log-likelihood ratio p < 0.001). CONCLUSIONS This study reveals a nonlinear association between the TyG-BMI index and both all-cause mortality and HF rehospitalization in HF patients with CHD, positioning the TyG-BMI index as a significant prognostic marker in this population.
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Affiliation(s)
- Lyu Lyu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xinhong Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Xu
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Zhenzhen Liu
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanru He
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenjing Zhu
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lin Lin
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Benchuan Hao
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
- Medical School of Chinese PLA, Beijing, China.
| | - Hongbin Liu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
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7
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Liao J, Goodrich JA, Chen W, Qiu C, Chen JC, Costello E, Alderete TL, Chatzi L, Gilliland F, Chen Z. Cardiometabolic profiles and proteomics associated with obesity phenotypes in a longitudinal cohort of young adults. Sci Rep 2024; 14:7384. [PMID: 38548792 PMCID: PMC10978904 DOI: 10.1038/s41598-024-57751-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
To assess cardiometabolic profiles and proteomics to identify biomarkers associated with the metabolically healthy and unhealthy obesity. Young adults (N = 156) enrolled were classified as not having obesity, metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) based on NCEP ATP-III criteria. Plasma proteomics at study entry were measured using Olink Cardiometabolic Explore panel. Linear regression was used to assess associations between proteomics and obesity groups as well as cardiometabolic traits of glucose, insulin, and lipid profiles at baseline and follow-up visits. Enriched biological pathways were further identified based on the significant proteomic features. Among the baseline 95 (61%) and 61 (39%) participants classified as not having obesity and having obesity (8 MHO and 53 MUHO), respectively. Eighty of the participants were followed-up with an average 4.6 years. Forty-one proteins were associated with obesity (FDR < 0.05), 29 of which had strong associations with insulin-related traits and lipid profiles (FDR < 0.05). Inflammation, immunomodulation, extracellular matrix remodeling and endoplasmic reticulum lumen functions were enriched by 40 proteins. In this study population, obesity and MHO were associated with insulin resistance and dysregulated lipid profiles. The underlying mechanism included elevated inflammation and deteriorated extracellular matrix remodeling function.
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Affiliation(s)
- Jiawen Liao
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Jesse A Goodrich
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Wu Chen
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Chenyu Qiu
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Jiawen Carmen Chen
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Elizabeth Costello
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Tanya L Alderete
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - Lida Chatzi
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Frank Gilliland
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA
| | - Zhanghua Chen
- Department of Public and Population Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90032, USA.
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8
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Stefkovich M, Titchenell PM. Location Matters: Mitochondrial Arginase 2 as a Treatment for Metabolic Disease? Cell Mol Gastroenterol Hepatol 2024; 17:883-884. [PMID: 38471656 PMCID: PMC11103180 DOI: 10.1016/j.jcmgh.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Megan Stefkovich
- Department of Physiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Institute for Diabetes, Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul M Titchenell
- Department of Physiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Institute for Diabetes, Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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9
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Romero-Becera R, Santamans AM, Arcones AC, Sabio G. From Beats to Metabolism: the Heart at the Core of Interorgan Metabolic Cross Talk. Physiology (Bethesda) 2024; 39:98-125. [PMID: 38051123 DOI: 10.1152/physiol.00018.2023] [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: 08/04/2023] [Revised: 10/26/2023] [Accepted: 12/01/2023] [Indexed: 12/07/2023] Open
Abstract
The heart, once considered a mere blood pump, is now recognized as a multifunctional metabolic and endocrine organ. Its function is tightly regulated by various metabolic processes, at the same time it serves as an endocrine organ, secreting bioactive molecules that impact systemic metabolism. In recent years, research has shed light on the intricate interplay between the heart and other metabolic organs, such as adipose tissue, liver, and skeletal muscle. The metabolic flexibility of the heart and its ability to switch between different energy substrates play a crucial role in maintaining cardiac function and overall metabolic homeostasis. Gaining a comprehensive understanding of how metabolic disorders disrupt cardiac metabolism is crucial, as it plays a pivotal role in the development and progression of cardiac diseases. The emerging understanding of the heart as a metabolic and endocrine organ highlights its essential contribution to whole body metabolic regulation and offers new insights into the pathogenesis of metabolic diseases, such as obesity, diabetes, and cardiovascular disorders. In this review, we provide an in-depth exploration of the heart's metabolic and endocrine functions, emphasizing its role in systemic metabolism and the interplay between the heart and other metabolic organs. Furthermore, emerging evidence suggests a correlation between heart disease and other conditions such as aging and cancer, indicating that the metabolic dysfunction observed in these conditions may share common underlying mechanisms. By unraveling the complex mechanisms underlying cardiac metabolism, we aim to contribute to the development of novel therapeutic strategies for metabolic diseases and improve overall cardiovascular health.
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Affiliation(s)
| | | | - Alba C Arcones
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Guadalupe Sabio
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
- Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
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10
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Yang K, Zhang X, Gui W, Zhen Q, Ban Y, Chen Y, Ma L, Pan S, Yan Y, Ding M. Alteration of Plasma Indoles in Polycystic Ovary Syndrome. Reprod Sci 2024; 31:764-772. [PMID: 37828362 DOI: 10.1007/s43032-023-01377-8] [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: 03/20/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in reproductive-aged women. The occurrence of PCOS was reported to be associated with the alteration of gut microbiota. Microbiota-derived indoles may possibly play a key role in glycemic control. The purpose of this work is to reveal the alteration of plasma indoles in PCOS patients and to investigate the correlation between indoles levels and glucose metabolism. Sixty-five patients with PCOS and twenty-eight age-matched women were enrolled in this work. The concentrations of plasma indoles, including indoxyl sulfate (IS), indole-3-acetic acid (IAA), indole-3-propionate (IPA), indole (IND), and 3-methylindole (3-MI), were measured by HPLC with the fluorescence detection. The plasma levels of IS, IAA, and IND were significantly elevated in patients with PCOS compared to those in the control group (p < 0.05). Furthermore, the plasma levels of IS, IAA, and IND were positively correlated with fasting glucose, fasting insulin, and the homeostatic model of insulin resistance index (HOMA-IR) (p < 0.05). Besides, the 3-MI level in the plasma was positively correlated with the fasting glucose level, whereas plasma levels of IS, IAA, IND, and 3-MI were negatively correlated with glucagon-like peptide 1 (p < 0.05). Moreover, IS and IND were considered to be risk factors for PCOS after age, BMI, T, LH, and HOMA-IR adjustment. The area under the receiver-operating characteristic curve of the combined index of five indoles was 0.867 for PCOS diagnosis. Additionally, plasma indoles altered in PCOS, which was closely associated with the glucose metabolism.
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Affiliation(s)
- Ke Yang
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, Chongqing, China
| | - Xiaoqing Zhang
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, Chongqing, China
| | - Wenwu Gui
- Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qianna Zhen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanna Ban
- Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Chen
- Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Ma
- Laboratory of Lipid &Glucose Metabolism, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shengnan Pan
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, Chongqing, China
| | - Yutong Yan
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, Chongqing, China
| | - Min Ding
- Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, School of Laboratory Medicine, Chongqing Medical University, Chongqing, China.
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11
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Agius R, Pace NP, Fava S. Anthropometric and Biochemical Correlations of Insulin Resistance in a Middle-Aged Maltese Caucasian Population. J Nutr Metab 2024; 2024:5528250. [PMID: 38420511 PMCID: PMC10901578 DOI: 10.1155/2024/5528250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/20/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Background Insulin resistance (IR) is associated with increased cardiovascular disease risk, and with increased all-cause, cardiovascular, and cancer mortality. A number of surrogate markers are used in clinical practice to diagnose IR. The aim of this study was to investigate the discriminatory power of a number of routinely available anthropometric and biochemical variables in predicting IR and to determine their optimal cutoffs. Methods We performed a cross-sectional study in a cohort of middle-aged individuals. We used receiver operator characteristics (ROC) analyses in order to determine the discriminatory power of parameters of interest in detecting IR, which was defined as homeostatic model assessment-insulin resistance ≥2.5. Results Both the lipid accumulation product (LAP) and visceral adiposity index (VAI) exhibited good discriminatory power to detect IR in both males and females. The optimal cutoffs were 42.5 and 1.44, respectively, in males and 36.2 and 1.41, respectively, in females. Serum triglycerides (TG) and waist circumference (WC) similarly demonstrated good discriminatory power in detecting IR in both sexes. The optimal cutoffs for serum TG and WC were 1.35 mmol/L and 96.5 cm, respectively, in men and 1.33 mmol/L and 82 cm, respectively, in women. On the other hand, systolic and diastolic blood pressure, liver transaminases, high-density lipoprotein cholesterol, serum uric acid, ferritin, waist-hip ratio, "A" body shape, thigh circumference, and weight-adjusted thigh circumference all had poor discriminatory power. Conclusions Our data show that LAP, VAI, TG, and WC all have good discriminatory power in detecting IR in both men and women. The optimal cutoffs for TG and WC were lower than those currently recommended in both sexes. Replication studies are required in different subpopulations and different ethnicities in order to be able to update the current cut points to ones which reflect the contemporary population as well as to evaluate their longitudinal relationship with longer-term cardiometabolic outcomes.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
| | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida MSD2090, Malta
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12
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Chen F, Shi Y, Yu M, Hu Y, Li T, Cheng Y, Xu T, Liu J. Joint effect of BMI and metabolic status on mortality among adults: a population-based longitudinal study in United States. Sci Rep 2024; 14:2775. [PMID: 38307987 PMCID: PMC10837108 DOI: 10.1038/s41598-024-53229-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/30/2024] [Indexed: 02/04/2024] Open
Abstract
We explored the joint effects of different metabolic obesity phenotypes on all-cause and disease-specific mortality risk among the American population. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Mortality outcome data were from mortality files linked to National Death Index record and follow-up information was up to December 31, 2019. 50,013 participants were finally included. Four metabolic obesity phenotypes were defined based on obesity and metabolic status: metabolically healthy obese (MHO), metabolically unhealthy obese (MUO), metabolically healthy non-obese (MHNO), and metabolically unhealthy non-obese (MUNO). Population-weighted Cox proportional hazards models were used to explore the all-cause and disease-specific mortality risk of metabolic obesity phenotypes. The all-cause mortality risk of MUO and MUNO was significantly higher than MHNO. MUNO was associated with a significantly increased risk of death from heart disease (HR: 1.40, 95% CI 1.16-1.70), hypertension (HR: 1.68, 95% CI 1.34-2.12), diabetes (HR: 2.29, 95% CI 1.67-3.15), and malignant neoplasms (HR:1.29, 95% CI 1.09-1.53). Metabolic unhealth significantly increased the risk of all-cause mortality, regardless of obesity status. Among individuals with metabolic unhealthy status, obesity significantly reduced the risk of all-cause mortality (HR: 0.91, 95% CI 0.85-0.98). Our study highlights the importance of identifying and characterizing metabolic obesity phenotypes in obese and metabolically abnormal patients, as well as healthy adults. Comprehensive evaluation of obesity and metabolic status is necessary to adopt appropriate interventions and treatment measures and maximize patient benefit.
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Affiliation(s)
- Feilong Chen
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No.5, Dong dan san tiao, Beijing, 100005, China
| | - Yunping Shi
- Department of Information and Statistics, Beijing Center for Disease Prevention and Control, No. 16 Heping Li Middle Street, Dongcheng District, Beijing, 100013, China
| | - Miao Yu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No.5, Dong dan san tiao, Beijing, 100005, China
| | - Yuehua Hu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, No. 155 Changbai Road Changping District, Beijing, 102206, China
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, China
| | - Yijing Cheng
- Child Health Big Data Research Center, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, China
| | - Tao Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, No.5, Dong dan san tiao, Beijing, 100005, China.
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, No. 2 Yabao Road, Beijing, 100020, China.
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13
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Jurado-Fasoli L, Sanchez-Delgado G, Alcantara JMA, Acosta FM, Sanchez-Sanchez R, Labayen I, Ortega FB, Martinez-Tellez B, Ruiz JR. Adults with metabolically healthy overweight or obesity present more brown adipose tissue and higher thermogenesis than their metabolically unhealthy counterparts. EBioMedicine 2024; 100:104948. [PMID: 38184936 PMCID: PMC10808934 DOI: 10.1016/j.ebiom.2023.104948] [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: 09/15/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND There is a subset of individuals with overweight/obesity characterized by a lower risk of cardiometabolic complications, the so-called metabolically healthy overweight/obesity (MHOO) phenotype. Despite the relatively higher levels of subcutaneous adipose tissue and lower visceral adipose tissue observed in individuals with MHOO than individuals with metabolically unhealthy overweight/obesity (MUOO), little is known about the differences in brown adipose tissue (BAT). METHODS This study included 53 young adults (28 women) with a body mass index (BMI) ≥25 kg/m2 which were classified as MHOO (n = 34) or MUOO (n = 19). BAT was assessed through a static 18F-FDG positron emission tomography/computed tomography scan after a 2-h personalized cooling protocol. Energy expenditure, skin temperature, and thermal perception were assessed during a standardized mixed meal test (3.5 h) and a 1-h personalized cold exposure. Body composition was assessed by dual-energy x-ray absorptiometry, energy intake was determined during an ad libitum meal test and dietary recalls, and physical activity levels were determined by a wrist-worn accelerometer. FINDINGS Participants with MHOO presented higher BAT volume (+124%, P = 0.008), SUVmean (+63%, P = 0.001), and SUVpeak (+133%, P = 0.003) than MUOO, despite having similar BAT mean radiodensity (P = 0.354). In addition, individuals with MHOO exhibited marginally higher meal-induced thermogenesis (P = 0.096) and cold-induced thermogenesis (+158%, P = 0.050). Moreover, MHOO participants showed higher supraclavicular skin temperature than MUOO during the first hour of the postprandial period and during the cold exposure, while no statistically significant differences were observed in other skin temperature parameters. We observed no statistically significant differences between MHOO and MUOO in thermal perception, body composition, outdoor ambient temperature exposure, resting metabolic rate, energy intake, or physical activity levels. INTERPRETATION Adults with MHOO present higher BAT volume and activity than MUOO. The higher meal- and cold-induced thermogenesis and cold-induced supraclavicular skin temperature are compatible with a higher BAT activity. Overall, these results suggest that BAT presence and activity might be linked to a healthier phenotype in young adults with overweight or obesity. FUNDING See acknowledgments section.
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Affiliation(s)
- Lucas Jurado-Fasoli
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; Department of Physiology, Faculty of Medicine, University of Granada, Granada, Andalucía, Spain.
| | - Guillermo Sanchez-Delgado
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; Department of Medicine, Division of Endocrinology, Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Instituto de Investigación Biosanitaria, Ibs.Granada, Granada, Spain
| | - Juan M A Alcantara
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Department of Health Sciences, "Institute for Sustainability & Food Chain Innovation", Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco M Acosta
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; Turku PET Centre, University of Turku, Turku, Finland; Turku PET Centre, Turku University Hospital, Turku, Finland; InFLAMES Research Flagship, University of Turku, 20014, Turku, Finland; MediCity/PET Preclinical Laboratory, University of Turku, Turku PET Centre, Turku, Finland
| | - Rocio Sanchez-Sanchez
- Instituto de Investigación Biosanitaria, Ibs.Granada, Granada, Spain; Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Idoia Labayen
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Department of Health Sciences, "Institute for Sustainability & Food Chain Innovation", Public University of Navarre, Pamplona, Spain; Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Borja Martinez-Tellez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Department of Education, Faculty of Education Sciences and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Carretera de Alfacar s/n, 18071, Granada, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain; Instituto de Investigación Biosanitaria, Ibs.Granada, Granada, Spain.
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Zhang L, Vella A, Nair KS, Jensen MD. Characteristics of Normal Weight Insulin-Resistant Adults with Unfavorable Health Outcomes. Metab Syndr Relat Disord 2024. [PMID: 38227797 DOI: 10.1089/met.2023.0154] [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] [Indexed: 01/18/2024] Open
Abstract
Background: Insulin resistance can be present in otherwise healthy, normal weight adults. Whether there are phenotype/sex-differences between normal weight insulin-resistant (NWIR) and normal weight insulin-sensitive (NWIS) Caucasians and whether there are differences in adverse health outcomes are unknown. Our goal was to define phenotypes and intermediate-term health outcomes of NWIR versus NWIS Caucasian adults. Methods: We analyzed data from 227 healthy volunteers body mass index 18 to <25.0 kg/m2 who underwent insulin clamp studies between January 1987 and January 2017 at Mayo Clinic to identify those in the top (NWIS, n = 56) and bottom (NWIR, n = 56) quartiles of insulin action. We compared the phenotypical characteristics and were able to collect medical records data for 80% of NWIS and 88% of NWIR to identify time to onset of hypertension, hyperglycemia, coronary heart disease, cerebrovascular disease, peripheral vascular disease, and all cause death; the follow-up averaged 11 (4, 20) years. Results: Body fat was significantly greater and peak VO2 was significantly less in both NWIS than NWIR males and females. Only in females was abdominal subcutaneous fat by computed tomography significantly greater in NWIR than NWIS. In NWIR males high-density lipoprotein-cholesterol and fat free mass were significantly less, and fasting insulin was greater than NWIS males. For the entire NWIS population, Kaplan-Meier disease-free survival analysis showed longer times free of hypertension, hyperglycemia, and some cardiovascular diseases than for NWIR. Conclusions: There are sex-specific phenotypes of NWIR in Caucasian adults. NWIR may be associated with accelerated onset of some adverse medical outcomes.
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Affiliation(s)
- Lili Zhang
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Adrian Vella
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - K Sreekumaran Nair
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael D Jensen
- Division of Endocrinology, Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
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15
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Mir FA, Abdesselem HB, Cyprian F, Iskandarani A, Doudin A, Samra TA, Alkasem M, Abdalhakam I, Taheri S, Abou-Samra AB. Inflammatory protein signatures in individuals with obesity and metabolic syndrome. Sci Rep 2023; 13:22185. [PMID: 38092892 PMCID: PMC10719383 DOI: 10.1038/s41598-023-49643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023] Open
Abstract
There is variability in the metabolic health status among individuals presenting with obesity; some may be metabolically healthy, while others may have developed the metabolic syndrome, a cluster including insulin resistance, hypertension, dyslipidemia, and increased risk of cardiovascular disease and type 2 diabetes. The mechanisms contributing to this metabolic heterogeneity are not fully understood. To address this question, plasma samples from 48 individuals with BMI ≥ 35 kg/m2 were examined (27 with and 21 without metabolic syndrome). Fasting plasma samples were subjected to Olink proteomics analysis for 184 cardiometabolic and inflammation-enriched proteins. Data analysis showed a clear differentiation between the two groups with distinct plasma protein expression profiles. Twenty-four proteins were differentially expressed (DEPs) between the two groups. Pathways related to immune cell migration, leukocyte chemotaxis, chemokine signaling, mucosal inflammatory response, tissue repair and remodeling were enriched in the group with metabolic syndrome. Functional analysis of DEPs revealed upregulation of 15 immunological pathways. The study identifies some of the pathways that are altered and reflect metabolic health in individuals with obesity. This provides valuable insights into some of the underlying mechanisms and can lead to identification of therapeutic targets to improve metabolic health in individuals with obesity.
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Affiliation(s)
- Fayaz Ahmad Mir
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| | - Houari B Abdesselem
- Proteomics Core Facility, Office of the Vice President for Research (OVPR), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation, Doha, Qatar
| | - Farhan Cyprian
- College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Ahmad Iskandarani
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Asmma Doudin
- Laboratory of Immunoregulation, Research Department, Sidra Medicine, Doha, Qatar
| | - Tareq A Samra
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Meis Alkasem
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Ibrahem Abdalhakam
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Shahrad Taheri
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
- National Obesity Treatment Center, Hamad Medical Corporation, Doha, Qatar
- Weil Cornell Medicine -Qatar, Doha, Qatar
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute, Academic Health System, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
- National Obesity Treatment Center, Hamad Medical Corporation, Doha, Qatar
- Weil Cornell Medicine -Qatar, Doha, Qatar
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16
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Colosimo S, Mitra SK, Chaudhury T, Marchesini G. Insulin resistance and metabolic flexibility as drivers of liver and cardiac disease in T2DM. Diabetes Res Clin Pract 2023; 206:111016. [PMID: 37979728 DOI: 10.1016/j.diabres.2023.111016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/15/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
Metabolic flexibility refers to the ability of tissues to adapt their use of energy sources according to substrate availability and energy demands. This review aims to disentangle the emerging mechanisms through which altered metabolic flexibility and insulin resistance promote NAFLD and heart disease progression. Insulin resistance and metabolic inflexibility are central drivers of hepatic and cardiac diseases in individuals with type 2 diabetes. Both play a critical role in the complex interaction between glucose and lipid metabolism. Disruption of metabolic flexibility results in hyperglycemia and abnormal lipid metabolism, leading to increased accumulation of fat in the liver, contributing to the development and progression of NAFLD. Similarly, insulin resistance affects cardiac glucose metabolism, leading to altered utilization of energy substrates and impaired cardiac function, and influence cardiac lipid metabolism, further exacerbating the progression of heart failure. Regular physical activity promotes metabolic flexibility by increasing energy expenditure and enabling efficient switching between different energy substrates. On the contrary, weight loss achieved through calorie restriction ameliorates insulin sensitivity without improving flexibility. Strategies that mimic the effects of physical exercise, such as pharmacological interventions or targeted lifestyle modifications, show promise in effectively treating both diabetes and NAFLD, finally reducing the risk of advanced liver disease.
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Affiliation(s)
- Santo Colosimo
- School of Nutrition Science, University of Milan, Milan, Italy
| | - Sandip Kumar Mitra
- Diabetes and Endocrinology Unit, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Tirthankar Chaudhury
- Diabetes and Endocrinology Unit, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Giulio Marchesini
- IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.
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17
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Chen F, Sarver DC, Saqib M, Velez LM, Aja S, Seldin MM, Wong GW. Loss of CTRP10 results in female obesity with preserved metabolic health. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.01.565163. [PMID: 37961647 PMCID: PMC10635050 DOI: 10.1101/2023.11.01.565163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Obesity is a major risk factor for type 2 diabetes, dyslipidemia, cardiovascular disease, and hypertension. Intriguingly, there is a subset of metabolically healthy obese (MHO) individuals who are seemingly able to maintain a healthy metabolic profile free of metabolic syndrome. The molecular underpinnings of MHO, however, are not well understood. Here, we report that CTRP10/C1QL2-deficient mice represent a unique female model of MHO. CTRP10 modulates weight gain in a striking and sexually dimorphic manner. Female, but not male, mice lacking CTRP10 develop obesity with age on a low-fat diet while maintaining an otherwise healthy metabolic profile. When fed an obesogenic diet, female Ctrp10 knockout (KO) mice show rapid weight gain. Despite pronounced obesity, Ctrp10 KO female mice do not develop steatosis, dyslipidemia, glucose intolerance, insulin resistance, oxidative stress, or low-grade inflammation. Obesity is largely uncoupled from metabolic dysregulation in female KO mice. Multi-tissue transcriptomic analyses highlighted gene expression changes and pathways associated with insulin-sensitive obesity. Transcriptional correlation of the differentially expressed gene (DEG) orthologous in humans also show sex differences in gene connectivity within and across metabolic tissues, underscoring the conserved sex-dependent function of CTRP10. Collectively, our findings suggest that CTRP10 negatively regulates body weight in females, and that loss of CTRP10 results in benign obesity with largely preserved insulin sensitivity and metabolic health. This female MHO mouse model is valuable for understanding sex-biased mechanisms that uncouple obesity from metabolic dysfunction.
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Affiliation(s)
- Fangluo Chen
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dylan C. Sarver
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Muzna Saqib
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leandro M Velez
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - Susan Aja
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marcus M. Seldin
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - G. William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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18
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Ramírez-Mejía MM, Qi X, Abenavoli L, Romero-Gómez M, Eslam M, Méndez-Sánchez N. Metabolic dysfunction: The silenced connection with fatty liver disease. Ann Hepatol 2023; 28:101138. [PMID: 37468095 DOI: 10.1016/j.aohep.2023.101138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 07/21/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents a global public health burden. Despite the increase in its prevalence, the disease has not received sufficient attention compared to the associated diseases such as diabetes mellitus and obesity. In 2020 it was proposed to rename NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) in order to recognize the metabolic risk factors and the complex pathophysiological mechanisms associated with its development. Furthermore, along with the implementation of the proposed diagnostic criteria, the aim is to address the whole clinical spectrum of the disease, regardless of BMI and the presence of other hepatic comorbidities. As would it be expected with such a paradigm shift, differing viewpoints have emerged regarding the benefits and disadvantages of renaming fatty liver disease. The following review aims to describe the way to the MAFLD from a historical, pathophysiological and clinical perspective in order to highlight why MAFLD is the approach to follow.
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Affiliation(s)
- Mariana M Ramírez-Mejía
- Plan of Combined Studies in Medicine (PECEM-MD/PhD), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Liaoning Province, China
| | - Ludovico Abenavoli
- Department of Health Sciences, University Magna Graecia of Catanzaro, Italy
| | - Manuel Romero-Gómez
- Digestive Diseases Unit, Department of Medicine, SeLiver Group, Institute of Biomedicine of Sevilla (HUVR/CSIC/US), University of Seville, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia
| | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico; Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
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19
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Guo W, Jia J, Zhan M, Li X, Zhu W, Lu J, Zhao X, Xu N, Zhang Q. Association of metabolically unhealthy non-obese and metabolically healthy obese individuals with arterial stiffness and 10-year cardiovascular disease risk: a cross-sectional study in Chinese adults. Nutr J 2023; 22:44. [PMID: 37726745 PMCID: PMC10510138 DOI: 10.1186/s12937-023-00870-9] [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: 11/21/2022] [Accepted: 08/13/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The relationship between metabolically healthy obese individuals (MHO) and cardiovascular disease (CVD) risk is disputed. This study investigated the association of metabolically unhealthy non-obese(MUNO) individuals and MHO with arterial stiffness and 10-year CVD risk. METHODS A total of 13,435 participants were enrolled and further divided into the metabolically healthy non-obese (MHNO) phenotype (n = 4927), MUNO phenotype (n = 1971), MHO phenotype (n = 2537) and metabolically unhealthy obese (MUO) phenotype (n = 4000) according to body mass index (BMI) and metabolic status. We used brachial ankle pulse wave velocity (baPWV) to measure arterial stiffness and the Framingham risk score (FRS) to evaluate the 10-year CVD risk. RESULTS The MUO and MUNO phenotypes had higher mean baPWV values than the MHO and MHNO phenotypes, regardless of age (1446.19 ± 233.65 vs. 1423.29 ± 240.72 vs. 1283.57 ± 213.77 vs. 1234.08 ± 215.99 cm/s, P < 0.001). Logistic regression analysis indicated that the MUNO and MUO phenotypes were independently correlated with elevated baPWV and 10-year CVD risk, while the MHO phenotype was independently associated with only the 10-year CVD risk. In metabolically healthy subjects, BMI showed a dose-dependent increase in the risk of elevated baPWV, with an adjusted OR of 1.007 (95% CI 1.004-1.010, P < 0.001). However, in metabolically unhealthy participants, the estimate for the relationship between elevated baPWV and BMI was nonsignificant. CONCLUSIONS The MUNO phenotype exhibits increased arterial stiffness and 10-year CVD risk. However, BMI is positively and dose-dependently correlated with arterial stiffness only in metabolically healthy subjects. We speculate that metabolic status may be a strong confounder in the obesity-elevated baPWV association.
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Affiliation(s)
- Wen Guo
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Jue Jia
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Jiangsu University, Zhenjiang, 212000 China
| | - Mengyao Zhan
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
| | - Xiaona Li
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Wenfang Zhu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Jing Lu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Xin Zhao
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Nainzhen Xu
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Qun Zhang
- Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
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20
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Zhao H, Huang R, Jiang M, Wang W, Chai Y, Liu Q, Zhang W, Han Y, Yan F, Lu Q, Tao Z, Wu Q, Yue J, Ma J, Pu J. Myocardial Tissue-Level Characteristics of Adults With Metabolically Healthy Obesity. JACC Cardiovasc Imaging 2023; 16:889-901. [PMID: 37052557 DOI: 10.1016/j.jcmg.2023.01.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND It remains unclear whether adults with metabolically healthy obesity (MHO) have altered myocardial tissue-level characteristics. OBJECTIVES This study aims to assess the subclinical myocardial tissue-level characteristics of adults with MHO. METHODS The EARLY-MYO-OBESITY (EARLY Assessment of MYOcardial Tissue Characteristics in OBESITY; NCT05277779) registry was a prospective, 3-center, cardiac imaging study of obese nondiabetic individuals without cardiac symptoms who underwent cardiac magnetic resonance. Myocardial tissue-level characteristics, including extracellular volume fraction (ECV) and native T2 values, were measured as indicators of myocardial fibrosis and edema. Global longitudinal peak systolic strain and early diastolic longitudinal strain rate were assessed by tissue tracking analysis to detect subclinical systolic and diastolic dysfunction. RESULTS A total of 120 participants were included: MHO (n = 32; mean age, 38 years; 41% men), metabolically healthy controls without obesity (n = 32; mean age: 37 years; 41% men), and metabolically unhealthy obesity (MUHO) (n = 56; mean age: 37 years; 55% men). The MHO group had higher ECV and native T2 values than healthy controls (both P < 0.001); furthermore, the ECV was higher in the MUHO group than in the MHO group (P = 0.002). The prevalence of myocardial fibrosis was 44% (14 of 32) in the MHO group and 71% (40 of 56) in the MUHO group. Although there was no intergroup difference in left ventricular ejection fraction, the MHO group had reduced global longitudinal peak systolic and early diastolic longitudinal strain rates, indicating subclinical systolic and diastolic dysfunction. Multivariate regression analysis identified increased body mass index to be an independent risk factor for myocardial fibrosis (OR: 6.28 [95% CI: 3.17-12.47]; P < 0.001). CONCLUSIONS This study provides the first evidence of subclinical myocardial tissue-level remodeling in adults with obesity, regardless of metabolic health. Early identification of cardiac impairment may facilitate preventive strategies against heart failure in the MHO population. (EARLY Assessment of MYOcardial Tissue Characteristics in OBESITY [EARLY-MYO-OBESITY]; NCT05277779).
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Affiliation(s)
- Hang Zhao
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rong Huang
- Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Meng Jiang
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Wei Wang
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yezi Chai
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiming Liu
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhang
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuchi Han
- Cardiovascular Division, The Ohio State Wexner Medical Center, Columbus, Ohio, USA
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qifan Lu
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhengyu Tao
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qizhen Wu
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiang Yue
- Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Ma
- Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Jun Pu
- Division of Cardiology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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21
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Tanriover C, Copur S, Gaipov A, Ozlusen B, Akcan RE, Kuwabara M, Hornum M, Van Raalte DH, Kanbay M. Metabolically healthy obesity: Misleading phrase or healthy phenotype? Eur J Intern Med 2023; 111:5-20. [PMID: 36890010 DOI: 10.1016/j.ejim.2023.02.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Obesity is a heterogenous condition with multiple different phenotypes. Among these a particular subtype exists named as metabolically healthy obesity (MHO). MHO has multiple definitions and its prevalence varies according to study. The potential mechanisms underlying the pathophysiology of MHO include the different types of adipose tissue and their distribution, the role of hormones, inflammation, diet, the intestinal microbiota and genetic factors. In contrast to the negative metabolic profile associated with metabolically unhealthy obesity (MUO), MHO has relatively favorable metabolic characteristics. Nevertheless, MHO is still associated with many important chronic diseases including cardiovascular disease, hypertension, type 2 diabetes, chronic kidney disease as well as certain types of cancer and has the risk of progression into the unhealthy phenotype. Therefore, it should not be considered as a benign condition. The major therapeutic alternatives include dietary modifications, exercise, bariatric surgery and certain medications including glucagon-like peptide-1 (GLP-1) analogs, sodium-glucose cotransporter-2 (SGLT-2) inhibitors and tirzepatide. In this review, we discuss the significance of MHO while comparing this phenotype with MUO.
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Affiliation(s)
- Cem Tanriover
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Abduzhappar Gaipov
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan; Clinical Academic Department of Internal Medicine, CF "University Medical Center", Astana, Kazakhstan
| | - Batu Ozlusen
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Rustu E Akcan
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | | | - Mads Hornum
- Department of Nephrology, Rigshospitalet, Inge Lehmanns Vej 7, Copenhagen 2100, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel H Van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, Loaction VUMC, Amsterdam, the Netherlands
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul 34010, Turkey.
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22
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Glunk V, Laber S, Sinnott-Armstrong N, Sobreira DR, Strobel SM, Batista TM, Kubitz P, Moud BN, Ebert H, Huang Y, Brandl B, Garbo G, Honecker J, Stirling DR, Abdennur N, Calabuig-Navarro V, Skurk T, Ocvirk S, Stemmer K, Cimini BA, Carpenter AE, Dankel SN, Lindgren CM, Hauner H, Nobrega MA, Claussnitzer M. A non-coding variant linked to metabolic obesity with normal weight affects actin remodelling in subcutaneous adipocytes. Nat Metab 2023; 5:861-879. [PMID: 37253881 DOI: 10.1038/s42255-023-00807-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/12/2023] [Indexed: 06/01/2023]
Abstract
Recent large-scale genomic association studies found evidence for a genetic link between increased risk of type 2 diabetes and decreased risk for adiposity-related traits, reminiscent of metabolically obese normal weight (MONW) association signatures. However, the target genes and cellular mechanisms driving such MONW associations remain to be identified. Here, we systematically identify the cellular programmes of one of the top-scoring MONW risk loci, the 2q24.3 risk locus, in subcutaneous adipocytes. We identify a causal genetic variant, rs6712203, an intronic single-nucleotide polymorphism in the COBLL1 gene, which changes the conserved transcription factor motif of POU domain, class 2, transcription factor 2, and leads to differential COBLL1 gene expression by altering the enhancer activity at the locus in subcutaneous adipocytes. We then establish the cellular programme under the genetic control of the 2q24.3 MONW risk locus and the effector gene COBLL1, which is characterized by impaired actin cytoskeleton remodelling in differentiating subcutaneous adipocytes and subsequent failure of these cells to accumulate lipids and develop into metabolically active and insulin-sensitive adipocytes. Finally, we show that perturbations of the effector gene Cobll1 in a mouse model result in organismal phenotypes matching the MONW association signature, including decreased subcutaneous body fat mass and body weight along with impaired glucose tolerance. Taken together, our results provide a mechanistic link between the genetic risk for insulin resistance and low adiposity, providing a potential therapeutic hypothesis and a framework for future identification of causal relationships between genome associations and cellular programmes in other disorders.
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Affiliation(s)
- Viktoria Glunk
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Samantha Laber
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
| | - Nasa Sinnott-Armstrong
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Department of Genetics, Stanford University, Stanford, CA, USA
- Herbold Computational Biology Program, Publich Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Debora R Sobreira
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Sophie M Strobel
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
| | - Thiago M Batista
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Phil Kubitz
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bahareh Nemati Moud
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Hannah Ebert
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Yi Huang
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Beate Brandl
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Garrett Garbo
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
| | - Julius Honecker
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - David R Stirling
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nezar Abdennur
- Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Virtu Calabuig-Navarro
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Thomas Skurk
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Soeren Ocvirk
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Intestinal Microbiology Research Group, Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Kerstin Stemmer
- Molecular Cell Biology, Institute for Theoretical Medicine, University of Augsburg, Augsburg, Germany
- Institute for Diabetes and Obesity, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Beth A Cimini
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Anne E Carpenter
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Simon N Dankel
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Cecilia M Lindgren
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA
- Big Data Institute at the Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food & Health, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Life Sciences, Technical University of Munich, Freising, Germany
| | - Marcelo A Nobrega
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Melina Claussnitzer
- Broad Institute of MIT and Harvard, Medical and Population Genetics Program & Type 2 Diabetes Systems Genomics Initiative, Cambridge, MA, USA.
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
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23
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De Santi M, Annibalini G, Marano G, Biganzoli G, Venturelli E, Pellegrini M, Lucertini F, Brandi G, Biganzoli E, Barbieri E, Villarini A. Association between metabolic syndrome, insulin resistance, and IGF-1 in breast cancer survivors of DIANA-5 study. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04755-6. [PMID: 37106164 PMCID: PMC10374719 DOI: 10.1007/s00432-023-04755-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Circulating insulin-like growth factor-1 (IGF-1) is positively associated with the risk of BC recurrence, and is more frequently dysregulated in older people, especially in those with metabolic syndrome (MetS) and obesity. This study aimed to analyze the association between IGF-1 levels and indices of MetS and insulin resistance in BC survivors. METHODS Baseline data of 563 BC survivors enrolled in the DIet and ANdrogen-5 (DIANA-5; NCT05019989) study were analyzed. RESULTS Lower circulating IGF-1 levels in subjects with MetS than in those without MetS were found. After stratification of the patients according to the diagnosis of MetS, we highlighted that the insulin was the main predictor of elevated IGF-1 levels only in subjects without MetS. Moreover, we found an interaction between high-density lipoprotein cholesterol (HDL-C), glycemia, and IGF-1 levels, showing a positive correlation between HDL-C and IGF-1, especially in subjects with higher values of glycemia and without a diagnosis of MetS. CONCLUSIONS While IGF-1 levels appear to be much more impaired in subjects diagnosed with MetS, in non-MetS subjects, IGF-1 levels may respond better to metabolic parameters and lifestyle changes. Further studies are needed to analyze the role of physical activity and/or dietary intervention in modulating IGF-1 concentrations in BC survivors. IMPLICATIONS FOR CANCER SURVIVORS These results could have important clinical implications for planning customized strategies aimed at modulating IGF-1 levels in BC survivors. In fact, while the IGF-1 system seems to be much more compromised in subjects with a diagnosis of MetS, in noMetS subjects, IGF-1 levels could better respond to lifestyle changes.
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Affiliation(s)
- Mauro De Santi
- Unit of Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giuseppe Marano
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Giacomo Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Elisabetta Venturelli
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giorgio Brandi
- Unit of Hygiene, Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Elia Biganzoli
- Department of Clinical Sciences and Community Health and DSRC, University of Milan, Milan, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences - Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy.
| | - Anna Villarini
- Hygiene and Public Health, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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24
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Association of obesity and cardiovascular disease and progress in pharmacotherapy: what is next for obesity? Int J Rehabil Res 2023; 46:14-25. [PMID: 36727942 DOI: 10.1097/mrr.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Obesity has recently emerged as one of the most severe health concerns. Obesity is a key autonomous risk factor for heart failure and contributes to cardiovascular disease (CVD) risk factors such as hypertension, type 2 diabetes, and metabolic abnormalities. Obesity is caused by a metabolic imbalance, which occurs when calories burnt are fewer than the number of calories consumed. There are several pathways accountable for the adverse impacts of obesity on the cardiovascular system. Inflammatory cell infiltration develops in the adipose tissue, the pancreas, and other issues similar to the progression of obesity. Inflammation is triggered by immune cells that invade dysfunctional adipose tissue. The atherosclerotic inflammation phase, related to obesity, induces coronary calcification. Obesity is linked to elevated levels of leptin and high blood pressure. Leptin causes systemic vasoconstriction, sodium retention, and increased blood pressure by influencing the synthesis of nitric oxide and activating the sympathetic nervous system. Obesity is a well-known risk factor for CVD and is one of the leading causes of the greater risk of diseases, including dyslipidemia, hypertension, depression, metabolic syndrome, atrial fibrillation, and heart failure in adults and children. When used with dietary improvements, antiobesity drugs improve the probability of experiencing clinically healthy (5%) weight loss. This review aimed to address the consequences of obesity on cardiac structure and function, risk factors, the impact of the obesity paradox, pharmacological treatment strategies for managing and recommended exercise and diet.
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25
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Mäkinen VP, Kettunen J, Lehtimäki T, Kähönen M, Viikari J, Perola M, Salomaa V, Järvelin MR, Raitakari OT, Ala-Korpela M. Longitudinal metabolomics of increasing body-mass index and waist-hip ratio reveals two dynamic patterns of obesity pandemic. Int J Obes (Lond) 2023; 47:453-462. [PMID: 36823293 DOI: 10.1038/s41366-023-01281-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND/OBJECTIVE This observational study dissects the complex temporal associations between body-mass index (BMI), waist-hip ratio (WHR) and circulating metabolomics using a combination of longitudinal and cross-sectional population-based datasets and new systems epidemiology tools. SUBJECTS/METHODS Firstly, a data-driven subgrouping algorithm was employed to simplify high-dimensional metabolic profiling data into a single categorical variable: a self-organizing map (SOM) was created from 174 metabolic measures from cross-sectional surveys (FINRISK, n = 9708, ages 25-74) and a birth cohort (NFBC1966, n = 3117, age 31 at baseline, age 46 at follow-up) and an expert committee defined four subgroups of individuals based on visual inspection of the SOM. Secondly, the subgroups were compared regarding BMI and WHR trajectories in an independent longitudinal dataset: participants of the Young Finns Study (YFS, n = 1286, ages 24-39 at baseline, 10 years follow-up, three visits) were categorized into the four subgroups and subgroup-specific age-dependent trajectories of BMI, WHR and metabolic measures were modelled by linear regression. RESULTS The four subgroups were characterised at age 39 by high BMI, WHR and dyslipidemia (designated TG-rich); low BMI, WHR and favourable lipids (TG-poor); low lipids in general (Low lipid) and high low-density-lipoprotein cholesterol (High LDL-C). Trajectory modelling of the YFS dataset revealed a dynamic BMI divergence pattern: despite overlapping starting points at age 24, the subgroups diverged in BMI, fasting insulin (three-fold difference at age 49 between TG-rich and TG-poor) and insulin-associated measures such as triglyceride-cholesterol ratio. Trajectories also revealed a WHR progression pattern: despite different starting points at the age of 24 in WHR, LDL-C and cholesterol-associated measures, all subgroups exhibited similar rates of change in these measures, i.e. WHR progression was uniform regardless of the cross-sectional metabolic profile. CONCLUSIONS Age-associated weight variation in adults between 24 and 49 manifests as temporal divergence in BMI and uniform progression of WHR across metabolic health strata.
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Affiliation(s)
- Ville-Petteri Mäkinen
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Computational and Systems Biology Program, Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia. .,Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia.
| | - Johannes Kettunen
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.,Biocenter Oulu, Oulu, Finland.,Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Perola
- Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland.,Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Veikko Salomaa
- Department of Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Ala-Korpela
- Systems Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Biocenter Oulu, Oulu, Finland. .,NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
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26
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Seo MW, Kim JY. Metabolically unhealthy phenotype in adults with normal weight: Is cardiometabolic health worse off when compared to adults with obesity? Obes Res Clin Pract 2023; 17:116-121. [PMID: 36813589 DOI: 10.1016/j.orcp.2023.02.001] [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: 12/02/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 02/22/2023]
Abstract
The concept of metabolically healthy vs. unhealthy obese (MHO vs. MUO) was expanded to non-obese individuals as obesity-related comorbidities exist in a sub-group of normal weight (NW), i.e., MHNW vs. MUNW. It is unclear if MUNW differs from MHO with respect to cardiometabolic health. PURPOSE The purpose of this study was to compare cardiometabolic disease risk factors between MH vs. MU across weight status, NW, and obesity. METHOD A total of 8160 adults were included in the study from both the 2019 and 2020 Korean National Health and Nutrition Examination Surveys. Individuals with NW vs. obesity were further stratified as MH vs. MU by using AHA/NHLBI criterion for metabolic syndrome. A retrospective pair-matched analysis with respect to sex (male/female) and age ( ± 2 years) was performed to verify our total cohort analyses/results. RESULTS Despite a gradual increase in BMI and waist circumference from MHNW to MUNW to MHO to MUO, the surrogate estimates of insulin resistance and arterial stiffness were higher in MUNW vs. MHO. When compared to the MHNW, MUNW and MUO showed higher odds of hypertension (MUNW: 512%, MUO: 784%), dyslipidemia (MUNW: 210%, MUO: 245%), and diabetes (MUNW: 920%, MUO: 4012%), with no difference between MHNW and MHO. CONCLUSION Individuals with MUNW vs. MHO have greater vulnerability to cardiometabolic disease. Our data indicate that cardiometabolic risk is not solely dependent on adiposity, suggesting that early preventive efforts for chronic disease are needed for individuals with NW yet MU.
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Affiliation(s)
- Myong-Won Seo
- Department of Exercise Science, David B. Falk College of Sports & Human Dynamics, Syracuse University, NY, USA
| | - Joon Young Kim
- Department of Exercise Science, David B. Falk College of Sports & Human Dynamics, Syracuse University, NY, USA.
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27
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Mazza E, Calesella F, Paolini M, di Pasquasio C, Poletti S, Lorenzi C, Falini A, Zanardi R, Colombo C, Benedetti F. Insulin resistance disrupts white matter microstructure and amplitude of functional spontaneous activity in bipolar disorder. Bipolar Disord 2023; 25:32-42. [PMID: 36377438 DOI: 10.1111/bdi.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is linked to several structural and functional brain alterations. In addition, BD patients have a three-fold increased risk of developing insulin resistance, which is associated with neural changes and poorer BD outcomes. Therefore, we investigated the effects of insulin and two derived measures (insulin resistance and sensitivity) on white matter (WM) microstructure, resting-state (rs) functional connectivity (FC), and fractional amplitude of low-frequency fluctuation (fALFF). METHODS BD patients (n = 92) underwent DTI acquisition, and a subsample (n = 22) underwent rs-fMRI. Blood samples were collected to determine insulin and glucose levels. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were computed. DTI data were analyzed via tract-based spatial statistics and threshold-free cluster enhancement. From rs-fMRI data, both ROI-to-ROI FC matrices and fALFF maps were extracted. RESULTS Insulin showed a widespread negative association with fractional anisotropy (FA) and a positive effect on radial diffusivity (RD) and mean diffusivity (MD). HOMA-IR exerted a significant effect on RD in the right superior longitudinal fasciculus, whereas QUICKI was positively associated with FA and negatively with RD and MD in the left superior longitudinal fasciculus, left anterior corona radiata, and forceps minor. fALFF was negatively modulated by insulin and HOMA-IR and positively associated with QUICKI in the precuneus. No significant results were found in the ROI-to-ROI analysis. CONCLUSION Our findings suggest that WM microstructure and functional alterations might underlie the effect of IR on BD pathophysiology, even if the causal mechanisms need to be further investigated.
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Affiliation(s)
- Elena Mazza
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Calesella
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Paolini
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Sara Poletti
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Zanardi
- Vita-Salute San Raffaele University, Milan, Italy.,Mood Disorders Unit, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Vita-Salute San Raffaele University, Milan, Italy.,Mood Disorders Unit, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
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28
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El-Khateeb E, El-Berri EI, Mosalam EM, Nooh MZ, Abdelsattar S, Alghamdi AM, Alrubia S, Abdallah MS. Evaluating the safety and efficacy of the leukotriene receptor antagonist montelukast as adjuvant therapy in obese patients with type 2 diabetes mellitus: A double-blind, randomized, placebo-controlled trial. Front Pharmacol 2023; 14:1153653. [PMID: 37113754 PMCID: PMC10126434 DOI: 10.3389/fphar.2023.1153653] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) is common with obesity. Metformin is a first-line therapy for this condition. However, it has only a minor impact on weight loss in some patients. Aim: This study aimed to evaluate the effectiveness, tolerability, and safety of combining montelukast therapy with metformin in obese diabetic patients. Methods: One hundred obese diabetic adult patients were recruited and randomized into two equal groups. Group 1 received placebo plus metformin 2 g/d, and Group 2 received 2 g/d metformin plus 10 mg/d montelukast. Demographic, anthropometric measurements (e.g., body weight, body mass index [BMI], and visceral adiposity index), lipid profile, diabetes control measures (fasting blood glucose, glycated hemoglobin [HbA1c], and homeostatic model assessment for insulin resistance [HOMA-IR]), adiponectin, and inflammatory markers (e.g., TNF-α, IL-6, and leukotriene B4) were assessed and reported for each group at baseline and after 12 weeks of treatment. Results: Both interventions significantly reduced all the measured parameters, except for adiponectin and HDL-C, levels of which increased compared to baseline data (p < 0.001). The montelukast group significantly improved in all parameters compared to the placebo group (ANCOVA test p < 0.001). The percentage changes in BMI, HbA1c, HOMA-IR, and inflammatory markers were 5%, 9%, 41%, and 5%-30%, respectively, in the placebo group compared to 8%, 16%, 58%, and 50%-70%, respectively, in the montelukast group. Conclusion: Montelukast adjuvant therapy was superior to metformin-only therapy in diabetes control and weight loss, most likely due to its increased insulin sensitivity and anti-inflammatory properties. The combination was tolerable and safe throughout the study duration. Clinical Trial Registration: [Clinicaltrial.gov], identifier [NCT04075110].
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Affiliation(s)
- Eman El-Khateeb
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Al-Gharbia, Egypt
- Certara UK Limited (Simcyp Division), Sheffield, United Kingdom
- *Correspondence: Eman El-Khateeb,
| | - Eman I. El-Berri
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Al-Gharbia, Egypt
| | - Esraa M. Mosalam
- Department of Biochemistry, Faculty of Pharmacy, Menoufia University, Shebin ElKoum, Egypt
| | - Mohamed Z. Nooh
- Department of Internal Medicine, Faculty of Medicine, Menoufia University, Shebin ElKoum, Egypt
| | - Shimaa Abdelsattar
- Department of Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Shebin ElKoum, Egypt
| | - Amira M. Alghamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah Alrubia
- Pharmaceutical Chemistry Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud S. Abdallah
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Sadat City, Sadat City, Menoufia, Egypt
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29
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Taieb AB, Roberts E, Luckevich M, Larsen S, le Roux CW, de Freitas PG, Wolfert D. Understanding the risk of developing weight-related complications associated with different body mass index categories: a systematic review. Diabetol Metab Syndr 2022; 14:186. [PMID: 36476232 PMCID: PMC9727983 DOI: 10.1186/s13098-022-00952-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obesity and overweight are major risk factors for several chronic diseases. There is limited systematic evaluation of risk equations that predict the likelihood of developing an obesity or overweight associated complication. Predicting future risk is essential for health economic modelling. Availability of future treatments rests upon a model's ability to inform clinical and decision-making bodies. This systematic literature review aimed to identify studies reporting (1) equations that calculate the risk for individuals with obesity, or overweight with a weight-related complication (OWRC), of developing additional complications, namely T2D, cardiovascular (CV) disease (CVD), acute coronary syndrome, stroke, musculoskeletal disorders, knee replacement/arthroplasty, or obstructive sleep apnea; (2) absolute or proportional risk for individuals with severe obesity, obesity or OWRC developing T2D, a CV event or mortality from knee surgery, stroke, or an acute CV event. METHODS Databases (MEDLINE and Embase) were searched for English language reports of population-based cohort analyses or large-scale studies in Australia, Canada, Europe, the UK, and the USA between January 1, 2011, and March 29, 2021. Included reports were quality assessed using an adapted version of the Newcastle Ottawa Scale. RESULTS Of the 60 included studies, the majority used European cohorts. Twenty-nine reported a risk prediction equation for developing an additional complication. The most common risk prediction equations were logistic regression models that did not differentiate between body mass index (BMI) groups (particularly above 40 kg/m2) and lacked external validation. The remaining included studies (31 studies) reported the absolute or proportional risk of mortality (29 studies), or the risk of developing T2D in a population with obesity and with prediabetes or normal glucose tolerance (NGT) (three studies), or a CV event in populations with severe obesity with NGT or T2D (three studies). Most reported proportional risk, predominantly a hazard ratio. CONCLUSION More work is needed to develop and validate these risk equations, specifically in non-European cohorts and that distinguish between BMI class II and III obesity. New data or adjustment of the current risk equations by calibration would allow for more accurate decision making at an individual and population level.
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Affiliation(s)
| | | | | | | | - Carel W. le Roux
- Diabetes Complications Research Centre, Conway Institute, University College, Dublin, Ireland
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30
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Tirani SA, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. Dairy intake in relation to metabolic health status in overweight and obese adolescents. Sci Rep 2022; 12:18365. [PMID: 36319803 PMCID: PMC9626638 DOI: 10.1038/s41598-022-22827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2022] Open
Abstract
There was a lack of evidence on the association between dairy intake and metabolic health status in overweight/obese adolescents. This study evaluated the association between dairy intake and metabolic health status in overweight/obese Iranian adolescents. Overweight/obese adolescents (n = 203; 101 boys and 102 girls) selected by a multistage cluster random sampling method have participated in this cross-sectional study. Dietary intake was assessed using a validated 147-item food frequency questionnaire. Anthropometric indices, blood pressure, fasting glucose, insulin, and lipid profile were measured. Participants were categorized to metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) according to International Diabetes Federation (IDF) criteria and a combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR) criteria. The frequency of MUO based on IDF, and IDF/HOMA-IR definitions was 38.9% and 33.0%, respectively. In fully-adjusted model, participants in the highest tertile of dairy intake had 61% lower odds of MUO based on IDF criteria (OR = 0.39, 95% CI 0.15-0.99). Higher dairy intake was associated with a non-significant lower risk of MUO according to IDF/HOMA-IR definition in the maximally-adjusted model (OR = 0.44, 95% CI 0.17-1.16). Stratifies analysis by sex and body mass index revealed that the association was stronger in girls and overweight subjects. Furthermore, higher intake of low-fat dairy was related to a reduced likelihood of MUO, while higher intake of high-fat dairy was related to increased odds of MUO. This community-based cross-sectional study revealed that higher intake of dairy was associated with a significant lower odd of MUO among Iranian adolescents, especially in girls and overweight subjects.
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Affiliation(s)
- Shahnaz Amani Tirani
- grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeideh Mirzaei
- grid.412571.40000 0000 8819 4698Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- grid.46072.370000 0004 0612 7950Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- grid.412571.40000 0000 8819 4698Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
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Sivanantham P, Sahoo JP, Lakshminarayanan S, Bobby Z, Kar SS. High prevalence of abdominal obesities and metabolically unhealthy individuals in a highly urbanized district of India: findings of a cross-sectional survey in Puducherry. Fam Pract 2022; 40:282-289. [PMID: 35909311 DOI: 10.1093/fampra/cmac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Abdominal obesities are better markers for predicting cardiovascular abnormalities than risk stratification based only on body mass index (BMI). We aimed to estimate the prevalence of abdominal adiposities using predictive equations for Asian Indian adults and to determine the prevalence of metabolically healthy subjects among those overweight/obese and with normal BMI. METHODS A community-based survey was conducted among those aged 18-69 years in the district of Puducherry between February 2019 and February 2020. We surveyed 2,560 individuals selected through multi-stage cluster random sampling from urban and rural areas (50 wards and 50 villages, respectively) of the district. Anthropometric measurements, such as height, weight, waist circumference, and blood pressure were recorded from each participant. Fasting blood sample was collected from each alternate participant to estimate metabolic risk factors. RESULTS Over four-fifths (85.6%; 95% CI: 84.2-86.9) and two-thirds (69.7%; 95% CI: 67.9-71.6) of the population in the district had high levels of intra-abdominal adipose tissue (IAAT) and total abdominal fat (TAF), respectively. Both the risk factors were significantly higher among women and urban population. About 43% (95% CI: 41-44.9) of the population had high abdominal subcutaneous adipose tissue (SCAT) with a significantly higher prevalence among the urban population. Among those overweight/obese (n = 773), almost all 99.4% (95% CI: 98.7-99.9) were metabolically unhealthy. Among subjects with normal BMI (n = 314), only about 2.9% (95% CI: 1.3-4.8) were metabolically healthy. CONCLUSION We highlight the substantially high prevalence of IAAT, TAF, and SCAT in the district of Puducherry. Almost all the study population was metabolically unhealthy irrespective of their BMI levels.
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Affiliation(s)
- Parthibane Sivanantham
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jaya Prakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Subitha Lakshminarayanan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Zachariah Bobby
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Su L, Pan Y, Chen H. The Harm of Metabolically Healthy Obese and the Effect of Exercise on Their Health Promotion. Front Physiol 2022; 13:924649. [PMID: 35910571 PMCID: PMC9329531 DOI: 10.3389/fphys.2022.924649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity and obesity-related diseases [type 2 diabetes, cardiovascular disease (CVD), and cancer] are becoming more common, which is a major public health concern. Metabolically healthy obesity (MHO) has become a type of obesity, accounting for a large proportion of obese people. MHO is still harmful to health. It was discovered that MHO screening criteria could not well reflect health hazards, whereas visceral fat, adiponectin pathway, oxidative stress, chronic inflammation, and histological indicators at the microlevel could clearly distinguish MHO from health control, and the biological pathways involved in these micro indicators were related to MHO pathogenesis. This review reveals that MHO’s micro metabolic abnormality is the initial cause of the increase of disease risk in the future. Exploring the biological pathway of MHO is important in order to develop an effective mechanism-based preventive and treatment intervention strategy. Exercise can correct the abnormal micro metabolic pathway of MHO, regulate metabolic homeostasis, and enhance metabolic flexibility. It is a supplementary or possible alternative to the traditional healthcare prevention/treatment strategy as well as an important strategy for reducing MHO-related health hazards.
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Affiliation(s)
- Liqiang Su
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Yihe Pan
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Haichun Chen
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
- *Correspondence: Haichun Chen,
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Agius R, Fava MC, Pace NP, Fava S. Prevalence rates of metabolic health and body size phenotypes by different criteria and association with insulin resistance in a Maltese Caucasian population. BMC Endocr Disord 2022; 22:160. [PMID: 35706017 PMCID: PMC9199253 DOI: 10.1186/s12902-022-01071-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Hyperinsulinemia and insulin resistance are known to be associated with increased cardiovascular morbidity and mortality. A metabolically unhealthy phenotype is frequently used as a surrogate marker for insulin resistance. The aims of the current study were to compare the prevalence of the body size phenotypes using different definitions of metabolic health and to investigate which one of them is most strongly associated with insulin resistance in men and women. METHODS We conducted a cross-sectional study in a middle-aged cohort of Maltese Caucasian non-institutionalized population. Metabolic health was defined using the various currently used definitions. RESULTS There were significant differences in the prevalence of body size phenotypes according to the different definitions. We also found significant sex differences in the predictive value of the various definitions of the metabolically unhealthy phenotype to predict insulin resistance. The strongest association was for the definition of having >2 NCEP-ATPIII criteria to characterize the metabolic unhealthy phenotype in women (odds ratio of 19.7). On the other hand, the Aguilar-Salinas et al. definition had the strongest association in men (odds ratio of 18.7). CONCLUSIONS We found large differences in the prevalence of the various body size phenotypes when using different definitions, highlighting the need for having standard criteria. Our data also suggest the need for sex-specific definitions of metabolic health.
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Affiliation(s)
- Rachel Agius
- Faculty of Medicine and Surgery, University of Malta Medical School, Tal-Qroqq, Msida, Malta
- Mater Dei Hospital, Triq Dun Karm, Msida, MSD2090, Malta
| | | | - Nikolai Paul Pace
- Faculty of Medicine and Surgery, University of Malta Medical School, Tal-Qroqq, Msida, Malta
| | - Stephen Fava
- Faculty of Medicine and Surgery, University of Malta Medical School, Tal-Qroqq, Msida, Malta.
- Mater Dei Hospital, Triq Dun Karm, Msida, MSD2090, Malta.
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Du T, Fonseca V, Chen W, Bazzano LA. Changes in body size phenotypes from childhood to adulthood and the associated cardiometabolic outcomes. Diabetes Res Clin Pract 2022; 187:109884. [PMID: 35487340 DOI: 10.1016/j.diabres.2022.109884] [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: 02/10/2022] [Revised: 04/17/2022] [Accepted: 04/22/2022] [Indexed: 11/22/2022]
Abstract
AIM To examine the effects of changes in body size phenotypes between childhood and adulthood on risks of diabetes and left ventricular hypertrophy (LVH) in adulthood. METHODS We included 3,351 individuals who participated as both children and adults in the Bogalusa Heart Study. RESULTS Compared with participants with persistently metabolically healthy normal weight (MHNW) from childhood to adulthood, MHNW children who became metabolically unhealthy in adulthood had increased diabetes burden and LVH risk in adulthood; Metabolically unhealthy normal weight (MUNW) children who became MHNW or metabolically healthy obese (MHO) as adults and individuals with persistent MHO from childhood to adulthood were not at increased risks of diabetes or LVH. The risks were increased if MHO during childhood transitioned to metabolically unhealthy obesity (MUO) by adulthood or MUO stayed from childhood to adulthood. MUO children who became MHO or MHNW as adults had decreased diabetes burden and LVH risk in adulthood. CONCLUSIONS Individuals maintained MHO from childhood to adulthood and MUNW children who became MHO as adults had a diabetes burden and LVH risk similar to individuals with persistent MHNW. Progression to metabolically unhealthy status and maintenance of metabolically unhealthy status, regardless of childhood BMI status, were associated with increased cardiometabolic outcomes.
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Affiliation(s)
- Tingting Du
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China.
| | - Vivian Fonseca
- Section of Endocrinology, Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA; Southeast Louisiana Veterans Healthcare System Medical Center, New Orleans, LA, USA
| | - Wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lydia A Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
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Sex-Specific Impact of Different Obesity/Metabolic Phenotypes on Long-Term Cardiovascular Outcomes in Acute Coronary Syndrome Patients. Biomedicines 2022; 10:biomedicines10020424. [PMID: 35203633 PMCID: PMC8962273 DOI: 10.3390/biomedicines10020424] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity, a major risk factor for acute coronary syndrome (ACS), is a multifaceted disease with different metabolic phenotypes and sex-specific features. Here, we evaluated the long-term cardiovascular risk by different obesity/metabolic phenotypes and by sex in ACS patients. The occurrence of the composite outcome of death, nonfatal reinfarction with or without PCI and/or stroke was evaluated in 674 patients (504 men; 170 women), consecutively hospitalized for ACS and followed-up for 7 years, who were stratified in metabolically healthy (MHNW) and unhealthy normal weight (MUNW), and in metabolically healthy (MHO) and unhealthy obese (MUO) groups. At baseline, 54.6% of patients were included in the MHNW group, 26.4% in the MUNW, 5.9% in the MHO and 13.1% in the MUO, with no sex-differences in the distribution of phenotypes. The overall rate of major outcome (100 person-years) in the reference group (MHNW) was higher in men than in women (RR: 1.19 vs. 0.6). The Kaplan–Meier curves for cumulative survival free from cardiovascular events according to obesity/metabolic status diverged significantly according to sex (log rank test, p = 0.006), this effect being more prominent in men (log 11.20; p = 0.011), than in women (log 7.98; p = 0.047). Compared to MHNW, the risk increased in obese men (RR: 2.2; 95% 1.11–1.54 in MUO group), whereas in women the risk was confined to metabolically unhealthy subjects (RR: 3.2; 95% CI 1.23–9.98, MUNW group). Our data show a sex-specific impact of obesity phenotypes on long-term cardiovascular risk in patients hospitalized for ACS.
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Doustmohamadian S, Hosseinpanah F, Momeni M. Are abdominal obese metabolically healthy phenotype a benign condition? Protocol for a systematic review. Int J Prev Med 2022; 13:36. [PMID: 35529510 PMCID: PMC9069148 DOI: 10.4103/ijpvm.ijpvm_392_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 05/27/2021] [Indexed: 11/07/2022] Open
Abstract
Background: The prevalence of obesity is increasing worldwide. Obesity is associated with severe health effects. Abdominal obesity has a strong association with metabolic dysfunction. A subgroup of people with central obesity has been identified without typical metabolic disorders associated with obesity that has been known metabolically healthy abdominal obese (MHAO). The purpose of this review is to evaluate the MHAO phenotype in the context of type 2 DM incidence, risk of cardiovascular diseases, and all-cause of mortality. Methods: This is a protocol of systematic review. We will search PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, and ProQuest. Additional studies will be identified through manual searching of reference lists. Quantitative studies evaluating abdominal obesity phenotype outcomes in adults will be included. Primary results will be assaying abdominal obesity phenotype results, including DM2 incidence, cardiovascular disease risk, and all-cause mortality. Two reviewers will independently screen full-text articles and abstract data. Statistical Analysis Used: Potential conflicts will be resolved through discussion. Results: The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct a random-effects meta-analysis. The researchers will also assess the quality of the articles independently based on Newcastle-Ottawa scale. Conclusions: The results of this review will provide a useful reference for the effect of abdominal obesity on metabolic dysfunction and cardiovascular or all-cause mortality
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Talisman S, Friedlander Y, Hochner H. Perinatal socio-behavioral and obstetric predictors of metabolically healthy and unhealthy obesity in adult offspring. Obesity (Silver Spring) 2022; 30:209-220. [PMID: 34786873 DOI: 10.1002/oby.23288] [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: 01/14/2021] [Revised: 07/03/2021] [Accepted: 08/08/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether obstetric and perinatal socio-behavioral characteristics at the time of pregnancy predict obesity phenotypes of adult offspring. METHODS The Jerusalem Perinatal Study was conducted among 17,003 deliveries during 1974 to 1976. Follow-up studies were conducted during 2007 to 2009 and 2017 to 2019 among 1,440 offspring undergoing examinations. Offspring were classified into four phenotypes according to obesity and metabolic status: metabolically healthy normal weight (MHNW, reference group), unhealthy normal weight, healthy obesity (MHO), and unhealthy obesity (MUO). Regression models were carried out to identify perinatal predictors for risk phenotypes at age 30 to 35 years, emphasizing the differentiation between socio-behavioral and obstetric features. RESULTS A total of 15.7% of participants were classified as MUO, and 5.4% were classified as MHO. Low socioeconomic status was associated with both obesity phenotypes (e.g., odds ratio [OR]MHO/MHNW = 2.98, p < 0.001). High socioeconomic status was associated with MUO (ORMUO/MHNW = 1.93, p = 0.002). Maternal low education was also associated with both obesity phenotypes (ORMUO/MHNW = 2.46, p < 0.001, ORMHO/MHNW = 2.45, p = 0.005). Participants with MUO were more likely to have a smoking father (ORMUO/MHNW = 1.48, p = 0.021). CONCLUSIONS Perinatal socio-behavioral characteristics are associated with adult obesity phenotypes. The findings point to possible mechanisms underlying the development of obesity in young adults and, thus, contribute toward identifying high-risk groups that would mostly benefit from obesity risk-reduction interventions.
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Affiliation(s)
- Shahar Talisman
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Hagit Hochner
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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Obesity-Related Metabolic Dysfunction in Dairy Cows and Horses: Comparison to Human Metabolic Syndrome. Life (Basel) 2021; 11:life11121406. [PMID: 34947937 PMCID: PMC8705694 DOI: 10.3390/life11121406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022] Open
Abstract
Obesity has become a serious health problem with frequent occurrence both in human and animal populations. It is estimated that it may affect over 85% of the human population and 70–80% of horses and cows by 2030. Fat cow syndrome (FCS) is a combination of metabolic, digestive, infectious, and reproductive disorders that affects obese periparturient dairy cows, and occurs most frequently in loose-housing systems, where periparturient and dry cows are fed and managed in one group disregarding the lactation stages. Equine metabolic syndrome (EMS) was named after human metabolic syndrome (MetS) and has insulin dysregulation as a central and consistent feature. It is often associated with obesity, although EMS may occur in a lean phenotype as well. Other inconsistent features of EMS are cardiovascular changes and adipose dysregulation. Laminitis is the main clinical consequence of EMS. MetS holds a 30-years old lead in research and represents a clustering of risk factors that comprise abdominal obesity, dyslipidemia, hypertension, and hyperglycemia (impaired fasting glucose or type 2 diabetes mellitus—T2DM), which are associated with doubled atherosclerotic cardiovascular disease risk, and a 5-fold increased risk for T2DM. The main aim of this review is to provide critical information for better understanding of the underlying mechanisms of obesity-related metabolic dysfunction in animals, especially in cows and horses, in comparison with MetS. Human medicine studies can offer suitable candidate mechanisms to fill the existing gap in the literature, which might be indispensable for owners to tackle FCS, EMS, and their consequences.
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Natural histories of metabolite BMI phenotypes and their impacts on cardiovascular disease risk over a decade-long follow-up. Obes Res Clin Pract 2021; 15:579-586. [PMID: 34742668 DOI: 10.1016/j.orcp.2021.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/09/2021] [Accepted: 10/17/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE The prognostic significance of obesity phenotypes is under debate, and few studies have characterized their transition trajectories. This study examined the natural courses of different phenotypes and their associations with cardiovascular disease risks. METHODS A total of 1827 participants were followed for 14 years and re-evaluated every 4-5 years. Four metabolite BMI phenotypes were determined according to overweight or obesity (BMI ≥ 24 kg/m2) and metabolic health status (≤1 Adult Treatment Panel III criteria, excluding waist circumference). Cardiovascular risks were assessed by evaluating baPWV and hypertension, diabetes and chronic kidney disease (CKD) development. RESULTS More than 20% of participants changed their initial phenotypes within 5 years. One-third of healthy overweight/obese (MHO) individuals became unhealthy, and only 10.6% regressed to a healthy normal weight (MHN) at the end of follow-up. Compared with MHN participants, MHO participants had higher odds of increased baPWV (OR: 1.18, 95% CI, 0.42-3.33) and increased risks of incident hypertension (HR: 1.87, 95% CI, 1.18-2.98) and diabetes (HR: 2.61, 95% CI, 1.35-5.03). Metabolic deterioration during follow-up resulted in an increased risk of baPWV and clinical diseases. CONCLUSIONS The natural trajectory of metabolite BMI phenotypes is time-varying, and interventions for both healthy and unhealthy overweight/obese individuals should be widely recommended.
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Ragno VM, Klein CD, Sereda NS, Uehlinger FD, Zello GA, Robinson KA, Montgomery JB. Morphometric, metabolic, and inflammatory markers across a cohort of client-owned horses and ponies on the insulin dysregulation spectrum. J Equine Vet Sci 2021; 105:103715. [PMID: 34607688 DOI: 10.1016/j.jevs.2021.103715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/09/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
In human metabolic syndrome and type II diabetes, methylglyoxal (MG), D-lactate, and several cytokines have been recognized as biomarkers of important metabolic and inflammatory processes. Equine metabolic syndrome (EMS) shares many similarities with these human counterparts. The objectives of this cross-sectional study were to compare body condition score (BCS), cresty neck score (CNS), resting insulin, MG, D-lactate, L-lactate, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1) between horses with and without insulin dysregulation, as classified via combined glucose and insulin test (CGIT). 32 client-owned horses were included. History and morphometric data such as BCS and CNS were recorded. Subjects with abnormalities on physical examination or CBC, elevated ACTH or incomplete information were excluded. Baseline serum or plasma concentrations of biomarkers were tested via commercial ELISA or colorimetric assays. Characteristics of insulin dysregulated and insulin sensitive horses were compared by univariate analysis and forward logistic regression. 12 (38%) of the 32 horses were classified as insulin dysregulated. No significant difference between the 2 groups was found for age, BCS, baseline glucose, triglycerides, MG, D-lactate, L-lactate, TNF-α, IL-6, and MCP-1. Baseline insulin was significantly associated with insulin dysregulation in univariate analysis (P = 0.02), but not in the final model. Horses with CNS ≥ 3 had 11.3 times higher odds of having insulin dysregulation (OR 11.3, 95% C.I. 2.04 - 63.08, P = 0.006). In this population, horses with mild-moderate signs of EMS presented similar metabolic and inflammatory profiles to non-insulin dysregulated controls.
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Affiliation(s)
- Valentina M Ragno
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Colby D Klein
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nicole S Sereda
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Fabienne D Uehlinger
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gordon A Zello
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan Canada
| | - Katherine A Robinson
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Julia B Montgomery
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Eley VA, Thuzar M, Navarro S, Dodd BR, Zundert AAV. Obesity, metabolic syndrome, and inflammation: an update for anaesthetists caring for patients with obesity. Anaesth Crit Care Pain Med 2021; 40:100947. [PMID: 34534700 DOI: 10.1016/j.accpm.2021.100947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/20/2021] [Indexed: 11/25/2022]
Abstract
Our understanding of chronic inflammation in obesity is evolving. Suggested mechanisms include hypoxia of adipose tissue and a subsequent increase in circulating cytokines. It is now known that adipose tissue, far from being an inert tissue, produces and secretes multiple peptides that influence inflammation and metabolism, including substrates of the renin-angiotensin-aldosterone system (RAAS). RAAS blocking antihypertensive medication and cholesterol-lowering agents are now being evaluated for their metabolic and inflammation-modulating effects. Surgery also has pro-inflammatory effects, which may be exacerbated in patients with obesity. This narrative review will summarise the recent literature surrounding obesity, metabolic syndrome, inflammation, and interplay with the RAAS, with evidence-based recommendations for the optimisation of patients with obesity, prior to surgery and anaesthesia.
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Affiliation(s)
- Victoria A Eley
- Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Butterfield St, Herston, 4006 Queensland, Australia; Faculty of Medicine, The University of Queensland, St Lucia, 4067 Queensland, Australia.
| | - Moe Thuzar
- Faculty of Medicine, The University of Queensland, St Lucia, 4067 Queensland, Australia; Department of Endocrinology and Diabetes, Princess Alexandra Hospital, Ipswich Road Woolloongabba, 4102 Queensland, Australia; Endocrine Hypertension Research Centre, The University of Queensland Diamantina Institute, Ipswich Road Woolloongabba, 4102 Queensland, Australia
| | - Séverine Navarro
- Department of Immunology, QIMR Berghofer Medical Research Institute Herston Rd, Herston, 4006 Queensland, Australia; Woolworths Centre for Childhood Nutrition Research, Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, 4059 Queensland, Australia
| | - Benjamin R Dodd
- Faculty of Medicine, The University of Queensland, St Lucia, 4067 Queensland, Australia; Department of Upper GI and Bariatric Surgery, The Royal Brisbane and Women's Hospital, Butterfield St, Herston, 4006 Queensland, Australia
| | - André A Van Zundert
- Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Butterfield St, Herston, 4006 Queensland, Australia; Faculty of Medicine, The University of Queensland, St Lucia, 4067 Queensland, Australia
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Pelluri R, Kongara S, Chimakurthy J, Mahadevan S, Nagasubramanian V. The role of body mass index or metabolic syndrome components causing depression in women: An observation from weight reduction clinical trial. J Clin Pharm Ther 2021; 46:1757-1763. [PMID: 34490636 DOI: 10.1111/jcpt.13522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Depression is most important psychological problem that is much prevalent in women than men. Obesity and depression are the leading causes of both physical and mental disability and the link between these disorders had not explored well. The present study evaluated the link between the depression, Body mass index (BMI) and the components of metabolic syndrome (MetS) in subjects with, without insulin resistance. METHODS A total of 150 subjects, vital and biochemical parameters were measured for eligible screened subjects in the trial of weight loss intervention at first visit. A self-reported Patient Health Questionnaire (PHQ-9) scale was used to assess the depression among the participants. The association of BMI and MetS components with risk of depression was analysed using multiple logistic regression analysis in subjects with and without insulin resistance. RESULTS Obesity was associated with highly significant increase in risk of depression (OR = 13.01, 95% CI 4.40-38.49) as compared to overweight subjects. Female subjects with obesity had a greater risk for depression (β: 3.725, OR: 42.62, 95% CI: 5.74-316.3 and p < 0.0001) than male subjects (β: 1.922, OR: 6.83, 95% CI: 1.8-26 and p = 0.005), and it was statistically significant. There was no association between other models (IR and MetS) and depression in both genders (p < 0.05). WHAT IS NEW AND CONCLUSION The odds of depression was 42.62 times more in obese women and 6.83 time more in obese men compared to overweight subjects. Subjects those who are having ≥3 metabolic syndrome (MetS) components, increased the risk of depression by 0.75 times in women and 1.50 times in men. In view of these results of our study, we conclude that the body mass index is an individual strong predictor of depression whereas metabolic syndrome and insulin resistance had no significant association with depression.
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Affiliation(s)
- Ranakishor Pelluri
- Department of Pharmacy Practice, Vignan Pharmacy College, Guntur, 522213, India.,Department of Endocrinology and Metabolism, Endo-life Speciality Hospital, Guntur, India.,Department of Pharmacy Practice, Sri Ramachandra Institute of Higher Education & Research, Deemed to be University, Chennai, India
| | - Srikanth Kongara
- Department of Endocrinology and Metabolism, Endo-life Speciality Hospital, Guntur, India
| | - Jithendra Chimakurthy
- Department of Pharmaceutical Sciences, Vignan's Foundation for Science Technology and Research, Deemed to be University, Guntur, 522213, India
| | - Shriraam Mahadevan
- Department of Pharmacy Practice, Sri Ramachandra Institute of Higher Education & Research, Deemed to be University, Chennai, India.,Department of Endocrinology and Metabolism, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education & Research, Deemed to be University, Chennai, India
| | - Vanitharani Nagasubramanian
- Department of Endocrinology and Metabolism, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education & Research, Deemed to be University, Chennai, India
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Kim SA, Lim K, Lee JK, Kang D, Shin S. Metabolically healthy obesity and the risk of all-cause and cardiovascular disease mortality in a Korean population: a prospective cohort study. BMJ Open 2021; 11:e049063. [PMID: 34489281 PMCID: PMC8423515 DOI: 10.1136/bmjopen-2021-049063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES This study aimed to examine the association between metabolically healthy obesity and all-cause and cardiovascular disease (CVD) mortality in a Korean population. DESIGN A prospective study. SETTING This study used data from the Korean Genome and Epidemiology Study. PARTICIPANTS A total of 140 137 participants were followed up over a median period of 9.2 years. Participants were categorised into four groups according to obesity (obese: body mass index ≥25 kg/m2 or non-obese) and metabolic health (metabolically unhealthy: two or more metabolic abnormalities or metabolically healthy). PRIMARY AND SECONDARY OUTCOME MEASURES All-cause and CVD mortality of the participants until 31 December 2018 were ascertained by the National Health Insurance Service of beneficiary status of Korea. RESULTS Metabolically unhealthy non-obese participants were at elevated risk of all-cause mortality (HR, 1.12; 95% CI, 1.04 to 1.21; p=0.0019) and CVD mortality (HR, 1.39; 95% CI, 1.17 to 1.65; p=0.0002), particularly mortality from ischaemic heart disease (IHD) (HR, 1.54; 95% CI, 1.10 to 2.14; p=0.0116) compared with metabolically healthy non-obese participants. Surprisingly, metabolically healthy obese participants were at reduced risk of all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; p=0.0197). Metabolically unhealthy obese participants were at elevated risk of CVD mortality (HR, 1.51; 95% CI, 1.26 to 1.81; p<0.0001) and IHD mortality (HR, 1.88; 95% CI, 1.35 to 2.63; p=0.0002) compared with metabolically healthy non-obese participants. CONCLUSIONS In a Korean population, metabolically healthy obese participants had reduced risk of all-cause mortality compared with their non-obese counterparts, whereas metabolically unhealthy participants had elevated risk of CVD mortality, in particular mortality from IHD regardless of obesity.
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Affiliation(s)
- Seong-Ah Kim
- Department of Urban Society, Seoul Institute, Seoul, Republic of Korea
| | - Kyungjoon Lim
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, Victoria, Australia
| | - Jong-Koo Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Daehee Kang
- Department of Preventive Medicine, College of Medicine Seoul National University, Seoul, Republic of Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung Ang University, Anseong, Republic of Korea
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Bignotto M, Dei Cas M, Paroni R, Bianco E, Zermiani P, Gangale MG, Zadro V, Maregatti M, Piagnani A, Russo A, Baldassarre D, Folli F, Battezzati PM, Zuin M. CA.ME.LI.A. An epidemiological study on the prevalence of CArdiovascular, MEtabolic, LIver and Autoimmune diseases in Northern Italy. Nutr Metab Cardiovasc Dis 2021; 31:1416-1426. [PMID: 33814235 DOI: 10.1016/j.numecd.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS CA.ME.LI.A (CArdiovascular risks, MEtabolic syndrome, LIver and Autoimmune disease) is a cross-sectional, epidemiological study performed between 2009-2011 in Abbiategrasso (Milan, Italy) to estimate the prevalence of cardiovascular risk factors, metabolic syndrome, liver and autoimmune diseases in the general adult population. This report focuses on the description and presentation of baseline characteristics of the population. METHODS AND RESULTS Citizens were randomly selected from the city electoral registers (n = 30903), yielding a sample of 2554 subjects (M = 1257, F = 1297; age, 47 ± 15 yrs; range 18-77 yrs). Men had higher prevalence of overweight or obesity (60.8% vs 41.6%; p < 0.0001) and greater thickness of visceral adipose tissue (40 ± 19 vs 27 ± 17 mm; p < 0.0001); no gender difference was found in subcutaneous adipose tissue thickness. Men also showed higher levels of serum triglycerides, γ-GT, fasting blood glucose, insulin and Homa-IR Index, while HDL, CRP, and prevalence of elevated (>5.0 mg/L) CRP were lower. Compared to normal weight men, risk-ratio (RR) of CRP elevation was 1.32 (ns) in overweight and 2.68 (p < 0.0001) in obese subjects. The corresponding figures in females were 2.68 (p < 0.0001) and 5.18 (p < 0.0001). Metabolic syndrome was more frequent in men (32.7% vs 14.5%; RR: 2.24, p < 0.0001). Interadventitia common carotid artery diameter was higher in men and increased with age and BMI. CONCLUSIONS The present study reports on the overall characteristics of a large population from Northern Italy. It aims to identify the associations among cardiovascular risk factors to prevent their development and progression, improve healthy lifestyle and identify subjects liable to pharmacological interventions.
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Affiliation(s)
- Monica Bignotto
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Michele Dei Cas
- Clinical Biochemistry and Mass Spectrometry, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Rita Paroni
- Clinical Biochemistry and Mass Spectrometry, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Elena Bianco
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Paola Zermiani
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Maria G Gangale
- ASST Ovest Milanese, via Papa Giovanni Paolo II, Legnano, Milan, Italy
| | - Valentina Zadro
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Margherita Maregatti
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Alessandra Piagnani
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy
| | - Antonio Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Franco Folli
- Endocrinology and Metabolism, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy; ASST Santi Paolo e Carlo, University Hospital San Paolo, via A. Di Rudini', Milan, Italy.
| | - Pier Maria Battezzati
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy; ASST Santi Paolo e Carlo, University Hospital San Paolo, via A. Di Rudini', Milan, Italy
| | - Massimo Zuin
- Liver and Gastroenterology Unit, Department of Health Sciences, Universita' degli Studi di Milano, Milan, Italy; ASST Santi Paolo e Carlo, University Hospital San Paolo, via A. Di Rudini', Milan, Italy.
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Farsijani S, Marron MM, Miljkovic I, Baugh ME, Kritchevsky SB, Newman AB. Metabolic Markers Demonstrate the Heterogeneity of Myosteatosis in Community-Dwelling Older Black Men from the Health ABC Study. Metabolites 2021; 11:metabo11040224. [PMID: 33917005 PMCID: PMC8067743 DOI: 10.3390/metabo11040224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 11/16/2022] Open
Abstract
Myosteatosis is a complex condition, associated with aging and diverse pathological conditions (e.g., diabetes), that contributes to mobility disability. Improved characterization of myosteatosis is required to develop targeted interventions to maintain muscle health in aging. We first determined the associations between plasma metabolites and intermuscular fat (IMF) in a cross-sectional analysis of 313 older Black men from Health ABC Study. Using partial correlation analysis, 34/350 metabolites were associated with IMF, the majority of which were lipids and organic acids. Next, we used Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), as an indicator of metabolic health to delineate the anthropometric, functional, and metabolic heterogeneity of myosteatosis in a case-control matching analysis. We categorized participants based on their IMF and HOMA-IR levels into: Low-IMF with Low- versus High-HOMA, as well as High-IMF with Low- versus High-HOMA. Among participants with similar levels of IMF, those who were metabolically unhealthy, i.e., with High HOMA-IR, had higher fat and lean mass, muscle strength, and had hyperglycemia, hypertriglyceridemia, hyperinsulinemia, and higher levels of plasma metabolites belonging to diacylglycerols, triacylglycerols, fatty acid and aminoacyl-tRNA biosynthesis pathways versus those with Low HOMA-IR. In summary, HOMA-IR delineates the heterogeneity of myosteatosis by distinguishing metabolically healthy versus unhealthy individuals.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Megan M. Marron
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Iva Miljkovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
| | - Mary Elizabeth Baugh
- Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA 24016, USA;
| | - Stephen B. Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Anne B. Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (S.F.); (M.M.M.); (I.M.)
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Correspondence:
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Genua I, Tuneu L, Ramos A, Stantonyonge N, Caimari F, Balagué C, Fernández-Ananin S, Sánchez-Quesada JL, Pérez A, Miñambres I. Effectiveness of Bariatric Surgery in Patients with the Metabolically Healthy Obese Phenotype. Obes Surg 2021; 31:517-522. [PMID: 32915359 DOI: 10.1007/s11695-020-04967-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the effectiveness and safety of bariatric surgery in metabolically healthy obese (MHO) patients. METHODS In this retrospective, observational study, we reviewed the medical records of patients who underwent bariatric surgery at a tertiary care hospital between January 2007 and March 2015. Patients who underwent revisional surgery and patients with type 1 diabetes were excluded from the analysis. MHO patients were defined as those without a previous diagnosis of diabetes or atherogenic dyslipidemia and absence of hypoglycemic treatment or treatment with fibrates. RESULTS A total of 188 patients were included (mean age 48.97 ± 10.32 years, 68.6% of women). Sleeve gastrectomy was performed in 121 patients (64%) and a gastric bypass in 67 patients (36%). Prior to surgery, 36 patients (19%) were MHO. In the second- and third-year post-surgery, MHO patients presented a higher percentage of total weight loss (%TWL) (35.16% vs. 30.34%; p = 0.02 and 33.97% vs. 27.78%; p = 0.013 respectively). Multiple regression analysis showed that MHO was associated with a higher weight loss irrespective of age, sex, baseline BMI, and type of surgery. We did not detect any differences in acute complications between patients with and without MHO after bariatric surgery. CONCLUSIONS Bariatric surgery in MHO patients in our study was associated with higher weight loss than that in MUHO patients. There were no differences between the two groups in respect to acute complications following surgery.
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Affiliation(s)
- Idoia Genua
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Laura Tuneu
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Analía Ramos
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Nicole Stantonyonge
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain
| | - Francisca Caimari
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Carmen Balagué
- Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Antonio Pérez
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
| | - Inka Miñambres
- Endocrinology and Nutrition department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.
- Universitat Autònoma de Barcelona, 08193, Bellaterra, Barcelona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, 28029, Madrid, Spain.
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Smati S, Tramunt B, Wargny M, Caussy C, Gaborit B, Vatier C, Vergès B, Ancelle D, Amadou C, Bachir LA, Bourron O, Coffin‐Boutreux C, Barraud S, Dorange A, Fremy B, Gautier J, Germain N, Larger E, Laugier‐Robiolle S, Meyer L, Monier A, Moura I, Potier L, Sabbah N, Seret‐Bégué D, Winiszewski P, Pichelin M, Saulnier P, Hadjadj S, Cariou B, Gourdy P. Relationship between obesity and severe COVID-19 outcomes in patients with type 2 diabetes: Results from the CORONADO study. Diabetes Obes Metab 2021; 23:391-403. [PMID: 33051976 PMCID: PMC7675375 DOI: 10.1111/dom.14228] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022]
Abstract
AIM To assess the relationship between body mass index (BMI) classes and early COVID-19 prognosis in inpatients with type 2 diabetes (T2D). METHODS From the CORONAvirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study, we conducted an analysis in patients with T2D categorized by four BMI subgroups according to the World Health Organization classification. Clinical characteristics and COVID-19-related outcomes (i.e. intubation for mechanical ventilation [IMV], death and discharge by day 7 [D7]) were analysed according to BMI status. RESULTS Among 1965 patients with T2D, 434 (22.1%) normal weight (18.5-24.9 kg/m2 , reference group), 726 (36.9%) overweight (25-29.9 kg/m2 ) and 805 (41.0%) obese subjects were analysed, including 491 (25.0%) with class I obesity (30-34.9 kg/m2 ) and 314 (16.0%) with class II/III obesity (≥35 kg/m2 ). In a multivariable-adjusted model, the primary outcome (i.e. IMV and/or death by D7) was significantly associated with overweight (OR 1.65 [1.05-2.59]), class I (OR 1.93 [1.19-3.14]) and class II/III obesity (OR 1.98 [1.11-3.52]). After multivariable adjustment, primary outcome by D7 was significantly associated with obesity in patients aged younger than 75 years, while such an association was no longer found in those aged older than 75 years. CONCLUSIONS Overweight and obesity are associated with poor early prognosis in patients with T2D hospitalized for COVID-19. Importantly, the deleterious impact of obesity on COVID-19 prognosis was no longer observed in the elderly, highlighting the need for specific management in this population.
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Affiliation(s)
- Sarra Smati
- Département d'EndocrinologieDiabétologie et Nutrition, L'Institut du Thorax, INSERM, CNRS, University of Nantes, CHU NantesNantesFrance
| | - Blandine Tramunt
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 INSERM/UPSUniversité de ToulouseToulouseFrance
| | | | - Cyrielle Caussy
- University of Lyon, CarMen Laboratory, INSERM, INRA, INSA LyonUniversité Claude Bernard Lyon 1Pierre‐BéniteFrance
- Département Endocrinologie, Diabète et Nutrition, Hôpital Lyon SudHospices Civils de LyonPierre‐BéniteFrance
| | - Bénédicte Gaborit
- Département d'Endocrinologie et de DiabétologieHôpital Nord, Assistance Publique Hôpitaux de MarseilleMarseilleFrance
| | - Camille Vatier
- APHP, Hôpital Saint‐AntoineReference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Département d'EndocrinologieParisFrance
- Sorbonne UniversitéINSERM UMRS 938, Centre de Recherche Saint‐AntoineParisFrance
| | - Bruno Vergès
- Endocrinologie, DiabétologieCHU Dijon, Hôpital du BocageDijonFrance
| | - Deborah Ancelle
- Service de Diabétologie EndocrinologieCentre Hospitalier MonodLe HavreFrance
| | - Coralie Amadou
- Département de DiabétologieCentre Hospitalier Sud FrancilienCorbeil EssonneFrance
| | - Leila A. Bachir
- Département de DiabétologieHôpital Franco‐BritanniqueLevallois PerretFrance
| | - Olivier Bourron
- Sorbonne UniversitéParisFrance
- Assistance Publique‐Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié Salpêtrière‐Charles Foix, INSERM, Centre de Recherche des CordeliersParisFrance
- Institute of Cardiometabolism and NutritionParisFrance
| | | | - Sara Barraud
- Département de DiabétologieCHU de ReimsReimsFrance
| | - Anne Dorange
- Département de DiabétologieEndocrinologie, Nutrition, CH Le MansLe MansFrance
| | | | - Jean‐François Gautier
- Département de Diabétologie et EndocrinologieHôpital Lariboisière, APHPParisFrance
- INSERM UMRS 1138Université́ Paris Diderot‐Paris VII, Sorbonne Paris CitéParisFrance
| | - Natacha Germain
- Service Endocrinologie CHU de Saint‐Etienne et Laboratoire TAPESaint‐EtienneFrance
| | - Etienne Larger
- Service de DiabétologieHôpital Cochin, APHP, Université de ParisParisFrance
| | | | - Laurent Meyer
- Département d'EndocrinologieDiabétologie et Nutrition, Hôpitaux Universitaires de StrasbourgStrasbourgFrance
| | - Arnaud Monier
- Département d'EndocrinologieDiabétologie, Nutrition, Centre Hospitalier Louis PasteurChartresFrance
| | - Isabelle Moura
- Unité Transversale de DiabétologieEndocrinologie, Nutrition, Centre Hospitalier d'AlbiAlbiFrance
| | - Louis Potier
- Département d'EndocrinologieDiabétologie et Nutrition, Hôpital Bichat, Assistance Publique‐Hôpitaux de Paris, Centre de Recherche des Cordeliers, INSERM, U‐1138, Université de ParisParisFrance
| | - Nadia Sabbah
- Département d'Endocrinologie et Maladies Métaboliques, André Rosemon, Hôpital de CayenneUniversité des Antilles et de la Guyane FrançaisePointe à PitreFrance
- EA3593, Amazon Ecosystems and Tropical DiseasesUniversité de GuyaneGuyane FrançaiseFrance
| | | | | | - Matthieu Pichelin
- Département d'EndocrinologieDiabétologie et Nutrition, L'Institut du Thorax, INSERM, CNRS, University of Nantes, CHU NantesNantesFrance
| | - Pierre‐Jean Saulnier
- Centre d'Investigation Clinique CIC 1402Université de Poitiers, INSERM, CHU de PoitiersPoitiersFrance
| | - Samy Hadjadj
- Département d'EndocrinologieDiabétologie et Nutrition, L'Institut du Thorax, INSERM, CNRS, University of Nantes, CHU NantesNantesFrance
| | - Bertrand Cariou
- Département d'EndocrinologieDiabétologie et Nutrition, L'Institut du Thorax, INSERM, CNRS, University of Nantes, CHU NantesNantesFrance
| | - Pierre Gourdy
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 INSERM/UPSUniversité de ToulouseToulouseFrance
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Luzi L, Bucciarelli L, Ferrulli A, Terruzzi I, Massarini S. Obesity and COVID-19: the ominous duet affecting the renin-angiotensin system. Minerva Endocrinol (Torino) 2021; 46:193-201. [PMID: 33435650 DOI: 10.23736/s2724-6507.20.03402-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The world population is facing a health challenge never seen since the Spanish influenza of one hundred years ago. During the last months, the scientific community has been debating on the potential harmful effect of angiotensin-converting-enzyme inhibitors (ACEi) or angiotensin II receptor type 1 receptor blockers (AT1-receptor blockers, ARBs) during the COVID-19 pandemic. That is because the S spike protein of SARS-CoV viruses utilizes the angiotensin-converting enzyme 2 (ACE2) as a receptor to enter alveolar epithelial cells. Obesity, often associated to type 2 Diabetes, was shown to worsen the prognosis of SARS-CoV-2 infection. Herein we discuss the complex interaction between the renin-angiotensin-aldosterone system (RAAS), its receptors, and the interaction with the Kallikrein-Kinin-system (KKS) and the potential activation of the coagulation cascade. Alteration of the equilibrium between the RAAS system and the KKS cascade may explain the frequent thromboembolic complications of COVID-19 mainly seen in obese and diabetic-obese patients. In contrast, angiotensin (1-7) contributes to maintaining a correct balance between RAAS and KKS system. Our conclusion is that the higher mortality rate in patients with obesity is linked to the alteration of RAS and RAS-KKS interaction consequent to SARS-CoV-2-cell entrance. At present, no data support the necessity of modifying ACEi or ARBs treatment in hypertensive patients.
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Affiliation(s)
- Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy - .,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy -
| | - Loredana Bucciarelli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefano Massarini
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
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Kim HS, Lee J, Cho YK, Park JY, Lee WJ, Kim YJ, Jung CH. Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study. Front Endocrinol (Lausanne) 2021; 12:625083. [PMID: 33716978 PMCID: PMC7947792 DOI: 10.3389/fendo.2021.625083] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/14/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Metabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years. METHODS The Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI ≥25 kg/m2 according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first. RESULTS The MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20-1.39], 1.37 [1.22-1.53], and 1.63 [1.50-1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status. CONCLUSIONS Metabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF.
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Affiliation(s)
- Hwi Seung Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Jiwoo Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Yun Kyung Cho
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Woo Je Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- *Correspondence: Chang Hee Jung, ; Ye-Jee Kim,
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Asan Diabetes Center, Asan Medical Center, Seoul, South Korea
- *Correspondence: Chang Hee Jung, ; Ye-Jee Kim,
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Tsou MT, Yun CH, Lin JL, Sung KT, Tsai JP, Huang WH, Liu CY, Hou CJY, Tsai IH, Su CH, Hung CL, Hung TC. Visceral Adiposity, Pro-Inflammatory Signaling and Vasculopathy in Metabolically Unhealthy Non-Obesity Phenotype. Diagnostics (Basel) 2020; 11:E40. [PMID: 33383705 PMCID: PMC7824214 DOI: 10.3390/diagnostics11010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022] Open
Abstract
The debate regarding the actual cardiovascular burden in metabolically healthy obese or metabolically unhealthy non-obesity individuals is ongoing. Accumulating data have suggested a unique pathophysiological role of pro-inflammatory cytokines in mediating metabolic and cardiovascular disorders by dysregulated visceral adiposity. To compare the burden of visceral adiposity, the inflammatory marker high-sensitivity C-reactive protein (hs-CRP) and the prevalent atherosclerotic burden in metabolically healthy obese (MHO) or metabolically unhealthy (MU) populations, were compared to those of metabolically healthy non-obesity subjects (MHNO). Coronary artery calcification score (CACS) and visceral fat, including pericardial fat (PCF)/thoracic peri-aortic fat (TAT), were quantified in 2846 asymptomatic subjects using a CT dataset. A cross-sectional analysis comparing CACS, inflammatory marker hs-CRP, and visceral fat burden among four obesity phenotypes (MHNO, metabolically unhealthy non-obesity (MUNO), MHO, and metabolically unhealthy obese (MUO)) was performed. Both MUNO and MUO demonstrated significantly higher hs-CRP and greater CACS than MHNO/MHO (adjusted coefficient: 25.46, 95% confidence interval (CI): 5.29-45.63; 43.55, 95% CI: 23.38-63.73 for MUNO and MUO (MHNO as reference); both p < 0.05). Visceral fat (PCF/TAT) was an independent determinant of MU and was similarly higher in the MUNO/MHO groups than in the MHNO group, with the MUO group having the largest amount. PCF/TAT, obesity, and MU remained significantly associated with higher CACS even after adjustment, with larger PCF/TAT modified effects for MU and diabetes in CACS (both pinteraction < 0.05). MU tightly linked to excessive visceral adiposity was a strong and independent risk factor for coronary atherosclerosis even in lean individuals, which could be partially explained by its coalignment with pathological pro-inflammatory signaling.
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Affiliation(s)
- Meng-Ting Tsou
- Department of Family Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Department of Nursing, Mackay Junior College of Medicine, Nursing and Management, New Taipei 25245, Taiwan
| | - Chun-Ho Yun
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Department of Radiology, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Jiun-Lu Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Kuo-Tzu Sung
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Jui-Peng Tsai
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Wen-Hung Huang
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Chia-Yuan Liu
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Charles Jia-Yin Hou
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - I.-Hsien Tsai
- Nutritional Medicine Center, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Cheng-Huang Su
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei 25245, Taiwan
| | - Ta-Chuan Hung
- Department of Nursing, Mackay Junior College of Medicine, Nursing and Management, New Taipei 25245, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei 25245, Taiwan; (C.-H.Y.); (K.-T.S.); (J.-P.T.); (W.-H.H.); (C.-Y.L.); (C.J.-Y.H.); (C.-H.S.)
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
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