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Summer M, Ali S, Fiaz U, Hussain T, Khan RRM, Fiaz H. Revealing the molecular mechanisms in wound healing and the effects of different physiological factors including diabetes, age, and stress. J Mol Histol 2024:10.1007/s10735-024-10223-3. [PMID: 39120834 DOI: 10.1007/s10735-024-10223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/05/2024] [Indexed: 08/10/2024]
Abstract
Wounds are the common fates in various microbial infections and physical damages including accidents, surgery, and burns. In response, a healthy body with a potent immune system heals that particular site within optimal time by following the coagulation, inflammation, proliferation, and remodeling phenomenon. However, certain malfunctions in the body due to various diseases particularly diabetes and other physiological factors like age, stress, etc., prolong the process of wound healing through various mechanisms including the Akt, Polyol, and Hexosamine pathways. The current review thoroughly explains the wound types, normal wound healing mechanisms, and the immune system's role. Moreover, the mechanistic role of diabetes is also elaborated comprehensively.
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Affiliation(s)
- Muhammad Summer
- Medical Toxicology and Biochemistry Laboratory, Department of Zoology, GC University Lahore, Lahore, 54000, Pakistan.
| | - Shaukat Ali
- Medical Toxicology and Biochemistry Laboratory, Department of Zoology, GC University Lahore, Lahore, 54000, Pakistan.
| | - Umaima Fiaz
- Medical Toxicology and Biochemistry Laboratory, Department of Zoology, GC University Lahore, Lahore, 54000, Pakistan
| | - Tauqeer Hussain
- Medical Toxicology and Biochemistry Laboratory, Department of Zoology, GC University Lahore, Lahore, 54000, Pakistan
| | | | - Hashim Fiaz
- Ammer-ud-Din Medical College, Lahore, 54000, Pakistan
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2
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Kasher Meron M, Eizenstein S, Cukierman-Yaffe T, Oieru D. Missed diagnosis-a major barrier to patient access to obesity healthcare in the primary care setting. Int J Obes (Lond) 2024; 48:1003-1010. [PMID: 38649487 PMCID: PMC11216998 DOI: 10.1038/s41366-024-01514-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To investigate whether individuals with an elevated BMI measurement, for whom a diagnosis of overweight or obesity (OW/OB) is not recorded, are less likely to be offered clinical care for obesity compared to those with a recorded diagnosis. SUBJECTS A retrospective cohort study using the electronic medical record database of Maccabi Healthcare Services (MHS) in Israel. Included were 200,000 adults with BMI ≥ 25 kg/m2 measurement recorded during a primary care visit between 2014 and 2020, and no prior diagnosis of OW/OB or related co-morbidities. METHODS The relationships between a recorded diagnosis of OW/OB and two composite outcomes: 1. A composite of referrals to screening tests for metabolic complications; 2. A composite of weight loss intervention and follow up, were analyzed using multivariate logistic regression models. RESULTS In only 18% of individuals, a diagnosis of OW/OB was recorded. After adjusting for multiple potential confounding factors, individuals who received a recorded diagnosis were 18% more likely to be offered an evaluation for obesity-related metabolic complication, (OR 1.18, 95% CI 1.15-1.21, p < 0.001), and almost twice as likely to be offered intervention and follow up for their excess body weight (OR 1.84, 95% CI 1.76-1.94, p < 0.001) compared to individuals with missed diagnosis. These results persisted after adjusting for inter-physician variability. In addition, male sex, older age, and Arab sector were all associated with lower rates of weight loss intervention and follow up, while young individuals were less likely to be screened for metabolic complications. CONCLUSION Beyond BMI measurement, a recorded diagnosis of OW/OB is associated with statistically and clinically significant higher rates of performance of obesity care and intervention. Undiagnosed OW/OB presents a significant clinical opportunity, as recording a diagnosis of OW/OB would predict improved patient access to obesity healthcare and improved clinical outcomes.
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Affiliation(s)
- Michal Kasher Meron
- Meir Medical Center, Clalit Health Services, Kfar Saba, Israel.
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Sapir Eizenstein
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Tali Cukierman-Yaffe
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-HaShomer, Israel
| | - Dan Oieru
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
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McGrath G. Using the Australian Dietary Guidelines 2&5 education message in supermarket shopping trolleys to nudge shoppers to purchase more fruit and vegetables: A feasibility study using an intervention design. NUTR BULL 2024; 49:189-198. [PMID: 38610075 DOI: 10.1111/nbu.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/03/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing chronic diseases; however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of modifying shopper purchasing behaviour to purchase more F&Vs using the Australian Dietary Guidelines 2&5 education message covering one-half of the base of shopping trolleys. Placards giving the message that eating 2 fruits and 5 vegetables every day for good health were placed at the base of shopping trolleys as an educational nudge. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting paper sales receipts to measure the weight (kg), total spending and F&V-specific spending (Australian dollars) for intervention versus control trolleys for one Saturday. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the 2&5 education nudge placards (n = 101) purchased 1.66 kg less weight of F&Vs (Intervention: mean = 3.89 kg, SD = 3.40 kg, 95% CI = 3.21 kg, 4.56 kg, vs. Control: mean 5.55 kg, SD = 4.16 kg, 95% CI = 4.73 kg, 6.37 kg, p = 0.002) and spent less on F&Vs compared to shoppers in the control group (n = 102; Intervention: mean = $26.00, SD = $21.60, 95% CI = $21.78, $30.32 vs. Control: mean $36.00, SD = $27.00, 95% CI = $30.72, $42.36, p = 0.004). Intervention group shoppers also spent less in total spending between groups (Intervention: mean = $115.40, SD = $68.30, 95% CI = $101.95, $128.95 vs. Control: mean $151.30, SD = $79.40, 95% CI = $135.73, $166.93, p = 0.001). The 2&5 education nudge placard had the opposite effect as intended on shoppers' purchases to buy more F&Vs, although there may have been other differences between the intervention and the control groups since they were not randomised. Larger studies are required to elucidate and confirm these findings over the longer term.
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Affiliation(s)
- Greg McGrath
- La Trobe University, Melbourne, Victoria, Australia
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Iacobini C, Vitale M, Haxhi J, Menini S, Pugliese G. Impaired Remodeling of White Adipose Tissue in Obesity and Aging: From Defective Adipogenesis to Adipose Organ Dysfunction. Cells 2024; 13:763. [PMID: 38727299 PMCID: PMC11083890 DOI: 10.3390/cells13090763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The adipose organ adapts and responds to internal and environmental stimuli by remodeling both its cellular and extracellular components. Under conditions of energy surplus, the subcutaneous white adipose tissue (WAT) is capable of expanding through the enlargement of existing adipocytes (hypertrophy), followed by de novo adipogenesis (hyperplasia), which is impaired in hypertrophic obesity. However, an impaired hyperplastic response may result from various defects in adipogenesis, leading to different WAT features and metabolic consequences, as discussed here by reviewing the results of the studies in animal models with either overexpression or knockdown of the main molecular regulators of the two steps of the adipogenesis process. Moreover, impaired WAT remodeling with aging has been associated with various age-related conditions and reduced lifespan expectancy. Here, we delve into the latest advancements in comprehending the molecular and cellular processes underlying age-related changes in WAT function, their involvement in common aging pathologies, and their potential as therapeutic targets to influence both the health of elderly people and longevity. Overall, this review aims to encourage research on the mechanisms of WAT maladaptation common to conditions of both excessive and insufficient fat tissue. The goal is to devise adipocyte-targeted therapies that are effective against both obesity- and age-related disorders.
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Bezerra A, Boppre G, Freitas L, Battista F, Duregon F, Faggian S, Busetto L, Ermolao A, Fonseca H. Body Composition Changes in Adolescents Who Underwent Bariatric Surgery: A Systematic Review and Meta-analysis. Curr Obes Rep 2024; 13:107-120. [PMID: 38172484 PMCID: PMC10933211 DOI: 10.1007/s13679-023-00549-6] [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] [Accepted: 09/05/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review and meta-analysis is to characterize the changes in body composition of children and adolescents who underwent bariatric surgery and identify possible negative effects of performing this procedure during pediatric ages. RECENT FINDINGS Bariatric surgery in children and adolescents is an emerging strategy to promote higher and faster body weight and fat mass losses. However, possible negative effects usually observed in surgical patients' muscle-skeletal system raise a major concern perform this intervention during growth. Despite these possible issues, most experimental studies and reviews analyze bariatric surgery's effectiveness only by assessing anthropometric outcomes such as body weight and BMI, disregarding the short- and long-term impact of bariatric surgery on all body composition outcomes. Bariatric surgery is effective to reduce fat mass in adolescents, as well as body weight, waist circumference, and BMI. Significant reduction in lean mass and fat-free mass is also observed. Bone mass seems not to be impaired. All outcomes reduction were observed only in the first 12 months after surgery. Sensitivity analysis suggests possible sex and type of surgery-related differences, favoring a higher fat mass, body weight, and BMI losses in boys and in patients who underwent RYGB.
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Affiliation(s)
- Andréa Bezerra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Giorjines Boppre
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Human Motricity Research Center, University Adventista, Chillean, Chile
| | - Laura Freitas
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy.
| | - Federica Duregon
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Sara Faggian
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Luca Busetto
- Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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McGrath G. Using a divider nudge in supermarket shopping trolleys to increase fruit and vegetable purchases: A feasibility study using an intervention design. NUTR BULL 2023; 48:513-522. [PMID: 37864781 DOI: 10.1111/nbu.12642] [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: 03/24/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in 16 Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test the feasibility of covertly modifying shopper purchasing behaviour to purchase more F&Vs using a visual divider nudge message (prompts) covering the entire base of shopping trolleys. Placards provided a visual representation of the recommended proportion of the trolley base that should be allocated to fruits and vegetables (implied social norm). Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the weight (kg), total spending and F&V specific spending (Australian dollars) for intervention versus control trolleys for one weekend day only. We also conducted a short intercept survey that was administered independently from the research study day on non-trial shoppers. Shoppers who selected trolleys with the divider nudge placards (n = 102) purchased equal weight of F&Vs (Intervention: mean = 6.25 kg, SD = 5.60 kg, 95% CI = 5.14 kg, 7.35 kg, vs. Control: mean 6.03 kg, SD = 5.17 kg, 95% CI = 5.01 kg, 7.04 kg, p = 0.768) and spent equal amounts on F&Vs compared to shoppers in the control group (n = 102) (Intervention: mean = $41.46, SD = $36.68, 95% CI = $34.25, $48.66, vs. Control: mean $39.85, SD = $33.30, 95% CI = $33.34, $46.39, p = 0.744). There was no difference in the total spending between groups (Intervention: mean = $135.99, SD = $90.10, 95% CI = $118.29, $153.68, vs. Control: mean $155.68, SD = $96.46, 95% CI = $136.73, $174.63, p = 0.133). The divider nudge placard did not lead to any difference in shoppers' purchases of F&Vs. However, this study demonstrates the feasibility of testing a cheap, simple and easy supermarket nutrition intervention. Larger studies are required to elucidate and confirm these findings over the longer term.
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Affiliation(s)
- Greg McGrath
- La Trobe University, Melbourne, Victoria, Australia
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Almontashri AM, Almontashri RM, Almatrafi K, Almontashri KM, Aljehani RK, Alshehri MS, Aloqla FM, Alhindi YZ. Awareness About the Benefits of Post-bariatric Surgery in Diabetic Patients in Makkah Almukarramah, Saudi Arabia. Cureus 2023; 15:e48273. [PMID: 38054130 PMCID: PMC10694479 DOI: 10.7759/cureus.48273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 12/07/2023] Open
Abstract
AIM To measure awareness about the benefits of post-bariatric surgery, which is a shortening of the gut in order to lose weight in diabetic patients in the Makkah region, Saudi Arabia. METHODS A cross-sectional survey was conducted among diabetic patients aged 18-65 from February to July 2023. An online questionnaire via Google Forms was distributed and used to assess the participants' awareness of the benefits of post-bariatric surgery for diabetic patients. RESULTS Overall, 388 participants (56.40% female, 43.60% male) were surveyed. Most participants (91.5%) showed awareness of gastric sleeve surgery, while a significant proportion (85.8%) recognized obesity as a disease. A majority of participants (80.90%) showed awareness of the association between obesity, diabetes, and high blood pressure. However, only 46.10% of participants showed awareness of eligibility criteria associated with bariatric surgery. The majority recognized the effectiveness of bariatric surgery for weight loss but did not consider it the first choice, emphasizing a preference for non-surgical weight loss strategies. CONCLUSION Participants demonstrated good knowledge about obesity and its implications for health. They also demonstrated good knowledge about bariatric surgery as an effective weight reduction method but expressed a preference for non-surgical methods, which reflects their awareness of the complications of bariatric surgery. However, the results showed a lack of awareness of postoperative indications and lifestyle changes, thus highlighting the need for comprehensive patient education and counseling.
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Affiliation(s)
| | | | | | | | | | | | | | - Yosra Z Alhindi
- Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
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de Lemos Muller CH, Moritz CEJ, Schroeder HT, Battastini AMO, Reischak-Oliveira A, de Bittencourt Júnior PIH, De Vito G, Krause M. Influence of body composition and cardiorespiratory fitness on plasma HSP72, norepinephrine, insulin, and glucose responses to an acute aerobic exercise bout performed in the fed state. Cell Stress Chaperones 2023; 28:721-729. [PMID: 37462825 PMCID: PMC10746641 DOI: 10.1007/s12192-023-01364-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 06/19/2023] [Indexed: 12/23/2023] Open
Abstract
Being overweight is already considered a metabolic risk factor, which can be overcome by increasing cardiorespiratory fitness (CRF). Acute exercise is known to induce changes in plasma hormones and heat shock proteins release. However, there is a lack of studies investigating the impact of body composition and CRF on these variables following acute aerobic exercise. To assess the influence of body composition and cardiorespiratory fitness on plasma heat shock protein 72 kDa (HSP72), norepinephrine (NE), insulin, and glucose responses to an acute aerobic exercise bout in the fed state. Twenty-four healthy male adults were recruited and allocated into three groups: overweight sedentary (n = 8), normal weight sedentary (n = 8), and normal weight active (n = 8). The volunteers performed an acute moderate exercise session on a treadmill at 70% of VO2 peak. Blood samples were drawn at baseline, immediately post-exercise, and at 1-h post-exercise. The exercise session did not induce changes in HSP72 nor NE but changes in glucose and insulin were affected by body mass index. Also, subjects with elevated CRF maintain reduced NE through exercise. At baseline, the overweight sedentary group showed elevated NE, insulin, and glucose; these last two impacting the HOMA-IR index. Thirty minutes of aerobic exercise at 70% VO2 peak, in the fed state, did not change the levels of plasma NE and HSP72. Elevated body composition seems to impact metabolic profile and increase sympathetic activity. Conversely, subjects with increased cardiorespiratory fitness seem to have attenuated sympathetic activity.
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Affiliation(s)
- Carlos Henrique de Lemos Muller
- Laboratório de Pesquisa em Inflamação, Metabolismo e Exercício (LAPIMEX) E Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Cesar Eduardo Jacintho Moritz
- Programa de Pós-Graduação Em Ciências Do Movimento Humano, Escola de Educação Física, Fisioterapia E Dança (ESEFID), Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Helena Trevisan Schroeder
- Laboratório de Pesquisa em Inflamação, Metabolismo e Exercício (LAPIMEX) E Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Ana Maria Oliveira Battastini
- Programa de Pós-Graduação Em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Alvaro Reischak-Oliveira
- Programa de Pós-Graduação Em Ciências Do Movimento Humano, Escola de Educação Física, Fisioterapia E Dança (ESEFID), Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90690-200, Brazil
| | - Paulo Ivo Homem de Bittencourt Júnior
- Laboratório de Pesquisa em Inflamação, Metabolismo e Exercício (LAPIMEX) E Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Giuseppe De Vito
- Neuromuscular Physiology Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Maurício Krause
- Laboratório de Pesquisa em Inflamação, Metabolismo e Exercício (LAPIMEX) E Laboratório de Fisiologia Celular, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil.
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies. J Glob Health 2023; 13:04088. [PMID: 37651631 PMCID: PMC10471153 DOI: 10.7189/jogh.13.04088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Diabetes is more prevalent among overweight/obese individuals, but has become a significant public health challenge among normal weight populations. In this meta-analysis, we aimed to estimate diabetes/prediabetes incidence and its temporal trends by weight status. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched until 8 December 2021. Prospective cohort studies reporting diabetes incidence by baseline body mass index (BMI) categories in adults were included. The median year of data collection was used to assess the temporal trends. Subgroup analyses and meta-regression were also performed. Results We included 94 studies involving 3.4 million adults from 22 countries. The pooled diabetes incidence in underweight, normal-weight, and overweight/obese adults was 4.5 (95% confidence interval (CI) = 2.8-7.3), 2.7 (95% CI = 2.2-3.3), and 10.5 (95% CI = 9.3-11.8) per 1000 person-years, respectively. The diabetes incidence in low- and middle-income countries (LMICs) was higher than in high-income countries among normal-weight (5.8 vs 2.0 per 1000 person-years) or overweight/obese (15.9 vs 8.9 per 1000 person-years) adults. European and American regions had a higher diabetes incidence than the non-Western areas, regardless of weight status. Underweight diabetes incidence decreased significantly from 1995-2000 to 2005-2010. Diabetes incidence in normal-weight populations has increased continuously since 1985 by an estimated 36% every five years. In overweight/obese adults, diabetes incidence increased between 1985-1990 and 1995-2000, stabilised between 2000 and 2010, and spiked suddenly after 2010. Conclusions Diabetes incidence and its temporal trends differed by weight status. The continuous upward trend of diabetes incidence among overweight/obese individuals requires urgent attention, particularly in LMICs. Furthermore, diabetes among normal-weight individuals is becoming a significant public health problem. Registration PROSPERO (CRD42020215957).
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Affiliation(s)
- Hong-jie Yu
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Xiangxiang Liu
- National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Jundi Yang
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
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Kim KK, Haam JH, Kim BT, Kim EM, Park JH, Rhee SY, Jeon E, Kang E, Nam GE, Koo HY, Lim JH, Jeong JE, Kim JH, Kim JW, Park JH, Hong JH, Lee SE, Min SH, Kim SJ, Kim S, Kim YH, Lee YJ, Cho YJ, Rhie YJ, Kim YH, Kang JH, Lee CB. Evaluation and Treatment of Obesity and Its Comorbidities: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2023; 32:1-24. [PMID: 36945077 PMCID: PMC10088549 DOI: 10.7570/jomes23016] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/28/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.
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Affiliation(s)
- Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Ji-Hee Haam
- Deptartment of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bom Taeck Kim
- Department of Family Practice & Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Eonju Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Eungu Kang
- Department of Pediatrics, Korea University Ansan Hospital, Ansan, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hye Yeon Koo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Hyun Lim
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea
| | - Jo-Eun Jeong
- Department of Psychiatry, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Jong-Hee Kim
- Department of Physical Education, Hanyang University, Seoul, Korea
| | - Jong Won Kim
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jung Ha Park
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jun Hwa Hong
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Sang Eok Lee
- Department of Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Se Hee Min
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Jun Kim
- Department of Psychiatry, Konyang University College of Medicine, Daejeon, Korea
| | - Sunyoung Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
- Depertment of Family Medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yeon Ji Lee
- Department of Family Medicine, Inha University College of Medicine, Incheon, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Youn-hee Kim
- Mindscan Clinic, Heart Scan Health Care, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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11
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McGrath GM. Using social norm nudges in supermarket shopping trolleys to increase fruit and vegetable purchases. NUTR BULL 2023; 48:115-123. [PMID: 36842136 DOI: 10.1111/nbu.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/02/2023] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
Fruit and vegetable (F&V) consumption is associated with a reduced risk of developing obesity and chronic diseases: however, only one in twenty Australian adults consume F&Vs at the recommended two servings of fruit and five servings of vegetables per day. What and how much people eat is influenced by their social and physical environments. Supermarkets are a key setting influencing food purchases, and as such, they can shape consumption patterns of F&Vs. Implementing effective strategies to increase F&V intake is crucial. The objective of this research was to test if shopper purchasing behaviour can be modified to purchase more F&Vs using social norm nudge messages (prompts) placed in shopping trolleys. Placards giving the message that the majority of shoppers purchased F&Vs at each shop were placed in shopping trolleys. Applying an intervention research design, 30 out of ~100 trolleys were fitted with the placards and shopper purchases were measured by collecting receipts to measure the quantity (kg), total and F&V spending (Australian dollars) for intervention versus control trolleys. We also conducted a short intercept survey that was administered independently from the research study day. Shoppers who selected trolleys with the social norm nudge placards (n = 109) purchased 1.25 kg more F&Vs (Intervention: mean = 5.45 kg, SD = 4.23 kg, 95% CI 4.65 kg, 6.26 kg vs. Control: mean 4.19 kg, SD = 3.75 kg, 95% CI 3.48 kg, 4.90 kg, p = 0.020, Cohen's d = 0.32) and spent an extra $9.10 more on F&Vs compared to shoppers in the control group (n = 109; Intervention: mean = $36.20, SD = $26.30, 95% CI = $31.24, $41.26 vs. Control: mean $27.10, SD = $24.00, 95% CI = $22.50, $31.67, p = 0.008, Cohen's d = 0.36). The social norm nudge placard shows promise in modifying shoppers' purchases to buy more F&Vs. Larger studies are required to elucidate and confirm these findings over the longer term.
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Zara S, Brähler E, Sachser C, Fegert JM, Häuser W, Krakau L, Kampling H, Kruse J. Associations of different types of child maltreatment and diabetes in adulthood - the mediating effect of personality functioning: Findings from a population-based representative German sample. Ann Epidemiol 2023; 78:47-53. [PMID: 36586456 DOI: 10.1016/j.annepidem.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE This study aimed to examine the role of personality functioning in the association between various types of child maltreatment (CM) (sexual, physical, and emotional abuse as well as physical and emotional neglect) and diabetes in adulthood. METHODS Analyses are based on representative data of the German population (N = 5,041) from 2016 to 2019. Self-report questionnaires assessed diagnosis of diabetes, child maltreatment (CTQ), personality functioning (OPD-SQS), and symptoms of depression/anxiety (PHQ-4). Odd ratios were calculated to examine the association between CM and diabetes, and mediation analyses including PHQ-4 as covariate were conducted to examine the role of personality functioning. RESULTS All CM types significantly elevated the odds of having diabetes in adulthood. Personality functioning mediated the association between abuse and diabetes (sexual: b = 0.012, 95% CI [.002, 0.022], PM = 25.0%, physical: b = 0.009, 95% CI [.001, 0.017], PM = 12.0%, and emotional: b = 0.013, 95% CI [.002, 0.024], PM = 59.8%), but not between neglect and diabetes. CONCLUSIONS CM is associated with an increased risk of diabetes, with personality functioning being a relevant mediator for CM abuse types. Hence, by focusing on CM prevention and considering impaired personality functioning in diabetes treatment, diabetes self-management and health behavior could be improved.
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Affiliation(s)
- Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany.
| | - Elmar Brähler
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Winfried Häuser
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany; Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany
| | - Lina Krakau
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Marburg, Germany
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13
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Yang C, Liu X, Dang Y, Li J, Jing J, Tian D, Qiu J, Zhang J, Yan N, Liu X, Zhao Y, Zhang Y. Obesity Metabolic Phenotype, Changes in Time and Risk of Diabetes Mellitus in an Observational Prospective Study on General Population. Int J Public Health 2022; 67:1604986. [PMID: 36250153 PMCID: PMC9556707 DOI: 10.3389/ijph.2022.1604986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the distribution and changes in different obesity metabolic phenotypes, as well as their impact on the incidence of type 2 diabetes mellitus (T2DM) in a northwest Chinese population sample. Methods: Data comes from prospective cohort study (n = 1,393, mean follow up = 9.46 years). Participants were classified into four groups through a combination of the Chinese Diabetes Society (CDS) diagnostic criteria for metabolic syndrome with anthropometric measurements: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). Cox regression models with time-dependent covariates were used to evaluate changes in obesity metabolic phenotypes and risk of T2DM. Results: Participants in MUO state had the highest risk of developing T2DM, the incidence density was 12.10/1,000 person-year. The MHO and MUO groups showed an increased risk of incident diabetes based on body mass index (BMI) (HR, 1.29; 95% CI, 1.03–1.61; p = 0.026 and HR, 1.20; 95% CI, 1.02–1.40; p = 0.024 respectively.) Besides, the MHO group had an increased risk of incident diabetes based on waist circumference (WC) (HR, 1.41; 95% CI, 1.10–1.80; p = 0.006). Conclusion: Diabetes is more frequent in the MHO and MUO groups and co-occurrence of obesity and metabolic abnormalities (MA) contributes to the development of T2DM.
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Affiliation(s)
- Chan Yang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- Department of Community Nursing, School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Xiaowei Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Yuanyuan Dang
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Juan Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jingyun Jing
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Di Tian
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jiangwei Qiu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Jiaxing Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Ni Yan
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Xiuying Liu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Yi Zhao
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
- *Correspondence: Yi Zhao, ; Yuhong Zhang,
| | - Yuhong Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
- *Correspondence: Yi Zhao, ; Yuhong Zhang,
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14
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Suzuki Y, Kaneko H, Okada A, Matsuoka S, Itoh H, Fujiu K, Michihata N, Jo T, Takeda N, Morita H, Yamaguchi S, Node K, Yamauchi T, Yasunaga H, Komuro I. Prediabetes in Young Adults and Its Association With Cardiovascular Health Metrics in the Progression to Diabetes. J Clin Endocrinol Metab 2022; 107:1843-1853. [PMID: 35446413 DOI: 10.1210/clinem/dgac247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The natural history of young adults with prediabetes and its association with cardiovascular health (CVH) metrics in progression to diabetes remain unknown. OBJECTIVE We examined the association between CVH metrics and the annual incidence of diabetes in young adults with prediabetes. METHODS This observational cohort study used the JMDC Claims Database. We analyzed 18 908 participants aged 18 to 44 years, with available fasting plasma glucose (FPG) data for 5 consecutive years, and who had prediabetes (FPG 100-125 mg/dL) at the initial health checkup. The ideal CVH metrics were as follows: nonsmoking, body mass index (BMI) less than 25 kg/m2, physical activity at goal, optimal dietary habits, blood pressure less than 120/80 mm Hg, and total cholesterol less than 200 mg/dL. We analyzed the association between CVH metrics and the annual incidence of diabetes. We also examined the relationship between 1-year changes in CVH metrics and the subsequent risk of diabetes. RESULTS The incidence of diabetes was 3.3% at 1 year and 9.5% at 5 years after the initial health checkup. An increasing number of nonideal CVH metrics have been associated with an increased risk of diabetes. Nonideal BMI, smoking, blood pressure, and total cholesterol level were associated with an increased risk of diabetes. This association was observed both in men and women. A one-point increase in the number of nonideal CVH metric components was associated over 1 year with an increased risk of diabetes. CONCLUSION CVH metrics can stratify the risk of diabetes in young adults with prediabetes. Improving CVH metrics may reduce the risk of developing diabetes.
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Affiliation(s)
- Yuta Suzuki
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- Department of Rehabilitation Science, Graduate School of Medical Sciences, Kitasato University, Kanagawa 252-0373, Japan
| | - Hidehiro Kaneko
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- The Department of Advanced Cardiology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Satoshi Matsuoka
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- Department of Cardiology, New Tokyo Hospital, Matsudo 270-2232, Japan
| | - Hidetaka Itoh
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Katsuhito Fujiu
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- The Department of Advanced Cardiology, The University of Tokyo, Tokyo 113-8655, Japan
| | - Nobuaki Michihata
- The Department of Health Services Research, The University of Tokyo, Tokyo 113-8655, Japan
| | - Taisuke Jo
- The Department of Health Services Research, The University of Tokyo, Tokyo 113-8655, Japan
| | - Norifumi Takeda
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroyuki Morita
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Satoko Yamaguchi
- Department of Prevention of Diabetes and Lifestyle-related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga 849-8501, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan
| | - Issei Komuro
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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15
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Association of weight status and the risks of diabetes in adults: a systematic review and meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46:1101-1113. [PMID: 35197569 DOI: 10.1038/s41366-022-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China.
| | | | - Jundi Yang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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16
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Park BG, Kim GM, Lee HJ, Ryu JH, Kim DH, Seong JY, Kim S, Park ZY, Kim YJ, Lee J, Kim JI. Antiobesity therapeutics with complementary dual-agonist activities at glucagon and glucagon-like peptide 1 receptors. Diabetes Obes Metab 2022; 24:50-60. [PMID: 34491605 DOI: 10.1111/dom.14546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/17/2021] [Accepted: 09/01/2021] [Indexed: 12/21/2022]
Abstract
AIM To develop more effective and long-lasting antiobesity and antidiabetic therapeutics by employing novel chemical modifications of glucagon-like peptide-1 receptor (GLP-1R) agonists. METHODS We constructed novel unimolecular dual agonists of GLP-1R and glucagon receptor prepared by linking sEx-4 and native glucagon (GCG) via lysine or triazole [sEx4-GCG(K) and sEx4-GCG(T), respectively] and evaluated their antiobesity and antidiabetic efficacy in the diabetic and obese mouse model. RESULTS Both sEx4-GCG(K) and sEx4-GCG(T) showed the beneficial metabolic effects of GLP-1 and glucagon: they promoted weight loss and ameliorated insulin resistance and hepatic steatosis. They also increased thermogenesis in brown adipose tissue, and lipolysis and β-oxidation in white adipose tissue, with concomitant suppression of lipogenesis. Furthermore, both dual agonists activated the 5'-AMP-activated protein kinase signalling pathway and prevented palmitate-induced oxidative stress in skeletal muscle cells. CONCLUSION Through their complementary dual agonism, sEx4-GCG(T) and sEx4-GCG(K) induce more marked weight loss and metabolic improvements than conventional agonists, and could be developed as novel therapeutic agents for the treatment of obesity and associated metabolic disorders in humans.
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Affiliation(s)
- Bong Gyu Park
- Department of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Gyeong Min Kim
- Department of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Hye-Jin Lee
- Department of Pharmacology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Ha Ryu
- Pilot Plant, Anygen, Gwangju, Republic of Korea
| | - Dong-Hoon Kim
- Department of Pharmacology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae-Young Seong
- Graduate School of Medicine, Korea University, Seoul, Republic of Korea
| | - Soojeong Kim
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | - Zee-Yong Park
- Department of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Young-Joon Kim
- Department of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Jaemin Lee
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | - Jae Il Kim
- Department of Life Sciences, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
- Pilot Plant, Anygen, Gwangju, Republic of Korea
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17
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Bhattacharya S, Kalra S, Kapoor N, Singla R, Dutta D, Aggarwal S, Khandelwal D, Surana V, Dhingra A, Kantroo V, Chittawar S, Deka N, Bindal V, Dutta P. Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery. World J Diabetes 2021; 12:1587-1621. [PMID: 34754367 PMCID: PMC8554368 DOI: 10.4239/wjd.v12.i10.1587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/18/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) and obesity are interrelated in a complex manner, and their coexistence predisposes patients to a plethora of medical problems. Metabolic surgery has evolved as a promising therapeutic option for both conditions. It is recommended that patients, particularly those of Asian origin, maintain a lower body mass index threshold in the presence of uncontrolled DM. However, several comorbidities often accompany these chronic diseases and need to be addressed for successful surgical outcome. Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used bariatric procedures worldwide. The bariatric benefits of RYGB and LSG are similar, but emerging evidence indicates that RYGB is more effective than LSG in improving glycemic control and induces higher rates of long-term DM remission. Several scoring systems have been formulated that are utilized to predict the chances of remission. A glycemic target of glycated hemoglobin < 7% is a reasonable goal before surgery. Cardiovascular, pulmonary, gastrointestinal, hepatic, renal, endocrine, nutritional, and psychological optimization of surgical candidates improves perioperative and long-term outcomes. Various guidelines for preoperative care of individuals with obesity have been formulated, but very few specifically focus on the concerns arising from the presence of concomitant DM. It is hoped that this statement will lead to the standardization of presurgical management of individuals with DM undergoing metabolic surgery.
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Affiliation(s)
| | - Sanjay Kalra
- Endocrinology, Bharti Hospital, Karnal 132001, Haryana, India
| | - Nitin Kapoor
- Endocrinology, Christian Medical College, Vellore 632004, Tamil Nadu, India
| | - Rajiv Singla
- Endocrinology, Kalpavriksh Super Speciality Center, New Delhi 110075, India
| | - Deep Dutta
- Endocrinology, CEDAR Superspecialty Clinic, New Delhi 110075, India
| | - Sameer Aggarwal
- Endocrinology, Apex Plus Superspeciality Hospital, Rohtak 124001, Haryana, India
| | | | - Vineet Surana
- Endocrinology, Manipal Hospitals, New Delhi 110075, India
| | - Atul Dhingra
- Endocrinology, Gangaram Bansal Super Speciality Hospital, Sri Ganganagar 335001, Rajasthan, India
| | - Viny Kantroo
- Respiratory Medicine & Critical Care, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
| | - Sachin Chittawar
- Endocrinology, Gandhi Medical College, Bhopal 462001, Madhya Pardesh, India
| | - Nilakshi Deka
- Endocrinology, Apollo Hospitals, Guwahati 781005, Assam, India
| | - Vivek Bindal
- Minimal Access, Metabolic and Bariatric surgery, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
| | - Puja Dutta
- Nutrition, Max Superspeciality Hospital, Patparganj, New Delhi 110092, India
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18
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Zhou Z, Macpherson J, Gray SR, Gill JMR, Welsh P, Celis-Morales C, Sattar N, Pell JP, Ho FK. Are people with metabolically healthy obesity really healthy? A prospective cohort study of 381,363 UK Biobank participants. Diabetologia 2021; 64:1963-1972. [PMID: 34109441 PMCID: PMC8382657 DOI: 10.1007/s00125-021-05484-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS People with obesity and a normal metabolic profile are sometimes referred to as having 'metabolically healthy obesity' (MHO). However, whether this group of individuals are actually 'healthy' is uncertain. This study aims to examine the associations of MHO with a wide range of obesity-related outcomes. METHODS This is a population-based prospective cohort study of 381,363 UK Biobank participants with a median follow-up of 11.2 years. MHO was defined as having a BMI ≥ 30 kg/m2 and at least four of the six metabolically healthy criteria. Outcomes included incident diabetes and incident and fatal atherosclerotic CVD (ASCVD), heart failure (HF) and respiratory diseases. RESULTS Compared with people who were not obese at baseline, those with MHO had higher incident HF (HR 1.60; 95% CI 1.45, 1.75) and respiratory disease (HR 1.20; 95% CI 1.16, 1.25) rates, but not higher ASCVD. The associations of MHO were generally weaker for fatal outcomes and only significant for all-cause (HR 1.12; 95% CI 1.04, 1.21) and HF mortality rates (HR 1.44; 95% CI 1.09, 1.89). However, when compared with people who were metabolically healthy without obesity, participants with MHO had higher rates of incident diabetes (HR 4.32; 95% CI 3.83, 4.89), ASCVD (HR 1.18; 95% CI 1.10, 1.27), HF (HR 1.76; 95% CI 1.61, 1.92), respiratory diseases (HR 1.28; 95% CI 1.24, 1.33) and all-cause mortality (HR 1.22; 95% CI 1.14, 1.31). The results with a 5 year landmark analysis were similar. CONCLUSIONS/INTERPRETATION Weight management should be recommended to all people with obesity, irrespective of their metabolic status, to lower risk of diabetes, ASCVD, HF and respiratory diseases. The term 'MHO' should be avoided as it is misleading and different strategies for risk stratification should be explored.
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Affiliation(s)
- Ziyi Zhou
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Macpherson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Human Performance Laboratory, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
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19
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Horesh A, Tsur AM, Bardugo A, Twig G. Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood-a Systematic Review. Curr Obes Rep 2021; 10:301-310. [PMID: 33950400 DOI: 10.1007/s13679-021-00439-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Rates of childhood obesity have been soaring in recent decades. The association between obesity in adulthood and excess morbidity and mortality has been readily established, whereas the association of childhood and adolescent obesity has not. The purpose of this review is to summarize existing data regarding the association of the presence of obesity in childhood/adolescence and early-onset adverse outcomes in adulthood, with specific focus on young adults under the age of 45 years. RECENT FINDINGS Diabetes, cancer, and cardiometabolic outcomes in midlife are closely linked to childhood and adolescent obesity. Childhood and adolescent obesity confer major risks of excess and premature morbidity and mortality, which may be evident before age 30 years in both sexes. The scientific literature is mixed regarding the independent risk of illness, which may be attributed to childhood BMI regardless of adult BMI, and additional data is required to establish causality between the two. Nonetheless, the increasing prevalence of childhood and adolescent obesity may impose an increase of disease burden in midlife, emphasizing the need for effective interventions to be implemented at a young age.
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Affiliation(s)
- Adi Horesh
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Avishai M Tsur
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aya Bardugo
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Gilad Twig
- The Israel Defense Forces Medical Corps, Ramat Gan, Israel.
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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20
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Who is getting screened for diabetes according to body mass index and waist circumference categories in Peru? a pooled analysis of national surveys between 2015 and 2019. PLoS One 2021; 16:e0256809. [PMID: 34449806 PMCID: PMC8396776 DOI: 10.1371/journal.pone.0256809] [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: 04/27/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND At the population level we would expect that people with obesity undergo diabetes screening tests more often than people with overweight and much more often than people with normal weight. We described the trends of diabetes screening according to body mass index (BMI) and waist circumference (WC) in Peru. METHODS Pooled analysis of health national surveys (2015-2019); men and women aged 35-70 years. We used relative frequencies to study: among those who have had a glucose test in the last year, how many there were in each BMI and WC category. We fitted a Poisson model to study whether people with high BMI or WC were more likely to have had a glucose test. RESULTS People with overweight (PR = 1.34; 95% CI: 1.29-1.38), obesity (PR = 1.57; 95% CI: 1.51-1.63) and central obesity (PR = 1.63; 95% CI: 1.35-1.96) were more likely to have had a glucose test. At the sub-national level, there was one (of twenty-five) region in which men with obesity were more often screened for diabetes than men with overweight and much more than men with normal weight. There were seven regions in which women with obesity were the most often screened for diabetes. CONCLUSIONS Consistent with a risk-based prevention approach, people with obesity would be screened for diabetes more often than those with overweight and those with normal weight. This ideal profile was only observed in few regions. Diabetes screening strategies should be strengthened and homogenised, so that they reach those at high risk of diabetes.
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21
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Natarajan H, Shanthi Rani CS, Krishna Kumar D, Anjana RM, Ranjit U, Venkatesan U, Uma Sankari G, Pradeepa R, Mohan V, Deepa M. Future risk of diabetes among Indians with metabolic and phenotypic obesity: Results from the 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES-158). Acta Diabetol 2021; 58:1051-1058. [PMID: 33759049 DOI: 10.1007/s00592-021-01698-7] [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: 10/15/2020] [Accepted: 02/27/2021] [Indexed: 12/19/2022]
Abstract
AIM To investigate the risk of type 2 diabetes (T2DM) among the combinations of BMI categories and metabolic syndrome in Asian Indians. MATERIALS AND METHODS Individuals from the Chennai Urban Rural Epidemiology Study cohort (n = 1,368), free of diabetes at baseline were stratified by BMI and metabolic health as metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically obese non-obese (MONO) and metabolically obese obese (MOO). Phenotypic obesity was defined as BMI ≥ 25 kg/m2 and metabolic obesity as presence of any two of the metabolic abnormalities: hyperglycemia, high blood pressure, high triglyceridemia or low HDL cholesterol. Hazard ratios for progression to diabetes were estimated using Cox proportional hazard regression. RESULTS During median 9.1 years of follow-up, incident cases of diabetes were highest among MOO-45.1%, followed by MONO-41.3%, MHO-27.1% and MHNO-15.9%. Incidence rates of diabetes among MOO, MONO, MHO and MHNO were 57.8, 50.9, 30.4 and 18.1 per 1000 person years, respectively. Hazard ratio for diabetes development were 1.71 in MHO, 2.87 in MONO, and 3.39 in MOO compared with MHNO. CONCLUSIONS Increased BMI and metabolic risk factor clustering independently contribute to the increased risk of T2DM in obese individuals. Screening for metabolic abnormalities should be performed routinely in clinic to identify high-risk individuals and institute appropriate preventive measures.
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Affiliation(s)
- Hariharasudan Natarajan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Coimbatore Subramanian Shanthi Rani
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Dharman Krishna Kumar
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Unnikrishnan Ranjit
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Ganesan Uma Sankari
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Rajendra Pradeepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India.
| | - Mohan Deepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Center for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
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22
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Smith KJ, Magnussen CG, Pahkala K, Koskinen J, Sabin MA, Hutri-Kähönen N, Kähönen M, Laitinen T, Tammelin T, Tossavainen P, Jokinen E, Viikari JSA, Juonala M, Raitakari OT. Youth to adult body mass index trajectories as a predictor of metabolically healthy obesity in adulthood. Eur J Public Health 2021; 30:195-199. [PMID: 31169878 DOI: 10.1093/eurpub/ckz109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adiposity in childhood and adolescence (youth) has been shown to associate with adult metabolic health. What is not known, is whether youth body mass index (BMI) associates with metabolically healthy obesity (MHO) in adulthood, and if so, the age when the BMI to MHO association emerges. This study aimed to determine if BMI trajectories from youth to adulthood differed between adults with MHO and metabolically unhealthy obesity (MUHO). METHODS The Cardiovascular Risk in Young Finns Study had measured weight and height up to eight times in individuals from youth (3-18 years in 1980) to adulthood (24-49 years). Adult MHO was defined as BMI ≥ 30 kg m-2, normal fasting glucose (<5.6 mmol l-1), triglycerides (<1.695 mmol l-1), high density lipoprotein cholesterol (≥1.295 mmol l-1 females, ≥1.036 mmol l-1 males), blood pressure (<130/85 mmHg) and no medications for these conditions. BMI trajectories were compared for adults with MHO and MUHO using multilevel mixed models adjusted for age, sex and follow-up time. RESULTS Mean (SD) follow-up time was 29 (3) years. Five hundred and twenty-four participants were obese in adulthood, 66 (12.6%) had MHO. BMI was similar through childhood, adolescence and young adulthood. BMI trajectories diverged at age 33, when individuals with MHO had at least 1.0 kg m-2 lower BMI than those with MUHO, significantly lower at 36 (-2.1 kg m-2, P = 0.001) and 42 years (-1.7 kg m-2; P = 0.005). CONCLUSION Adult MHO was characterized by lower adult BMI, not youth BMI. Preventing additional weight gain among adults who are obese may be beneficial for metabolic health.
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Affiliation(s)
- Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Matthew A Sabin
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere, Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine, Tampere University Hospital, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | | | - Eero Jokinen
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - Jorma S A Viikari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - 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
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23
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Gao H, Ding L, Liu R, Zheng X, Xia X, Wang F, Qi J, Tong W, Qiu Y. Characterization of Anoectochilus roxburghii polysaccharide and its therapeutic effect on type 2 diabetic mice. Int J Biol Macromol 2021; 179:259-269. [PMID: 33675836 DOI: 10.1016/j.ijbiomac.2021.02.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 02/05/2023]
Abstract
Anoectochilus roxburghii is a traditional herb in China that can be potentially used to treat diabetes. A novel polysaccharide ARLP-W was isolated from Anoectochilus roxburghii by chromatography on DEAE-52 cellulose. Chemical analysis indicated that ARLP-W (8.1 × 104 Da) was mainly composed of mannose and glucose. The main linkages of glycosidic bonds of ARLP-W were β-1, 4-Manp and α-1, 4-Glcp. The terminal Glcp was connected to Manp-via O-3. RT-qPCR and western blotting analysis showed that ARLP-W caused a significant reduction in the levels of the key gluconeogenesis enzymes phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase) in the liver. The results of the insulin resistance tests indicated that ARLP-W increased glucose absorption. These results indicate that ARLP-W has a good therapeutic effect on type 2 diabetes and can assist with further development and application treatment of diabetes.
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Affiliation(s)
- Huashan Gao
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China
| | - Linlin Ding
- College of Life Science, Xinyang Normal University, Xinyang, Henan 464000, China
| | - Rui Liu
- College of chemistry, Zhengzhou University, Zhengzhou, Henan 450001, China
| | - Xinhua Zheng
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China
| | - Xichao Xia
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China
| | - Fuan Wang
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China
| | - Jinxu Qi
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China
| | - Weishuang Tong
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China.
| | - Yuanhao Qiu
- College of Medicine, Henan Engineering Research Center of Funiu Mountain's Medicinal Resources Utilization and Molecular Medicine, Pingdingshan University, Pingdingshan, Henan 467000, China.
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24
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Bardugo A, Fishman B, Libruder C, Tanne D, Ram A, Hershkovitz Y, Zucker I, Furer A, Gilon R, Chodick G, Tiosano S, Derazne E, Tzur D, Afek A, Pinhas-Hamiel O, Bendor CD, Yaniv G, Rotem RS, Twig G. Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke 2021; 52:2043-2052. [PMID: 33980044 DOI: 10.1161/strokeaha.120.033595] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Aya Bardugo
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.)
| | - Boris Fishman
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.).,Hypertension Unit, Internal Medicine D (B.F.), Sheba Medical Center, Ramat Gan, Israel.,The Dr. Pinchas Bornstein Talpiot Medical Leadership Program (B.F., G.Y., G.T.), Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Carmit Libruder
- Israel Center for Disease Control, Ministry of Health, Ramat Gan (C.L., A.R., Y.H., I.Z.)
| | - David Tanne
- Rambam Health Care Campus and Rappaport Faculty of Medicine, Haifa, Israel (D. Tanne)
| | - Amit Ram
- Israel Center for Disease Control, Ministry of Health, Ramat Gan (C.L., A.R., Y.H., I.Z.)
| | - Yael Hershkovitz
- Israel Center for Disease Control, Ministry of Health, Ramat Gan (C.L., A.R., Y.H., I.Z.)
| | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.).,Israel Center for Disease Control, Ministry of Health, Ramat Gan (C.L., A.R., Y.H., I.Z.)
| | - Ariel Furer
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.)
| | - Roy Gilon
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.)
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.).,Maccabitech (G.C.), Maccabi Healthcare Services, Tel Aviv, Israel
| | - Shmuel Tiosano
- Division of Cardiology, Leviev Heart and Vascular Center (S.T.), Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Estela Derazne
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Dorit Tzur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.)
| | - Arnon Afek
- Central Management (A.A.), Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Orit Pinhas-Hamiel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital (O.P.-H.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Cole Daniel Bendor
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.)
| | - Gal Yaniv
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program (B.F., G.Y., G.T.), Sheba Medical Center, Ramat Gan, Israel.,Department of Diagnostic Imaging (G.Y.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
| | - Ran Shmuel Rotem
- Kahn-Sagol-Maccabi Research and Innovation Institute (R.S.R.), Maccabi Healthcare Services, Tel Aviv, Israel.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (R.S.R.)
| | - Gilad Twig
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.).,The Dr. Pinchas Bornstein Talpiot Medical Leadership Program (B.F., G.Y., G.T.), Sheba Medical Center, Ramat Gan, Israel.,Institute of Endocrinology (G.T.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.)
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25
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Santaularia NJ, Baker MR, Erickson D, Frazier P, Laska MN, Lust K, Mason SM. Classes of lifetime adversity in emerging adult women and men and their associations with weight status. Prev Med 2021; 146:106455. [PMID: 33636192 PMCID: PMC8149137 DOI: 10.1016/j.ypmed.2021.106455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 11/17/2022]
Abstract
The aim of this paper was to better understand how child and adult adversities cluster together into classes, and how these classes relate to body weight and obesity. Analyses included 2015 and 2018 data from emerging adults (18-25 years old) who participated in a state surveillance system of 2- and 4-year college students in Minnesota (N = 7475 in 2015 and N = 6683 in 2018). Latent Class Analyses (LCA) of 12 child and adult adversities were run stratified by gender and replicated between 2015 and 2018. The distal outcome procedure and three-step Bolck-Croon-Hagenaars approach were used to estimate predicted BMI means and predicted probabilities of obesity for each class, adjusted for covariates. The LCA identified seven classes in women and 5 in men. In women, BMI ranged from 23.9 kg/m2 in the lowest-BMI class ("Adult Adversities and Childhood Household Dysfunction"; 95% CI: 22.6-25.1) to 27.3 kg/m2 in the highest-BMI class ("High Lifetime Adversities"; 95% CI: 25.9-28.7), a statistically significant difference of 3.4 kg/m2. In men, the adjusted BMIs ranged from 24.6 kg/m2 ("Low Adversities"; 95% CI: 24.3-25.0) to 26.0 kg/m2 ("Childhood Household Mental Illness"; 95% CI: 25.1-26.9), a statistically significant difference of 1.4 kg/m2. The pattern was similar for obesity. These results indicate that specific classes of child and adult adversities are strongly associated with BMI and obesity, particularly in women. A key contribution of LCA appeared to be identification of small classes at high risk for excess weight.
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Affiliation(s)
- N Jeanie Santaularia
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America; Minnesota Population Center, University of Minnesota, 225 19th Ave S #50th, Minneapolis, MN 55455, United States of America.
| | - Majel R Baker
- Department of Psychology, University of Minnesota, 75 E River Rd, Minneapolis, MN 55455, United States of America
| | - Darin Erickson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, 75 E River Rd, Minneapolis, MN 55455, United States of America
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
| | - Katherine Lust
- Boynton Health, University of Minnesota, 410 Church St SE, Minneapolis, MN 55455, United States of America
| | - Susan M Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454, United States of America
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26
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Differences in the vascular and metabolic profiles between metabolically healthy and unhealthy obesity. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2020.100077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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27
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Min J, Hu X, Zhang J, Zeng T, Wang Y, Tian S, Liu G, Zhong X, Qiu K, Peng M, Chen L. Short-Term Changes in Metabolically Healthy Overweight/Obesity Status Impact the Susceptibility to Type 2 Diabetes in Chinese Adults. Diabetes Metab Syndr Obes 2021; 14:2561-2571. [PMID: 34135608 PMCID: PMC8200172 DOI: 10.2147/dmso.s313475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/27/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Changes in transition from metabolically healthy overweight/obesity (MHO) to metabolically unhealthy overweight/obesity (MUO) are associated with the risk for cardiometabolic complications. This study aims to investigate the effects of short-term dynamic changes in body mass index (BMI) and metabolic status on the risk of type 2 diabetes (T2D) and to identify biological predictors for the MHO-to-MUO transition. PATIENTS AND METHODS A total of 4604 subjects from the REACTION study were included for a 3-year follow-up. Subjects were categorized based on their BMI and metabolic syndrome status. Overweight/obesity was defined as BMI ≥ 24 kg/m2. Metabolically healthy was defined as having two or fewer of the metabolic syndrome components proposed by the Chinese Diabetes Society. Thus, subjects were divided into four groups: metabolically healthy normal weight (MHNW), MHO, metabolically unhealthy normal weight (MUNW), and MUO. RESULTS Compared with MHNW, MHO was not predisposed to an increased risk for T2D (OR 1.08, 95% CI 0.64-1.83, P = 0.762). However, a 3-year transition probability of 20.6% was identified for subjects who shifted from MHO to MUO; this conversion increased the risk of T2D by 3-fold (OR 3.04, 95% CI 1.21-7.68, P = 0.018). The fatty liver index independently predicted the MHO-to-MUO transition with an OR 3.14 (95% CI 1.56-7.46, P = 0.002) when comparing the fourth quartile to the first quartile. CONCLUSION This study reveals that metabolic changes affect the short-term susceptibility to T2D in the overweight/obese Chinese population, and the fatty liver index is an efficient clinical parameter for identifying those with a metabolic deterioration risk.
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Affiliation(s)
- Jie Min
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Xiang Hu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Jiaoyue Zhang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Tianshu Zeng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Ying Wang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Shenghua Tian
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Geng Liu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Xueyu Zhong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Kangli Qiu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Miaomiao Peng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Lulu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
- Correspondence: Lulu Chen Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, 430022, People’s Republic of ChinaTel +86 27 8572 6082Fax +86 27 8535 6365 Email
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Lu Y, Yang H, Xu Z, Tang X. Association Between Different Obesity Patterns and the Risk of Developing Type 2 Diabetes Mellitus Among Adults in Eastern China: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:2631-2639. [PMID: 34140792 PMCID: PMC8203197 DOI: 10.2147/dmso.s309400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/22/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Obesity has become a public health challenge worldwide and can lead to the development of diabetes. However, studies examining the associations between different obesity patterns and the development of type 2 diabetes mellitus (T2DM) in China are limited. Therefore, this study aimed to explore the associations between three obesity patterns and the risk of T2DM development in Eastern China. METHODS A cross-sectional study was conducted at our health examination center, involving 5860 adults, from June to December 2019. Data, including sociodemographic information, lifestyle, and biochemical measurements, were collected, and obesity was classified into three patterns: overweight and general obesity, abdominal obesity, and compound obesity. Multivariate logistic regression was used to assess the associations between different obesity patterns and T2DM risk after adjustment for confounding factors. Subgroup analysis was used to further explore the associations between obesity patterns and T2DM risk. RESULTS A total of 5860 subjects were enrolled in this study. A significant difference in the T2DM incidence was observed between men and women with normal weight or overweight and general obesity (p < 0.05); however, no significant differences were observed between men and women with abdominal obesity and compound obesity. After multivariable adjustment, multivariate logistic regression analysis showed that the odds ratios (ORs) [95% confidence interval (CI)] for T2DM in individuals with abdominal and compound obesity were 1.55 [1.08-2.24] and 1.85 [1.25-2.73], respectively, compared with the normal-weight group. Subgroup analysis showed that different obesity patterns were not independent risk factors for T2DM development among adults aged ≥ 60 years, whereas abdominal and compound obesity were highly associated with the risk of T2DM development among individuals who report current smoking or alcohol drinking. CONCLUSION Abdominal obesity and compound obesity are risk factors for T2DM. More attention should be paid to obesity prevention among individuals younger than 60 years and improving control of cigarette and alcohol abuse.
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Affiliation(s)
- Yayun Lu
- Health Examination Center, Huadong Sanatorium, Wuxi, 214065, People’s Republic of China
| | - Hao Yang
- Department of Stomatology, Huadong Sanatorium, Wuxi, 214065, People’s Republic of China
| | - Zhiyue Xu
- Health Examination Center, Huadong Sanatorium, Wuxi, 214065, People’s Republic of China
| | - Xuefeng Tang
- Health Examination Center, Huadong Sanatorium, Wuxi, 214065, People’s Republic of China
- Correspondence: Xuefeng Tang Tel +86 13961704961 Email
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EGLP-1 lowers body weight better than exendin-4 by reducing food intake and increasing basal energy expenditure in diet-induced obese mice. Exp Cell Res 2020; 399:112454. [PMID: 33359447 DOI: 10.1016/j.yexcr.2020.112454] [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: 06/07/2020] [Revised: 11/07/2020] [Accepted: 12/18/2020] [Indexed: 12/17/2022]
Abstract
It is well known that GLP-1 activates GLP-1R to reduce body weight by inhibiting eating. GLP-1 is cleaved by the neutral endopeptidase (NEP) 24.11 into a pentapeptide GLP-1 (32-36) amide, which increases basal energy expenditure and inhibits weight gain in obese mice. It is well known that GLP-1 analogs can reduce weight by suppressing eating. However, there are few reports of reducing weight through the dual effects of inhibiting eating and increasing basic energy. Here, we report the peptide EGLP-1, a GLP-1 analogue, which can reduce food intake and increase basal energy expenditure. In C2C12 myotubes, EGLP-1 can increase both phosphorylation of acetyl CoA carboxylase (ACC) and the ratio between phosphorylation of ACC and the total expression of ACC (pACC/ACC). In diet-induced obese mice, EGLP-1 is more effective than exendin-4 in reducing body weight, reducing fat mass and improving hepatic steatosis. At the same time, EGLP-1 can improve hyperglycemia, reduce food intake, and improve insulin resistance, just like exendin-4. In addition, EGLP-1, not exendin-4, can improve physiological parameters associated with lipid metabolism and increase oxygen consumption by increasing uncoupling proteins 3 (UCP3) expression and pACC/ACC ratio in skeletal muscle. Taken together, this data showed that EGLP-1 is able to reduce body weight by reducing food intake and increasing basal energy expenditure, suggesting it may be more effective in treating diabetic and non-diabetic overweight or obese people than pure GLP-1R agonist exendin-4.
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Gurung RL, M Y, Moh AMC, Dorajoo R, Liu S, Liu JJ, Shabbir A, So JBY, Tan CH, Cheng AKS, Lim SC. Correlation of Telomere Length in Adipose Tissue and Leukocytes and its Association with Postsurgical Weight Loss. Obesity (Silver Spring) 2020; 28:2424-2430. [PMID: 33230966 DOI: 10.1002/oby.23017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/15/2020] [Accepted: 08/10/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between telomere length (TL) in subcutaneous adipose tissue (SAT), visceral adipose tissues (VAT), and leukocytes, as well as to examine the associations of TL in these tissues with postsurgical weight loss in Asians with severe obesity. METHODS Presurgery TL was measured in leukocytes, SAT, and VAT of 91 patients who underwent weight loss surgery. Correlation between TL in multiple tissues was assessed using Pearson correlation. The association of presurgery TL and postsurgical weight loss at 6 or 12 months, expressed as a percentage of weight loss, was determined using linear regression in 70 patients. RESULTS Telomeres were longer in VAT compared with those in leukocytes and SAT (P < 0.001) but were highly correlated between tissues. The strongest correlation was observed between TL in VAT and leukocytes (r = 0.739, P = 6.22 × 10-17 ). Compared with individuals in the highest tertile, those in the lowest tertile of VAT TL showed greater weight loss (β = 6.23, SE = 3.10, P = 0.044) independent of age, sex, ethnicity, types of surgery, diabetes condition, preoperative BMI, and follow-up period. CONCLUSIONS Among patients with severe obesity, TL in leukocytes and adipose tissue was highly correlated. However, there was variability in the association of TL in these tissues with weight loss after surgery.
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Affiliation(s)
- Resham L Gurung
- Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Yiamunaa M
- Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore
| | | | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Sylvia Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Jian-Jun Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore
| | - Asim Shabbir
- Department of General Surgery, National University Hospital, Singapore
| | - Jimmy Bok Yan So
- Department of General Surgery, National University Hospital, Singapore
| | - Chun Hai Tan
- Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore
| | | | - Su Chi Lim
- Clinical Research Unit, Khoo Teck Puat Hospital, Yishun, Singapore
- Diabetes Centre, Admiralty Medical Centre, Singapore
- Saw Swee Hock School of Public Heath, Singapore
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Prevention of Diabetes and Cardiovascular Disease in Obesity. Int J Mol Sci 2020; 21:ijms21218178. [PMID: 33142938 PMCID: PMC7663329 DOI: 10.3390/ijms21218178] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022] Open
Abstract
Obesity is one of the major risk factors for the development of both impaired glucose tolerance (IGT, or prediabetes) and type 2 diabetes (T2D), and its prevalence worldwide drives toward an increased rate of cardiovascular morbidity and mortality. Given the estimations of the World Health Organization (WHO) and the recommendation of the Diabetes Prevention Program (DPP), where IGT and diabetes are considered as risk factors for the development of cardiovascular complications and obesity, the development of diabetes should be treated because of its potential reversibility. In this view, several interventions such as diet, lifestyle changes, and pharmacological treatment are effective, including bariatric metabolic surgery (BMS), which is the most incisive way to efficiently lower body weight. In this review, we sought to summarize some of the major aspects linked to diabetes prevention in overweight/obesity, focusing on the use of surgery; we also attempted to elucidate molecular pathways involved in a variety of obesity-induced processes able to favor the progression of chronic diseases, such as diabetes and its complications.
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Cabrera LO, Trindade EN, Leite C, Abegg EH, Trindade MRM. Preoperative Level of Leptin Can Be a Predictor of Glycemic Control for Patients with Diabetes Undergoing Bariatric Surgery. Obes Surg 2020; 30:4829-4833. [PMID: 32996102 DOI: 10.1007/s11695-020-05011-3] [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: 05/05/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Bariatric surgery is a first-line treatment for patients with obesity and diabetes. It is uncertain whether leptin has an influence on glycemia in the postoperative period. METHODS A cohort study of thirty-eight individuals with obesity and diabetes who underwent laparoscopic Roux-en-Y gastric bypass was undertaken. The levels of leptin, glucose, and glycosylated hemoglobin were verified in the preoperative period and in the first and third postoperative months. RESULTS The majority of patients were women (81.6%), and the mean age was 47.3 years (SD 8.8). The mean BMI was reduced by 17.75% (from 47.3 to 38.9 kg/m2) and the mean glycemia by 26.76%. Preoperative leptin had a moderate positive correlation with glucose level at the third month (Pearson r = 0.46, P = 0.02), but not with HbA1c. Patients with leptin above 27.34 ng/mL had a higher glucose level at the end of observation (101.9 versus 88.9, t test, P = 0.042). CONCLUSION The search for factors that influence diabetes control after bariatric surgery is of major importance in clinical practice. Our study reported a level of leptin that can predict the prognosis of glycemic control after the intervention. This finding still needs to be validated and confirmed in other populations.
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Affiliation(s)
- Luisa Ortiz Cabrera
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Eduardo Neubarth Trindade
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Department of Surgery, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
| | - Carine Leite
- Department of Gastroenterology, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
- , Porto Alegre, Brazil.
| | | | - Manoel Roberto Maciel Trindade
- Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Department of Surgery, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
- School of Medicine, UFRGS, Porto Alegre, RS, Brazil
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Reilly MJ, Larsen NK, Agrawal S, Thankam FG, Agrawal DK, Fitzgibbons RJ. Selected conditions associated with an increased incidence of incisional hernia: A review of molecular biology. Am J Surg 2020; 221:942-949. [PMID: 32977928 DOI: 10.1016/j.amjsurg.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/16/2020] [Accepted: 09/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Incisional hernias (IH) following a laparotomy, on average, occur in 10-20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively. METHODS We examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis. RESULTS The expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions. CONCLUSION Understanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH.
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Affiliation(s)
| | | | - Swati Agrawal
- Creighton University School of Medicine, Omaha, NE, 68178, USA; Department of Surgery, Creighton University Medical Center, Omaha, NE, 68131, USA
| | - Finosh G Thankam
- Department of Translational Research, Western University of Health Sciences, Pomona, CA, 91766, USA
| | - Devendra K Agrawal
- Department of Translational Research, Western University of Health Sciences, Pomona, CA, 91766, USA
| | - Robert J Fitzgibbons
- Department of Surgery, Creighton University Medical Center, Omaha, NE, 68131, USA.
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Wang S, Lu Z, Wang Y, Zhang T, He X. Metalloproteins and apolipoprotein C: candidate plasma biomarkers of T2DM screened by comparative proteomics and lipidomics in ZDF rats. Nutr Metab (Lond) 2020; 17:66. [PMID: 32817751 PMCID: PMC7425165 DOI: 10.1186/s12986-020-00488-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Early diagnosis of type 2 diabetes mellitus (T2DM) is still difficult. Screening of plasma biomarkers has great significance of optimizing diagnosis and predicting the complications of T2DM. Methods We used a special diet, Purina #5008, to induce diabetes in Zucker leptin receptor gene-deficient rats (fa/fa) to establish Zucker diabetic fatty (ZDF) rats, simulating the early stage of T2DM. The differentially expressed proteins (DEP) and lipids (DEL), as potential biomarkers, were screened to compare the plasma expression levels in ZDF rats and their basic diet-fed wild-type controls (fa/+) by Tandem Mass Tags (TMT) and liquid chromatography-tandem mass spectrometry. Results These two groups had different plasma proteins and lipids profiles consisting of 84 DEPs and, 179 DELs identified in the positive ion mode and 178 DELs in the negative ion mode, respectively. Enrichment analysis of these different indicators showed that oxidative stress, insulin resistance and metabolic disorders of glycan and lipid played an important role in generating the difference. Some markers can be used as candidate biomarkers in prediction and treatments of T2DM, such as ceruloplasmin, apolipoprotein C-I, apolipoprotein C-II and apolipoprotein C-IV. Conclusion These plasma differences help to optimize the diagnosis and predict the complications of T2DM, although this remains to be verified in the crowd. Trace elements related-metalloproteins, such as ceruloplasmin, and lipid metabolism and transport-related apolipoprotein C are expected to be candidate biomarkers of T2DM and should be given more attention.
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Affiliation(s)
- Shuai Wang
- Institute of Toxicology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
| | - Zhiyuan Lu
- Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
| | - Yuxin Wang
- Department of Physical and Chemical Inspection, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
| | - Tianran Zhang
- Department of Physical and Chemical Inspection, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China
| | - Xiaodong He
- Department of Physical and Chemical Inspection, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China.,Shandong Provincial Key Laboratory of Infection and Immunity, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012 Shandong China
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35
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Twig G, Zucker I, Afek A, Cukierman-Yaffe T, Bendor CD, Derazne E, Lutski M, Shohat T, Mosenzon O, Tzur D, Pinhas-Hamiel O, Tiosano S, Raz I, Gerstein HC, Tirosh A. Adolescent Obesity and Early-Onset Type 2 Diabetes. Diabetes Care 2020; 43:1487-1495. [PMID: 32321731 DOI: 10.2337/dc19-1988] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/01/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Type 2 diabetes (T2D) is increasingly diagnosed at younger ages. We investigated the association of adolescent obesity with incident T2D at early adulthood. RESEARCH DESIGN AND METHODS A nationwide, population-based study evaluated 1,462,362 adolescents (59% men, mean age 17.4 years) during 1996-2016. Data were linked to the Israeli National Diabetes Registry. Weight and height were measured at study entry. Cox proportional models were applied. RESULTS During 15,810,751 person-years, 2,177 people (69% men) developed T2D (mean age at diagnosis 27 years). There was an interaction among BMI, sex, and incident T2D (P interaction = 0.023). In a model adjusted for sociodemographic variables, the hazard ratios for diabetes diagnosis were 1.7 (95% CI 1.4-2.0), 2.8 (2.3-3.5), 5.8 (4.9-6.9), 13.4 (11.5-15.7), and 25.8 (21.0-31.6) among men in the 50th-74th percentile, 75th-84th percentile, overweight, mild obesity, and severe obesity groups, respectively, and 2.2 (1.6-2.9), 3.4 (2.5-4.6), 10.6 (8.3-13.6), 21.1 (16.0-27.8), and 44.7 (32.4-61.5), respectively, in women. An inverse graded relationship was observed between baseline BMI and mean age of T2D diagnosis: 27.8 and 25.9 years among men and women with severe obesity, respectively, and 29.5 and 28.5 years among low-normal BMI (5th-49th percentile; reference), respectively. The projected fractions of adult-onset T2D that were attributed to high BMI (≥85th percentile) at adolescence were 56.9% (53.8-59.9%) and 61.1% (56.8-65.2%) in men and women, respectively. CONCLUSIONS Severe obesity significantly increases the risk for incidence of T2D in early adulthood in both sexes. The rise in adolescent severe obesity is likely to increase diabetes incidence in young adults in coming decades.
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Affiliation(s)
- Gilad Twig
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, and the Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Cole D Bendor
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, and the Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miri Lutski
- The Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Ramat Gan, Israel
| | - Tammy Shohat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofri Mosenzon
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Dorit Tzur
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, and the Israel Defense Forces Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Shmuel Tiosano
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Medicine, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Itamar Raz
- The Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | | - Amir Tirosh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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Smith GI, Mittendorfer B, Klein S. Metabolically healthy obesity: facts and fantasies. J Clin Invest 2020; 129:3978-3989. [PMID: 31524630 DOI: 10.1172/jci129186] [Citation(s) in RCA: 326] [Impact Index Per Article: 81.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Although obesity is typically associated with metabolic dysfunction and cardiometabolic diseases, some people with obesity are protected from many of the adverse metabolic effects of excess body fat and are considered "metabolically healthy." However, there is no universally accepted definition of metabolically healthy obesity (MHO). Most studies define MHO as having either 0, 1, or 2 metabolic syndrome components, whereas many others define MHO using the homeostasis model assessment of insulin resistance (HOMA-IR). Therefore, numerous people reported as having MHO are not metabolically healthy, but simply have fewer metabolic abnormalities than those with metabolically unhealthy obesity (MUO). Nonetheless, a small subset of people with obesity have a normal HOMA-IR and no metabolic syndrome components. The mechanism(s) responsible for the divergent effects of obesity on metabolic health is not clear, but studies conducted in rodent models suggest that differences in adipose tissue biology in response to weight gain can cause or prevent systemic metabolic dysfunction. In this article, we review the definition, stability over time, and clinical outcomes of MHO, and discuss the potential factors that could explain differences in metabolic health in people with MHO and MUO - specifically, modifiable lifestyle factors and adipose tissue biology. Better understanding of the factors that distinguish people with MHO and MUO can produce new insights into mechanism(s) responsible for obesity-related metabolic dysfunction and disease.
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Robinson E, Haynes A, Sutin A, Daly M. Self-perception of overweight and obesity: A review of mental and physical health outcomes. Obes Sci Pract 2020; 6:552-561. [PMID: 33082997 PMCID: PMC7556430 DOI: 10.1002/osp4.424] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/10/2020] [Accepted: 05/06/2020] [Indexed: 12/12/2022] Open
Abstract
The obesity crisis is one of the largest public health challenges of the 21st century. Population‐level adiposity has increased dramatically in recent times, and people not recognizing that they have overweight or obesity is now common. It has been widely assumed that not recognizing oneself as having overweight is detrimental to weight management and long‐term health. Here, diverse research is reviewed that converges on the counterintuitive conclusion that not recognizing oneself as having overweight is actually associated with more favourable physical and mental health outcomes than recognizing oneself as having overweight. Drawing on existing models in social psychology and weight stigma research, an explanatory model of the health effects of self‐perception of overweight is outlined. This model proposes that self‐perception of overweight triggers social rejection concerns and the internalization of weight stigma, which in turn induce psychological distress and negatively impact health‐promoting lifestyle behaviours. How self‐perception of overweight may in part explain progression from overweight to obesity, and the public health implications of self‐perception of overweight and obesity are also discussed.
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Affiliation(s)
- Eric Robinson
- Psychological Sciences University of Liverpool Liverpool UK
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer Cancer Council Victoria Melbourne VIC Australia
| | - Angelina Sutin
- College of Medicine Florida State University Tallahassee Florida USA
| | - Michael Daly
- UCD Geary Institute for Public Policy University College Dublin Dublin Ireland.,Behavioural Science Centre University of Stirling Stirling UK
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Abstract
PURPOSE OF REVIEW To present a comprehensive overview regarding criteria, epidemiology, and controversies that have arisen in the literature about the existence and the natural course of the metabolic healthy phenotype. RECENT FINDINGS The concept of metabolically healthy obesity (MHO) implies that a subgroup of obese individuals may be free of the cardio-metabolic risk factors that commonly accompany obese subjects with adipose tissue dysfunction and insulin resistance, known as having metabolic syndrome or the metabolically unhealthy obesity (MUO) phenotype. Individuals with MHO appear to have a better adipose tissue function, and are more insulin sensitive, emphasizing the central role of adipose tissue function in metabolic health. The reported prevalence of MHO varies widely, and this is likely due the lack of universally accepted criteria for the definition of metabolic health and obesity. Also, the natural course and the prognostic value of MHO is hotly debated but it appears that it likely evolves towards MUO, carrying an increased risk for cardiovascular disease and mortality over time. Understanding the pathophysiology and the determinants of metabolic health in obesity will allow a better definition of the MHO phenotype. Furthermore, stratification of obese subjects, based on metabolic health status, will be useful to identify high-risk individuals or subgroups and to optimize prevention and treatment strategies to compact cardio-metabolic diseases.
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Affiliation(s)
- Agathocles Tsatsoulis
- Department of Endocrinology, School of Health Sciences, University of Ioannina, 451 10, Ioannina, Greece.
| | - Stavroula A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Torres-Lopez LV, Cadenas-Sanchez C, Migueles JH, Adelantado-Renau M, Plaza-Florido A, Solis-Urra P, Molina-Garcia P, Ortega FB. Associations of Sedentary Behaviour, Physical Activity, Cardiorespiratory Fitness and Body Composition with Risk of Sleep-Related Breathing Disorders in Children with Overweight/Obesity: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9051544. [PMID: 32443799 PMCID: PMC7291123 DOI: 10.3390/jcm9051544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to examine the associations of sedentary behaviour, physical activity, cardiorespiratory fitness (CRF), and body composition parameters with risk of sleep-related breathing disorders (SRBD) in children with overweight/obesity. One-hundred and nine children (10.0 ± 1.1 years old, 45 girls) with overweight (n = 27) and obesity (n = 82) were included. Television viewing time was self-reported by using the Spanish adaptation of the "Youth Activity Profile" (YAP) questionnaire. Sedentary time and physical activity were measured with accelerometry. CRF was assessed with the 20-m shuttle-run test and body composition parameters with Dual-energy X-ray absorptiometry. SRBD were evaluated by using the Spanish version of the Pediatric Sleep Questionnaire. Television viewing time was positively associated with risk of SRBD (r = 0.222, p = 0.021). CRF was negatively correlated with risk of SRBD (r = -0.210, p = 0.030). Body composition parameters were positively associated with risk of SRBD (all p < 0.05), except fat mass index. Stepwise regression analyses showed that body mass index (BMI) explained the largest proportion of the variance in SRBD (r2 = 0.063, p = 0.01) and television viewing time was the only one added after BMI (r2 change = 0.048, p = 0.022). This study supports the notion that higher body weight status negatively influences risk of SRBD and adds that unhealthy behaviours could contribute to worsen SRBD, related to an increased risk of cardiovascular diseases. All the significant association observed in this manuscript were of small magnitude, indicating than other factors in addition to the one hereby studied contribute to explain the variance in SRBD.
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Affiliation(s)
- Lucia V. Torres-Lopez
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
- Correspondence:
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
- MOVE-IT research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cádiz, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
| | | | - Abel Plaza-Florido
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
| | - Patricio Solis-Urra
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, 3000 Leuven, Belgium
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18011 Granada, Spain; (C.C.-S.); (J.H.M.); (A.P.-F.); (P.S.-U.); (P.M.-G.); (F.B.O.)
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Huddinge, Sweden
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Teliewubai J, Fan X, Ji H, Maimaitiaili R, Tang J, Zhao S, Yu S, Chi C, Xu Y, Zhang Y. Does healthy obesity exist in the elderly? Findings from the Northern Shanghai Study. Nutr Metab Cardiovasc Dis 2020; 30:749-757. [PMID: 32249139 DOI: 10.1016/j.numecd.2020.01.010] [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: 09/16/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Metabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort. METHODS AND RESULTS A total of 3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associations of metabolic status and obesity with organ damages were investigated. In all, 1317 (39.6%) participants were metabolically unhealthy and 481 (14.5%) were obese. Compared with metabolically healthy nonobese (MH-nonobese) individuals, metabolically healthy obese subjects had a greater left ventricular mass index (LVMI) and pulse wave velocity (PWV). Metabolically unhealthy subjects, regardless of their obesity status, had greater organ damage parameters including E/Ea, LVMI, PWV, and urine albumin-creatinine ratio (UACR) than MH-nonobese subjects (all P < 0.05). After multivariate adjustments, both metabolic unhealthiness and obesity increased the risk of left ventricular hypertrophy (LVH) (OR 1.31, 95% CI 1.10-1.57 and OR 1.63, 95% CI 1.30-2.04), diastolic dysfunction (OR 1.33, 95% CI 1.06-1.67 and OR 1.51, 95% CI 1.14-1.99), and lower extremity atherosclerosis (OR 1.44, 95% CI 1.11-1.85 and OR 2.01, 95% CI 1.49-2.70). Metabolic unhealthiness was also associated with arterial stiffness, microalbuminuria and chronic kidney disease (all P < 0.05). In a subgroup analysis, metabolic unhealthiness was associated with more organ damages in nonobese subjects, and obesity was associated with LVH and lower extremity atherosclerosis regardless of metabolic status. CONCLUSION Both obesity and metabolic unhealthiness were associated with organ damages. Metabolic unhealthiness was associated with more organ damages, especially in nonobese individuals. Even healthy obesity was significantly associated with cardiac and vascular impairment. REGISTRATION NUMBER FOR CLINICAL TRIALS NCT02368938.
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MESH Headings
- Age Factors
- Aged
- Albuminuria/epidemiology
- Biomarkers/blood
- Biomarkers/urine
- China/epidemiology
- Cross-Sectional Studies
- Energy Metabolism
- Female
- Geriatric Assessment
- Humans
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/epidemiology
- Hypertrophy, Left Ventricular/physiopathology
- Male
- Metabolic Syndrome/diagnosis
- Metabolic Syndrome/epidemiology
- Metabolic Syndrome/physiopathology
- Obesity, Metabolically Benign/diagnosis
- Obesity, Metabolically Benign/epidemiology
- Obesity, Metabolically Benign/physiopathology
- Peripheral Arterial Disease/diagnosis
- Peripheral Arterial Disease/epidemiology
- Peripheral Arterial Disease/physiopathology
- Prevalence
- Prospective Studies
- Renal Insufficiency, Chronic/epidemiology
- Risk Assessment
- Risk Factors
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/epidemiology
- Ventricular Dysfunction, Left/physiopathology
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Affiliation(s)
- Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Ximin Fan
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Hongwei Ji
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | | | - Jiamin Tang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China.
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, China.
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Johnson BZ, Stevenson AW, Prêle CM, Fear MW, Wood FM. The Role of IL-6 in Skin Fibrosis and Cutaneous Wound Healing. Biomedicines 2020; 8:biomedicines8050101. [PMID: 32365896 PMCID: PMC7277690 DOI: 10.3390/biomedicines8050101] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022] Open
Abstract
The timely resolution of wound healing is critical for restoring the skin as a protective barrier. The switch from a proinflammatory to a reparative microenvironment must be tightly regulated. Interleukin (IL)-6 is a key modulator of the inflammatory and reparative process: it is involved in the differentiation, activation, and proliferation of leukocytes, endothelial cells, keratinocytes, and fibroblasts. This review examines the role of IL-6 in the healing of cutaneous wounds, and how dysregulation of IL-6 signaling can lead to either fibrosis or a failure to heal. The role of an IL-6/TGF-β feedback loop is discussed in the context of fibrogenesis, while IL-6 expression and responses in advanced age, diabetes, and obesity is outlined regarding the development of chronic wounds. Current research on therapies that modulate IL-6 is explored. Here, we consider IL-6′s diverse impact on cutaneous wound healing.
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Affiliation(s)
- Blair Z. Johnson
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- Correspondence:
| | - Andrew W. Stevenson
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
| | - Cecilia M. Prêle
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- Institute for Respiratory Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Mark W. Fear
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
| | - Fiona M. Wood
- School of Biomedical Sciences, University of Western Australia, Crawley, WA 6009, Australia; (A.W.S.); (C.M.P.); (M.W.F.); (F.M.W.)
- WA Department of Health, 189 Royal St, East Perth, WA 6004, Australia
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Desai RJ, Dejene S, Jin Y, Liu J, Kim SC. Comparative Risk of Diabetes Mellitus in Patients With Rheumatoid Arthritis Treated With Biologic or Targeted Synthetic Disease-Modifying Drugs: A Cohort Study. ACR Open Rheumatol 2020; 2:222-231. [PMID: 32267094 PMCID: PMC7164631 DOI: 10.1002/acr2.11124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/12/2020] [Indexed: 12/22/2022] Open
Abstract
Objective The objective of this study is to compare the risk of incident diabetes mellitus (DM) in patients with rheumatoid arthritis (RA) treated with biologic or targeted synthetic disease‐modifying antirheumatic drugs. Methods A new‐user observational cohort study was conducted using data from a US commercial (Truven MarketScan, 2005‐2016) claims database and a public insurance (Medicare, 2010‐2014) claims database. Patients with RA who did not have DM were selected into one of eight exposure groups (abatacept, infliximab, adalimumab, golimumab, certolizumab, etanercept, tocilizumab, or tofacitinib) and observed for the outcome of incident DM, defined as a combination of a diagnosis code and initiation of a hypoglycemic treatment. A stabilized inverse probability–weighted Cox proportional hazards model was used to account for 56 confounding variables and estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All analyses were conducted separately in two databases, and estimates were combined using inverse variance meta‐analysis. Results Among a total of 50 505 patients with RA from Truven and 17 251 patients with RA from Medicare, incidence rates (95% CI) for DM were 6.8 (6.1‐7.6) and 6.6 (5.4‐7.9) per 1000 person‐years, respectively. After confounding adjustment, the pooled HRs (95% CI) indicated a significantly higher risk of DM among adalimumab (2.00 [1.11‐3.03]) and infliximab initiators (2.34 [1.38‐3.98]) compared with abatacept initiators. The pooled HR (95% CI) for the etanercept versus abatacept comparison was elevated but not statistically significant (1.65 [0.91‐2.98]). The effect estimates for certolizumab, golimumab, tocilizumab, and tofacitinib, compared with abatacept, were highly imprecise because of a limited sample size. Conclusion Initiation of abatacept was associated with a lower risk of incident DM in patients with RA compared with infliximab or adalimumab.
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Affiliation(s)
- Rishi J Desai
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sara Dejene
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yinzhu Jin
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jun Liu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Seoyoung C Kim
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Lee S, Lacy ME, Jankowich M, Correa A, Wu WC. Association between obesity phenotypes of insulin resistance and risk of type 2 diabetes in African Americans: The Jackson Heart Study. J Clin Transl Endocrinol 2020; 19:100210. [PMID: 31871895 PMCID: PMC6909037 DOI: 10.1016/j.jcte.2019.100210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/05/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To determine whether insulin resistance (IR) measured by homeostasis model of insulin resistance (HOMA-IR) can further stratify diabetes risk in African Americans (AAs) beyond obesity and identify obese, low risk and non-obese, high risk individuals. METHODS Using the Jackson Heart Study cohort, we categorized participants without diabetes into four phenotypes: non-obese/insulin-sensitive, non-obese/IR, obese/insulin-sensitive and obese/IR. Obesity was defined as BMI ≥ 30 or BMI 25-30 plus an increased waist circumference. IR was defined as HOMA-IR ≥ 2. We used modified Poisson regression models to estimate the incident risk-ratios (IRR) of diabetes across these phenotypes adjusting for potential confounders and HbA1c. RESULTS Among 3219 AAs without diabetes, 14.0% were non-obese/insulin-sensitive, 24.6% non-obese/IR, 6.2% obese/insulin-sensitive, and 55.3% obese/IR. The overall crude incidence rate of diabetes was 29.91 cases/1000 person-years. In fully-adjusted models, compared to the non-obese/insulin-sensitive group, the relative risk of diabetes was highest in obese/IR (IRR = 2.35; 95% CI: 1.53, 3.60), followed by non-obese/IR (IRR = 1.59; 95% CI: 1.02, 2.46), and non-significant for the obese/insulin-sensitive (IRR = 1.70; 95% CI: 0.97, 2.99) group. CONCLUSIONS HOMA-IR can further stratify diabetes risk in AA adults beyond obesity, identifying non-obese high-risk and lower-risk obese individuals. However, diabetes risk should still be carefully monitored in obese populations despite insulin sensitivity.
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Affiliation(s)
- Sean Lee
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
| | - Mary E. Lacy
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Department of Epidemiology, University of Kentucky, United States
| | - Mathew Jankowich
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
| | - Adolfo Correa
- Departments of Medicine and Population Health Science, University of Mississippi Medical Center, United States
| | - Wen-Chih Wu
- Providence VA Medical Center, Alpert Medical School & School of Public Health at Brown University, United States
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Chait A, den Hartigh LJ. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Front Cardiovasc Med 2020; 7:22. [PMID: 32158768 PMCID: PMC7052117 DOI: 10.3389/fcvm.2020.00022] [Citation(s) in RCA: 590] [Impact Index Per Article: 147.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
Adipose tissue plays essential roles in maintaining lipid and glucose homeostasis. To date several types of adipose tissue have been identified, namely white, brown, and beige, that reside in various specific anatomical locations throughout the body. The cellular composition, secretome, and location of these adipose depots define their function in health and metabolic disease. In obesity, adipose tissue becomes dysfunctional, promoting a pro-inflammatory, hyperlipidemic and insulin resistant environment that contributes to type 2 diabetes mellitus (T2DM). Concurrently, similar features that result from adipose tissue dysfunction also promote cardiovascular disease (CVD) by mechanisms that can be augmented by T2DM. The mechanisms by which dysfunctional adipose tissue simultaneously promote T2DM and CVD, focusing on adipose tissue depot-specific adipokines, inflammatory profiles, and metabolism, will be the focus of this review. The impact that various T2DM and CVD treatment strategies have on adipose tissue function and body weight also will be discussed.
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Affiliation(s)
- Alan Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
| | - Laura J den Hartigh
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
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Cadenas-Sanchez C, Intemann T, Labayen I, Artero EG, Alvarez-Bueno C, Sanchis-Moysi J, Benito PJ, Beltran-Valls MR, Pérez-Bey A, Sanchez-Delgado G, Palou P, Vicente-Rodríguez G, Moreno LA, Ortega FB. Prevalence of severe/morbid obesity and other weight status and anthropometric reference standards in Spanish preschool children: The PREFIT project. Pediatr Res 2020; 87:501-510. [PMID: 30776792 DOI: 10.1038/s41390-019-0325-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/02/2019] [Accepted: 01/21/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Childhood obesity has become a major health problem in children under the age of 5 years. Providing reference standards would help paediatricians to detect and/or prevent health problems related to both low and high levels of body mass and to central adiposity later in life. Therefore, the aim of this study was to examine the prevalence of different weight status categories and to provide sex- and age-specific anthropometry reference standards for Spanish preschool children. METHODS A total of 3178 preschool children (4.59±0.87 years old) participated in this study. Prevalence of different degrees of obesity (mild, severe, and morbid) and other weight status categories were determined. RESULTS Reference standards were obtained. Prevalence of overweight and obese preschool children in the Spanish population ranged from 21.4 to 34.8%. Specifically, the obesity prevalence was 3.5, 1.2, and 1.3% of these subjects were categorized as mild, severe, and morbid obese. Sex- and age-specific reference standards for anthropometric parameters are provided for every 0.25 years (i.e. every trimester of life). CONCLUSION Our results show a high prevalence of overweight/obese preschoolers. The provided sex- and age-specific anthropometric reference standards could help paediatricians to track and monitor anthropometric changes at this early stage in order to prevent overweight/obesity.
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Affiliation(s)
- Cristina Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
| | - Timm Intemann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Idoia Labayen
- Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Enrique G Artero
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almeria, Almeria, Spain
| | - Celia Alvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Joaquin Sanchis-Moysi
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Island, Spain
| | - Pedro J Benito
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Alejandro Pérez-Bey
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Guillermo Sanchez-Delgado
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pere Palou
- Department of Pedagogy and Specific Didactics, University of the Balearic Islands, Balearic Islands, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Faculty of Health and Sport Science (FCSD, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Instituto Agroalimentario de Aragón -IA2- (CITA-Universidad de Zaragoza), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain and Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
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Wei Y, Wang J, Han X, Yu C, Wang F, Yuan J, Miao X, Yao P, Wei S, Wang Y, Liang Y, Zhang X, Guo H, Zheng D, Tang Y, Yang H, He M. Metabolically healthy obesity increased diabetes incidence in a middle-aged and elderly Chinese population. Diabetes Metab Res Rev 2020; 36:e3202. [PMID: 31291052 DOI: 10.1002/dmrr.3202] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 07/01/2019] [Accepted: 07/06/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND We examined the association between metabolically healthy obese (MHO) and diabetes incidence in a middle-aged and elderly population and whether the association differed by the presence of nonalcoholic fatty liver disease (NAFLD). METHODS We examined 17 801 participants without diabetes at study entry (7980 males and 9821 females with a mean age of 63.2 years) derived from the Dongfeng-Tongji cohort study (median follow-up: 4.6 years). Participants were divided into six groups based on BMI (normal weight, overweight, or obese) and metabolic health (healthy/unhealthy) defined by the Adult Treatment Panel III criteria. The MHO was defined as BMI greater than 28.0 kg/m2 with 0 or 1 of four metabolic abnormalities (elevated blood pressure, triglyceridaemia, hyperglycaemia, low HDL cholesterol). The hazard ratio (HR) and 95% confidence interval (CI) for incident diabetes were derived from the Cox proportional hazard regression model. RESULTS During 79 843 person-years of follow-up, 1453 individuals developed diabetes. Compared with metabolically healthy normal weight (MH-NW) individuals, the multivariable-adjusted HRs (95% CI) were 1.74 (1.16-2.59) for MHO and 2.15 (1.65-2.81) for metabolically unhealthy obese subjects after adjusting for age, sex, smoking, alcohol drinking, physical activity, fruit and vegetable consumption, family history of diabetes, fasting glucose, waist circumference, and NAFLD. Among those without NAFLD, MHO individuals showed higher incidence of diabetes (multivariate-adjusted HR = 2.71, 95% CI: 1.47-5.00) than MH-NW individuals. CONCLUSIONS The MHO phenotype was associated with increased incidence of diabetes in a middle-aged and elderly population, and the association did not differ by the presence or absence of NAFLD.
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Affiliation(s)
- Yue Wei
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Han
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Caizheng Yu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yuan
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Miao
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yao
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Wei
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Zheng
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhan Tang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Metabolic syndrome and metabolically healthy status in adults with overweight or obesity, expressing no desire to lose weight. Obes Res Clin Pract 2019; 14:47-53. [PMID: 31883739 DOI: 10.1016/j.orcp.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/14/2019] [Accepted: 11/28/2019] [Indexed: 12/27/2022]
Abstract
AIM To examine the prevalence of metabolic syndrome (MetS) and metabolically healthy status (MHS) in adults with excess weight, who express no desire to lose weight (DLW). METHODS We used the National Health and Nutrition Examination Survey (2011-2016) to conduct a cross-sectional analysis of 4509 adults with excess weight. The prevalence of MetS and MHS was estimated by a DLW status. The prevalence ratios (PRs) were estimated, adjusting for demographic characteristics, to compare the prevalence of MetS and MHS between those with and without a DLW. RESULTS Among adults who were overweight, the crude prevalence of MetS was 28.9% (95% CI 23.7, 34.1) in the no-DLW group and 36.0% (95% CI 31.9, 40.0) in the DLW group (adjusted PR 0.88; 95% CI 0.70, 1.11). Among adults with obesity, the crude prevalence of MetS was 60.0% (95% CI 52.3, 67.6) in the no-DLW group and 63.2% (95% CI 60.0, 66.4) in the DLW group (adjusted PR 1.00; 95% CI 0.88, 1.14). Among adults who were overweight, the prevalence of MHS was 17.5% (95% CI 13.4, 22.2) in the no-DLW group, and 9.5% (95% CI 7.6, 11.6) in the DLW group (adjusted PR 1.27; 95% CI 0.96, 1.69). Nearly all adults with obesity had at least one component of MetS regardless of DSW status. CONCLUSIONS One in four overweight adults and three in five obese adults without a DLW had MetS in the U.S. A majority of adults who were overweight or obese without a DSW had at least one component of MetS.
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Probing the Antitumor Mechanism of Solanum nigrum L. Aqueous Extract against Human Breast Cancer MCF7 Cells. Bioengineering (Basel) 2019; 6:bioengineering6040112. [PMID: 31835887 PMCID: PMC6955812 DOI: 10.3390/bioengineering6040112] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 12/24/2022] Open
Abstract
Solanum nigrum L. is one of the major medicinal plants used to treat cancer. However, the functional mechanism of S. nigrum L. extract is still unknown in spite of numerous studies on its active components. In this study, we probed the potential anticancer mechanism of the aqueous extract of S. nigrum L. (AESN) towards human breast cancer cell line MCF7. At a concentration of 10 g/L, AESN caused 43% cytotoxicity, inhibited the migration, and suppressed the activities of hexokinase and pyruvate kinase by about 30% and 40%, respectively, towards the MCF7 cells. RT2-PCR analysis of a panel of 89 caner-related genes identified 13 upregulated and eight downregulated genes (>2-folds) in MCF7 cells upon AESN treatment. Gene ontology (GO) and functional disease ontology (FunDO) analyses show that the antitumor function of S. nigrum L. involves multiple genes and these genes are shared across other diseases or disorders.
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Juárez-Rojas JG, Torre-Villalvazo I, Medina-Urrutia AX, Reyes-Barrera J, Sainz-Escárrega VH, Posadas-Romero C, Macías-Cruz A, Jorge-Galarza E. Participation of white adipose tissue dysfunction on circulating HDL cholesterol and HDL particle size in apparently healthy humans. Int J Obes (Lond) 2019; 44:920-928. [PMID: 31792333 DOI: 10.1038/s41366-019-0493-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/15/2019] [Accepted: 11/17/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To use the combined presence of the elevated insulin resistance index in adipose tissue (Adipo-IR) and low values of adiponectin as a marker of dysfunctional adipose tissue, and to analyze its possible association with low values of high-density lipoprotein cholesterol (HDL-C) and small size of HDL particles. RESEARCH DESIGN AND METHODS The analysis included 253 subjects with functional adipose tissue and 253 with dysfunctional adipose tissue, considering similar gender, age, and body mass index (BMI). Adipo-IR was considered when index values (free fatty acids × insulin concentrations) were ≥75th percentile. Low levels of adiponectin were considered when concentration in serum was <25th percentile (determined by ELISA). HDL size was estimated by a quantitative validated equation. Small HDL size was considered when values were <25th percentile. RESULTS When comparing subjects with functional adipose tissue with those of dysfunctional adipose tissue, the latter had a higher prevalence of low HDL-C (51.4% vs. 64.0%; p = 0.004) and small HDL (56.9% vs. 67.6%; p = 0.009). Multivariate analysis indicated that independently from other metabolic risk factors, dysfunction of adipose tissue is significantly associated with low HDL-C (OR: 1.624 [CI 95%: 1.100-2.397]) and small HDL (OR: 1.462 [CI 95%: 1.000-2.139]). Adding BMI, waist circumference, and subcutaneous or visceral adipose tissue did not modify the association. CONCLUSIONS Dysfunction of adipose tissue is associated with a 65 and 50% higher probability of having low HDL-C and small HDL. Identification of dysfunctional adipose tissue could be a useful tool in the clinical setting to prevent the cardiometabolic risk independently from adiposity.
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Affiliation(s)
- Juan G Juárez-Rojas
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Ivan Torre-Villalvazo
- Department of Nutrition Physiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aida X Medina-Urrutia
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Juan Reyes-Barrera
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Víctor H Sainz-Escárrega
- Department of Cardiothoracic Surgery, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Carlos Posadas-Romero
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Alejandro Macías-Cruz
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Esteban Jorge-Galarza
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
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Tajik S, Mirzababaei A, Ghaedi E, Kord-Varkaneh H, Mirzaei K. Risk of type 2 diabetes in metabolically healthy people in different categories of body mass index: an updated network meta-analysis of prospective cohort studies. J Cardiovasc Thorac Res 2019; 11:254-263. [PMID: 31824606 PMCID: PMC6891044 DOI: 10.15171/jcvtr.2019.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 10/05/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction: Risk of diabetes mellitus type 2 (T2DM) is variable between individuals due to different metabolic phenotypes. In present network meta-analysis, we aimed to evaluate the risk of T2DM related with current definitions of metabolic health in different body mass index (BMI) categories.
Methods: Relevant articles were collected by systematically searching PubMed and Scopus databases up to 20 March 2018 and for analyses we used a random-effects model. Nineteen prospective cohort studies were included in the analyses and metabolically healthy normal weight (MHNW) was considered as the reference group in direct comparison for calculating indirect comparisons in difference type of BMI categories.
Results: Total of 199403 participants and 10388 cases from 19 cohort studies, were included in our network meta-analysis. Metabolically unhealthy obesity (MUHO) group poses highest risk for T2DM development with 10 times higher risk when is compared with MHNW (10.46 95% CI; 8.30, 13.18) and after that Metabolically unhealthy overweight (MUOW) individuals were at highest risk of T2DM with 7 times higher risk comparing with MHNW (7.25, 95% CI; 5.49, 9.57). Metabolically healthy overweight and obese (MHOW/MHO) individuals have (1.77, 95% CI; 1.33, 2.35) and (3.00, 95% CI; 2.33, 3.85) risk ratio for T2DM development in comparison with MHNW respectively.
Conclusion: In conclusion we found that being classified as overweight and obese increased the risk of T2DM in comparison with normal weight. In addition, metabolically unhealthy (MUH) individuals are at higher risk of T2DM in all categories of BMI compared with metabolically healthy individuals.
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Affiliation(s)
- Somayeh Tajik
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Student's Scientific Research Center, Tehran, Iran
| | - Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Kord-Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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