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Schon SB, Cabre HE, Redman LM. The impact of obesity on reproductive health and metabolism in reproductive-age females. Fertil Steril 2024; 122:194-203. [PMID: 38704081 DOI: 10.1016/j.fertnstert.2024.04.036] [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: 03/14/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Obesity is a highly prevalent chronic disease that impacts >40% of reproductive-aged females. The pathophysiology of obesity is complex and can be understood simply as a chronic energy imbalance whereby caloric intake exceeds caloric expenditure with an energy surplus stored in adipose tissue. Obesity may be categorized into degrees of severity as well as different phenotypes on the basis of metabolic health and underlying pathophysiology. Obesity and excess adiposity have a significant impact on fertility and reproductive health, with direct effects on the hypothalamic-pituitary-ovarian axis, the ovary and oocyte, and the endometrium. There are significant adverse pregnancy outcomes related to obesity, and excess weight gain before, during, and after pregnancy that can alter the lifelong risk for metabolically unhealthy obesity. Given the high prevalence and pervasive impact of obesity on reproductive health, there is a need for better and individualized care for reproductive-aged females that considers obesity phenotype, underlying pathophysiology, and effective and sustainable interventions to treat obesity and manage weight gain before, during, and after pregnancy.
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Affiliation(s)
- Samantha B Schon
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
| | - Hannah E Cabre
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Leanne M Redman
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
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2
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Horino T, Tokunaga R, Miyamoto Y, Baba H. Advanced Lung Cancer Inflammation Index: A Novel Comprehensive Biomarker of Host Status for Patients with Metastatic Colorectal Cancer. J Anus Rectum Colon 2024; 8:137-149. [PMID: 39086873 PMCID: PMC11286371 DOI: 10.23922/jarc.2023-077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/18/2024] [Indexed: 08/02/2024] Open
Abstract
Numerous biomarkers that reflect host status have been identified for patients with metastatic colorectal cancer (mCRC). However, there has been a paucity of biomarker studies that comprehensively indicate body composition, nutritional assessment, and systemic inflammation status. The advanced lung cancer inflammation index (ALI), initially introduced as a screening tool for patients with non-small-cell lung cancer in 2013, emerges as a holistic marker encompassing all body composition, nutritional status, and systemic inflammation status. The index is calculated by the simple formula: body mass index × albumin value / neutrophil-to-lymphocyte ratio. Given its accessibility in routine clinical practice, the ALI has exhibited promising clinical utility in prognosticating outcomes for patients with multiple types of cancer. In this review, we focus on the significance of host status and the clinical applicability of the ALI in the treatment and management of patients with malignancies, including mCRC. We also suggest its potential in guiding the formulation of treatment strategies against mCRC and outline future perspectives.
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Affiliation(s)
- Taichi Horino
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Ryuma Tokunaga
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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3
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Zhang M, Hou Y, Ren X, Cai Y, Wang J, Chen O. Association of a body shape index with femur bone mineral density among older adults: NHANES 2007-2018. Arch Osteoporos 2024; 19:63. [PMID: 39037488 DOI: 10.1007/s11657-024-01424-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
This study investigated the relationship between A body shape index (ABSI) and bone mineral density (BMD) in older Americans and found a negative linear association, which was particularly pronounced in diabetic population. An early focus on ABSI in the elderly population will help in the prevention of osteoporosis. OBJECTIVE A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations. METHODS This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD. RESULTS This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD. CONCLUSIONS The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.
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Affiliation(s)
- Mengyuan Zhang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yue Hou
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Xiaohe Ren
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yingying Cai
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Jingyi Wang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China.
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Börgeson E, Tavajoh S, Lange S, Jessen N. The challenges of assessing adiposity in a clinical setting. Nat Rev Endocrinol 2024:10.1038/s41574-024-01012-9. [PMID: 39009863 DOI: 10.1038/s41574-024-01012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/17/2024]
Abstract
To tackle the burden of obesity-induced cardiometabolic disease, the scientific community relies on accurate and reproducible adiposity measurements in the clinic. These measurements guide our understanding of underlying biological mechanisms and clinical outcomes of human trials. However, measuring adiposity and adipose tissue distribution in a clinical setting can be challenging, and different measurement methods pose important limitations. BMI is a simple and high-throughput measurement, but it is associated relatively poorly with clinical outcomes when compared with waist-to-hip and sagittal abdominal diameter measurements. Body composition measurements by dual energy X-ray absorptiometry or MRI scans would be ideal due to their high accuracy, but are not high-throughput. Another important consideration is that adiposity measurements vary between men and women, between adults and children, and between people of different ethnic backgrounds. In this Perspective article, we discuss how these critical challenges can affect our interpretation of research data in the field of obesity and the design and implementation of clinical guidelines.
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Affiliation(s)
- Emma Börgeson
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Saeideh Tavajoh
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stephan Lange
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Cardiology, School of Medicine, UC San Diego, La Jolla, CA, USA
| | - Niels Jessen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
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Grannell A, le Roux C. Obesity as a disease: a pressing need for alignment. Int J Obes (Lond) 2024:10.1038/s41366-024-01582-8. [PMID: 38987635 DOI: 10.1038/s41366-024-01582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024]
Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland.
| | - Carel le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
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Chen Q, Li K, Liu Y, Yu X, Ou F. Association of body composition indicators with colorectal cancer: a hospital-based case-control study. J Cancer Res Clin Oncol 2024; 150:344. [PMID: 38981909 PMCID: PMC11233301 DOI: 10.1007/s00432-024-05866-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE Colorectal cancer (CRC) is a common malignancy that affects adults worldwide, causing a high disease burden. Few studies have examined the relationship between body composition (BC) measures and the prevalence of CRC. Our purpose was to investigate the relationship between pertinent BC indicators and CRC. METHODS Bioelectrical impedance analysis, laboratory test results, face-to-face questionnaire investigation, and nutritional risk assessment (Nutritional Risk Screening 2002 and Patient-Generated Subjective Global Assessment) were used in this case-control study. Bioelectrical impedance analysis in the case group was performed prior to antitumor therapy/surgery. RESULTS From June 2018 to January 2019, a total of 303 cases and 286 controls were included. The results showed that low body fat percentage (BFP) and high visceral adiposity index (VAI) groups had a higher risk of developing CRC in comparison to the normal BFP and normal VAI groups. The risk of CRC decreased with the increase of BFP. The group with a normal BC had a lower risk of developing CRC compared to those with a greater VAI and a lower BFP, as indicated by the results of the pairwise and total combinations of VAI, fat-free mass index (FFMI), and BFP. Additionally, FFMI and VAI had positive correlations with prealbumin, serum albumin, and nutritional risk scores. CONCLUSION Low BFP and high VAI are associated with higher CRC risk. FFMI and VAI are positively correlated with prealbumin, serum albumin, and nutritional risk scores in CRC patients.
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Affiliation(s)
- Qiujin Chen
- Department of Clinical Nutrition, The First Hospital of China Medical University, Shenyang, 110001, China
- Department of Immunization, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, 214023, China
| | - Kai Li
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Yang Liu
- Department of Clinical Nutrition, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Xiaozhai Yu
- Department of Clinical Nutrition, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Fengrong Ou
- Department of Clinical Nutrition, The First Hospital of China Medical University, Shenyang, 110001, China.
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Gordito Soler M, López-González ÁA, Vallejos D, Martínez-Almoyna Rifá E, Vicente-Herrero MT, Ramírez-Manent JI. Usefulness of Body Fat and Visceral Fat Determined by Bioimpedanciometry versus Body Mass Index and Waist Circumference in Predicting Elevated Values of Different Risk Scales for Non-Alcoholic Fatty Liver Disease. Nutrients 2024; 16:2160. [PMID: 38999907 PMCID: PMC11243258 DOI: 10.3390/nu16132160] [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: 06/03/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. METHODS A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. RESULTS As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). CONCLUSIONS In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.
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Affiliation(s)
| | - Ángel Arturo López-González
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07010 Palma, Balearic Islands, Spain
| | - Daniela Vallejos
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07010 Palma, Balearic Islands, Spain
| | - Emilio Martínez-Almoyna Rifá
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07010 Palma, Balearic Islands, Spain
| | - María Teófila Vicente-Herrero
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain
| | - José Ignacio Ramírez-Manent
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain
- Institut d'Investigació Sanitària de les Illes Balears (IDISBA), Balearic Islands Health Research Institute Foundation, 07010 Palma, Balearic Islands, Spain
- Balearic Islands Health Service, 07010 Palma, Balearic Islands, Spain
- Faculty of Medicine, University of the Balearic Islands, 07010 Palma, Balearic Islands, Spain
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Boulanger B, Bégin C, Bédard A, Lévy-Ndejuru J, Carbonneau É, Lemieux S. A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI. Appl Physiol Nutr Metab 2024; 49:966-978. [PMID: 38527328 DOI: 10.1139/apnm-2023-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.
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Affiliation(s)
- Benoît Boulanger
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
| | - Julia Lévy-Ndejuru
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Élise Carbonneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
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Jakubiak GK, Pawlas N, Morawiecka-Pietrzak M, Starzak M, Stanek A, Cieślar G. Retrospective Cross-Sectional Study of the Relationship of Thyroid Volume and Function with Anthropometric Measurements, Body Composition Analysis Parameters, and the Diagnosis of Metabolic Syndrome in Euthyroid People Aged 18-65. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1080. [PMID: 39064509 PMCID: PMC11278658 DOI: 10.3390/medicina60071080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: The thyroid is a key endocrine gland for the regulation of metabolic processes. A body composition analysis (BCA) is a valuable complement to the assessment of body mass index, which is derived only from body weight and height. This cross-sectional retrospective study aimed to investigate the relationships between thyroid volume (TV) and thyroid function parameters, anthropometric measurements, BCA parameters, and the presence of metabolic syndrome (MetS) in adults without clinically overt thyroid disease. Material and Methods: This study involved 45 people (females: 57.8%; MetS: 28.9%) hospitalized for planned diagnostics without signs of acute illness or a deterioration of their health and without thyroid disease, who underwent thyroid ultrasound scans, biochemical tests to assess their thyroid function, MetS assessments, anthropometric measurements, and BCAs using the bioelectrical impedance method. Results: The TV was significantly larger in people with MetS compared to people without MetS. The TV was significantly higher and the serum thyrotropin (TSH) concentration was significantly lower in overweight and obese people than in normal and underweight people. The free triiodothyronine (FT3) serum concentration and TV were correlated with waist circumference and some parameters of the BCA, and the FT3 concentration was also correlated with the body mass index, waist-hip ratio, and waist-height ratio. No significant correlations were found between the FT4 and TSH and the results of the anthropometric and BCA measurements. Conclusions: Even in a population of euthyroid patients without clinically overt thyroid disease, there were some significant relationships between the volume and function of the thyroid gland and the results of their anthropometric parameters, BCAs, and the presence of MetS features.
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Affiliation(s)
- Grzegorz K. Jakubiak
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-902 Bytom, Poland; (A.S.); (G.C.)
| | - Natalia Pawlas
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland;
| | | | - Monika Starzak
- Department of Internal Medicine, Angiology and Physical Medicine, Specialist Hospital No. 2, 41-902 Bytom, Poland;
| | - Agata Stanek
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-902 Bytom, Poland; (A.S.); (G.C.)
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-902 Bytom, Poland; (A.S.); (G.C.)
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10
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Huang C, Xu S, Chen R, Ding Y, Fu Q, He B, Jiang T, Zeng B, Bao M, Li S. Assessing causal associations of bile acids with obesity indicators: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e38610. [PMID: 38905395 PMCID: PMC11191951 DOI: 10.1097/md.0000000000038610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024] Open
Abstract
Maintaining a balanced bile acids (BAs) metabolism is essential for lipid and cholesterol metabolism, as well as fat intake and absorption. The development of obesity may be intricately linked to BAs and their conjugated compounds. Our study aims to assess how BAs influence the obesity indicators by Mendelian randomization (MR) analysis. Instrumental variables of 5 BAs were obtained from public genome-wide association study databases, and 8 genome-wide association studies related to obesity indicators were used as outcomes. Causal inference analysis utilized inverse-variance weighted (IVW), weighted median, and MR-Egger methods. Sensitivity analysis involved MR-PRESSO and leave-one-out techniques to detect pleiotropy and outliers. Horizontal pleiotropy and heterogeneity were assessed using the MR-Egger intercept and Cochran Q statistic, respectively. The IVW analysis revealed an odds ratio of 0.94 (95% confidence interval: 0.88, 1.00; P = .05) for the association between glycolithocholate (GLCA) and obesity, indicating a marginal negative causal association. Consistent direction of the estimates obtained from the weighted median and MR-Egger methods was observed in the analysis of the association between GLCA and obesity. Furthermore, the IVW analysis demonstrated a suggestive association between GLCA and trunk fat percentage, with a beta value of -0.014 (95% confidence interval: -0.027, -0.0004; P = .04). Our findings suggest a potential negative causal relationship between GLCA and both obesity and trunk fat percentage, although no association survived corrections for multiple comparisons. These results indicate a trend towards a possible association between BAs and obesity, emphasizing the need for future studies.
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Affiliation(s)
- Chunxia Huang
- School of Stomatology, Changsha Medical University, Changsha, China
| | - Shuling Xu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Rumeng Chen
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yining Ding
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Qingming Fu
- School of Stomatology, Changsha Medical University, Changsha, China
| | - Binsheng He
- The Hunan Provincial Key Laboratory of the TCM Agricultural Biogenomics, Changsha Medical University, Changsha, China
| | - Ting Jiang
- School of Stomatology, Changsha Medical University, Changsha, China
| | - Bin Zeng
- School of Stomatology, Changsha Medical University, Changsha, China
| | - Meihua Bao
- The Hunan Provincial Key Laboratory of the TCM Agricultural Biogenomics, Changsha Medical University, Changsha, China
- Hunan Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, School of Pharmaceutical Science, Changsha Medical University, Changsha, China
| | - Sen Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
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11
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Wu Y, Li D, Vermund SH. Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:757. [PMID: 38929003 PMCID: PMC11204233 DOI: 10.3390/ijerph21060757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
Obesity reflects excessive fat deposits. At-risk individuals are guided by healthcare professionals to eat fewer calories and exercise more, often using body mass index (BMI; weight/height2) thresholds for screening and to guide progress and prognosis. By conducting a mini-narrative review of original articles, websites, editorials, commentaries, and guidelines, we sought to place BMI in the context of its appropriate use in population health, clinical screening, and monitoring in clinical care. The review covers studies and publications through 2023, encompassing consensus reviews and relevant literature. Recent consensus reviews suggest that BMI is a valuable tool for population surveys and primary healthcare screening but has limitations in predicting the risk of chronic diseases and assessing excess fat. BMI can guide nutritional and exercise counseling, even if it is inadequate for reliable individual risk prediction. BMI cut-offs must be reconsidered in populations of varying body build, age, and/or ethnicity. Since BMI-diagnosed overweight persons are sometimes physically and physiologically fit by other indicators, persons who are overweight on BMI should be more fully evaluated, diagnosed, and monitored with combined anthropometric and performance metrics to better clarify risks. The use of combined anthropometric and performance metrics involves integrating measurements of body composition with assessments of physical function and fitness to provide a more comprehensive evaluation of an individual's health and fitness status. Eligibility for bariatric surgery or semaglutide satiety/appetite-reduction medications should not be determined by BMI alone. Awareness of the advantages and limitations of using BMI as a tool to assess adult obesity can maximize its appropriate use in the context of population health and in rapid clinical screening and evaluation.
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Affiliation(s)
- Yilun Wu
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Dan Li
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Sten H. Vermund
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
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12
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Ghosh S, Bouchard C. Considerations on efforts needed to improve our understanding of the genetics of obesity. Int J Obes (Lond) 2024:10.1038/s41366-024-01528-0. [PMID: 38849463 DOI: 10.1038/s41366-024-01528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Sujoy Ghosh
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
| | - Claude Bouchard
- Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA.
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13
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Cannarella R, Crafa A, Curto R, Condorelli RA, La Vignera S, Calogero AE. Obesity and male fertility disorders. Mol Aspects Med 2024; 97:101273. [PMID: 38593513 DOI: 10.1016/j.mam.2024.101273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
Often associated with obesity, male infertility represents a widespread condition that challenges the wellbeing of the couple. In this article, we provide a comprehensive and critical analysis of studies exploring the association between obesity and male reproductive function, to evaluate the frequency of this association, and establish the effects of increased body weight on conventional and biofunctional sperm parameters and infertility. In an attempt to find possible molecular markers of infertility in obese male patients, the numerous mechanisms responsible for infertility in overweight/obese patients are reviewed in depth. These include obesity-related functional hypogonadism, insulin resistance, hyperinsulinemia, chronic inflammation, adipokines, irisin, gut hormones, gut microbiome, and sperm transcriptome. According to meta-analytic evidence, excessive body weight negatively influences male reproductive health. This can occurr through a broad array of molecular mechanisms. Some of these are not yet fully understood and need to be further elucidated in the future. A better understanding of the effects of metabolic disorders on spermatogenesis and sperm fertilizing capacity is very useful for identifying new diagnostic markers and designing therapeutic strategies for better clinical management of male infertility.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Roberto Curto
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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14
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Walton KLW. Approaches to teaching about mechanisms of obesity in undergraduate pathophysiology courses. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:304-308. [PMID: 38452331 DOI: 10.1152/advan.00122.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/13/2024] [Accepted: 03/05/2024] [Indexed: 03/09/2024]
Abstract
Views of obesity as a consequence of "lack of willpower" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.NEW & NOTEWORTHY This article describes approaches for teaching obesity in an allied health major pathophysiology course, and, additionally, in an upper-division biology major course on the cellular and molecular basis of disease.
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Affiliation(s)
- Kristen L W Walton
- Department of Biology, Missouri Western State University, St. Joseph, Missouri, United States
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15
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Feng T, Hu S, Song C, Zhong M. Establishment of a novel weight reduction model after laparoscopic sleeve gastrectomy based on abdominal fat area. Front Surg 2024; 11:1390045. [PMID: 38826810 PMCID: PMC11140024 DOI: 10.3389/fsurg.2024.1390045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/17/2024] [Indexed: 06/04/2024] Open
Abstract
In light of ongoing research elucidating the intricacies of obesity and metabolic syndrome, the role of abdominal fat (especially visceral fat) has been particularly prominent. Studies have revealed that visceral adipose tissue can accelerate the development of metabolic syndrome by releasing various bioactive compounds and hormones, such as lipocalin, leptin and interleukin. A retrospective analysis was performed on the clinical data of 167 patients with obesity. Among them, 105 patients who satisfied predefined inclusion and exclusion criteria were included. The parameters evaluated included total abdominal fat area (TAFA), laboratory indicators and anthropometric measurements. Weight reduction was quantified through percent total weight loss (%TWL) and percent excess weight loss (%EWL) postoperatively. Binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to identify predictors of weight loss. Binary logistic regression analysis emphasized that total abdominal fat area was an independent predictor of %EWL ≥75% (p < 0.001). Total abdominal fat area (p = 0.033) and BMI (p = 0.003) were independent predictors of %TWL ≥30%. In our cohort, %TWL ≥30% at 1 year after surgery was closely related to the abdominal fat area and BMI. Based on these results, we formulated a novel model based on these factors, exhibiting superior predictive value for excellent weight loss.
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Affiliation(s)
- Tianyi Feng
- Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Sanyuan Hu
- Department of General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Changrong Song
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
| | - Mingwei Zhong
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
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16
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Liu X, He M, Li Y. Adult obesity diagnostic tool: A narrative review. Medicine (Baltimore) 2024; 103:e37946. [PMID: 38669386 PMCID: PMC11049696 DOI: 10.1097/md.0000000000037946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Obesity is a complex chronic metabolic disorder characterized by abnormalities in lipid metabolism. Obesity is not only associated with various chronic diseases but also has negative effects on physiological functions such as the cardiovascular, endocrine and immune systems. As a global health problem, the incidence and prevalence of obesity have increased significantly in recent years. Therefore, understanding assessment methods and measurement indicators for obesity is critical for early screening and effective disease control. Current methods for measuring obesity in adult include density calculation, anthropometric measurements, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, computerized imaging, etc. Measurement indicators mainly include weight, hip circumference, waist circumference, neck circumference, skinfold thickness, etc. This paper provides a comprehensive review of the literature to date, summarizes and analyzes various assessment methods and measurement indicators for adult obesity, and provides insights and guidance for the innovation of obesity assessment indicators.
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Affiliation(s)
- Xiaolong Liu
- School of Life & Environmental Sciences, Guilin University of Electronic Technology, Guilin, Guangxi, China
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, Guangxi, China
- Rehabilitation College, Guilin Life and Health Career Technical College, Guilin, Guangxi, China
| | - Mengxiao He
- School of Physical Education and Health, Guilin University, Guilin, Guangxi, China
| | - Yi Li
- School of Physical Education and Health, Guilin University, Guilin, Guangxi, China
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17
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Heymsfield SB. Advances in body composition: a 100-year journey. Int J Obes (Lond) 2024:10.1038/s41366-024-01511-9. [PMID: 38643327 DOI: 10.1038/s41366-024-01511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 04/22/2024]
Abstract
Knowledge of human body composition at the dawn of the twentieth century was based largely on cadaver studies and chemical analyses of isolated organs and tissues. Matters soon changed by the nineteen twenties when the Czech anthropologist Jindřich Matiegka introduced an influential new anthropometric method of fractionating body mass into subcutaneous adipose tissue and other major body components. Today, one century later, investigators can not only quantify every major body component in vivo at the atomic, molecular, cellular, tissue-organ, and whole-body organizational levels, but go far beyond to organ and tissue-specific composition and metabolite estimates. These advances are leading to an improved understanding of adiposity structure-function relations, discovery of new obesity phenotypes, and a mechanistic basis of some weight-related pathophysiological processes and adverse clinical outcomes. What factors over the past one hundred years combined to generate these profound new body composition measurement capabilities in living humans? This perspective tracks the origins of these scientific innovations with the aim of providing insights on current methodology gaps and future research needs.
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Affiliation(s)
- Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
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18
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Dubovyk V, Vasileiadis GK, Fatima T, Zhang Y, Kapetanovic MC, Kastbom A, Rizk M, Söderbergh A, Zhao SS, van Vollenhoven RF, Hetland ML, Haavardsholm EA, Nordström D, Nurmohamed MT, Gudbjornsson B, Lampa J, Østergaard M, Heiberg MS, Sokka-Isler T, Gröndal G, Lend K, Hørslev-Petersen K, Uhlig T, Rudin A, Maglio C. Obesity is a risk factor for poor response to treatment in early rheumatoid arthritis: a NORD-STAR study. RMD Open 2024; 10:e004227. [PMID: 38580350 PMCID: PMC11148705 DOI: 10.1136/rmdopen-2024-004227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE This report from the NORD-STAR (Nordic Rheumatic Diseases Strategy Trials and Registries) trial aimed to determine if obesity is associated with response to conventional and biological antirheumatic treatment in early rheumatoid arthritis (RA). METHODS This report included 793 participants with untreated early RA from the randomised, longitudinal NORD-STAR trial, all of whom had their body mass index (BMI) assessed at baseline. Obesity was defined as BMI ≥30 kg/m2. All participants were randomised 1:1:1:1 to one of four treatment arms: active conventional treatment, certolizumab-pegol, abatacept and tocilizumab. Clinical and laboratory measurements were performed at baseline and at 8, 12, 24 and 48-week follow-up. The primary endpoint for this report was response to treatment based on Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) remission and Disease Activity Score with 28 joints using C-reactive protein (DAS28-CRP) <2.6 stratified by BMI. RESULTS Out of 793 people included in the present report, 161 (20%) had obesity at baseline. During follow-up, participants with baseline obesity had higher disease activity compared with those with lower BMI, despite having similar disease activity at baseline. In survival analyses, obesity was associated with a lower likelihood of achieving response to treatment during follow-up for up to 48 weeks (CDAI remission, HR 0.84, 95% CI 0.67 to 1.05; SDAI, HR 0.77, 95% CI 0.62 to 0.97; DAS28-CRP <2.6, HR 0.78, 95% CI 0.64 to 0.95). The effect of obesity on response to treatment was not influenced by the treatment arms. CONCLUSION In people with untreated early RA followed up for up to 48 weeks, obesity was associated with a lower likelihood of good treatment response, irrespective of the type of randomised treatment received. TRIAL REGISTRATION NUMBER NCT01491815.
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Affiliation(s)
- Violetta Dubovyk
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Georgios K Vasileiadis
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Tahzeeb Fatima
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Yuan Zhang
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | | | - Alf Kastbom
- Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
| | - Milad Rizk
- Rheumatology Clinic, Västmanlands Hospital, Vasteras, Sweden
| | - Annika Söderbergh
- Department of Rheumatology, Örebro University Hospital, Orebro, Sweden
| | - Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Science, The University of Manchester, Manchester, UK
| | - Ronald F van Vollenhoven
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
- Rheumatology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Merete Lund Hetland
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Espen A Haavardsholm
- Centre for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Dan Nordström
- Department of Medicine and Rheumatology, Helsinki University Central Hospital, Helsinki, Uusimaa, Finland
| | - Michael T Nurmohamed
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology center, Amsterdam, The Netherlands
| | - Bjorn Gudbjornsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Jon Lampa
- Rheumatology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marte Schrumpf Heiberg
- Centre for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
| | - Tuulikki Sokka-Isler
- Department of Medicine, Jyväskylä Central Hospital, University of Eastern Finland, Jyväskylä, Finland
| | - Gerdur Gröndal
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Centre for Rheumatology Research, Landspitali University Hospital, Reykjavik, Iceland
| | - Kristina Lend
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
- Rheumatology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kim Hørslev-Petersen
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Till Uhlig
- Centre for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anna Rudin
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
| | - Cristina Maglio
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
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19
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Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. ROFO-FORTSCHR RONTG 2024. [PMID: 38569516 DOI: 10.1055/a-2263-1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND This review discusses the quantitative assessment of tissue composition in the human body (body composition, BC) using radiological methods. Such analyses are gaining importance, in particular, for oncological and metabolic problems. The aim is to present the different methods and definitions in this field to a radiological readership in order to facilitate application and dissemination of BC methods. The main focus is on radiological cross-sectional imaging. METHODS The review is based on a recent literature search in the US National Library of Medicine catalog (pubmed.gov) using appropriate search terms (body composition, obesity, sarcopenia, osteopenia in conjunction with imaging and radiology, respectively), as well as our own work and experience, particularly with MRI- and CT-based analyses of abdominal fat compartments and muscle groups. RESULTS AND CONCLUSION Key post-processing methods such as segmentation of tomographic datasets are now well established and used in numerous clinical disciplines, including bariatric surgery. Validated reference values are required for a reliable assessment of radiological measures, such as fatty liver or muscle. Artificial intelligence approaches (deep learning) already enable the automated segmentation of different tissues and compartments so that the extensive datasets can be processed in a time-efficient manner - in the case of so-called opportunistic screening, even retrospectively from diagnostic examinations. The availability of analysis tools and suitable datasets for AI training is considered a limitation. KEY POINTS · Radiological imaging methods are increasingly used to determine body composition (BC).. · BC parameters are usually quantitative and well reproducible.. · CT image data from routine clinical examinations can be used retrospectively for BC analysis.. · Prospectively, MRI examinations can be used to determine organ-specific BC parameters.. · Automated and in-depth analysis methods (deep learning or radiomics) appear to become important in the future.. CITATION FORMAT · Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2263-1501.
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Affiliation(s)
- Nicolas Linder
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Sankt Gallen, Switzerland
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
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20
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Di Fusco SA, Mocini E, Gori M, Iacoviello M, Bilato C, Corda M, De Luca L, Di Marco M, Geraci G, Iacovoni A, Milli M, Navazio A, Pascale V, Riccio C, Scicchitano P, Tizzani E, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists position paper-obesity in adults: a clinical primer. Eur Heart J Suppl 2024; 26:ii221-ii235. [PMID: 38784672 PMCID: PMC11110455 DOI: 10.1093/eurheartjsupp/suae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient-clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.
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Affiliation(s)
- Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mauro Gori
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Iacoviello
- S.C. Di Cardiologia Universitaria-Utic Policlinico Riuniti, Foggia, Italy
| | - Claudio Bilato
- U.O.C. Cardiologia, Dipartimento di Medicina Cardiovascolare, Ospedali dell’Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Marco Corda
- S.C. Cardiologia e UTIC, Dipartimento Cardiovascolare, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | - Leonardo De Luca
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Giovanna Geraci
- U.O. Cardiologia, P.O. Sant’Antonio Abate, ASP Trapani, Erice, TP, Italy
| | - Attilio Iacovoni
- Dipartimento Cardiovascolare, SSD Chirurgia dei Trapianti e del Trattamento Chirurgico dello Scompenso, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Massimo Milli
- Cardiologia Firenze 1 (Ospedali S. Maria Nuova e Nuovo San Giovanni di Dio), Azienda USL Toscana Centro, Firenze, Italy
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia—IRCCS, Reggio Emilia, Italy
| | - Vittorio Pascale
- SOC di Cardiologia-UTIC-Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero ‘Pugliese’, Azienda Ospedaliero-Universitaria ‘Renato Dulbecco’, Catanzaro, Italy
| | - Carmine Riccio
- Dipartimento Cardio-Vascolare, U.O.S.D. Follow-up del Paziente Post-Acuto, AORN Sant’Anna e San Sebastiano, Caserta, Italy
| | | | - Emanuele Tizzani
- Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli, TO, Italy
| | - Domenico Gabrielli
- Fondazione per il Tuo cuore—Heart Care Foundation, Firenze, Italy
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - Massimo Grimaldi
- U.O.C. Cardiologia-UTIC, Ospedale Miulli, Acquaviva delle Fonti, BA, Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Dipartimento di Emergenza e Accettazione, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, via Martinotti 20, 00135 Roma, Italy
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
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21
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Liang LX, Lin LZ, Zeeshan M, Zhou Y, Tang YX, Chu C, Zhang YT, Liu RQ, Feng W, Dong GH. Relationship of single and co-exposure of per-and polyfluoroalkyl substances and their alternatives with uric acid: A community-based study in China. JOURNAL OF HAZARDOUS MATERIALS 2024; 466:133500. [PMID: 38266584 DOI: 10.1016/j.jhazmat.2024.133500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/29/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
Numerous studies have suggested per-and polyfluoroalkyl substances (PFASs) are related to uric acid levels, but evidence related to PFAS alternatives is limited. Moreover, the effect of the combined exposure to PFASs and their alternatives on uric acid has not been reported. Hence, we conducted a cross-sectional study involving 1312 adults in Guangzhou, China. Generalized linear regression model was adopted to explore the effect of single PFAS exposure on serum uric acid levels. Further, multi-pollutant models such as Bayesian kernel machine regression, weighted quantile sum, and quantile G-computation were employed to investigate the combined association of PFASs and alternatives with serum uric acid levels. We performed molecular docking to understand the potential interaction of PFAS with Organic Anion Transporters (OATs), involved in the secretion of uric acid. Per log serum 6:2 Cl-PFESA and PFOA increases were accompanied with an increase of serum uric acid with statistical significance (for 6:2 Cl-PFESA: beta: 0.19 ng/mL, 95% CI 0.11-0.26 and for PFOA: beta: 0.43 ng/mL, 95% CI 0.34-0.52). The associations were strongest among overweight and elderly. Multi-pollutant models also revealed a positive association. These positive associations may be PFASs can competitively combine with OAT1 and OAT3, leading to the increase of serum uric acid.
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Affiliation(s)
- Li-Xia Liang
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Zi Lin
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Mohammed Zeeshan
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Developmental Biology and Genetics, Indian Institute of Science, Bangalore, India
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Yong-Xiang Tang
- Occupational Health Surveillance Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Chu Chu
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yun-Ting Zhang
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ru-Qing Liu
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wenru Feng
- Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
| | - Guang-Hui Dong
- Joint International Research Laboratory of Environment and Health, Ministry of Education,Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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22
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Velasquez-Mieyer PA, Nieto-Martinez R, Neira CP, De Oliveira-Gomes D, Velasquez Rodriguez AE, Ugel E, Cowan PA. Relative Body Mass Index Improves the BMI Percentile Performance for Detection and Monitoring of Excess Adiposity in Adolescents. Nutrients 2024; 16:703. [PMID: 38474830 DOI: 10.3390/nu16050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/18/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Obesity is defined as excess adipose tissue; however, commonly used methods may under-detect adiposity in adolescents. This study compared the performance of body mass index percentile (BMI%) and relative body mass index (RBMI) in identifying excess body fat percentage (BF%) and estimated RBMI cut points to better stratify severity of adiposity. In 567 adolescents ages 11-19 year, BF% measured by DXA was used to compare BMI% and RBMI performance at different degrees of adiposity. RBMI cut points for adiposity detection were derived via ROC curve analysis. BF% was strongly correlated with BMI% (r = 0.889, p < 0.001) and RBMI (r = 0.901, p < 0.001). However, RBMI exhibited less dispersion and better discriminated the relationship with BF% independent of age, race, and gender. Both BMI% and RBMI performed similarly for detecting high BF% (≥25 BF% in males; ≥30 BF% in females). Nonetheless, the relationship of BMI% with BF% was diminished among leaner adolescents. RBMI detected overweight in 21.3% more females and 14.2% more males. RBMI improved the detection of excess adiposity in individuals otherwise classified as having normal weight or overweight by BMI%. RBMI is a valuable and accessible tool for earlier detection, intervention, and effective follow-up of excess adiposity in youth at higher risk for complications.
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Affiliation(s)
- Pedro A Velasquez-Mieyer
- Lifedoc Health, 6625 Lenox Park Drive, Suite 205, Memphis, TN 38115, USA
- Lifedoc Research, 6625 Lenox Park Drive, Suite 205, Memphis, TN 38115, USA
| | - Ramfis Nieto-Martinez
- Lifedoc Health, 6625 Lenox Park Drive, Suite 205, Memphis, TN 38115, USA
- Departments of Global Health and Population and Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Claudia P Neira
- Lifedoc Health, 6625 Lenox Park Drive, Suite 205, Memphis, TN 38115, USA
- Lifedoc Research, 6625 Lenox Park Drive, Suite 205, Memphis, TN 38115, USA
| | - Diana De Oliveira-Gomes
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | | | - Eunice Ugel
- Departments of Global Health and Population and Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Patricia A Cowan
- College of Nursing, University of Arkansas for Medical Science, Little Rock, AR 72205, USA
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23
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Lima LCBDA, Aquino SLS, da Cunha ATO, Peixoto TDN, Lima SCVC, Sena-Evangelista KCM, Lima JG, Pedrosa LFC. Associations between Components of Metabolic Syndrome and Demographic, Nutritional, and Lifestyle Factors. J Nutr Metab 2024; 2024:8821212. [PMID: 38282753 PMCID: PMC10817810 DOI: 10.1155/2024/8821212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives To evaluate the associations between individuals with and without changes in components of metabolic syndrome (MetS) and demographic, nutritional, and lifestyle factors. Methods A cross-sectional study was conducted with 224 individuals followed-up at a public hospital in Northeast Brazil. We used National Cholesterol Education Program-Adult Treatment Panel III (NCEP) criteria to diagnose MetS. We assessed components of MetS as dependent variables, while sex, age, food consumption, smoking, alcohol intake, physical activity, anthropometric parameters, and sleep hours were independent variables. Results Comparing individuals with and without changes in components of MetS, the logistic regression models revealed that female sex was predictive of increased waist circumference and low HDL-c levels while advanced age was predictive of increased blood pressure and blood glucose levels. BMI emerged as a predictor for waist circumference and a protective factor for triglyceride levels. In addition, potassium intake, physical activity, and sleep duration were protective against decreased HDL-c, elevated triglyceride, and elevated blood pressure levels, respectively. Conclusion This study demonstrated that sex, age, BMI, dietary potassium intake, physical activity, and hours of sleep are factors to be targeted in public health actions for prevention and treatment of MetS.
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Affiliation(s)
| | - Séphora Louyse Silva Aquino
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
| | - Aline Tuane Oliveira da Cunha
- Collaborative Researcher in Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, Brazil
| | - Talita do Nascimento Peixoto
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
| | - Severina Carla Vieira Cunha Lima
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
| | - Karine Cavalcanti Maurício Sena-Evangelista
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
| | - Josivan Gomes Lima
- Department of Clinical Medicine, Endocrine Unit, Federal University of Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN 59010-180, Brazil
| | - Lucia Fátima Campos Pedrosa
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal 59078970, RN, Brazil
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte, Av. Cordeiro de Farias s/n, Natal 59012-570, RN, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Salgado Filho, 3000-Lagoa Nova, Natal, RN 59078-970, Brazil
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24
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Garg D, Que LG, Ingram JL. Effects of biological therapies on patients with Type-2 high asthma and comorbid obesity. Front Pharmacol 2024; 14:1315540. [PMID: 38259298 PMCID: PMC10800376 DOI: 10.3389/fphar.2023.1315540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Over 20 million adults and 6 million children in the United States (US) have asthma, a chronic respiratory disease characterized by airway inflammation, bronchoconstriction, and mucus hypersecretion. Obesity, another highly prevalent disease in the US, is a major risk factor for asthma and a significant cause of diminished asthma control, increased submucosal eosinophilia, and reduced quality of life. A large subgroup of these patients experiences severe symptoms and recurrent exacerbations despite maximal dosage of standard asthma therapies. In the past two decades, the development of biological therapies has revolutionized the field and advanced our understanding of type 2 inflammatory biomarkers. However, patients with obesity and comorbid asthma are not principally considered in clinical trials of biologics. Large landmark cluster analyses of patients with asthma have consistently identified specific asthma phenotypes that associate with obesity but may be differentiated by age of asthma onset and inflammatory cell profiles in sputum. These patterns suggest that biologic processes driving asthma pathology are heterogenous among patients with obesity. The biological mechanisms driving pathology in patients with asthma and comorbid obesity are not well understood and likely multifactorial. Future research needs to be done to elicit the cellular and metabolic functions in the relationship of obesity and asthma to yield the best treatment options for this multiplex condition. In this review, we explore the key features of type 2 inflammation in asthma and discuss the effectiveness, safety profile, and research gaps regarding the currently approved biological therapies in asthma patients with obesity.
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Affiliation(s)
- Diya Garg
- Department of Pathology and Laboratory Medicine, Neurology, and Biological Chemistry, Irvine, CA, United States
| | - Loretta G. Que
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, United States
| | - Jennifer L. Ingram
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, NC, United States
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25
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Di Fusco SA, Mocini E, Gulizia MM, Gabrielli D, Grimaldi M, Oliva F, Colivicchi F. ANMCO (Italian Association of Hospital Cardiologists) scientific statement: obesity in adults-an approach for cardiologists. Eat Weight Disord 2024; 29:1. [PMID: 38168872 PMCID: PMC10761446 DOI: 10.1007/s40519-023-01630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Obesity is a complex, chronic disease requiring a multidisciplinary approach to its management. In clinical practice, body mass index and waist-related measurements can be used for obesity screening. The estimated prevalence of obesity among adults worldwide is 12%. With the expected further increase in overall obesity prevalence, clinicians will increasingly be managing patients with obesity. Energy balance is regulated by a complex neurohumoral system that involves the central nervous system and circulating mediators, among which leptin is the most studied. The functioning of these systems is influenced by both genetic and environmental factors. Obesity generally occurs when a genetically predisposed individual lives in an obesogenic environment for a long period. Cardiologists are deeply involved in evaluating patients with obesity. Cardiovascular risk profile is one of the most important items to be quantified to understand the health risk due to obesity and the clinical benefit that a single patient can obtain with weight loss. At the individual level, appropriate patient involvement, the detection of potential obesity causes, and a multidisciplinary approach are tools that can improve clinical outcomes. In the near future, we will probably have new pharmacological tools at our disposal that will facilitate achieving and maintaining weight loss. However, pharmacological treatment alone cannot cure such a complex disease. The aim of this paper is to summarize some key points of this field, such as obesity definition and measurement tools, its epidemiology, the main mechanisms underlying energy homeostasis, health consequences of obesity with a focus on cardiovascular diseases and the obesity paradox.Level of evidence V: report of expert committees.
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Affiliation(s)
- Stefania Angela Di Fusco
- Emergency Department, Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00161, Rome, Italy.
| | | | - Domenico Gabrielli
- Cardio-Thoracic-Vascular Department, San Camillo-Forlanini Hospital, Rome, Italy
- Heart Care Foundation, Florence, Italy
| | - Massimo Grimaldi
- Department of Cardiology, General Regional Hospital "F. Miulli", Acquaviva delle Fonti, 70021, Bari, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162, Milan, Italy
| | - Furio Colivicchi
- Emergency Department, Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
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26
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Vajdi M, Khajeh M, Safaei E, Moeinolsadat S, Mousavi S, Seyedhosseini-Ghaheh H, Abbasalizad-Farhangi M, Askari G. Effects of chromium supplementation on body composition in patients with type 2 diabetes: A dose-response systematic review and meta-analysis of randomized controlled trials. J Trace Elem Med Biol 2024; 81:127338. [PMID: 37952433 DOI: 10.1016/j.jtemb.2023.127338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Several randomized controlled trials (RCTs) have demonstrated the beneficial effects of chromium supplementation in managing type 2 diabetes mellitus (T2DM). The current systematic review and meta-analysis aimed to investigate the associations between chromium supplementation and body composition in patients with T2DM. METHODS To achieve this, PubMed, Scopus, Embase, Cochrane Library, and Web of Science were searched for randomized clinical trials (RCTs) that reported the effects of chromium supplementation on body composition such as body weight (BW), body mass index (BMI), fat mass (FM), and waist circumference (WC) in patients with T2DM from inception until July 2023. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. RESULTS The meta-analysis included a total of 14 RCTs. The results showed that chromium supplementation did not have any significant effect on FM (WMD = -0.43%; 95% CI -0.94, 0.09), BMI (WMD: 0.09 kg/M2, 95% CI: -0.03, 0.20), WC (WMD: -0.47 cm, 95% CI: -1.10, 0.16), and BW (WMD: -0.26 kg, 95% CI: -0.69, 0.16). However, subgroup analysis revealed that chromium intake decreased FM in subjects aged ≥ 55 years and when chromium picolinate was used as an intervention. Additionally, there was a non-linear association between the dose of chromium supplementation and BW. CONCLUSIONS The meta-analysis suggests that chromium supplementation does not significantly reduce BW, BMI, WC, and FM in patients with T2DM. Further RCTs with large-scale are required to determine the possible anti-obesity effects of chromium in patients with T2DM.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Khajeh
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Safaei
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Samin Mousavi
- Department of Pharmacognosy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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27
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Moyad MA. Embracing the Pros and Cons of the New Weight Loss Medications (Semaglutide, Tirzepatide, Etc.). Curr Urol Rep 2023; 24:515-525. [PMID: 37659049 DOI: 10.1007/s11934-023-01180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE OF REVIEW The history of multiple weight loss medications has been a concerning paradox based on an increased cardiovascular risk despite significant reductions in adipose tissue and weight. A new class of weight loss medications could change this past narrative based on early preliminary results of cardiovascular risk (not events-still need to be determined) and weight reduction in non-diabetics that acutely competes with results achieved with bariatric surgery. The purpose of this review is to provide a comprehensive summary of the advantages and disadvantages of these newer medications, and how they could impact urology. RECENT FINDINGS Weight loss of - 15 to - 20% compared to baseline has become plausible in the short-term and preliminary guidance to reduce acute and chronic adverse events are receiving attention. However, the cost, access, conflicts of interest, supply chain, life-long adherence issues, and the long-term diverse implications on mental and physical health when exposed to this class of medications (GLP-1 agonists) are unknown. The profound caloric reductions should also result in baseline or ongoing nutritional deficiency testing, and general and specific dietary recommendations, which could theoretically mimic some bariatric surgery pre- and post-surgical protocols but has yet to be studied. Regardless, the potential impact of these medicines within a variety of medical specialties needs clinical research. Current and future lifestyle interventions, dietary patterns, and medicines in the weight loss category need to be held to a paradigm whereby cardiovascular health should improve with significant weight loss without a negative impact on mental health. In urology, the ability to impact cancer risk, ED, FSD, incontinence, infertility, nephrolithiasis, and multiple other endpoints are plausible (based on bariatric surgery data) but need preliminary clinical research. Other medicines with a similar or even larger potential impact are in clinical trials, and thus, a concise overview for clinicians and researchers was needed for objective guidance. Currently, comprehensive lifestyle changes utilized with and without these medications continue to garner positive mental, physical, and legacy effects, which suggest that they are as necessary as ever in the treatment of the numerous conditions impacted by unhealthy weight gain.
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Affiliation(s)
- Mark A Moyad
- Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA.
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28
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Muscogiuri G, Verde L, Colao A. Body Mass Index (BMI): Still be used? Eur J Intern Med 2023; 117:50-51. [PMID: 37709557 DOI: 10.1016/j.ejim.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy.
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29
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Huang Y, Hu Y, Bao B. Relationship of body mass index and visceral fat area combination with arterial stiffness and cardiovascular risk in cardiovascular disease-free people: NHANES (2011-2018). Endocr Connect 2023; 12:e230291. [PMID: 37668220 PMCID: PMC10563637 DOI: 10.1530/ec-23-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/05/2023] [Indexed: 09/06/2023]
Abstract
Background Obesity and arterial stiffness are strongly associated with cardiovascular disease; however, their relationship remains controversial. Methods Body mass index was measured using anthropometric evaluation, and visceral fat area was calculated using an absorptiometry scan. Results The data of 5309 participants were collected from NHANES (National Health and Nutrition Examination Survey) (2011-2018). Based on the normal-weight normal visceral fat group that was considered as a reference, ePWV increased in all other groups, with the obese grade 2 visceral obesity group increasing the most by 26.35 cm/s (95% CI: 13.52, 39.18, P < 0.001), followed by normal-weight visceral obesity group 24.43 cm/s (95% CI: 1.88, 46.98, P = 0.035), which was even higher than obese grade 1 visceral obesity (β: 21.16, 95% CI: 9.24, 33.07, P = 0.001), obese grade 2 normal visceral fat group (β: 13.8; 95% CI: 0.10, 27.5, P = 0.048) and overweight visceral obesity group (β: 10.23; 95% CI: 1.89, 18.57, P = 0.018). For the 10-year cardiovascular risk, the obese grade 2 visceral obesity group had a 9.56-fold increase in compared with the control (OR: 10.56, 95% CI: 4.06, 27.51, P < 0.0001). Normal-weight visceral obesity, obese grade 1 visceral obesity, and overweight visceral obesity groups increased by 8.03-fold (OR: 9.03, 95% CI: 2.66, 30.69; P < 0.001), 7.91-fold (OR: 8.91, 95% CI: 3.82, 20.79, P < 0.001), and 7.28-fold (OR: 8.28, 95% CI: 3.19, 21.46, P < 0.001). The risk was lower in the normal visceral fat group. Except for the obese grade 2 normal visceral fat group, there was no significant difference in other groups. Conclusions Normal-weight visceral obesity was associated with higher arterial stiffness and 10-year cardiovascular risk.
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Affiliation(s)
- Yuan Huang
- Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yunyun Hu
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Bingshu Bao
- The Second People’s Hospital, Luqiao, Taizhou, Zhejiang, China
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30
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Ramírez-Manent JI, López-González ÁA, Tomás-Gil P, Riutord-Sbert P, Garrido-Sepulveda L, Vicente-Herrero MT. Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome. Diagnostics (Basel) 2023; 13:3356. [PMID: 37958252 PMCID: PMC10649100 DOI: 10.3390/diagnostics13213356] [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: 09/20/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity-based on hip circumference-and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations. MATERIALS, METHODS A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models. RESULTS The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598. CONCLUSIONS AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.
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Affiliation(s)
- José Ignacio Ramírez-Manent
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
- Faculty of Medicine, University of the Balearic Islands, 07009 Palma, Spain
- Institut d’Investigació Sanitària de les Illes Balears (IDISBA), Balearic Islands Health Research Institute Foundation, 07004 Palma, Spain
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Spain
| | - Ángel Arturo López-González
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | - Pilar Tomás-Gil
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | - Pere Riutord-Sbert
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
| | | | - María Teofila Vicente-Herrero
- ADEMA-Health Group, IUNICS University of Balearic Islands, 07009 Palma, Spain; (J.I.R.-M.); (P.T.-G.); (P.R.-S.); (M.T.V.-H.)
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Deng LH, Chi K, Zong Y, Li Y, Chen MG, Chen P. Malnutrition in patients with head and neck cancer undergoing radiotherapy: A cross-sectional study. Eur J Oncol Nurs 2023; 66:102387. [PMID: 37611500 DOI: 10.1016/j.ejon.2023.102387] [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: 03/21/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE In this study, we investigated the prevalence of malnutrition and analyzed the related factors among patients with head and neck cancer (HNC) undergoing radiotherapy. METHODS We included 108 patients with head and neck cancer undergoing radiotherapy from the oncology and thoracic surgery departments of a comprehensive medical center in Qingdao between January 2019 and June 2020. We used the Nutritional Risk Screening-2002 tool (NRS-2002) to evaluate their nutritional status during radiotherapy. We analyzed the basic sociodemographic information and laboratory indicators of the respondents to examine the impact of these factors on nutritional status. RESULTS In the 108 patients that we studied, those aged ≥65 years had a significantly higher nutritional risk when compared to patients <65 years of age (P < 0.05). Univariate analysis revealed that a late tumor stage (P = 0.039), the neck being the site of radiotherapy (P = 0.009), the presence of diabetes (P < 0.001), and the presence of anxiety and depression (P = 0.002) were associated with nutritional risks for patients with head and neck cancer undergoing radiotherapy. Multivariate logistic regression analysis identified a late tumor stage, the neck being the radiotherapy site, and combined anxiety and depression as nutritional risk factors in such patients. CONCLUSION We found a high incidence of malnutrition in patients undergoing radiotherapy for HNC; this highlights the importance of early identification of patients at risk and evaluation of related risk factors to enhance the efficacy of nutritional interventions.
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Affiliation(s)
- Li-Hua Deng
- Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China
| | - Kun Chi
- Nursing Department, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China
| | - Yi Zong
- Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China
| | - Yi Li
- Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China
| | - Mei-Gui Chen
- Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China
| | - Peng Chen
- Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital), Qingdao, Shandong, 266003, China.
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Zadarko-Domaradzka M, Sobolewski M, Zadarko E. Comparison of Several Anthropometric Indices Related to Body Fat in Predicting Cardiorespiratory Fitness in School-Aged Children-A Single-Center Cross-Sectional Study. J Clin Med 2023; 12:6226. [PMID: 37834868 PMCID: PMC10573168 DOI: 10.3390/jcm12196226] [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: 09/05/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Body fat (BF) and cardiorespiratory fitness (CRF) are important health markers that ought to be considered in screening exams. The aim of this study was to assess the value of six indicators, i.e., tri-ponderal mass index (TMI), relative fat mass (RFM), waist-BMI ratio, waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and body mass index (BMI) in predicting CRF in school-aged children. The analysis was based on the data coming from the examination of 190 children participating in school physical education (PE) classes. Their body weight (BW) and height (BH), waist and hip circumference (WC; HC) and percentage of body fat (%BF) were measured; the CRF test was performed with the use of the 20 m shuttle run test (20 mSRT); peak heart rate (HRpeak) was measured; TMI, relative fat mass pediatric (RFMp), waist-BMI ratio, WHtR, BMI and WHR were calculated. Statistical analysis was mainly conducted using regression models. The developed regression models, with respect to the sex and age of the children, revealed RFMp as the strongest CRF indicator (R2 = 51.1%) and WHR as well as waist-BMI ratio as the weakest ones (R2 = 39.2% and R2 = 40.5%, respectively). In predicting CRF in school-aged children, RFMp turned out to be comparable to body fat percentage obtained by means of the bioimpedance analysis (BIA) (R2 = 50.3%), and as such it can be used as a simple screening measure in prophylactic exams of school children. All of these models were statistically significant (p < 0.001).
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Affiliation(s)
- Maria Zadarko-Domaradzka
- Institute of Physical Culture Sciences, College of Medical Sciences, Rzeszow University, 35-959 Rzeszow, Poland;
| | - Marek Sobolewski
- Department of Quantitative Methods Rzeszow, University of Technology, 35-959 Rzeszow, Poland;
| | - Emilian Zadarko
- Institute of Physical Culture Sciences, College of Medical Sciences, Rzeszow University, 35-959 Rzeszow, Poland;
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Mela V, Agüera Z, Alvarez-Bermudez MD, Martín-Reyes F, Granero R, Sánchez-García A, Oliva-Olivera W, Tomé M, Moreno-Ruiz FJ, Soler-Humanes R, Fernández-Serrano JL, Sánchez-Gallegos P, Martínez-Moreno JM, Sancho-Marín R, Fernández-Aranda F, García-Fuentes E, Tinahones FJ, Garrido-Sánchez L. The Relationship between Depressive Symptoms, Quality of Life and miRNAs 8 Years after Bariatric Surgery. Nutrients 2023; 15:4109. [PMID: 37836393 PMCID: PMC10574314 DOI: 10.3390/nu15194109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: There are conflicting results on whether weight loss after bariatric surgery (BS) might be associated with quality of life (QoL)/depressive symptomatology. We aim to determine whether BS outcomes are associated with QoL/depressive symptomatology in studied patients at the 8-year follow-up after BS, as well as their relationship with different serum proteins and miRNAs. (2) Methods: A total of 53 patients with class III obesity who underwent BS, and then classified into "good responders" and "non-responders" depending on the percentage of excess weight lost (%EWL) 8 years after BS (%EWL ≥ 50% and %EWL < 50%, respectively), were included. Basal serum miRNAs and different proteins were analysed, and patients completed tests to evaluate QoL/depressive symptomatology at 8 years after BS. (3) Results: The good responders group showed higher scores on SF-36 scales of physical functioning, role functioning-physical, role functioning-emotional, body pain and global general health compared with the non-responders. The expression of hsa-miR-101-3p, hsa-miR-15a-5p, hsa-miR-29c-3p, hsa-miR-144-3p and hsa-miR-19b-3p were lower in non-responders. Hsa-miR-19b-3p was the variable associated with the response to BS in a logistic regression model. (4) Conclusions: The mental health of patients after BS is limited by the success of the intervention. In addition, the expression of basal serum miRNAs related to depression/anxiety could predict the success of BS.
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Affiliation(s)
- Virginia Mela
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
| | - Zaida Agüera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
- Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola d’Infermeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
| | - Maria D. Alvarez-Bermudez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
| | - Flores Martín-Reyes
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | - Roser Granero
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Ana Sánchez-García
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
| | - Wilfredo Oliva-Olivera
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
| | - Monica Tomé
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain;
| | - Francisco J. Moreno-Ruiz
- Unidad de Gestión Clínica de Cirugía General y Digestiva, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain;
| | - Rocío Soler-Humanes
- Unidad de Gestión Clínica de Cirugía General y Digestiva, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (R.S.-H.); (J.L.F.-S.)
| | - Jose L. Fernández-Serrano
- Unidad de Gestión Clínica de Cirugía General y Digestiva, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain; (R.S.-H.); (J.L.F.-S.)
| | - Pilar Sánchez-Gallegos
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain; (P.S.-G.); (J.M.M.-M.); (R.S.-M.)
| | - Jose M. Martínez-Moreno
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain; (P.S.-G.); (J.M.M.-M.); (R.S.-M.)
| | - Raquel Sancho-Marín
- Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain; (P.S.-G.); (J.M.M.-M.); (R.S.-M.)
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Psychiatry, University Hospital of Bellvitge, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Eduardo García-Fuentes
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Francisco J. Tinahones
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
| | - Lourdes Garrido-Sánchez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Malaga, Spain; (V.M.); (M.D.A.-B.); (F.M.-R.); (A.S.-G.); (W.O.-O.); (L.G.-S.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029 Madrid, Spain; (Z.A.); (R.G.); (F.F.-A.)
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Cunningham SD, Mandelbaum J, Shebl FM, Abraham M, O’Connor Duffany K. Neighborhood Social Environment and Body Mass Index: The Mediating Role of Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6602. [PMID: 37623185 PMCID: PMC10454589 DOI: 10.3390/ijerph20166602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
The association between neighborhood-built environment and body mass index (BMI) is well-characterized, whereas fewer studies have explored the mechanisms underlying the relationship between neighborhood social environment and obesogenic behaviors. Using data from a random sample of 16,820 residents ≥18 years from all 169 Connecticut towns and seven ZIP Codes in New York, this study examines the influence of neighborhood social environment on residents' mental wellbeing, physical activity, and BMI. Structural equation modeling was conducted to estimate direct and indirect effects of neighborhood social environment on BMI, using mental wellbeing and physical activity as intermediate variables. There were significant total [β(SE) = 0.741 (0.170), p < 0.0001], direct [β(SE) = 0.456 (0.1890), p = 0.016], and indirect [β(SE) = 0.285 (0.061), p < 0.0001] effects of neighborhood social environment on BMI. Low physical activity was a partial mediator of the effect of non-favorable neighborhood social environment on BMI [β(SE) = -0.071 (0.011), p < 0.0001]. The association between neighborhood social environment and BMI was also mediated by mental wellbeing [β(SE) = 0.214 (0.060), p < 0.0001], and by mental wellbeing through physical activity [β(SE) = 0.071 (0.011), p < 0.0001]. Study findings provide further support for building strong social environments to improve population health and suggest that strategies prioritizing mental wellbeing may benefit behavioral interventions aimed at reducing obesity risk and should be a focus of prevention efforts in and of itself.
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Affiliation(s)
- Shayna D. Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06032, USA;
| | | | - Fatma M. Shebl
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA 02114, USA;
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Kathleen O’Connor Duffany
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
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