Obesity Pillars最新文献

{"title":"Cardiovascular safety of fixed-dose extended-release naltrexone/bupropion in clinical practice","authors":"Michael Kyle ,&nbsp;Dustin Burns ,&nbsp;Catherine Rogers Murray ,&nbsp;Heather Watson ,&nbsp;Jeff Swaney ,&nbsp;Samuel Spevack ,&nbsp;Megan Leonhard ,&nbsp;Michael Simon ,&nbsp;Emma Moynihan ,&nbsp;Kate L. Lapane ,&nbsp;Shirley V. Wang ,&nbsp;Craig L. Longo ,&nbsp;Mary E. Ritchey ,&nbsp;David D. Dore","doi":"10.1016/j.obpill.2025.100169","DOIUrl":"10.1016/j.obpill.2025.100169","url":null,"abstract":"<div><h3>Background</h3><div>The fixed-dose extended-release combination of naltrexone/bupropion (NB-ER) is indicated to treat overweight and obesity in adults as an adjunct to a reduced-calorie diet and increased physical activity. This study compared the rate of major adverse cardiovascular events (MACE) and its components (nonfatal acute myocardial infarction [AMI], nonfatal stroke, and cardiovascular death) between patients initiating NB-ER and those initiating lorcaserin (removed from US market in 2020; included as active comparator to minimize possible confounding by indication) in routine clinical practice.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study with a new-user, active-comparator design. Patients initiating NB-ER or lorcaserin were identified using Arcadia Data Research electronic health records, including insurance claims (June 2012–February 2020). Incidence rate ratios were estimated, and adjusted hazard ratios (aHRs) with 95 % confidence intervals (CIs) were estimated using a propensity score (PS)-weighted Cox proportional hazard model in an intention-to-treat analysis.</div></div><div><h3>Results</h3><div>Patients initiating NB-ER (n = 12 475) or lorcaserin (n = 12 171) were followed for a mean observation period of 4.7 years. After PS weighting, baseline comorbidities, concomitant medications, lifestyle factors, and clinical measures were balanced between cohorts. MACE incidence was 0.77/1000 person-years for NB-ER and 1.03/1000 person-years for lorcaserin. Compared to lorcaserin, patients initiating NB-ER had statistically similar rates of MACE (aHR, 0.76; 95 % CI, 0.48–1.22), nonfatal AMI (aHR, 0.74; 95 % CI, 0.45–1.23), and nonfatal stroke (aHR, 1.05; 95 % CI, 0.34–3.22). No deaths were observed within 30 days of an AMI or stroke.</div></div><div><h3>Conclusion</h3><div>Patients initiating NB-ER compared with lorcaserin were not at an increased risk of MACE or its components. Conclusions from this study must be interpreted in the context of certain assumptions related to PS methodology and use of lorcaserin as an active comparator. Causal interpretations for the cardiovascular safety of NB-ER should be evaluated further in a prospective, randomized, blinded, controlled clinical trial.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and association of MASLD in metabolically healthy young Asian Americans with obesity: A nationwide inpatient perspective (2019)","authors":"Ahmad Alhomaid ,&nbsp;Sukhjinder Chauhan ,&nbsp;Yamini Katamreddy ,&nbsp;Avideep Sidhu ,&nbsp;Praveena Sunkara ,&nbsp;Rupak Desai","doi":"10.1016/j.obpill.2025.100168","DOIUrl":"10.1016/j.obpill.2025.100168","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Although the epidemiology of MASLD and its association with metabolically healthy obesity (MHO) is well-studied in the United States, data for Asian Americans with MHO is limited. We sought to evaluate the association of MASLD in young Asian American patients with MHO.</div></div><div><h3>Methods</h3><div>This was a retrospective, matched cohort, database review of Asian American Individuals. After excluding adult hospitalizations with metabolic risk factors (hypertension, diabetes, or hyperlipidemia), we identified all National Inpatient Sample (2019) admissions with obesity (MHO) and MASLD using relevant ICD-10-CM codes. We matched (1:1) propensity scores for age, sex, household income, hospital location, and teaching status to obtain cohorts with and without obesity (MHO+) vs. (MHO-). Categorical and continuous data were compared using the Chi-square and Mann-Whitney U tests. The primary endpoint was the prevalence and adjusted multivariable odds/predictors of MASLD in (MHO+) vs. (MHO-) cohort.</div></div><div><h3>Results</h3><div>In the adjusted multivariate regression for demographics, and comorbidities, the (MHO+) cohort was associated with higher odds of admissions with MASLD (OR 4.07, 95%CI 2.02–8.19, p ​&lt; ​0.001). In addition, among the (MHO+) cohort, higher rates of MASLD-related hospitalizations were observed in males (OR 8.40, p ​&lt; ​0.001), females (OR 2.69, p ​= ​0.025), high-income quartiles (OR 10.51, p ​&lt; ​0.001), no prior bariatric surgery (OR 4.07, p ​&lt; ​0.001), non-tobacco users(OR 4.16, p ​&lt; ​0.001), and non-hypothyroid patients (OR 4.00, p ​&lt; ​0.001) compared to the (MHO-) cohort. There was no statistically significant difference in the groups with low-income quartiles, tobacco use disorder, and hypothyroidism.</div></div><div><h3>Conclusion</h3><div>This nationwide analysis demonstrates that (MHO+) is associated with a higher prevalence of MASLD. In the (MHO+) cohort, there was an association of MASLD with sex, high-income quartile, no prior bariatric surgery, non-tobacco use, and non-hypothyroidism. Further prospective multicenter studies are needed to evaluate the association of MASLD in (MHO+) patients with comorbid conditions.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of obesity according to body mass index, waist circumference, and waist-to-height ratio in Peru: A systematic review and meta-analysis","authors":"Luisa Erika Milagros Vásquez-Romero ,&nbsp;Fiorella E. Zuzunaga-Montoya ,&nbsp;Joan A. Loayza-Castro ,&nbsp;Enrique Vigil-Ventura ,&nbsp;Willy Ramos ,&nbsp;Víctor Juan Vera-Ponce","doi":"10.1016/j.obpill.2025.100166","DOIUrl":"10.1016/j.obpill.2025.100166","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is a global public health epidemic with significant health implications. However, studies on the prevalence of obesity in Peru have yielded varied results, highlighting the need for updated data to inform effective public health policies.</div></div><div><h3>Objective</h3><div>The primary objective of this study is to determine the prevalence of obesity in Peru using three anthropometric measures: body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR).</div></div><div><h3>Methods</h3><div>Between March and April 2024, a systematic review of published studies reporting the prevalence of obesity in Peru was conducted. The databases Scopus, Web of Science, Embase, PubMed, LILACS, and Scielo were Searched.</div></div><div><h3>Results</h3><div>Overall, the prevalence of obesity was 23.23 %, 38.90 %, and 81.53 % according to BMI, WC, and WHtR, respectively. However, these figures show wide variability, ranging from 13.10 % to 37.4 % according to BMI and from 19.4 % to 51.6 % according to WC. The highest reported prevalence of obesity by WHtR was 85.4 %. Nonetheless, only a fraction of these studies were published in the last five years, and few specifically focused on obesity as the primary objective.</div></div><div><h3>Conclusions</h3><div>The prevalence of obesity in Peru varies significantly depending on the anthropometric measure used. To improve the collection and frequency of data on obesity in Peru, it is recommended that cut-off points be standardized to be suitable for the country and that annual national surveys specifically designed for this purpose be implemented.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging diagnosis and biometric data from the All of Us Research Program to uncover disparities in obesity diagnosis","authors":"Alina Arseniev-Koehler ,&nbsp;Ming Tai-Seale ,&nbsp;Crystal W. Cené ,&nbsp;Eduardo Grunvald ,&nbsp;Amy Sitapati","doi":"10.1016/j.obpill.2025.100165","DOIUrl":"10.1016/j.obpill.2025.100165","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive efforts to standardize definitions of obesity, clinical practices of diagnosing obesity vary widely. This study examined (1) discrepancies between biometric body mass index (BMI) measures of obesity and documented diagnoses of obesity in patient electronic health records (EHRs) and (2) how these discrepancies vary by patient gender and race and ethnicity from an intersectional lens.</div></div><div><h3>Methods</h3><div>Observational study of 383,380 participants in the National Institutes of Health <em>All of Us</em> Research Program dataset.</div></div><div><h3>Results</h3><div>Over half (60 %) of participants with a BMI indicating obesity had no clinical diagnosis of obesity in their EHRs. Adjusting for BMI, comorbidities, and other covariates, women's adjusted odds of diagnosis were far higher than men's (95 % confidence interval 1.66–1.75). However, the gender gap between women's and men's likelihood of diagnosis varied widely across racial groups. Overall, Non-Hispanic (NH) Black women and Hispanic women were the most likely to be diagnosed and NH-Asian men were the least likely to be diagnosed.</div></div><div><h3>Conclusion</h3><div>Men, and particularly NH-Asian men, may be at heightened risk of underdiagnosis of obesity. Women, and especially Hispanic and NH-Black women, may be at heightened risk of unanticipated harms of obesity diagnosis, including stigma and competing demand with other health concerns. Leveraging diagnosis and biometric data from this unique public domain dataset from the All of Us project, this study revealed pervasive disparities in diagnostic attribution by gender, race, and ethnicity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight and cardiometabolic effects of a novel oral shape-shifting superabsorbent hydrogel capsule: Prespecified and exploratory analysis of the Epitomee capsule RESET study","authors":"H.E. Bays ,&nbsp;J.D. Ard ,&nbsp;P.M. O'Neil ,&nbsp;T.A. Wadden ,&nbsp;R.F. Kushner ,&nbsp;J.M. Jakicic ,&nbsp;H.R. Wyatt ,&nbsp;F.L. Greenway ,&nbsp;M. Kamar ,&nbsp;E. Ganon-Elazar ,&nbsp;L. Cohen Asaraf ,&nbsp;D.H. Ryan","doi":"10.1016/j.obpill.2025.100163","DOIUrl":"10.1016/j.obpill.2025.100163","url":null,"abstract":"<div><h3>Background</h3><div>Management of obesity potentially improves cardiometabolic risk factors in patients with metabolic syndrome (MetS). The Epitomee capsule is a non-pharmacological, biodegradable device treatment for weight reduction in patients with overweight and obesity.</div></div><div><h3>Methods</h3><div>This secondary analysis of the Randomized Evaluation of Safety and Efficacy of the Epitomee capsule Trial (RESET) (a randomized, 24-week, multicenter, placebo-controlled, double-blind trial that enrolled 279 adults aged ≥18 years with a BMI of 27–40 kg/m2) evaluated changes in cardiometabolic parameters in participants treated with Epitomee or placebo combined with lifestyle counseling among (a) the entire RESET study population, and (b) participants meeting diagnostic criteria for prediabetes. Predefined and exploratory endpoints included changes in waist circumference, glycemic parameters, blood pressure, and lipid blood levels; this analysis also assessed percent weight loss in participants with MetS.</div></div><div><h3>Results</h3><div>Waist circumference, systolic and diastolic blood pressure and some measures of glycemia and lipids, improved with both Epitomee and placebo with no significant differences. Participants with prediabetes treated with Epitomee showed significantly greater reductions in HOMA-IR (p &lt; 0.007) and insulin levels (p &lt; 0.003) than the placebo group. Participants with MetS at baseline experienced significantly greater percent change in initial weight when treated with the Epitomee capsule (n = 27) compared to placebo (n = 31), −8.3% vs −5.2 %, respectively (p &lt; 0.0004). Similar percentages of participants with MetS in both groups achieved ≥5 % weight reduction (59.3 % and 54.8 %, in Epitomee and placebo groups respectively). Significantly more participants with MetS treated with Epitomee achieved ≥10 % weight reduction compared with those treated with placebo (40.7 % vs. 6.5 %, respectively, p &lt; 0.002).</div></div><div><h3>Conclusion</h3><div>Treatment with either Epitomee and placebo combined with lifestyle improve cardiometabolic risk factors. Compared to placebo, Epitomee significantly reduced HOMA-IR and insulin levels in participants with prediabetes. Among participants with MetS, Epitomee significantly reduced body weight <span><span>[ClinicalTrials.gov</span><svg><path></path></svg></span> ID NCT04222322].</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143388251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of GLP-1 receptor agonists for weight reduction: A model-based meta-analysis of placebo-controlled trials","authors":"Haoyang Guo ,&nbsp;Juan Yang ,&nbsp;Jihan Huang ,&nbsp;Ling Xu ,&nbsp;Yinghua Lv ,&nbsp;Yexuan Wang ,&nbsp;Jiyuan Ren ,&nbsp;Yulin Feng ,&nbsp;Qingshan Zheng ,&nbsp;Lujin Li","doi":"10.1016/j.obpill.2025.100162","DOIUrl":"10.1016/j.obpill.2025.100162","url":null,"abstract":"<div><h3>Aim</h3><div>Obesity is a global epidemic. The FDA has approved glucagon-like peptide-1 (GLP-1) receptor agonists such as Liraglutide, Semaglutide, and the GLP-1/gastric inhibitory polypeptide (GIP) dual agonist Tirzepatide for the treatment of obesity. Clinical trials of GLP-1/GIP/glucagon(GCG) triple agonists are ongoing. This study compared the efficacy and safety profiles of different GLP-1 receptor agonists (GLP-1RAs) for weight reduction and explored the related influencing factors, providing quantitative information for the development of GLP-1RAs and their clinical use.</div></div><div><h3>Methods</h3><div>This systematic review of public databases included placebo-controlled randomized clinical trials of GLP-1RAs. Time-course, dose-response, and covariate models were used to describe the efficacy characteristics and influencing factors of different GLP-1RAs. Subgroup analyses were performed to explore efficacy differences in receptor specificity. Meta-analyses compared the incidence of adverse event and dropout rates among different GLP-1RAs.</div></div><div><h3>Results</h3><div>Fifty-five studies involving 16,269 participants and 12 GLP-1RAs were included. Six drugs showed significant dose-response relationships. The maximum weight reduction effect ranged from 4.25 kg (Liraglutide) to 22.6 kg (Retatrutide). Reported onset times ranged from 6.4 weeks (Orforglipron) to 19.5 weeks (Tirzepatide). At 52 weeks, weight reduction effects were 7.03 kg, 11.07 kg, and 24.15 kg for mono-agonists, dual-agonists, and tri-agonists, respectively. There was a significant negative correlation in the exponential pattern between age and weight reduction effect, whereas baseline weight and BMI had no significant impact. Common adverse events of GLP-1RAs, reported in the literature include nausea, vomiting, diarrhea, and constipation, with a significantly higher incidence of nausea than that of placebo.</div></div><div><h3>Conclusions</h3><div>This study provides a quantitative evaluation of the efficacy and safety of GLP-1RAs and offers valuable insights into the assessment of new drugs for weight reduction.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic health records tools for treating obesity among adult patients in primary care: A scoping review","authors":"Jyotsna Ghosh ,&nbsp;Kimberly A. Gudzune ,&nbsp;Jessica L. Schwartz","doi":"10.1016/j.obpill.2025.100161","DOIUrl":"10.1016/j.obpill.2025.100161","url":null,"abstract":"<div><h3>Background</h3><div>Electronic health record (EHR)-based tools, such as clinical decision support systems (CDSS), support practitioners to promote evidence-based care, which may include obesity treatment. Our objective was to identify obesity-focused CDSS for adult patients in primary care settings to describe their designs, associated primary care practitioner (PCP) training, and outcomes among PCPs and patients.</div></div><div><h3>Methods</h3><div>We conducted a scoping review to identify and map available evidence using a search strategy for citations in MEDLINE from February 2009 to June 2024. We extracted information from included studies that described EHR-based CDSS tools designed to support obesity care (e.g., clinical decision support, counseling) for adult patients in primary care settings. We mapped common tool features to support weight management and synthesized key lessons learned during implementation of these tools.</div></div><div><h3>Results</h3><div>Of the 445 citations identified in our search, we included 13 citations reporting on 8 studies. The most common features across EHR-based CDSS tools were 1) identifying overweight or obesity using BMI (88 %) and 2) suggesting treatment strategies (88 %), particularly lifestyle modifications. Most studies provided limited information on the training PCPs received. Few PCPs used the CDSS with eligible patients (&lt;20 %), describing these tools as cumbersome and lacking clinical workflow integration. Novel approaches included using CDSS during weight management-dedicated visits or for referral to obesity medicine physicians, which both showed promising early results of patients achieving weight reduction.</div></div><div><h3>Conclusion</h3><div>There is a growing body of evidence for obesity-focused CDSS among adult patients in the primary care setting. Our review identified three key lessons that may inform future health system implementation: 1) EHR-based CDSS tools need to be easy to use and integrate with clinical workflows; 2) PCPs need training on these tools for obesity treatment; and 3) Primary care workflow or work-scope may need to be modified to address obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical considerations in the management of obesity in children and adolescents","authors":"Whitney Herring ,&nbsp;Carina Kugelmas ,&nbsp;Evan P. Nadler ,&nbsp;Marsha Novick ,&nbsp;Melissa Santos ,&nbsp;Rachana Shah ,&nbsp;Gitanjali Srivastava ,&nbsp;Stephanie Walsh","doi":"10.1016/j.obpill.2025.100160","DOIUrl":"10.1016/j.obpill.2025.100160","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a complex, chronic disease affecting more than one-fifth of adolescent children aged 12–19 years in the United States. Recent guidelines have recommended optimization of diagnosis and treatment approaches to help improve the immediate and long-term health of people with obesity.</div></div><div><h3>Methods</h3><div>Here, we describe the insights and recommendations of 9 nationally recognized experts in pediatric obesity, summarized from a virtual advisory board discussion.</div></div><div><h3>Results</h3><div>Advisors described their background, experiences, and patient populations, conveyed the journey experienced by many pediatric patients with obesity, discussed the recent landscape for pharmacotherapy in adolescents, and provided their perspectives on updated American Academy of Pediatrics Clinical Practice Guidelines.</div></div><div><h3>Conclusion</h3><div>Overall, the advisors agreed that the key to addressing the growing prevalence of obesity in children and adolescents depends on increased education in the medical field and community-wide initiatives to promote early intervention. Collaboration among all parties (e.g., physicians, policymakers, insurance companies, academic institutions, and researchers) to address barriers to treatment and reduce the social stigma surrounding obesity is also essential.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between timing of screening for gestational diabetes mellitus and maternal and fetal outcomes: A retrospective cohort study linking primary care electronic and hospital administrative data","authors":"Helena Piccinini-Vallis ,&nbsp;Mathew Grandy ,&nbsp;Lynn Bussey ,&nbsp;Jillian Coolen ,&nbsp;Sarah Sabri","doi":"10.1016/j.obpill.2025.100159","DOIUrl":"10.1016/j.obpill.2025.100159","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes (GDM) is associated with adverse outcomes including a large-for-gestational age (LGA) baby, which in turn is associated with downstream childhood obesity. Appropriate timing of GDM screening is important for prompt initiation and optimization of medical management, potentially mitigating the risk of those outcomes. The present study explored the association between the timing of GDM screening and macrosomia, LGA, shoulder dystocia and caesarean section.</div></div><div><h3>Methods</h3><div>This retrospective cohort study linked primary care prenatal data and intrapartum data from a provincial hospital administrative database. Women with singleton pregnancies who received prenatal care between July 1, 2019 and December 31, 2022 and who also delivered within that timeframe were included in the study.</div></div><div><h3>Results</h3><div>198 participants were linked between the databases. Among participants for whom GDM risk could be calculated (n = 180), 30.6 % had late GDM screening. Unadjusted logistic regression models showed that late screening for GDM was associated with higher likelihood of LGA (OR = 2.89; 95 % CI = 1.19–7.04; p = 00.019). Adjusted models showed that the best predictor of macrosomia, LGA, and shoulder dystocia was excess gestational weight gain (GWG) (OR = 3.26, CI = 1.17–9.10, p = 0.024; OR 3.00, 95 % CI 0.91–9.93, p = 00.072; and OR = 3.52, CI = 0.83–14.84, p = 00.087 respectively); the best predictor of caesarean section was pre-pregnancy BMI (OR = 2.86; CI = 1.12 = 7.27; p = 0.028).</div></div><div><h3>Conclusions</h3><div>Almost one-third of participants had screening later than recommended, and late screening for GDM was associated with a higher likelihood of LGA. Linking longitudinal prenatal primary care data to hospital administrative data creates opportunities for future studies pertaining to prenatal care, potentially resulting in improvements in the care provided to vulnerable populations experiencing disproportionate rates of pre-pregnancy obesity and excess GWG.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular outcomes in metabolically healthy Asian-American population with obesity (18–44 years): Insights from the National Inpatient Sample","authors":"Rupak Desai ,&nbsp;Avilash Mondal ,&nbsp;Boney Lapsiwala ,&nbsp;Venkata Balaji Chenna ,&nbsp;Pratik Rajpopat ,&nbsp;Vaidehi Mendpara ,&nbsp;Athri Kodali ,&nbsp;Amritha R. Nair ,&nbsp;Ayodya Perera ,&nbsp;Subramanian Gnanaguruparan","doi":"10.1016/j.obpill.2025.100158","DOIUrl":"10.1016/j.obpill.2025.100158","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity, often associated with cardiometabolic risk factors such as hypertension, diabetes, and hyperlipidemia, is a predictor of major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients. However, in-hospital outcomes among young, metabolically healthy (MHO) Asians with obesity have not been explored.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study that utilized 2019 National Inpatient Sample (NIS) database to identify hospitalizations of metabolically healthy young (18–44 years) Asian-Americans/Pacific Islanders (AA/API). Demographically matched cohorts of metabolically healthy Asians with obesity (MHO+) and Asians without obesity (MHO-) patients were compared for comorbidities and in-hospital outcomes using 1:1 propensity matching. Multivariable logistic regression analysis was conducted to identify predictors of MACCE in the MHO+ group.</div></div><div><h3>Results</h3><div>Among 327,065 young AA/API hospitalizations, 7.8 % (n=25,470) were obese. Of which, 14315 were metabolically healthy after excluding encounters with concomitant cardiometabolic risk factors. Matched cohorts (MHO+ and MHO-, N = 14,200, median age 32 years, &gt;84 % female) showed that the MHO + group had higher rates of depression, anxiety, tobacco use disorder, chronic pulmonary disease, and hypothyroidism, while the MHO- group had higher cancer and cannabis use disorder rates. The odds of MACCE (aOR 0.98, 95%CI 0.70–1.37, p = 0.886), and the odds of all-cause mortality (aOR 1.26, 95CI% 0.4–3.99, p = 0.690) were not of statistical significance. Males (aOR 10.18, 95%Cl 3.39–30.53), drug users (aOR 2.87, 95%Cl 1.05–7.86), cancer patients (aOR 9.70, 95%Cl 2.14–44.01), and those with congenital circulatory anomalies (aOR 21.77, 95%Cl 4.07–116.60) had significantly higher odds of MACCE. Depression (aOR 3.09, 95%Cl 0.86–11.08), elective admission (aOR 3.71, 95%Cl 0.74–18.58), and tobacco use (aOR 0.81, 95%Cl 0.26–2.60) were not statistically significant predictors.</div></div><div><h3>Conclusion</h3><div>Asian Americans males, drug users and cancer patients face elevated cardiovascular risk despite having a lower BMI, while overall odds of in-hospital cardiovascular event rates were not statistically significant compared to metabolically healthy cohorts with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}