Obesity Pillars最新文献

{"title":"Chronicity of obesity and the importance of early treatment to reduce cardiometabolic risk and improve body composition","authors":"Sandra Christensen ,&nbsp;Christina Nelson","doi":"10.1016/j.obpill.2025.100175","DOIUrl":"10.1016/j.obpill.2025.100175","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a chronic disease that affects millions of adults and children globally. Obesity is particularly prevalent in the US and is associated with adiposity-related complications, such as cardiovascular disease, hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cancer, and reduced quality of life. The Obesity Medicine Association's 4 pillars of obesity treatment are nutrition therapy, physical activity, behavioral counseling, and medical interventions, the latter of which includes pharmacotherapy, complication management, and bariatric procedures. Long-term obesity treatment using these treatment modalities guides chronic disease management to achieve sustained weight reduction, improved health outcomes, and improved quality of life.</div></div><div><h3>Methods</h3><div>In this narrative review, we focus on obesity as a chronic disease and the importance of chronic disease management. We also review body composition changes that occur with obesity and the goals of obesity treatment as they relate to body composition. Finally, obesity treatment modalities and recommendations are discussed.</div></div><div><h3>Results</h3><div>Individuals with pre-obesity, which is a state of early obesity, often progress to obesity. Further, individuals with obesity attempting weight reduction frequently reduce weight and experience subsequent weight recurrence, highlighting the chronic nature of obesity. Pathophysiologic factors such as the location and degree of adiposity, as well as the health of adipose tissue, impact the risk factors, outcomes, and treatment options for patients with obesity. Treatment modalities and appointment frequency can be personalized to individualize treatment and maximize adiposity reduction and preservation of lean body mass.</div></div><div><h3>Conclusions</h3><div>Early and lifelong treatment is critical for maintaining lean body mass as well as preventing weight recurrence and increased adiposity. Obesity treatment should reduce adiposity, preserve lean muscle, and maintain bone health. Weight-reduction maintenance that can be sustained long-term is also a critical component of chronic disease management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"15 ","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity management in primary care: A joint clinical perspective and expert review from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) - 2025","authors":"Nicholas Pennings ,&nbsp;Catherine Varney ,&nbsp;Shaun Hines ,&nbsp;Bernadette Riley ,&nbsp;Patricia Happel ,&nbsp;Samir Patel ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2025.100172","DOIUrl":"10.1016/j.obpill.2025.100172","url":null,"abstract":"<div><h3>Background</h3><div>This collaboration from the Obesity Medicine Association (OMA) and the American College of Osteopathic Family Physicians (ACOFP) examines obesity management from a primary care perspective.</div></div><div><h3>Methods</h3><div>This joint perspective is based upon scientific evidence, clinical experience of the authors, and peer review by the OMA and ACOFP leadership. The goal is to identify and answer sentinel questions about obesity management from a primary care perspective, utilizing evidence-based publications, and guided by expert clinical experience.</div></div><div><h3>Results</h3><div>Obesity is a disease that contributes to both biomechanical complications and the most common cardiometabolic abnormalities encountered in primary care. Barriers that impede optimal care of patients with obesity in primary care include failure to recognize obesity as a disease, lack of accurate diagnosis, insufficient access to obesity treatment resources, inadequate training, insufficient time, lack of adequate reimbursement and the adverse impact of bias, stigma, and discrimination.</div></div><div><h3>Conclusions</h3><div>Family physicians are often the first line of treatment in the healthcare setting. This affords early intervention opportunities to prevent and/or treat overweight and/or obesity. Patient care is enhanced when primary care clinicians recognize the risks and benefits of anti-obesity medications and bariatric procedures, as well as long-term follow-up. Practical tools regarding the 4 pillars of nutrition therapy, physical activity, behavior modification, and medical interventions (anti-obesity medications and bariatric surgery) may assist primary care clinicians improve the health and lives of patients living with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739098","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 association between hepatic steatosis, vitamin D status, and insulin resistance in adolescents with obesity","authors":"Emir Tas ,&nbsp;Amanda Flint ,&nbsp;Ingrid Libman ,&nbsp;Radhika Muzumdar ,&nbsp;Xiawei Ou ,&nbsp;David K. Williams ,&nbsp;Elisabet Børsheim ,&nbsp;Eva C. Diaz","doi":"10.1016/j.obpill.2025.100173","DOIUrl":"10.1016/j.obpill.2025.100173","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidemiological studies suggest an inverse relationship between circulating 25-hydroxy-vitamin D [25(OH)D] levels and insulin resistance (IR), yet interventional studies have yielded inconsistent findings. This study examined the relationship between changes in vitamin D status and markers of IR in adolescents, with a focus on the modifying effect of liver fat.</div></div><div><h3>Methods</h3><div>A post-hoc analysis was performed using data from 44 adolescents participating in a 6-month observational study evaluating biomarkers of hepatosteatosis. Participants were categorized into two groups based on vitamin D status at the end of the observation period: those whose vitamin D levels increased or remained sufficient (VDI, n = 22) and those whose levels decreased or remained insufficient/deficient (VDD, n = 22). Liver fat percentage was measured using magnetic resonance imaging (MRI) fat-fraction, and IR was assessed using the updated Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR) and the triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL).</div></div><div><h3>Results</h3><div>Across the cohort, liver fat was positively associated with HOMA2-IR (β = 0.08, p = 0.023). The association between changes in vitamin D status and HOMA2-IR trajectories was modified by liver fat but only in Hispanic adolescents (β = −0.18, p &lt; 0.001). Among Hispanic adolescents in the VDD group, HOMA-IR worsened, particularly at higher levels of liver fat. In non-Hispanic adolescents, HOMA-IR increased in the VDD group (β = 0.65, p = 0.033) compared to the VDI group, independent of baseline liver fat. Across the cohort, changes in vitamin D status interacted with liver fat to influence TG/HDL trajectories (β = 0.20, p = 0.034).</div></div><div><h3>Conclusions</h3><div>The metabolic response to changes in vitamin D status in adolescents with IR may vary based on racial and ethnic differences and liver fat status. These findings underscore the importance of considering liver fat and racial/ethnic background in vitamin D and metabolic health studies. Future research with more extensive and diverse cohorts spanning the fatty liver disease spectrum is needed to clarify these relationships.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681223","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 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":"The effect of weight reduction on the diabetes foot: A scoping review and clinical implications","authors":"Janine E. Roll Ahmed ,&nbsp;John Veto ,&nbsp;Derek Santos","doi":"10.1016/j.obpill.2024.100152","DOIUrl":"10.1016/j.obpill.2024.100152","url":null,"abstract":"<div><h3>Background</h3><div>This scoping review aims to explore the literature available on rapid weight reduction (either via diet/exercise or bariatric surgery) on the diabetes foot.</div></div><div><h3>Methods</h3><div>A search strategy was developed using Population, Intervention, Comparison, Outcome (PICO). A search using all identified keywords and index terms was performed on Cumulated Index in Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), PubMed, International Clinical Trials Registry Platform (ICTRP) and Web of Science (WoS) databases as well as Proquest, and Cochrane systematic reviews. A search of grey literature was also performed on Google Scholar and Internet explorer. No restrictions were placed on the date of publication.</div></div><div><h3>Results</h3><div>There were few studies that explored the effects of weight reduction on the diabetes foot. Only 2 articles met the scoping review's inclusion criteria. These were a case study where the intervention was bariatric surgery and a case series study where the interventions were bariatric surgery or diet and exercise.</div></div><div><h3>Conclusion</h3><div>This scoping review has highlighted the lack of research in this area, raising opportunities for further research that focus on the effects of rapid weight reduction (either following bariatric surgery or weight reduction and diet) on the diabetes foot. Patients with diabetes mellitus should receive individualised pre and post weight reduction care to their feet, either by a podiatrist or multidisciplinary care team.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578229","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":"Editorial: Exploring the nuances of obesity in Asian populations","authors":"Harold Bays (Editor– in -Chief)","doi":"10.1016/j.obpill.2024.100150","DOIUrl":"10.1016/j.obpill.2024.100150","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"13 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578230","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":"Management and impact of obesity in Canada: A real-world survey of people with obesity and their physicians","authors":"Jennifer Glass ,&nbsp;Sophie Carter ,&nbsp;Esther Artime ,&nbsp;Victoria Higgins ,&nbsp;Lewis Harrison ,&nbsp;Andrea Leith ,&nbsp;David CW. Lau ,&nbsp;Ian Patton ,&nbsp;Jennifer L. Kuk","doi":"10.1016/j.obpill.2025.100171","DOIUrl":"10.1016/j.obpill.2025.100171","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a chronic relapsing disease associated with multiple complications. This study described real-world demographic/clinical characteristics, including obesity-related complications (ORCs), prescribing rationale, and patient-reported outcome measures (PROMs) for adults living with obesity in Canada accessing treatment.</div></div><div><h3>Methods</h3><div>This was a cross-sectional survey of physicians and consulting people with obesity (PwO) in Canada with retrospective data capture in a real-world setting. Canadian data were drawn between July and November 2022 from the multinational Adelphi Real World Obesity Disease Specific Programme™. Consulting PwO were required to be on a weight management program and/or have a current body mass index of ≥30 kg/m². Physicians completed questionnaires for the next 3–5 consecutive PwO seen in their routine clinical practice. A quota was applied for obesity management medication (OMM). PROMs including Work Productivity and Activity Impairment (WPAI) questionnaire were provided voluntarily by PwO. Analyses were descriptive.</div></div><div><h3>Results</h3><div>Overall, 50 physicians (35 general practitioners, 15 endocrinologists) and 199 PwO were analyzed. More than 85 % of PwO had ≥1 ORC. The most common ORCs were hypertension, dyslipidemia, depression, and type 2 diabetes, and one-quarter to one-half of ORCs were not optimally controlled. Approximately two-thirds of the cohort were employed full-time, almost half had private insurance, and almost 70 % were classified as high socio-economic status. Mean number of weight-reduction attempts over the past 3 years was 2.9. Pharmacological treatment for obesity was common among those with ORCs. A general trend towards greater work impairment among people with ORCs than for PwO without ORCs was observed.</div></div><div><h3>Conclusions</h3><div>Among PwO participating in our study, ORCs were common, often uncontrolled, and their presence impacted the likelihood of obesity treatment and possibly impaired work productivity. Medical treatment for obesity was often delayed until ORCs developed, suggesting that preventative healthcare measures are not the norm for PwO in Canada. A large proportion of PwO had high socioeconomic status, suggesting that PwO who access treatment may not be representative of the overall population of PwO in Canada.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100171"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580057","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":"Appropriate use of the fixed-dose, extended-release combination of naltrexone and bupropion as treatment for obesity in primary care","authors":"Ethan Lazarus","doi":"10.1016/j.obpill.2025.100170","DOIUrl":"10.1016/j.obpill.2025.100170","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is considered a chronic disease and is influenced by biological, environmental, and behavioral factors that can contribute to its progression. Although lifestyle changes are integral to treating obesity and maintaining a healthful weight, weight reduction from behavioral intervention alone is often insufficient because neurophysiologic factors may work against such changes in lifestyle and behavior. Research suggests that the mechanisms underlying food cravings and obesity overlap with dopaminergic signaling in the brain and pathways involved in addiction. As a result, patients who are differentially impacted by food cravings may have better outcomes with treatments targeting neural systems implicated in both homeostatic and hedonic food consumption or addictive behaviors.</div></div><div><h3>Methods</h3><div>In this clinical review, we describe the safety and efficacy data for the fixed-dose, extended-release combination of naltrexone and bupropion (NB-ER) compared with its monotherapy constituents (naltrexone and bupropion), as well as discuss the appropriate use of NB-ER to treat patients with obesity.</div></div><div><h3>Results</h3><div>NB-ER is approved for the treatment of patients with obesity, with studies showing that patients can achieve significant weight reduction compared with placebo when treatment is combined with a reduced-calorie diet and increased physical activity. Across NB-ER phase 3 trials, responders to treatment had a mean body weight reduction of 11.7 % at 56 weeks. Of note, the unique combination of naltrexone, an opioid receptor antagonist, and bupropion, a norepinephrine-dopamine reuptake inhibitor associated with stimulating pro-opiomelanocortin cells (POMC), in NB-ER may work together to target POMC cells to prevent endogenous negative feedback, thereby decreasing appetite and improving weight-related outcomes.</div></div><div><h3>Conclusions</h3><div>Unlike monotherapy with its component drugs, NB-ER is optimized for the treatment of obesity. The appropriate use of NB-ER should consider the specific characteristics and adiposity-related complications of an individual.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593711","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":"Impact of metabolically healthy obesity on post percutaneous coronary intervention outcomes in patients with acute myocardial infarction: A nationwide propensity matched analysis","authors":"Rupak Desai ,&nbsp;Adhvithi Pingili ,&nbsp;Arankesh Mahadevan ,&nbsp;Vishal Reddy Bejugam ,&nbsp;Hafeezuddin Ahmed ,&nbsp;Vamsikalyan Borra ,&nbsp;Adil Sarvar Mohammed ,&nbsp;Gayatri Bondi ,&nbsp;Shobana Krishnamurthy ,&nbsp;Nithya Borra ,&nbsp;Gurpreet Kaur ,&nbsp;Rajesh Sachdeva ,&nbsp;Timir Paul","doi":"10.1016/j.obpill.2025.100167","DOIUrl":"10.1016/j.obpill.2025.100167","url":null,"abstract":"<div><h3>Background</h3><div>Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO—without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients.</div></div><div><h3>Methods</h3><div>We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser comorbidity index, we identified patients with and without obesity, defined as <strong>BMI &gt; 30</strong> <strong>kg/m</strong>^{<strong>2</strong>} and propensity score matching was done for age and sex. Later, multivariable regression analysis was done for in-hospital post-PCI outcomes.</div></div><div><h3>Results</h3><div>Among 25605 metabolically healthy patients who had AMI and underwent PCI, 2825 had obesity, and 22780 didn't. After propensity score matching (PSM) for age and sex, both cohorts had 2795 patients each. There was no statistically significant difference in in-hospital all-cause mortality (adjusted odds ratio [OR] 1.14, 95 % confidence interval [CI] 0.63–2.10, p = 0.661), post-PCI stroke (aOR 1.17, 95 % CI 0.50–2.75, p = 0.714), acute kidney injury (aOR 1.20, 95 % CI 0.84–1.72, p = 0.322), post-PCI bleeding (aOR 1.04, 95 % CI 0.35 to 3.12, p = 0.940) and intra or post-PCI cardiac arrest (aOR 1.14, 95 % CI 0.30 to 4.42, p = 0.835) between both cohorts.</div></div><div><h3>Conclusions</h3><div>No statistically significant association was found between obesity and post-PCI outcomes in metabolically healthy patients with AMI. Larger studies are needed to explore the controversial “obesity paradox” in cardiovascular diseases.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"14 ","pages":"Article 100167"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681222","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}