Clinical Obesity最新文献

Despite the growing popularity of one anastomosis gastric bypass (OAGB) as the third most commonly performed metabolic and bariatric surgery (MBS) procedure worldwide, concerns remain among MBS surgeons about performing OAGB in children and adolescents. This international expert survey was conducted to assess the perspectives of experts regarding the different aspects of OAGB specific to these patient groups. A total of 102 expert MBS surgeons from 41 countries were invited to participate in this survey, which took place between 24 May 2024, and 11 June 2024. The participating surgeons provided their responses through a 30-question online survey, employing a multiple-choice format. Approximately 6.85% of participants believe there should be no minimum age limit for OAGB and 26.5% of experts perform OAGB only in patients 18 years old and above. The experts define adherence to postoperative diet, patient cooperation, and managing family expectations as the main challenges encountered when performing OAGB in this population. About 92.2% of experts believe that consultation and follow-up by a paediatrician, as part of a multidisciplinary team (MDT), are essential before surgery. Also, 76.5% of experts believe that bone age should be determined in these age groups before OAGB. Despite the absence of strong evidence refuting the safety and efficacy of OAGB in children and adolescents, this survey revealed that there are still some concerns about the long-term safety and efficacy of OAGB in children and adolescents.

Cardiometabolic syndrome (CMS) is a global health issue that is commonly associated with obesity. This study aimed to assess the utility of neck circumference for predicting cardiometabolic risk in the Iranian population. A cross-sectional study with 6789 participants was conducted using face-to-face interviews, clinical evaluations, body composition measurements using Inbody 770 device, laboratory tests and anthropometric measurements. The anthropometric measurements included height, weight, body mass index, neck, waist, hip and wrist circumference, while laboratory measures included complete blood count, fasting blood glucose, lipid profile and lipid accumulation product. The results revealed that 22.4% of the population had CMS, with a higher prevalence in males (29.8%) than in females (16%). Waist circumference was the most prevalent indicator of CMS (75.8%), particularly in males (86%), while low high-density lipoprotein (HDL) levels were the least common (found in only 349 males). Neck circumference was significantly related to all CMS indicators. Univariate logistic regression analysis indicated that every unit increase in neck circumference led to a twofold increase in the probability of CMS (OR (95% CI) = 1.24 (1.21, 1.26), p < 0.001). Neck circumference had a higher predictive value (AUC = 0.7, sensitivity = 0.71, specificity = 0.6, validity = 0.63) for CMS risk than weight and body mass index (BMI). The cut-off points for neck circumference in diagnosing CMS among the males and females were 38.6 and 36.9 cm, respectively. Neck and waist circumference are better predictors of cardiovascular risk factors than BMI or waist-to-hip ratio. Monitoring changes in these measurements can help predict CMS.

Bariatric surgery can lead to significant weight loss and improved physical health. Still, it often also brings about complex psychological effects, including changes in self-esteem, body image and emotional well-being that require careful monitoring and support. This systematic review with meta-analysis aims to analyse the relationship between bariatric surgery and postoperative improvement in psychiatric and eating disorders. MEDLINE, EMBASE, COCHRANE Library and other specialized databases were searched in July 2024. Observational studies included individuals who had undergone any bariatric surgical treatment with a preoperative evaluation of eating disorders, depression and anxiety and at a postoperative measure of the same variables selected. Thirteen studies that met the eligibility criteria were included for qualitative synthesis and eight studies for meta-analysis. Two reviewers independently screened for eligibility. The mean difference was calculated using the random-effects model. Bariatric surgery was found to be effective in improving eating disorders (−0.81%, 95% CI –1.61 to –0.05; I2 = 98%, p < .05), depression (−0.56, 95% CI −1.09 to −0.04, I2 = 97%, p < .03) and anxiety (−0.74, 95% CI −1.17 to −0.31, I2 = 94%, p < .00). The literature reveals high heterogeneity between studies, particularly in assessing psychological factors, with a common reliance on self-reported questionnaires rather than gold-standard assessments. Nonetheless, based on the findings of this study, there was a genuine effect on eating disorders, depression and anxiety when those participants underwent bariatric surgery.

Obesity poses a significant health threat, contributing to the development of noncommunicable diseases (NCDs). Early identification of individuals at higher risk for obesity is crucial for implementing effective prevention strategies. This study explores the viability of non-dietary factors such as lifestyle, family history, and demographics as predictors of obesity risk. The dataset comprised 1068 males and 1043 females, aged between 14 and 61 years. Only non-dietary factors were used to build the machine learning models, including decision tree, random forest, support vector classification (SVC), k-nearest neighbour (KNN), and Gaussian Naïve Bayes (GNB). Random forest emerged as the optimal model, demonstrating 66.9% test accuracy, 66.4% precision, 66.9% recall, 66.4% F1-score, 94.5% specificity and 92.3% area under the receiver operating characteristic curve (AUC-ROC). Variability of the models' performance was also evaluated through bootstrapping. Lifestyle factors, while less impactful than family history and demographics, also contributed to predictive power. This indicates the potential for predicting obesity while relying less on dietary data, paving the way for future studies to refine predictive models. This could play a crucial role in identifying lifestyle factors as predictors of obesity, thereby preventing and intervening early to address obesity-related complications.

Data from clinical trials evaluating the effectiveness and safety of metabolic and bariatric surgery (MBS) compared to lifestyle modifications (LSM) in children and adolescents with obesity are scarce. This systematic review and meta-analysis (SRM) sought to fill this knowledge gap. Randomised or non-randomised trials spanning at least one-year involving children and adolescents with severe obesity receiving any form of MBS in the intervention group and LSM for weight loss in the control group were systematically searched through electronic databases. This SRM adhered to the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA checklists. The primary outcome of interest was the change in body weight from the baseline. Five trials (three randomised, open-label and two non-randomised) with 1–2 years follow-up durations were analysed, including 367 participants aged 10–19 years. MBS resulted in greater reductions in body weight (mean difference [MD] −25.83 kg, 95% confidence interval [CI] [−36.91, −14.75], p < .00001) and per cent body weight (MD −24.54%, 95% CI [−33.19, −15.89], p < .00001) compared to LSM. Furthermore, MBS outperformed LSM in reducing body mass index (BMI), BMI z-score, waist circumference, glycated haemoglobin, fasting plasma glucose, insulin resistance, triglycerides, alanine aminotransferase, high sensitivity C-reactive protein and an overall improvement of physical functioning and quality of life. The safety profile was comparable between the two groups; however, data was scarce. Larger, longer-term trials that include multinational and multiethnic representation are essential for making solid clinical practice recommendations regarding MBS for children with obesity.