Current Obesity Reports最新文献

Purpose of review: This review aims to provide a comprehensive synthesis of current clinical evidence on the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonists on body mass index (BMI), body composition, and glucose metabolism in patients with obesity and type 2 diabetes mellitus (T2DM), a condition often referred to as "diabesity."

Recent findings: The coexistence of obesity and T2DM represents a major clinical and public health challenge due to their synergistic effects on metabolic dysfunction and the increased risk of cardiovascular and renal complications. Traditional approaches focused solely on glycemic control have proven insufficient to address the intertwined pathophysiology of excess adiposity and impaired glucose metabolism. Recently, novel pharmacological agents, including SGLT2 inhibitors, GLP-1 RAs, and dual GIP/GLP-1 receptor agonists, have demonstrated dual benefits in improving glycemic control and reducing body weight. These drugs act through distinct but complementary mechanisms-such as promoting glycosuria, enhancing satiety, delaying gastric emptying, and modulating energy homeostasis-resulting in significant reductions in BMI and visceral fat. Among these agents, tirzepatide has shown superior efficacy in improving metabolic parameters and body composition compared with single receptor agonists. Understanding the multifaceted metabolic benefits of these pharmacotherapies is essential for optimizing individualized therapeutic strategies for patients with diabesity. Integrating these agents into comprehensive diabetes care allows clinicians to more effectively target the complex pathophysiology of diabesity, ultimately improving long-term metabolic and clinical outcomes in this growing patient population.

Purpose of review: We aimed to summarise recent evidence on age- and sex-specific reference curves for metabolic syndrome (MetS) indicators in paediatric populations.

Recent findings: There is a lack of consensus regarding diagnostic thresholds for MetS in children and adolescents, leading to challenges in its early identification and intervention. A systematic search was performed in PubMed/Medline, Web of Science and Scopus, covering the period between January 2018 and February 2025. Three researchers evaluated 8,529 studies according to the inclusion criteria. Finally, 46 articles that reported reference values for at least one metabolic indicator: waist circumference, fasting glucose, glycated haemoglobin, homeostatic model assessment for insulin resistance, high-density lipoprotein cholesterol, triglycerides, systolic or diastolic blood pressure, in children aged 0 to 18 years were included in the review and data synthesis. The age-specific trends in each MetS indicator were assessed by calculating the median reference curves along with the lower and upper percentile bounds. Overall, there has been a substantial heterogeneity in the reported reference values for waist circumference and glucose metabolism biomarkers. Comparatively smaller variations were observed for blood pressure and lipid parameters. Limited data were available for young age groups (0-4 years) and there have been substantial differences in study methodologies including study design, assays and statistical approaches used to derive reference curves. This systematic review highlighted the substantial inconsistencies in the reported reference curves for MetS indicators in children and adolescents. There is a pressing need for deriving harmonized reference curves for paediatric MetS from diverse populations.

Purpose of review: Obesity in childhood remains a critical public health issue, with emerging evidence highlighting developmental origins rooted in parental behaviours before conception. While diet and weight status of birthing parents are well-established predictors of offspring health, the role of preconception physical activity (PA) remains understudied. This scoping review synthesizes current evidence between preconception PA and its association with adverse birth outcomes, and downstream infant and child obesity outcomes, contextualizing findings within the broader parental lifestyle influence. A systematic literature search across ten databases identified 41 relevant studies, predominantly cohort designs, analyzing PA effects on birth weight, gestational diabetes mellitus (GDM), excessive gestational weight gain (eGWG), and offspring adiposity.

Recent findings: Findings revealed no consistent association between preconception PA and birth weight or preterm birth risk. However, studies suggest that preconception PA may lower the likelihood of GDM and eGWG, both of which are linked to increased obesity risk in offspring. A significant methodological limitation across studies was the widespread temporal discontinuity, with PA predominantly assessed through retrospective recall rather than objective measures. Additionally, inconsistencies in study design, PA intensity definitions, and confounding lifestyle factors limit definitive conclusions.  While obesity in birthing parents and suboptimal feeding practices dominate current etiological models, the potential preventive role of preconception PA warrants further investigation. Future research should implement intervention designs incorporating objective PA measures (e.g., accelerometry, wearable sensors) within life-course frameworks. Methodologically rigorous studies are critical for disentangling PA-specific effects from confounding lifestyle factors to inform evidence-based guidelines for preconception care.

Purpose of review: Myosteatosis, defined as the pathological accumulation of fat within skeletal muscle, has emerged as a critical yet underrecognized feature of muscle aging and metabolic dysregulation. Despite its growing clinical relevance, the field remains constrained by fragmented definitions, heterogeneous diagnostic criteria, and limited mechanistic understanding, all of which hamper effective detection and intervention. This review synthesizes current evidence to delineate the epidemiological landscape and clinical ramifications of myosteatosis across organ systems, and to highlight emerging myokine-driven endocrine signaling, biomarker candidates, and diagnostic strategies.

Recent findings: Population-level studies increasingly implicate myosteatosis in impaired mobility, heightened morbidity, and poor survival in chronic disease contexts. Susceptibility is influenced by age, sex, ethnicity, and genetic background, while pathological integration with sarcopenia, cardiometabolic dysfunction, malignancy, and systemic frailty is becoming evident. Additionally, dysregulated myokine-mediated endocrine signaling and altered muscle-adipose crosstalk are increasingly recognized as adjunct pathological signatures of myosteatosis, with potential relevance to its progression and metabolic complications. Advances in diagnostic strategies, including quantitative imaging modalities and circulating biomarkers, alongside ongoing progress toward laboratory determinants and assay standardization, have begun to refine disease characterization and translational potential, though consensus remains limited. Myosteatosis is a modifiable disease trait that bridges muscle quality decline with systemic metabolic risk. By outlining unresolved challenges and future research priorities, this review aims to reframe myosteatosis as a targetable axis in precision medicine, with implications for risk stratification, therapeutic development, and improved clinical outcomes.

Background: Obesity represents a significant public health challenge, particularly in the context of coexisting chronic diseases and multi-morbidity. In Spain, and specifically in Catalonia, primary care plays a central role in prevention and management, yet barriers such as weight-related stigma can compromise care delivery.

Aim: To evaluate the current state of obesity prevention and management within the health system, with a focus on implications for primary care in Catalonia, including prevalence, stigma, and integration of chronic disease care.

Methods: A narrative literature review was conducted, including studies, government reports, and policy documents relevant to obesity prevalence, psychosocial factors, and healthcare system strategies.

Results: Persistent weight bias among healthcare professionals can delay diagnosis, reduce treatment adherence, and negatively affect patient experience. Integrated, patient-centered care models that consider physical, psychological, and social health have gained traction. Holistic assessment-including behavioral context, mental health, and social determinants alongside cardiorenal metabolic diseases-is central to these approaches.

Conclusions: Effective obesity management requires integrated chronic disease management frameworks. Collaborative care models, community-based resources, and equitable health policies are essential. Incorporating patient experience helps identify unmet needs and improve care quality. A system-wide, holistic approach is critical to reducing the burden of obesity and related chronic diseases in Catalonia.

Purpose of review: This review explores the intricate and bidirectional relationship between mood disorders and obesity, focusing on the psychiatric implications of metabolic bariatric surgery and weight-loss pharmacotherapy. In particular, the review examines how these interventions impact psychiatric outcomes, identifying both benefits and risks.

Recent findings: While metabolic bariatric surgery and incretin-based therapies improve metabolic health and, in some cases, mental well-being, they may also lead to psychiatric complications. Studies indicate increased risks of mood episodes, self-harm, and altered psychotropic drug metabolism post-surgery. Concerns have also emerged regarding glucagon like peptide-1 (GLP-1) receptor agonists and their potential link to depression and suicidality. Weight-loss interventions require thorough psychiatric assessment prior to treatment, as well as long-term psychiatric monitoring thereafter. Future research should prioritize longitudinal studies with standardized psychiatric assessments to refine risk stratification and optimize clinical outcomes. A multidisciplinary approach integrating endocrinology, psychiatry, and behavioral sciences is essential for improving both physical and mental health outcomes.