Pub Date : 2024-10-18DOI: 10.1038/s41366-024-01647-8
Mojgan Gharipour, Jeffrey M. Craig, Garth Stephenson
Childhood obesity is a global health concern that has its origins before birth. Although genetics plays a crucial role, increasing evidence suggests that epigenetic modifications during fetal life could also influence its incidence. In this model, during the fetal period, interactions between genetic makeup, intrauterine factors, and environmental conditions, increase the risk of childhood obesity. This is in accordance with the Developmental Origins of Health and Disease (DOHaD) hypothesis, in which specific intrauterine environments can have long-lasting effects on the immune system’s essential functions during crucial stages of fetal growth, resulting in permanent changes to the immune function of the offspring. Consequently, dysfunction can consequently make the offspring more prone to inflammatory and immune-related disorders later in life. In this review, we examine how maternal inflammation could influence the risk of childhood obesity. We propose that during pregnancy, modification of the expression of critical genes in metabolic and signaling pathways, such as the kynurenine (Kyn) pathway, occurs due to increased levels of maternal inflammation. We also propose that such expression differences are mediated by epigenetic changes. Furthermore, we also hypothesize that the Kyn pathway produces metabolites that have immunoregulatory effects and may play a crucial role in regulating inflammation during pregnancy. As a result, interventions aimed at improving maternal inflammation may be able to help alleviate the risk of childhood obesity.
{"title":"Epigenetic programming of obesity in early life through modulation of the kynurenine pathway","authors":"Mojgan Gharipour, Jeffrey M. Craig, Garth Stephenson","doi":"10.1038/s41366-024-01647-8","DOIUrl":"10.1038/s41366-024-01647-8","url":null,"abstract":"Childhood obesity is a global health concern that has its origins before birth. Although genetics plays a crucial role, increasing evidence suggests that epigenetic modifications during fetal life could also influence its incidence. In this model, during the fetal period, interactions between genetic makeup, intrauterine factors, and environmental conditions, increase the risk of childhood obesity. This is in accordance with the Developmental Origins of Health and Disease (DOHaD) hypothesis, in which specific intrauterine environments can have long-lasting effects on the immune system’s essential functions during crucial stages of fetal growth, resulting in permanent changes to the immune function of the offspring. Consequently, dysfunction can consequently make the offspring more prone to inflammatory and immune-related disorders later in life. In this review, we examine how maternal inflammation could influence the risk of childhood obesity. We propose that during pregnancy, modification of the expression of critical genes in metabolic and signaling pathways, such as the kynurenine (Kyn) pathway, occurs due to increased levels of maternal inflammation. We also propose that such expression differences are mediated by epigenetic changes. Furthermore, we also hypothesize that the Kyn pathway produces metabolites that have immunoregulatory effects and may play a crucial role in regulating inflammation during pregnancy. As a result, interventions aimed at improving maternal inflammation may be able to help alleviate the risk of childhood obesity.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 1","pages":"49-53"},"PeriodicalIF":4.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01647-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore effective exercise types for reducing chronic inflammation in individuals with overweight and obesity (IOO) while accounting for confounders. A systematic search for RCTs in English between January 2000 and August 2023 was conducted to evaluating exercise effects on inflammatory biomarkers in IOO. A network meta-analysis conducted. A total of 123 RCTs were analyzed. Different exercise type yielded distinct effects on various inflammatory biomarkers. Specifically, aerobic exercise combined with resistance training (COM) and aerobic exercise (AE) were the most effective for improving leptin levels. AE exhibited the greatest effectiveness in reducing CRP and increasing adiponectin. High-intensity interval training (HIIT) was identified as the most effective exercise modality for ameliorating IL-6, TNF-α, and IL-10. Resistance training (RT) had the least effect compared to other exercise types. Meta regression and subgroup analyses revealed that high-intensity AE demonstrated a greater effect size compared to moderate-intensity AE. The impact of AE on IL-10 was positively associated with both the training period and the age of participants. Positive correlations were observed between reductions in body fat and the effect sizes of CRP, TNF-α, and IL-10. Gender influenced AE effects on IL-6 and TNF-α, with females responding better. This study highlights the potential of exercise in alleviating the inflammatory status in IOO, with different exercise types showing various effects on specific inflammatory biomarkers. The intensity and duration of exercise had a dose-response relationship with intervention effectiveness. Changes in body composition correlated with the effectiveness of the intervention. COM, AE, and HIIT are recommended exercise approaches.
{"title":"Effects of various exercise types on inflammatory response in individuals with overweight and obesity: a systematic review and network meta-analysis of randomized controlled trials","authors":"Chaofan Chen, Dong Zhang, Mingyi Ye, Yanwei You, Yiling Song, Xiaoke Chen","doi":"10.1038/s41366-024-01649-6","DOIUrl":"10.1038/s41366-024-01649-6","url":null,"abstract":"To explore effective exercise types for reducing chronic inflammation in individuals with overweight and obesity (IOO) while accounting for confounders. A systematic search for RCTs in English between January 2000 and August 2023 was conducted to evaluating exercise effects on inflammatory biomarkers in IOO. A network meta-analysis conducted. A total of 123 RCTs were analyzed. Different exercise type yielded distinct effects on various inflammatory biomarkers. Specifically, aerobic exercise combined with resistance training (COM) and aerobic exercise (AE) were the most effective for improving leptin levels. AE exhibited the greatest effectiveness in reducing CRP and increasing adiponectin. High-intensity interval training (HIIT) was identified as the most effective exercise modality for ameliorating IL-6, TNF-α, and IL-10. Resistance training (RT) had the least effect compared to other exercise types. Meta regression and subgroup analyses revealed that high-intensity AE demonstrated a greater effect size compared to moderate-intensity AE. The impact of AE on IL-10 was positively associated with both the training period and the age of participants. Positive correlations were observed between reductions in body fat and the effect sizes of CRP, TNF-α, and IL-10. Gender influenced AE effects on IL-6 and TNF-α, with females responding better. This study highlights the potential of exercise in alleviating the inflammatory status in IOO, with different exercise types showing various effects on specific inflammatory biomarkers. The intensity and duration of exercise had a dose-response relationship with intervention effectiveness. Changes in body composition correlated with the effectiveness of the intervention. COM, AE, and HIIT are recommended exercise approaches.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 2","pages":"214-225"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1038/s41366-024-01656-7
Tiina Suikki, Mirkka Maukonen, Heidi Marjonen-Lindblad, Niina Erika Kaartinen, Tommi Härkänen, Pekka Jousilahti, Anne-Maria Pajari, Satu Männistö
The roles of overall diet quality in linking genetic background with anthropometric measures are unclear, particularly regarding the recently developed Planetary Health Diet (PHD). This study aims to determine if the PHD mediates or moderates the relationship between genetic susceptibility to obesity and anthropometric measures. The study involved 2942 individuals from a Finnish population-based cohort (54% women, mean age 53 (SD ± 13) years). Habitual diet was assessed using a validated 130-item food frequency questionnaire, and the PHD Score (total score range 0–13 points) was adapted for Finnish food culture to evaluate diet quality. Genetic susceptibility to obesity was evaluated with a polygenic risk score (PRS) based on one million single nucleotide polymorphisms associated with body mass index (BMI). Baseline anthropometrics included weight, height, waist circumference (WC), and body fat percentage, with changes in these measures tracked over 7 years. A five-step multiple linear regression model and multivariable logistic regression with interaction terms were used to assess the mediating and moderating effects of the PHD. These analyses were also replicated in another Finnish cohort study (2 834 participants). PRS for BMI was positively associated with baseline BMI and changes in anthropometric measures, except waist circumference (p = 0.12). Significant associations were observed for baseline BMI and WC (p < 0.001), changes in BMI and WC (p = 0.01), and body fat percentage change (p = 0.05). However, the PHD (average score 3.8 points) did not mediate or moderate these relationships. These findings were consistent in the replication cohort. Diet quality assessed with the PHD did not mediate or moderate the associations between genetic susceptibility to obesity and anthropometric measures. This lack of effect may be partly due to low adherence to the PHD and the older age of participants ( > 50 years) at baseline.
{"title":"Role of Planetary Health Diet in the association between genetic susceptibility to obesity and anthropometric measures in adults","authors":"Tiina Suikki, Mirkka Maukonen, Heidi Marjonen-Lindblad, Niina Erika Kaartinen, Tommi Härkänen, Pekka Jousilahti, Anne-Maria Pajari, Satu Männistö","doi":"10.1038/s41366-024-01656-7","DOIUrl":"10.1038/s41366-024-01656-7","url":null,"abstract":"The roles of overall diet quality in linking genetic background with anthropometric measures are unclear, particularly regarding the recently developed Planetary Health Diet (PHD). This study aims to determine if the PHD mediates or moderates the relationship between genetic susceptibility to obesity and anthropometric measures. The study involved 2942 individuals from a Finnish population-based cohort (54% women, mean age 53 (SD ± 13) years). Habitual diet was assessed using a validated 130-item food frequency questionnaire, and the PHD Score (total score range 0–13 points) was adapted for Finnish food culture to evaluate diet quality. Genetic susceptibility to obesity was evaluated with a polygenic risk score (PRS) based on one million single nucleotide polymorphisms associated with body mass index (BMI). Baseline anthropometrics included weight, height, waist circumference (WC), and body fat percentage, with changes in these measures tracked over 7 years. A five-step multiple linear regression model and multivariable logistic regression with interaction terms were used to assess the mediating and moderating effects of the PHD. These analyses were also replicated in another Finnish cohort study (2 834 participants). PRS for BMI was positively associated with baseline BMI and changes in anthropometric measures, except waist circumference (p = 0.12). Significant associations were observed for baseline BMI and WC (p < 0.001), changes in BMI and WC (p = 0.01), and body fat percentage change (p = 0.05). However, the PHD (average score 3.8 points) did not mediate or moderate these relationships. These findings were consistent in the replication cohort. Diet quality assessed with the PHD did not mediate or moderate the associations between genetic susceptibility to obesity and anthropometric measures. This lack of effect may be partly due to low adherence to the PHD and the older age of participants ( > 50 years) at baseline.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 2","pages":"286-294"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01656-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1038/s41366-024-01655-8
Nadia Sweis, Julianne Jorgensen, Julia Zeng, Candice Choo-Kang, Joseph Zapater, Kweku Bedu-Addo, Terrence Forrester, Pascal Bovet, Estelle V. Lambert, Walter Riesen, Wolfgang Korte, Yang Dai, Lara R. Dugas, Brian T. Layden, Amy Luke
This cross-sectional study aims to assess the associations between serum leptin, adiponectin, leptin-to-adiponectin ratio (L/A ratio), and metabolic syndrome (MS) and HOMA-IR in five African-origin populations: Ghana, South Africa, Jamaica, Seychelles, and US. Clinical measures included serum glucose, insulin, adipokines, blood pressure and anthropometric measures. MS was determined using the Harmonized criteria. The final sample included 2087 adults. After adjusting for age, sex, and fat mass, L/A ratio, unlike HOMA-IR, was significantly associated with MS across all sites (p < 0.001). Within sites, L/A ratio was only associated with MS and HOMA-IR in the US (p < 0.001) and South Africa (p < 0.01), respectively. Leptin was associated with MS in South Africa only (p < 0.05) but was significantly associated with HOMA-IR across all five sites and within the US (p < 0.05). Similarly, adiponectin was associated with HOMA-IR in South Africa (p < 0.05) and with MS across all five sites (p < 0.001) and within each site separately, except Ghana. Our study suggests that individuals of the African diaspora in different geographical locations may differ in the determinants of MS. Future studies should investigate the determinants for the disparate relationships between MS, IS and adipokines across different African-origin populations.
研究目的这项横断面研究旨在评估五个非洲裔人群的血清瘦素、脂肪连素、瘦素与脂肪连素比率（L/A 比率）、代谢综合征（MS）与 HOMA-IR 之间的关联：方法：临床测量包括血清葡萄糖、胰岛素、脂肪因子、血压和人体测量。多发性硬化症是根据统一标准确定的。最终样本包括 2087 名成年人：结果：在对年龄、性别和脂肪量进行调整后，与 HOMA-IR 不同的是，L/A 比值与所有部位的 MS 都有显著相关性（p 结论：我们的研究表明，非洲人的 L/A 比值与 MS 有显著相关性：我们的研究表明，散居在不同地理位置的非洲人在多发性硬化症的决定因素方面可能存在差异。未来的研究应调查不同非洲裔人群中 MS、IS 和脂肪因子之间不同关系的决定因素。
{"title":"The relationship between leptin-to-adiponectin ratio and HOMA-IR and metabolic syndrome in five African-origin populations","authors":"Nadia Sweis, Julianne Jorgensen, Julia Zeng, Candice Choo-Kang, Joseph Zapater, Kweku Bedu-Addo, Terrence Forrester, Pascal Bovet, Estelle V. Lambert, Walter Riesen, Wolfgang Korte, Yang Dai, Lara R. Dugas, Brian T. Layden, Amy Luke","doi":"10.1038/s41366-024-01655-8","DOIUrl":"10.1038/s41366-024-01655-8","url":null,"abstract":"This cross-sectional study aims to assess the associations between serum leptin, adiponectin, leptin-to-adiponectin ratio (L/A ratio), and metabolic syndrome (MS) and HOMA-IR in five African-origin populations: Ghana, South Africa, Jamaica, Seychelles, and US. Clinical measures included serum glucose, insulin, adipokines, blood pressure and anthropometric measures. MS was determined using the Harmonized criteria. The final sample included 2087 adults. After adjusting for age, sex, and fat mass, L/A ratio, unlike HOMA-IR, was significantly associated with MS across all sites (p < 0.001). Within sites, L/A ratio was only associated with MS and HOMA-IR in the US (p < 0.001) and South Africa (p < 0.01), respectively. Leptin was associated with MS in South Africa only (p < 0.05) but was significantly associated with HOMA-IR across all five sites and within the US (p < 0.05). Similarly, adiponectin was associated with HOMA-IR in South Africa (p < 0.05) and with MS across all five sites (p < 0.001) and within each site separately, except Ghana. Our study suggests that individuals of the African diaspora in different geographical locations may differ in the determinants of MS. Future studies should investigate the determinants for the disparate relationships between MS, IS and adipokines across different African-origin populations.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 2","pages":"278-285"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01655-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 10.1038/s41366-024-01653-w
Zubeyir Salis, Ryan Gallagher, Luke Lawler, Amanda Sainsbury
While weight loss is recommended for managing hip osteoarthritis (OA), most evidence comes from knee OA studies, limiting its applicability to hip OA. This study addresses this gap by examining the effects of weight loss on hip OA symptoms. A retrospective audit of routinely collected healthcare data from participants enrolled in the Osteoarthritis Healthy Weight for Life (OAHWFL) program, designed for individuals with knee or hip OA. In total, 1714 adults with hip OA were selected from the OAHWFL program; 1408 completed the initial 18-week weight loss phase, while 306 did not complete it. After 18 weeks, participants transitioned to an indefinite weight maintenance phase. Percentage change in body weight from baseline at 18 weeks. Changes in the five subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS) (Pain, Activity Limitations in Daily Living, Stiffness and Range of Motion, Sports and Recreation Function, and Hip-related Quality of Life) from baseline to 18 weeks. Linear regression, adjusted for sex and baseline values of age, weight, and respective HOOS scores, assessed the relationship between percentage weight change (analyzed as both a continuous variable and in categories: ≤2.5%, >2.5–5.0%, >5.0–7.5%, >7.5–10%, and >10% of baseline weight) and changes in all five HOOS subscales. At baseline, participants had a mean age of 65.14 years, 70% were female, and 78% were individuals with obesity (Body Mass Index ≥30 kg/m2). A statistically significant dose-response relationship was observed between weight loss and improvements in all HOOS subscales, with the greatest improvement in the Hip-related Quality of Life subscale (14.42 points, 31.14%) for >10% weight loss. Our findings suggest that weight loss is associated with reduced symptoms of hip OA, supporting weight loss as an effective treatment strategy for hip OA.
{"title":"Loss of body weight is dose-dependently associated with reductions in symptoms of hip osteoarthritis","authors":"Zubeyir Salis, Ryan Gallagher, Luke Lawler, Amanda Sainsbury","doi":"10.1038/s41366-024-01653-w","DOIUrl":"10.1038/s41366-024-01653-w","url":null,"abstract":"While weight loss is recommended for managing hip osteoarthritis (OA), most evidence comes from knee OA studies, limiting its applicability to hip OA. This study addresses this gap by examining the effects of weight loss on hip OA symptoms. A retrospective audit of routinely collected healthcare data from participants enrolled in the Osteoarthritis Healthy Weight for Life (OAHWFL) program, designed for individuals with knee or hip OA. In total, 1714 adults with hip OA were selected from the OAHWFL program; 1408 completed the initial 18-week weight loss phase, while 306 did not complete it. After 18 weeks, participants transitioned to an indefinite weight maintenance phase. Percentage change in body weight from baseline at 18 weeks. Changes in the five subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS) (Pain, Activity Limitations in Daily Living, Stiffness and Range of Motion, Sports and Recreation Function, and Hip-related Quality of Life) from baseline to 18 weeks. Linear regression, adjusted for sex and baseline values of age, weight, and respective HOOS scores, assessed the relationship between percentage weight change (analyzed as both a continuous variable and in categories: ≤2.5%, >2.5–5.0%, >5.0–7.5%, >7.5–10%, and >10% of baseline weight) and changes in all five HOOS subscales. At baseline, participants had a mean age of 65.14 years, 70% were female, and 78% were individuals with obesity (Body Mass Index ≥30 kg/m2). A statistically significant dose-response relationship was observed between weight loss and improvements in all HOOS subscales, with the greatest improvement in the Hip-related Quality of Life subscale (14.42 points, 31.14%) for >10% weight loss. Our findings suggest that weight loss is associated with reduced symptoms of hip OA, supporting weight loss as an effective treatment strategy for hip OA.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 1","pages":"147-153"},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01653-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1038/s41366-024-01650-z
Lars Holger Ehlers, Nicoline Weinreich Reinstrup, Renée Hangaard Olesen, Jens-Christian Holm, Phil McEwan, Carel W. Le Roux
The treatment of obesity remains underprioritized. New pharmacologic options for the treatment of obesity have shown effectiveness and safety but are not widely reimbursed. Despite the unmet need and the existence of effective prevention and treatment strategies, substantial barriers exist to effectively address obesity as a disease. The purpose of this scoping review was to investigate the barriers for decision makers in prioritizing interventions for obesity and to seek out interconnection between barriers to prevention and treatment. A scoping review was conducted using a systematic search of both scientific databases and Health Technology Assessment (HTA) databases. Studies that addressed barriers to reimbursement or prioritization of obesity treatment and prevention were included. A total of 26 articles and 14 HTAs were included. Four main barriers for decision makers to prioritize new interventions for obesity were identified: perceptions, knowledge, economics, and politics. There was a high degree of interconnectedness among barriers, as well as large overlaps between barriers in relation to bariatric surgery, pharmacologic treatments, and prevention regulation. Multiple barriers exist that impact decision makers in prioritizing interventions for treating obesity. A strong interconnectedness of the barriers was found, indicating a systems approach to improve global prioritization to address the disease. This study suggests that decision makers should carefully consider all main barriers when addressing the obesity epidemic.
{"title":"Global barriers to decision makers for prioritizing interventions for obesity","authors":"Lars Holger Ehlers, Nicoline Weinreich Reinstrup, Renée Hangaard Olesen, Jens-Christian Holm, Phil McEwan, Carel W. Le Roux","doi":"10.1038/s41366-024-01650-z","DOIUrl":"10.1038/s41366-024-01650-z","url":null,"abstract":"The treatment of obesity remains underprioritized. New pharmacologic options for the treatment of obesity have shown effectiveness and safety but are not widely reimbursed. Despite the unmet need and the existence of effective prevention and treatment strategies, substantial barriers exist to effectively address obesity as a disease. The purpose of this scoping review was to investigate the barriers for decision makers in prioritizing interventions for obesity and to seek out interconnection between barriers to prevention and treatment. A scoping review was conducted using a systematic search of both scientific databases and Health Technology Assessment (HTA) databases. Studies that addressed barriers to reimbursement or prioritization of obesity treatment and prevention were included. A total of 26 articles and 14 HTAs were included. Four main barriers for decision makers to prioritize new interventions for obesity were identified: perceptions, knowledge, economics, and politics. There was a high degree of interconnectedness among barriers, as well as large overlaps between barriers in relation to bariatric surgery, pharmacologic treatments, and prevention regulation. Multiple barriers exist that impact decision makers in prioritizing interventions for treating obesity. A strong interconnectedness of the barriers was found, indicating a systems approach to improve global prioritization to address the disease. This study suggests that decision makers should carefully consider all main barriers when addressing the obesity epidemic.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 2","pages":"246-253"},"PeriodicalIF":4.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01650-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1038/s41366-024-01652-x
Tamta Nadaraia, Ed Whittaker, Indira Kenyon, Jirapitcha Boonpor, Ziyi Zhou, Shinya Nakada, Ike Dhiah Rochmawati, Carlos Celis-Morales, Joey Ward, Naja Hulvej Rod, Jill P. Pell, Helen Minnis, Thomas Hehlmann, Frederick K. Ho, Daniel Mackay
This study aims to explore the association of childhood maltreatment with obesity and type 2 diabetes (T2D) in adulthood, and whether obesity is a mediator of the latter. In a retrospective cohort study using UK Biobank data, participants recalled childhood maltreatment. Linear regression, logistic regression, and Cox proportional hazard models were used to investigate the associations with body mass index (BMI), obesity, and T2D, adjusted for sociodemographic factors. Decomposition analysis was used to examine the extent to which T2D excess risk was attributed to BMI. Of the 153,601 participants who completed the childhood maltreatment questions, one-third reported some form of maltreatment. Prevalence of adult obesity and incidence of T2D were higher with the number of reported childhood maltreatment types. People who reported ≥3 types of childhood maltreatment were at higher risk of obesity (OR 1.55, 95% CI 1.47–1.63) and incident T2D (HR 1.65, 95% CI 1.52–1.80). Excess T2D risk among those reporting maltreatment could be reduced by 39% if their BMI was comparable to participants who had not been maltreated, assuming causality. People who recalled maltreatment in childhood are at higher risk of T2D in adulthood, partly due to obesity.
研究背景本研究旨在探讨童年虐待与成年后肥胖和2型糖尿病（T2D）之间的关系，以及肥胖是否是后者的中介因素：在一项利用英国生物库数据进行的回顾性队列研究中，参与者回忆了童年时期遭受虐待的情况。采用线性回归、逻辑回归和 Cox 比例危险模型来研究与体重指数 (BMI)、肥胖和 T2D 的关系，并对社会人口因素进行调整。采用分解分析法研究了体质指数对终末期糖尿病超额风险的影响程度：在 153,601 名填写了儿童虐待问题的参与者中，有三分之一报告了某种形式的虐待。报告的童年虐待类型越多，成人肥胖率和T2D发病率越高。报告遭受过≥3种童年虐待的人患肥胖症（OR 1.55，95% CI 1.47-1.63）和T2D（HR 1.65，95% CI 1.52-1.80）的风险较高。假设存在因果关系，如果受虐待者的体重指数（BMI）与未受虐待者相当，那么报告受虐待者患T2D的风险可降低39%：结论：忆及童年受虐待的人成年后患 T2D 的风险较高，部分原因是肥胖。
{"title":"Childhood maltreatment, adulthood obesity and incident type 2 diabetes: a retrospective cohort study using UK Biobank","authors":"Tamta Nadaraia, Ed Whittaker, Indira Kenyon, Jirapitcha Boonpor, Ziyi Zhou, Shinya Nakada, Ike Dhiah Rochmawati, Carlos Celis-Morales, Joey Ward, Naja Hulvej Rod, Jill P. Pell, Helen Minnis, Thomas Hehlmann, Frederick K. Ho, Daniel Mackay","doi":"10.1038/s41366-024-01652-x","DOIUrl":"10.1038/s41366-024-01652-x","url":null,"abstract":"This study aims to explore the association of childhood maltreatment with obesity and type 2 diabetes (T2D) in adulthood, and whether obesity is a mediator of the latter. In a retrospective cohort study using UK Biobank data, participants recalled childhood maltreatment. Linear regression, logistic regression, and Cox proportional hazard models were used to investigate the associations with body mass index (BMI), obesity, and T2D, adjusted for sociodemographic factors. Decomposition analysis was used to examine the extent to which T2D excess risk was attributed to BMI. Of the 153,601 participants who completed the childhood maltreatment questions, one-third reported some form of maltreatment. Prevalence of adult obesity and incidence of T2D were higher with the number of reported childhood maltreatment types. People who reported ≥3 types of childhood maltreatment were at higher risk of obesity (OR 1.55, 95% CI 1.47–1.63) and incident T2D (HR 1.65, 95% CI 1.52–1.80). Excess T2D risk among those reporting maltreatment could be reduced by 39% if their BMI was comparable to participants who had not been maltreated, assuming causality. People who recalled maltreatment in childhood are at higher risk of T2D in adulthood, partly due to obesity.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 1","pages":"140-146"},"PeriodicalIF":4.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01652-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1038/s41366-024-01648-7
Adnan Malik, Muhammad Imran Malik, Sadia Javaid, Shahbaz Qureshi, Abdul Nadir
Bariatric surgery is recommended for patients with unhealthy weight. Our study aim to compare and rank different bariatric surgical approaches in reducing weight parameters. We searched MEDLINE, Cochrane CENTRAL, Scopus, and Web of Science databases from inception to September 2023. We extracted all outcomes as mean change from the baseline. The mean difference and 95% confidence interval were used as a summary measure. All analysis was conducted with R version 4.2.2 (2022-10-31) and R Studio version 2022.07.2 (2009–2022) (RStudio, Inc.). Included surgeries were: Biliopancreatic diversion (BPD-RYGB), Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Gastric Plication (LGP), Duodenal-Jejunal Bypass Sleeve (DJBS), Single-anastomosis gastric bypass (SAGB), Laparoscopic vertical banded gastroplasty (LVBG), Sleeve Gastrectomy (SG), Laparoscopic adjustable gastric banding (LAGB), Gastric plication, Biliopancreatic diversion (BPD), and Intra-gastric balloon (IGB). Only clinical trials were included, with outcomes focused on weight parameters such as reductions in BMI (kg/m²), weight (kg), waist circumference (cm), fat mass (kg), and excess weight loss (EWL) (%). Our analysis of 67 studies showed that SADI-S was the best surgical technique in decreasing BMI (kg/m2) (MD = −18.06; 95% CI [−25.31; −10.81]) and DS follows in efficacy with a P-score (MD = −18.88; 95% CI [−31.15; −6.62]) however the pooled analysis was heterogeneous (I2 = 98.5%). For weight (kg), waist circumference (cm), and fat mass (kg), BPD-RYGB was the best surgical technique to reduce these parameters (MD = −41.48; 95% CI [−47.80, −35.51], MD = −29.08; 95% CI [−37.16, −21.00], and MD = −31.11; 95% CI [−38.77, −23.46]; respectively). The pooled analysis was heterogeneous except in fat mass (I2 = 0%, p-value = 0.8). Our network meta-analysis showed that the best surgical technique in increasing EWL (%) was RY-DS (MD = −61.27; % CI [−91.72; −30.82]) the next one in efficacy according to P-score was LVBG (MD = −59.03; % CI [−84.47; −33.59]). SADI-S is most effective in reducing BMI followed by RYGB. DS was associated with most estimated weight loss %.
建议体重不健康的患者接受减肥手术。我们的研究旨在对不同减肥手术方法在减轻体重方面的参数进行比较和排序。我们检索了从开始到 2023 年 9 月的 MEDLINE、Cochrane CENTRAL、Scopus 和 Web of Science 数据库。我们将所有结果提取为与基线相比的平均变化。平均差异和 95% 的置信区间被用作总结性指标。所有分析均使用 R version 4.2.2 (2022-10-31) 和 R Studio version 2022.07.2 (2009-2022) (RStudio, Inc.) 进行。纳入的手术包括胆胰转流术（BPD-RYGB）、Roux-en-Y 胃旁路术（RYGB）、腹腔镜胃折叠术（LGP）、十二指肠空肠旁路袖带术（DJBS）、单吻合胃旁路术（SAGB）、腹腔镜垂直胃束带成形术（LVBG）、袖状胃切除术（SG）、腹腔镜可调节胃束带术（LAGB）、胃成形术、胆胰转流术（BPD）和胃内气球（IGB）。这些研究只包括临床试验，其结果主要集中在体重参数上，如体重指数（BMI）（千克/平方米）、体重（千克）、腰围（厘米）、脂肪量（千克）和超重（EWL）（%）的减少。我们对 67 项研究进行的分析表明，SADI-S 是降低 BMI（kg/m2）的最佳手术技术（MD = -18.06；95% CI [-25.31；-10.81]），DS 的疗效以 P 值（MD = -18.88；95% CI [-31.15；-6.62]）紧随其后，但汇总分析结果存在差异（I2 = 98.5%）。就体重（千克）、腰围（厘米）和脂肪量（千克）而言，BPD-RYGB 是降低这些参数的最佳手术技术（MD = -41.48; 95% CI [-47.80, -35.51]，MD = -29.08; 95% CI [-37.16, -21.00]，MD = -31.11; 95% CI [-38.77, -23.46]）。除脂肪量（I2 = 0%，P 值 = 0.8）外，汇总分析存在异质性。我们的网络荟萃分析表明，RY-DS（MD = -61.27；% CI [-91.72；-30.82]）是增加 EWL（%）的最佳手术技术，而根据 P 值，疗效次之的是 LVBG（MD = -59.03；% CI [-84.47；-33.59]）。SADI-S 在降低体重指数方面最为有效，其次是 RYGB。DS与估计体重减轻率最高有关。
{"title":"Comparative effectiveness of metabolic and bariatric surgeries: a network meta-analysis","authors":"Adnan Malik, Muhammad Imran Malik, Sadia Javaid, Shahbaz Qureshi, Abdul Nadir","doi":"10.1038/s41366-024-01648-7","DOIUrl":"10.1038/s41366-024-01648-7","url":null,"abstract":"Bariatric surgery is recommended for patients with unhealthy weight. Our study aim to compare and rank different bariatric surgical approaches in reducing weight parameters. We searched MEDLINE, Cochrane CENTRAL, Scopus, and Web of Science databases from inception to September 2023. We extracted all outcomes as mean change from the baseline. The mean difference and 95% confidence interval were used as a summary measure. All analysis was conducted with R version 4.2.2 (2022-10-31) and R Studio version 2022.07.2 (2009–2022) (RStudio, Inc.). Included surgeries were: Biliopancreatic diversion (BPD-RYGB), Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Gastric Plication (LGP), Duodenal-Jejunal Bypass Sleeve (DJBS), Single-anastomosis gastric bypass (SAGB), Laparoscopic vertical banded gastroplasty (LVBG), Sleeve Gastrectomy (SG), Laparoscopic adjustable gastric banding (LAGB), Gastric plication, Biliopancreatic diversion (BPD), and Intra-gastric balloon (IGB). Only clinical trials were included, with outcomes focused on weight parameters such as reductions in BMI (kg/m²), weight (kg), waist circumference (cm), fat mass (kg), and excess weight loss (EWL) (%). Our analysis of 67 studies showed that SADI-S was the best surgical technique in decreasing BMI (kg/m2) (MD = −18.06; 95% CI [−25.31; −10.81]) and DS follows in efficacy with a P-score (MD = −18.88; 95% CI [−31.15; −6.62]) however the pooled analysis was heterogeneous (I2 = 98.5%). For weight (kg), waist circumference (cm), and fat mass (kg), BPD-RYGB was the best surgical technique to reduce these parameters (MD = −41.48; 95% CI [−47.80, −35.51], MD = −29.08; 95% CI [−37.16, −21.00], and MD = −31.11; 95% CI [−38.77, −23.46]; respectively). The pooled analysis was heterogeneous except in fat mass (I2 = 0%, p-value = 0.8). Our network meta-analysis showed that the best surgical technique in increasing EWL (%) was RY-DS (MD = −61.27; % CI [−91.72; −30.82]) the next one in efficacy according to P-score was LVBG (MD = −59.03; % CI [−84.47; −33.59]). SADI-S is most effective in reducing BMI followed by RYGB. DS was associated with most estimated weight loss %.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 1","pages":"54-62"},"PeriodicalIF":4.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1038/s41366-024-01646-9
André Saad Cleto, João Matheus Schirlo, Mayara Beltrame, Victor Hugo Oliveira Gomes, Isabela Hellmann Acras, Guinter Sponholz Neiverth, Breno Bach Silva, Beatriz Moreira Salles Juliatto, Janete Machozeki, Camila Marinelli Martins
Semaglutide is a GLP-1 receptor agonist that provides a reduction in glycated hemoglobin and weight. The objective was to evaluate whether the use of semaglutide, in individuals with overweight or obesity, reduces cardiovascular outcomes and adverse effects (AE). The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane Library were surveyed. Initially, 3333 articles were found, of which 19 articles were included. An additional search included 19 studies, totaling 38 articles. Relative risk (RR) values were significant for hospitalization due to heart failure (HF) 0.24 95% CI 0.12–0.57 (n = 2; 1045 participants; I² = 0.18), death due to cardiovascular causes 0.83 95% CI 0.71–0.98 (n = 3; 24 084 participants; I² = 0.21), death from any cause 0.79 95% CI 0.70–0.89 (n = 3; 24 084 participants; I² = 0.07), coronary revascularization 0.76 95% CI 0.69–0.85 (n = 2;20 951 participants; I² = 0.41), and non-fatal myocardial infarction 0.76 95%CI 0.66–0.88 (n = 3; 24 084 participants; I² = 0.21), with a difference between the subgroups (p = 0.05), favoring the subcutaneous administration route. The RR of stroke was 0.65 95% CI 0.44–0.97 for patients with diabetes (n = 2; 6480 participants; I² = 0.66). There was no difference between the frequency of constipation and routes of administration, as well as between doses of oral semaglutide. The RR of adverse effects was only not significant for discontinuation of treatment for oral semaglutide. The use of semaglutide reduced 76% in hospitalization due to HF, 17% deaths due to cardiovascular causes, 21% deaths due to any cause, 24% non-fatal myocardial infarction, 24% coronary revascularization and 35% stroke (in patients with diabetes). The use of semaglutide was associated with a higher relative risk and frequency of most adverse effects evaluated.
{"title":"Semaglutide effects on safety and cardiovascular outcomes in patients with overweight or obesity: a systematic review and meta-analysis","authors":"André Saad Cleto, João Matheus Schirlo, Mayara Beltrame, Victor Hugo Oliveira Gomes, Isabela Hellmann Acras, Guinter Sponholz Neiverth, Breno Bach Silva, Beatriz Moreira Salles Juliatto, Janete Machozeki, Camila Marinelli Martins","doi":"10.1038/s41366-024-01646-9","DOIUrl":"10.1038/s41366-024-01646-9","url":null,"abstract":"Semaglutide is a GLP-1 receptor agonist that provides a reduction in glycated hemoglobin and weight. The objective was to evaluate whether the use of semaglutide, in individuals with overweight or obesity, reduces cardiovascular outcomes and adverse effects (AE). The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane Library were surveyed. Initially, 3333 articles were found, of which 19 articles were included. An additional search included 19 studies, totaling 38 articles. Relative risk (RR) values were significant for hospitalization due to heart failure (HF) 0.24 95% CI 0.12–0.57 (n = 2; 1045 participants; I² = 0.18), death due to cardiovascular causes 0.83 95% CI 0.71–0.98 (n = 3; 24 084 participants; I² = 0.21), death from any cause 0.79 95% CI 0.70–0.89 (n = 3; 24 084 participants; I² = 0.07), coronary revascularization 0.76 95% CI 0.69–0.85 (n = 2;20 951 participants; I² = 0.41), and non-fatal myocardial infarction 0.76 95%CI 0.66–0.88 (n = 3; 24 084 participants; I² = 0.21), with a difference between the subgroups (p = 0.05), favoring the subcutaneous administration route. The RR of stroke was 0.65 95% CI 0.44–0.97 for patients with diabetes (n = 2; 6480 participants; I² = 0.66). There was no difference between the frequency of constipation and routes of administration, as well as between doses of oral semaglutide. The RR of adverse effects was only not significant for discontinuation of treatment for oral semaglutide. The use of semaglutide reduced 76% in hospitalization due to HF, 17% deaths due to cardiovascular causes, 21% deaths due to any cause, 24% non-fatal myocardial infarction, 24% coronary revascularization and 35% stroke (in patients with diabetes). The use of semaglutide was associated with a higher relative risk and frequency of most adverse effects evaluated.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 1","pages":"21-30"},"PeriodicalIF":4.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Multidisciplinary lifestyle interventions for children with obesity in Denmark often include recommendations regarding physical activity, but no structured exercise program. We hypothesized that adding high-intensity interval training (HIIT) to a multidisciplinary lifestyle intervention would improve BMI z-score (primary outcome), waist circumference, blood pressure, and health-related quality of life (HRQOL). This randomized controlled trial included 173 children and adolescents with obesity. Participants were allocated to 12-months lifestyle intervention (N = 83), or 12-month lifestyle intervention accompanied by a 12-week HIIT program (N = 90). HIIT consisted of three weekly sessions and included activities eliciting intensities >85% of maximal heart rate. Attendance rate for the 3-months HIIT intervention was 68.0 ± 23.2%. Dropout was lower in HIIT compared to control at three months (7.8% vs. 20.5%) and 12 months (26.5% vs 48.2%). Changes in BMI z-score did not differ between HIIT and control at 3 months (Mean Difference (MD): 0.01, 95% confidence interval (CI): −0.09; 0.12, P = 0.82) or 12 months (MD: 0.06, CI: −0.07;0.19, P = 0.34). Across randomization, BMI z-score was reduced by 0.11 (CI: 0.17; 0.06, P < 0.01) at 3 months and 0.20 (CI: 0.26;0.14, P < 0.01) at 12 months. At 3 months, HIIT experienced a greater increase in HRQOL of 2.73 (CI: 0.01;5.44, P = 0.05) in PedsQL Child total-score and 3.85 (CI: 0.96; 6.74, P < 0.01) in psychosocial health-score compared to control. At 12 months, PedsQL Child physical-score was reduced by 6.89 (CI: 10.97; 2.83, P < 0.01) in HIIT compared to control. No group differences or changes over time were found for waist circumference or blood pressure. Adding a 12-week HIIT program did not further augment the positive effects of a 12-month lifestyle intervention on BMI z-score. Adding HIIT improved HRQOL after 3 months, but reduced HRQOL at 12 months. Implementation of HIIT in community-based settings was feasible and showed positive effects on adherence to the lifestyle intervention.
{"title":"Feasibility and efficacy of adding high-intensity interval training to a multidisciplinary lifestyle intervention in children with obesity—a randomized controlled trial","authors":"Charlotte Nørkjær Eggertsen, Ryan Godsk Larsen, Kirsten Duch, Morten Bilde Simonsen, Cecilie Brøns Christensen, Tine Caroc Warner, Jens Brøndum Frøkjær, Aase Handberg, Theresa Stjernholm, Esben Thyssen Vestergaard, Søren Hagstrøm","doi":"10.1038/s41366-024-01645-w","DOIUrl":"10.1038/s41366-024-01645-w","url":null,"abstract":"Multidisciplinary lifestyle interventions for children with obesity in Denmark often include recommendations regarding physical activity, but no structured exercise program. We hypothesized that adding high-intensity interval training (HIIT) to a multidisciplinary lifestyle intervention would improve BMI z-score (primary outcome), waist circumference, blood pressure, and health-related quality of life (HRQOL). This randomized controlled trial included 173 children and adolescents with obesity. Participants were allocated to 12-months lifestyle intervention (N = 83), or 12-month lifestyle intervention accompanied by a 12-week HIIT program (N = 90). HIIT consisted of three weekly sessions and included activities eliciting intensities >85% of maximal heart rate. Attendance rate for the 3-months HIIT intervention was 68.0 ± 23.2%. Dropout was lower in HIIT compared to control at three months (7.8% vs. 20.5%) and 12 months (26.5% vs 48.2%). Changes in BMI z-score did not differ between HIIT and control at 3 months (Mean Difference (MD): 0.01, 95% confidence interval (CI): −0.09; 0.12, P = 0.82) or 12 months (MD: 0.06, CI: −0.07;0.19, P = 0.34). Across randomization, BMI z-score was reduced by 0.11 (CI: 0.17; 0.06, P < 0.01) at 3 months and 0.20 (CI: 0.26;0.14, P < 0.01) at 12 months. At 3 months, HIIT experienced a greater increase in HRQOL of 2.73 (CI: 0.01;5.44, P = 0.05) in PedsQL Child total-score and 3.85 (CI: 0.96; 6.74, P < 0.01) in psychosocial health-score compared to control. At 12 months, PedsQL Child physical-score was reduced by 6.89 (CI: 10.97; 2.83, P < 0.01) in HIIT compared to control. No group differences or changes over time were found for waist circumference or blood pressure. Adding a 12-week HIIT program did not further augment the positive effects of a 12-month lifestyle intervention on BMI z-score. Adding HIIT improved HRQOL after 3 months, but reduced HRQOL at 12 months. Implementation of HIIT in community-based settings was feasible and showed positive effects on adherence to the lifestyle intervention.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 2","pages":"269-277"},"PeriodicalIF":4.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01645-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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