International Journal of Obesity最新文献

Background: Several studies have attempted to demonstrate the associations between body mass index (BMI) in early age and cardiovascular diseases (CVDs). However, their findings were inconsistent and inconclusive, indicating the need for further investigation.

Methods: We conducted a systematic review and meta-analysis of studies focusing on BMI in early age (age from 2 to 22) in relation to CVDs in adulthood, including coronary artery disease (CHD), ischemic and hemorrhagic stroke, myocardial infarction and heart failure. Fixed-effects and Random-effects models were used to pool the data. Sex, age, adjustment of socioeconomic status and fatal events specific analysis were conducted to examine their effects on the results.

Results: Thirty-eight studies were eligible for inclusion. BMI in early age was positively related to CVD (HR = 1.18, 95% CI: 1.07-1.30), CHD (HR = 1.13, 95% CI: 1.07-1.19), heart failure (HR = 1.16, 95% CI: 1.11-1.20) but not stroke (HR = 0.99, 95% CI: 0.93-1.05). The results remained consistent after stratified by sex, fatal or non-fatal events and adjustment for socioeconomic status. Further age-specific analysis showed that both childhood and early adulthood group showed positive associations on CHD and HF. While estimates in early adulthood for all CVDs were numerically higher than that for childhood. Category analyses showed a positive association between being overweight or obesity and adulthood CVDs, including stroke.

Conclusion: We found a positive association between early-age BMI and adulthood cardiovascular diseases except for stroke.

Trial registration: Systemic review registration https://www.crd.york.ac.uk/Prospero/ , identifier CRD42023403602.

Background: The effects of time-restricted eating (TRE) with exercise on body composition in adults are not clear.

Objective: This meta-analysis aimed to assess the effects of TRE when followed in combination with various forms of exercise, including aerobic, resistance, and combined aerobic and resistance [concurrent] training on body composition.

Methods: Studies published up to May 2023 were searched in EBSCOhost (MEDLINE, CINAHL, SPORTSDISCUS), PubMed, and SCOPUS databases. Fifteen studies, including 338 participants, that evaluated TRE vs. unrestricted eating in individuals performing exercise were analyzed. A random-effects model was used to calculate the weighted mean effect sizes (ES) with 95% confidence intervals (95% CI's).

Results: According to the pooled results, TRE had a small but significant reduction of fat mass (FM) kg with an effect size of -0.20 (95% CI = -0.28 to -0.13, p < 0.001) and on body fat percent (BF%) with an effect size of -0.23 (95% CI = -0.35 to -0.11, p < 0.001). The prediction interval ranged from -0.48 to 0.08 for FM and from -0.64 to 0.18 for BF%, respectively. TRE did not significantly alter fat-free mass (FFM) kg compared to control (p = 0.07). Furthermore, age, body mass index (BMI), exercise type, study duration, and energy intake did not have a significant impact on the variation in effect sizes according to the subgroup analyses (p > 0.05).

Conclusion: TRE with exercise may reduce fat mass compared to an unrestricted eating window exercise-matched control while preserving FFM. However, more studies are needed.

Background: Rare variants in melanocortin 4 receptor gene (MC4R) result in a severe form of early-onset obesity; however, it is unclear how these variants may affect abdominal fat distribution, intrahepatic fat accumulation, and related metabolic sequelae.

Methods: Eight hundred seventy-seven youth (6-21 years) with overweight/obesity, recruited from the Yale Pediatric Obesity Clinic in New Haven, CT, underwent genetic analysis to screen for functionally damaging, rare variants (MAF < 0.01) in MC4R. Participants were assigned to a Pathogenic Variant or No Pathogenic Variant group and completed a 10-timepoint 180-min oral glucose tolerance test (OGTT) and abdominal MRI.

Results: Compared to the No Pathogenic Variant group, the Pathogenic Variant group demonstrated significantly greater glucose concentrations (AUC_tot: 24.7 ± 1.22 g/dL × 180 min vs. 21.9 ± 1.41 g/dL × 180 min; p = 0.001), insulin levels (AUC_tot: 57.4 ± 11.5 mU/mL × 180 min vs. 35.5 ± 8.90 mU/mL × 180 min; p = 0.002), and lower insulin sensitivity (WBISI: 1.01 ± 0.137 vs. 1.85 ± 0.036; p = 0.0008) during the OGTT. The Pathogenic Variant group also presented with greater visceral adipose tissue (VAT) (85.1 cm² ± 10.3 vs. 56.1 cm² ± 1.64; p = 0.003) and intrahepatic fat content (HFF%) (19.4% ± 4.94 vs. 8.21% ± 0.495; p = 0.012) than the No Pathogenic Variant group despite the two groups having similar BMI z-scores (p = 0.255), subcutaneous adipose tissue (SAT) (p = 0.643), and total body fat (p = 0.225).

Conclusions: Pathogenic variants in MC4R are associated with increased VAT, HFF%, and insulin resistance, independent from the degree of obesity in youth.

Background: Understanding how obesity impacts human mammary adipose tissue (MAT) biology is crucial for deciphering its role in mammary epithelium during both physiological and pathophysiological processes, including breast cancer. Hypertrophic mammary adipocytes and Crown-Like Structures are present in MAT of patients with obesity but whether these changes initiate a fibro-inflammatory response at the tissue level remains insufficiently explored.

Objective: We investigated the markers of adipose tissue dysfunction (immune cell infiltration, secretion pattern and fibrosis) in tumor-free MAT of patients with obesity versus patients who are lean.

Methods: Tumor-free MAT were obtained from 96 women with (n = 43) or without (n = 53) obesity who underwent mastectomy for breast cancer risk reduction or treatment. Immune and non-immune cell infiltration were determined using flow cytometry. Bulk transcriptomic was used to characterize the phenotype of CD206+ macrophages whose infiltration is increased in patients with obesity. Conditioned-medium were prepared from MAT to characterize their secretome and dose adipokines and cytokines by ELISA assay. The extra-cellular matrix (ECM) deposition was evaluated by Masson trichrome staining on cross-stained sections, 3D imaging of red picrosirius-stained tissues and measure of hydroxyproline content.

Results: We observed an increase of CD206+/HLA-DR+ macrophages in the stromal vascular fraction of MAT from patients with obesity compared to patients who are lean. Other immune cell infiltration and endothelial or adipose progenitor cell numbers were similar between groups. Bulk transcriptomics on CD206+ macrophages revealed a significant decrease in ECM component expression and processing in obesity. In addition, no heightened secretion of pro-inflammatory cytokines, TGF-β1 or MCP-1 was observed in the samples from patients with obesity. ECM characterization revealed an absence of fibrosis, with MAT of patients with obesity showing even a slightly reduced collagen secretion and deposition compared with their lean counterparts.

Conclusions: Obesity is not associated with inflammation nor fibrosis in MAT, highlighting its unique behavior.

Introduction: Obesity is an independent risk factor for postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) surgery. POAF in patients with severe obesity (body mass index [BMI] ≥ 35 kg/m²) is less studied. Whether waist circumference (WC) improves prediction of POAF independently of BMI among patients with severe obesity remains unknown.

Aim: To evaluate the risk of POAF, the role of WC in predicting POAF and postoperative complications after CABG surgery in severe obesity.

Methods: Our cohort included 7995 patients undergoing CABG surgery (2006-19). POAF risk was compared across BMI and WC categories. In patients with severe obesity, the association of an increase in WC with POAF risk was assessed.

Results: 763 (9.5%) patients had a BMI ≥ 35 kg/m². In this group, BMI was 38.5 ± 3.6 kg/m² and WC was 123.4 ± 10.8 cm. More patients with severe obesity developed POAF compared to patients with a normal BMI (37 vs. 29%, aRR: 1.52[95%CI 1.36-1.72], p < 0.01). Within each BMI category, the risk of POAF was higher per increasing tertile of WC (p < 0.05). Among patients with a BMI ≥ 35 kg/m², every 10 cm increment in WC was associated with an increased risk of POAF (aRR: 1.16[95%CI 1.08-1.24], p < 0.01). POAF in patients with severe obesity was associated with increased hospital length of stay.

Conclusions: Severe obesity increases the risk of POAF after CABG surgery. In this subgroup, elevated WC may provide additional prognostic value independently of BMI. Since POAF is associated with adverse long-term outcomes, abdominal obesity by measurement of WC should be assessed and targeted even in patient with severe obesity. Central Illustration Increasing waist circumference associated with increased atrial fibrillation risk post coronary artery bypass grafting. Bar graph of the unadjusted absolute risk and 95% confidence interval of postoperative atrial fibrillation for each tertile of waist circumference per body mass index category. Comparison of postoperative atrial fibrillation risk with chi-square test showing an increasing risk of postoperative atrial fibrillation related to increasing waist circumference within each body mass index category.

Abbreviations: BMI, body mass index; POAF, postoperative atrial fibrillation; WC, waist circumference.

Background/objectives: Circadian health plays an important role in overall well-being. The objective of this study was to examine whether potential indicators of circadian disruption, such as exhibiting a later chronotype or greater social jetlag, in preschool-age could predict dietary habits or BMI z-scores in an eight-year follow-up.

Subjects/methods: Our data included 210 children who participated in the DAGIS Survey in 2015-2016 (baseline, mean [SD] age: 4.69 [0.89] years) and DAGIS Next in 2023 (follow-up, age: 12.03 [0.90] years). Chronotype and social jetlag were calculated from baseline sleep measures assessed from 7-day actigraphy. Diet was assessed at follow-up with a Food Frequency Questionnaire, which evaluated the weekly consumption frequency of (1) fruits and vegetables and (2) sugary foods and drinks. BMI z-score based on Finnish growth references was calculated from height and weight measures from baseline and follow-up. Associations were analyzed with linear regression models.

Results: Follow-up BMI z-score was predicted by both preschool-aged chronotype (β-est: 0.22 [95% CI: 0.01, 0.42] p = 0.03) and social jetlag (β-est: 0.33 [95% CI: 0.02, 0.65], p = 0.04) after covariate adjustment. No associations were observed between preschool-aged chronotype or social jetlag and preadolescent fruit and vegetable or sugary food and drink consumption.

Conclusions: Having a later chronotype and greater social jetlag during preschool age predicted a higher preadolescent weight outcome. Obesity prevention initiatives should include efforts to reduce the risk of circadian disruption among young children, by accounting for chronotype and aiming to reduce social jetlag in interventions.

Background: Overwhelming evidence showed that obesity was associated with abnormal brain functional networks. However, the changes of structural covariance networks (SCNs) based on cortical thickness (CT) and cortical surface area (CSA) in obesity is still unclear.

Methods: In this study, 243 young adults with obesity and matched 243 lean individuals were enrolled from the Human Connectome Project Release S1200 dataset. All participants underwent magnetic resonance imaging scans following clinical and neuropsychological assessments. SCNs matrices were constructed by Brain Connectivity Toolbox based on both CT and CSA. Nonparametric permutation tests were adopted to examine group differences of these matrices.

Results: Young adults with obesity exhibited lower CSA of left entorhinal cortex, but higher CT of both left rostral anterior cingulate cortex and right superior parietal lobule, as well as lower CT of left temporal pole. While in terms of global network measures, there were no significant group differences; in terms of nodal network measures, young adults with obesity exhibited alterations in widespread brain regions including left posterior cingulate cortex, bilateral superior frontal gyrus, left entorhinal cortex and right insula.

Conclusions: Young adults with obesity exhibited abnormal nodal network measures in widespread brain regions involved in default mode network, central executive network and salience network. These findings indicate the adverse effects of obesity on young adults might be associated with the altered triple network.

This study aimed to clarify the trajectory of BMI alongside age-related changes in height and weight among Japanese adults. Data from annual health checkups between 2015 and 2020 by the Japan Health Insurance Association were retrospectively analyzed. A total of 4,777,891 men and 3,378,003 women (age 35-69 years) were stratified into 14 subgroups based on sex and 5-year age categories. We used linear mixed-effects model to estimate values for each outcome, with six-time points (2015-2020) as the independent variable. Mean BMI changes were positive across all subgroups, indicating a trend of increasing BMI (men, 0.02 to 0.14 kg/m²/year; women, 0.05 to 0.16 kg/m²/year). In younger subgroups, the changed were relatively large, with the weight transitions mirroring those of BMI. However, the mean changes were negative (men, -0.06 kg/year; women, -0.01 kg/year) in the oldest subgroups. Height reduction increased with age across subgroups (men, -0.14 to -0.03 cm/year; women, -0.18 to -0.01 cm/year). In conclusion, BMI tended to increase with age in both sexes across all age groups of Japanese adults. The increase in BMI appeared to be influenced by weight gain in young to middle age, whereas height reduction influenced increased BMI in older age groups.