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Comparative effectiveness of metabolic and bariatric surgeries: a network meta-analysis. 代谢手术和减肥手术的比较效果:网络荟萃分析。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-14 DOI: 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。
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引用次数: 0
Semaglutide effects on safety and cardiovascular outcomes in patients with overweight or obesity: a systematic review and meta-analysis. 塞马鲁肽对超重或肥胖患者的安全性和心血管后果的影响:系统综述和荟萃分析。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-12 DOI: 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

Background: 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).

Methods: The data bases Pubmed, Lilacs, Scielo, Scopus, Web of Science and Cochrane Library were surveyed.

Results: 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.

Conclusion: 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.

背景塞马鲁肽是一种GLP-1受体激动剂,可降低糖化血红蛋白和体重。研究目的是评估超重或肥胖症患者使用塞马鲁肽是否会减少心血管后果和不良反应(AE):方法:调查了 Pubmed、Lilacs、Scielo、Scopus、Web of Science 和 Cochrane Library 等数据库:结果:初步检索到 3333 篇文章,其中 19 篇被收录。额外的搜索包括 19 项研究,共计 38 篇文章。相对风险(RR)值显著的有:心力衰竭(HF)导致的住院治疗 0.24 95% CI 0.12-0.57 (n = 2; 1045 名参与者;I² = 0.18)、心血管原因导致的死亡 0.83 95% CI 0.71-0.98 (n = 3; 24 084 名参与者;I² = 0.21)、任何原因导致的死亡 0.79 95% CI 0.70-0.89 (n = 3; 24 084 名参与者;I² = 0.亚组间存在差异(P = 0.05),皮下注射途径更优。糖尿病患者中风的 RR 为 0.65 95% CI 0.44-0.97(n = 2;6480 名参与者;I² = 0.66)。便秘频率与给药途径以及口服塞马鲁肽的剂量之间没有差异。只有口服塞马鲁肽中断治疗的不良反应发生率不显著:结论:在糖尿病患者中,使用塞马鲁肽可减少76%因高血压住院治疗、17%因心血管原因死亡、21%因任何原因死亡、24%非致命性心肌梗死、24%冠状动脉血运重建和35%中风。使用semaglutide与大多数不良反应的相对风险和频率较高有关。
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引用次数: 0
Feasibility and efficacy of adding high-intensity interval training to a multidisciplinary lifestyle intervention in children with obesity-a randomized controlled trial. 在针对肥胖儿童的多学科生活方式干预中加入高强度间歇训练的可行性和有效性--随机对照试验。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-10 DOI: 10.1038/s41366-024-01645-w
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

Background: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

背景:在丹麦,针对肥胖儿童的多学科生活方式干预通常包括有关体育锻炼的建议,但没有结构化的锻炼计划。我们假设,在多学科生活方式干预中加入高强度间歇训练(HIIT)将改善体重指数 z 值(主要结果)、腰围、血压和健康相关生活质量(HRQOL):这项随机对照试验包括 173 名肥胖儿童和青少年。参与者被分配接受为期 12 个月的生活方式干预(83 人),或接受为期 12 个月的生活方式干预,同时进行为期 12 周的 HIIT 训练(90 人)。HIIT每周进行三次,包括强度大于最大心率85%的活动:为期 3 个月的 HIIT 干预的参加率为 68.0 ± 23.2%。在三个月(7.8% 对 20.5%)和 12 个月(26.5% 对 48.2%)时,HIIT 的辍学率低于对照组。HIIT 和对照组在 3 个月和 12 个月时的 BMI z-score 变化没有差异(平均差 (MD): 0.01,95% 置信区间 (CI): -0.09; 0.12,P = 0.82)(MD: 0.06,CI: -0.07; 0.19,P = 0.34)。在整个随机过程中,BMI z-score降低了0.11(CI:0.17;0.06,P 结论:BMI z-score降低了0.11(CI:0.17;0.06):增加为期 12 周的 HIIT 训练并不能进一步增强为期 12 个月的生活方式干预对 BMI z 分数的积极影响。增加 HIIT 可改善 3 个月后的 HRQOL,但会降低 12 个月后的 HRQOL。在社区环境中实施 HIIT 是可行的,而且对坚持生活方式干预有积极作用。
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引用次数: 0
Association of metabolically healthy obesity with risk of heart failure and left ventricular dysfunction among older adults 代谢健康的肥胖与老年人心力衰竭和左心室功能障碍风险的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1038/s41366-024-01587-3
Peng Wang, Menghui Liu, Shaozhao Zhang, Yue Guo, Zhenyu Xiong, Yiquan Huang, Xiaojie Cai, Lixiang He, Zhuohui Chen, Yi Zhou, Xiaodong Zhuang, Xinxue Liao
Obesity is major cause of heart failure (HF), but it is related with a better prognosis among the elderly. Therefore, we aimed to examine whether metabolically healthy obesity (MHO) in late life increases HF risk and is reflected in impaired left ventricular (LV) function. The participants were grouped into four metabolic phenotypes based on obesity and metabolic status: metabolically healthy non-obesity (MHN), MHO, metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity (MUO). Association of metabolic phenotypes with LV function was evaluated using multiple linear regression models. And association between metabolic phenotypes and risk of HF was assessed using multivariable logistic regression models. In addition, we validated the association of metabolic phenotypes and HF risk in a separate longitudinal cohort. In the primary cohort of 6335 participant, there were 434 participants diagnosed with HF. Compared to MHN participants, the risk of HF was higher among older individuals with MUN (OR = 1.51 [95% CI: 1.14–1.99]) and MUO (OR = 2.01 [95% CI: 1.39–2.91]), but not older individuals with MHO (OR = 0.86 [95% CI: 0.30–2.43). Regarding to LV function, worse LV diastolic function was noted among MUN and MUO individuals rather than MHO individuals. Older adults with MHO were also not associated with risk of HF in the validation cohort. Among older individuals, the metabolic health status might modify the association of obesity with risk of HF and LV diastolic dysfunction. Worse LV diastolic function and higher risk of HF were just noted in individuals with MUO, but not in those with MHO.
背景:肥胖是导致心力衰竭(HF)的主要原因,但它与老年人较好的预后有关。因此,我们旨在研究晚年代谢健康型肥胖(MHO)是否会增加心力衰竭风险,并反映在左心室(LV)功能受损上:根据肥胖和代谢状况将参与者分为四种代谢表型:代谢健康非肥胖(MHN)、MHO、代谢不健康非肥胖(MUN)、代谢不健康肥胖(MUO)。代谢表型与左心室功能的关系采用多元线性回归模型进行评估。使用多变量逻辑回归模型评估了代谢表型与心房颤动风险之间的关系。此外,我们还在一个单独的纵向队列中验证了代谢表型与心房颤动风险之间的关联:在主要队列的 6335 名参与者中,有 434 人确诊为高血压。与MHN参与者相比,患有MUN(OR = 1.51 [95% CI: 1.14-1.99])和MUO(OR = 2.01 [95% CI: 1.39-2.91])的老年人患心房颤动的风险更高,但患有MHO(OR = 0.86 [95% CI: 0.30-2.43)的老年人患心房颤动的风险则不高。在左心室功能方面,MUN和MUO患者的左心室舒张功能比MHO患者差。在验证队列中,患有MHO的老年人也与罹患HF的风险无关:结论:在老年人中,代谢健康状况可能会改变肥胖与心房颤动和左心室舒张功能障碍风险的关系。MUO患者的左心室舒张功能较差,患心房颤动的风险较高,而MHO患者的左心室舒张功能较差,患心房颤动的风险较低。
{"title":"Association of metabolically healthy obesity with risk of heart failure and left ventricular dysfunction among older adults","authors":"Peng Wang,&nbsp;Menghui Liu,&nbsp;Shaozhao Zhang,&nbsp;Yue Guo,&nbsp;Zhenyu Xiong,&nbsp;Yiquan Huang,&nbsp;Xiaojie Cai,&nbsp;Lixiang He,&nbsp;Zhuohui Chen,&nbsp;Yi Zhou,&nbsp;Xiaodong Zhuang,&nbsp;Xinxue Liao","doi":"10.1038/s41366-024-01587-3","DOIUrl":"10.1038/s41366-024-01587-3","url":null,"abstract":"Obesity is major cause of heart failure (HF), but it is related with a better prognosis among the elderly. Therefore, we aimed to examine whether metabolically healthy obesity (MHO) in late life increases HF risk and is reflected in impaired left ventricular (LV) function. The participants were grouped into four metabolic phenotypes based on obesity and metabolic status: metabolically healthy non-obesity (MHN), MHO, metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity (MUO). Association of metabolic phenotypes with LV function was evaluated using multiple linear regression models. And association between metabolic phenotypes and risk of HF was assessed using multivariable logistic regression models. In addition, we validated the association of metabolic phenotypes and HF risk in a separate longitudinal cohort. In the primary cohort of 6335 participant, there were 434 participants diagnosed with HF. Compared to MHN participants, the risk of HF was higher among older individuals with MUN (OR = 1.51 [95% CI: 1.14–1.99]) and MUO (OR = 2.01 [95% CI: 1.39–2.91]), but not older individuals with MHO (OR = 0.86 [95% CI: 0.30–2.43). Regarding to LV function, worse LV diastolic function was noted among MUN and MUO individuals rather than MHO individuals. Older adults with MHO were also not associated with risk of HF in the validation cohort. Among older individuals, the metabolic health status might modify the association of obesity with risk of HF and LV diastolic dysfunction. Worse LV diastolic function and higher risk of HF were just noted in individuals with MUO, but not in those with MHO.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 11","pages":"1587-1592"},"PeriodicalIF":4.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390466","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}
引用次数: 0
Perspectives on obesity imaging: [18F]2FNQ1P a specific 5-HT6 brain PET radiotracer. 肥胖成像的前景:[18F]2FNQ1P--一种特异性 5-HT6 脑 PET 放射性示踪剂。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-07 DOI: 10.1038/s41366-024-01644-x
Pierre Courault, Sandrine Bouvard, Caroline Bouillot, Radu Bolbos, Waël Zeinyeh, Thibaut Iecker, François Liger, Thierry Billard, Luc Zimmer, Fabien Chauveau, Sophie Lancelot

Background: Estimates suggest that approximatively 25% of the world population will be overweight in 2025. Better understanding of the pathophysiology of obesity will help to develop future therapeutics. Serotonin subtype 6 receptors (5-HT6) have been shown to be critically involved in appetite reduction and weight loss. However, it is not known if the pathological cascade triggered by obesity modifies the density of 5-HT6 receptors in the brain.

Methods: Influence of diet-induced obesity (DIO) in Wistar rats was explored using MRI (whole-body fat) and PET ([18F]2FNQ1P as a specific 5-HT6 radiotracer). The primary goal was to monitor the 5-HT6 receptor density before and after a 10-week diet (DIO group). The secondary goal was to compare 5-HT6 receptor densities between DIO group, Wistar control diet group, Zucker rats (with genetic obesity) and Zucker lean strain rats.

Results: Wistar rats fed with high-fat diet showed higher body fat gain than Wistar control diet rats on MRI. [18F]2FNQ1P PET analysis highlighted significant clusters of voxels (located in hippocampus, striatum, cingulate, temporal cortex and brainstem) with increased binding after high-fat diet (p < 0.05, FWE corrected).

Conclusion: This study sheds a new light on the influence of high-fat diet on 5-HT6 receptors. This study also positions [18F]2FNQ1P PET as an innovative tool to explore neuronal consequences of obesity or eating disorder pathophysiology.

背景:据估计,到 2025 年,全球约有 25% 的人口将超重。更好地了解肥胖症的病理生理学有助于开发未来的治疗方法。研究表明,5-羟色胺亚型 6 受体(5-HT6)在降低食欲和减轻体重方面发挥着关键作用。然而,肥胖引发的病理级联是否会改变大脑中5-HT6受体的密度尚不清楚:方法:使用核磁共振成像(全身脂肪)和正电子发射计算机断层扫描([18F]2FNQ1P 作为特异性 5-HT6 放射性示踪剂)研究了饮食诱导肥胖(DIO)对 Wistar 大鼠的影响。主要目的是监测大鼠在 10 周饮食(DIO 组)前后的 5-HT6 受体密度。次要目标是比较 DIO 组、Wistar 对照饮食组、Zucker 大鼠(遗传性肥胖)和 Zucker 瘦株大鼠的 5-HT6 受体密度:结果:以高脂饮食喂养的 Wistar 大鼠在核磁共振成像上的体脂增加率高于 Wistar 对照饮食大鼠。[18F]2FNQ1P正电子发射计算机断层扫描分析显示,在高脂饮食后,海马、纹状体、扣带回、颞叶皮层和脑干等部位的体素结合率明显增加(p 结论:该研究对肥胖大鼠的体素结合率进行了分析:本研究揭示了高脂饮食对 5-HT6 受体的影响。这项研究还将[18F]2FNQ1P PET定位为探索肥胖或饮食失调病理生理学对神经元影响的创新工具。
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引用次数: 0
Has the BMI had its day? BMI 的时代过去了吗?
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-07 DOI: 10.1038/s41366-024-01643-y
Manfred J Müller, Anja Bosy-Westphal
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引用次数: 0
From starvation to time-restricted eating: a review of fasting physiology. 从饥饿到限时进食:禁食生理学回顾。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-05 DOI: 10.1038/s41366-024-01641-0
Candida J Rebello, Dachuan Zhang, Joseph C Anderson, Rebecca F Bowman, Pamela M Peeke, Frank L Greenway

We have long known that subjects with obesity who fast for several weeks survive. Calculations that assume the brain can only use glucose indicated that all carbohydrate and protein sources would be consumed by the brain within several weeks yet subjects with obesity who fasted for several weeks survived. This anomaly led to the determination of the metabolic role of ketone bodies. Subsequent studies transformed our understanding of ketone bodies and illustrated the value of challenging the norm and adapting theory to evidence. Although prolonged fasting is no longer a treatment for obesity, the early studies of starvation provided valuable insights about macronutrient metabolism and ketone body adaptations that fasting elicits. Intermittent fasting and its variants such as time-restricted eating are fasting models that are far less regimented than starvation and severe calorie restriction; yet they produce metabolic benefits. The mechanisms that produce the metabolic changes that intermittent fasting elicits are relatively unknown. In this article, we review the physiology of starvation, starvation adaptation diets, diet-induced ketosis, and intermittent fasting. Understanding the premise and physiology that these regimens induce is necessary to draw parallels and provoke thoughts on the mechanisms underlying the metabolic benefits of intermittent fasting and its variants.

我们早就知道,禁食数周的肥胖症患者能够存活下来。假设大脑只能使用葡萄糖的计算表明,所有碳水化合物和蛋白质都会在几周内被大脑消耗掉,但禁食几周的肥胖症患者却能存活下来。这一反常现象促使我们确定了酮体在新陈代谢中的作用。随后的研究改变了我们对酮体的认识,并说明了挑战常规和根据证据调整理论的价值。虽然长时间禁食不再是治疗肥胖症的方法,但早期的饥饿研究为我们提供了有关禁食引起的宏量营养素代谢和酮体适应的宝贵见解。间歇性禁食及其变体,如限时进食,是远不如饥饿和严格限制卡路里摄入量那样严格的禁食模式,但它们却能产生新陈代谢方面的益处。间歇性禁食引起新陈代谢变化的机制还相对未知。在本文中,我们将回顾饥饿、饥饿适应饮食、饮食诱导酮症和间歇性禁食的生理学原理。了解这些方案诱导的前提和生理学是必要的,以便对间歇性禁食及其变体的代谢益处的内在机制进行比较和思考。
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引用次数: 0
Body mass index across development and adolescent hair cortisol: the role of persistence, variability, and timing of exposure. 发育过程中的体重指数与青少年毛发皮质醇:持续性、可变性和暴露时间的作用。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-04 DOI: 10.1038/s41366-024-01640-1
Christina Y Cantave, Paula L Ruttle, Sylvana M Coté, Sonia J Lupien, Marie-Claude Geoffroy, Frank Vitaro, Mara Brendgen, Richard Tremblay, Michel Boivin, Isabelle Ouellet-Morin

Background: Research suggests a putative role of the glucocorticoid stress hormone cortisol in the accumulation of adiposity. However, obesity and weight fluctuations may also wear and tear physiological systems promoting adaptation, affecting cortisol secretion. This possibility remains scarcely investigated in longitudinal research. This study tests whether trajectories of body mass index (BMI) across the first 15 years of life are associated with hair cortisol concentration (HCC) measured two years later and whether variability in BMI and timing matter.

Methods: BMI (kg/m2) was prospectively measured at twelve occasions between age 5 months and 15 years. Hair was sampled at age 17 in 565 participants. Sex, family socioeconomic status, and BMI measured concurrently to HCC were considered as control variables.

Results: Latent class analyses identified three BMI trajectories: "low-stable" (59.2%, n = 946), "moderate" (32.6%, n = 507), and "high-rising" (8.2%, n = 128). BMI variability was computed by dividing the standard deviation of an individual's BMI measurements by the mean of these measurements. Findings revealed linear effects, such that higher HCC was noted for participants with moderate BMI trajectories in comparison to low-stable youth (β = 0.10, p = 0.03, 95% confidence interval (CI) = [0.02-0.40]); however, this association was not detected in the high-rising BMI youth (β = -0.02, p = 0.71, 95% CI = [-0.47-0.32]). Higher BMI variability across development predicted higher cortisol (β = 0.17, p = 0.003, 95% CI = [0.10-4.91]), additively to the contribution of BMI trajectories. BMI variability in childhood was responsible for that finding, possibly suggesting a timing effect.

Conclusions: This study strengthens empirical support for BMI-HCC association and suggests that more attention should be devoted to BMI fluctuations in addition to persistent trajectories of BMI.

背景:研究表明,糖皮质激素中的应激激素皮质醇可能在脂肪的积累过程中发挥了作用。然而,肥胖和体重波动也可能磨损促进适应的生理系统,影响皮质醇的分泌。在纵向研究中,对这种可能性的调查仍然很少。本研究测试了生命最初 15 年的体重指数(BMI)轨迹是否与两年后测量的毛发皮质醇浓度(HCC)相关,以及体重指数的变化和时间是否重要:方法:对 5 个月至 15 岁期间的 12 次体重指数(kg/m2)进行了前瞻性测量。对 565 名参与者 17 岁时的头发进行了采样。性别、家庭社会经济状况以及与 HCC 同时测量的 BMI 均被视为控制变量:潜类分析确定了三种 BMI 轨迹:结果:潜类分析确定了三种 BMI 轨迹:"低度稳定"(59.2%,n = 946)、"中度"(32.6%,n = 507)和 "高度上升"(8.2%,n = 128)。体重指数变异性的计算方法是将个人体重指数测量值的标准差除以这些测量值的平均值。研究结果显示了线性效应,与低稳定性青少年相比,中等BMI轨迹的参与者的HCC较高(β = 0.10,p = 0.03,95%置信区间(CI) = [0.02-0.40]);然而,在BMI高度上升的青少年中未发现这种关联(β = -0.02,p = 0.71,95% CI = [-0.47-0.32])。在整个发育过程中,较高的体重指数变异性可预测较高的皮质醇(β = 0.17,p = 0.003,95% CI = [0.10-4.91]),与体重指数轨迹的贡献相加。童年时期的 BMI 变异是造成这一结果的原因,这可能表明存在时间效应:这项研究加强了对 BMI 与HCC 关联性的实证支持,并建议除了关注 BMI 的持续轨迹外,还应更加关注 BMI 的波动。
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引用次数: 0
Weight loss as a predictor of reduced survival in patients with lung cancer: a systematic review with meta-analysis. 体重减轻是肺癌患者生存率降低的预测因素:系统综述与荟萃分析。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1038/s41366-024-01642-z
Junfang Zhang, Xuan Tang, Wenbo Zhang, Ying Xu, Heng Zhang, Yu Fan

Background: The impact of weight loss on survival outcomes remains challenging in patients with lung cancer. The objective of this systematic review with meta-analysis was to assess the association of weight loss with survival outcomes in these patients.

Methods: Two authors conducted a comprehensive literature search of PubMed, Web of Science, and Embase databases up to January 15, 2024. Observational studies that assessed the weight loss as a prognostic factor of overall survival and progression-free survival in patients with lung cancer were included this analysis. Weight loss defined by at least 5% loss of total body weight over 2 months.

Results: Fifteen studies involving 14,540 patients with lung cancer were included. Pooled adjusted hazard ratios (HR) indicated that weight loss was associated with reduced overall survival (HR 1.65; 95% confidence intervals [CI] 1.43-1.91) and progression-free survival (HR 1.40; 95% CI 1.15-1.71). Subgroup analysis showed that weight loss significantly predicted overall survival, regardless of study design, lung cancer subtypes, clinical stage of cancer, weight loss definition, or length of follow-up.

Conclusions: Weight loss is a significant predictor of overall survival and progression-free survival in patients with lung cancer. Weight monitoring has potential to improve prognostication of survival outcomes for these patients.

背景:减轻体重对肺癌患者生存结果的影响仍具有挑战性。本系统综述和荟萃分析的目的是评估减肥与这些患者生存结果的关系:两位作者对截至 2024 年 1 月 15 日的 PubMed、Web of Science 和 Embase 数据库进行了全面的文献检索。本分析纳入了将体重减轻作为肺癌患者总生存期和无进展生存期预后因素进行评估的观察性研究。体重减轻的定义是两个月内总重量至少减少 5%:共纳入 15 项研究,涉及 14,540 名肺癌患者。汇总调整后的危险比(HR)显示,体重减轻与总生存期(HR 1.65;95% 置信区间 [CI] 1.43-1.91)和无进展生存期(HR 1.40;95% CI 1.15-1.71)的降低有关。亚组分析显示,无论研究设计、肺癌亚型、癌症临床分期、体重减轻定义或随访时间长短如何,体重减轻都能显著预测总生存期:结论:体重减轻可显著预测肺癌患者的总生存期和无进展生存期。结论:体重减轻是肺癌患者总生存期和无进展生存期的重要预测指标,体重监测有可能改善这些患者的预后生存结果。
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引用次数: 0
Relationship between paternal excessive weight and neonatal anthropometry in a clinical trial of nutritional counseling for pregnant women with overweight 在对超重孕妇进行营养咨询的临床试验中,父亲体重超标与新生儿人体测量之间的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-24 DOI: 10.1038/s41366-024-01639-8
Mariana Rinaldi Carvalho, Daniela Elias Goulart de Andrade Miranda, Naiara Franco Baroni, Izabela da Silva Santos, Natália Posses Carreira, Livia Castro Crivellenti, Daniela Saes Sartorelli
Human studies suggest that fathers with obesity influence infant growth and development. This study aimed to evaluate the relationship between paternal body mass index (BMI) and waist circumference (WC) with neonatal anthropometry and adiposity. This study is a cohort nested in a randomized controlled clinical trial of nutritional counseling for pregnant women with overweight. In total, 89 partner-pregnant woman-neonate triads were included. Paternal anthropometric measurements were taken at the time of the interview. Secondary data related to birth were obtained through access to the health information systems. Neonatal skinfold thickness was assessed and the adiposity was estimated using a predictive anthropometric model. Pearson’s correlation and adjusted multivariate linear regression models were employed to evaluate the relationship between paternal BMI and WC with neonatal anthropometric measurements and adiposity. In total, 57.0% of the fathers presented a BMI ≥ 25 kg/m² and 14.6% a waist circumference ≥102 cm. The mean ± SD birth weight of the newborns (g) was 3357 ± 538. Paternal BMI and WC were inversely correlated with head circumference at birth [r = −0.31 (p = 0.004), r = −0.23 (p = 0.03), respectively]. Paternal BMI was also inversely correlated with the birth weight standardized by gestational age (z-score) [r = −0.23 (p = 0.03)]. In adjusted multivariate linear regression models, the paternal BMI (kg/m²) was inversely associated with the head circumference at birth (cm) [β = −0.07 (95% CI −0.15; −0.001) p = 0.04]. The data suggest that paternal excessive weight have a negative effect on fetal development, as assessed by anthropometric measurements. The inverse association between paternal BMI and the head circumference at birth was independent of confounders. Future studies with larger sample sizes are necessary to confirm or refute such hypotheses.
背景/目的:人类研究表明,父亲肥胖会影响婴儿的生长发育。本研究旨在评估父亲体重指数(BMI)和腰围(WC)与新生儿人体测量和脂肪含量之间的关系:本研究是一项针对超重孕妇进行营养咨询的随机对照临床试验的队列嵌套研究。共纳入了 89 个伴侣-孕妇-新生儿三人组。访谈时测量了父亲的人体测量数据。通过访问卫生信息系统获得了与出生有关的第二手数据。采用预测性人体测量模型评估新生儿皮褶厚度和脂肪含量。采用皮尔逊相关性和调整后多元线性回归模型来评估父亲的体重指数和腹围与新生儿人体测量和脂肪含量之间的关系:57.0%的父亲体重指数≥25 kg/m²,14.6%的父亲腰围≥102 cm。新生儿出生体重(克)的平均值(± SD)为 3357 ± 538。父亲的体重指数和腰围与出生时的头围成反比[分别为 r = -0.31 (p = 0.004)、r = -0.23 (p = 0.03)]。父亲的体重指数也与按胎龄标准化的出生体重(z-score)成反比[r = -0.23 (p = 0.03)]。在调整后的多元线性回归模型中,父亲的体重指数(kg/m²)与出生时的头围(厘米)成反比[β = -0.07 (95% CI -0.15; -0.001) p = 0.04]:数据表明,父亲体重过重对胎儿的发育有负面影响,这可以通过人体测量来评估。父亲体重指数与出生时头围之间的反向关系与混杂因素无关。未来有必要进行样本量更大的研究,以证实或反驳此类假设。
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引用次数: 0
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International Journal of Obesity
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