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Prolonged latency of the gustatory evoked potentials for sucrose solution in subjects living with obesity compared with normal-weight subjects. 与体重正常者相比,肥胖症患者对蔗糖溶液的味觉诱发电位潜伏期延长。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-25 DOI: 10.1038/s41366-024-01607-2
Thomas Mouillot, Marie-Claude Brindisi, Cyril Gauthier, Sophie Barthet, Clémence Quere, Djihed Litime, Manon Perrignon-Sommet, Sylvie Grall, Fabienne Lienard, Claire Fenech, Hervé Devilliers, Alexia Rouland, Marjolaine Georges, Luc Penicaud, Laurent Brondel, Corinne Leloup, Agnès Jacquin-Piques

Objectives: A difference in cortical treatment of taste information could alter food intake promoting the development of obesity. The main purpose was to compare, in subjects living with obesity (OB) and normal-weight subjects (NW), the characteristics of gustatory evoked potentials (GEP) for sucrose solution (10 g.100 mL-1) before and after a standard lunch. The secondary objective was to evaluate the correlations between GEP and the plasmatic levels of acylated ghrelin, leptin, insulin and serotonin.

Methods: Each subject had 2 randomized sessions spaced by an interval of 2 days. During one session, subjects were fasting and during the other, subjects took a lunch low in sugar. In each session, subjects had a blood test before a first GEP recording followed by a second GEP recording either after a lunch (feeding session) or no lunch (fasting session).

Results: Twenty-eight OB (BMI: 38.6 ± 9.0 kg.m-2) were matched to 22 NW (BMI: 22.3 ± 2.2 kg.m-2). GEP latencies were prolonged in OB regardless the sessions and the time before and after lunch, compared with NW (in Cz at the morning: 170 ± 33 ms vs 138 ± 25 ms respectively; p < 0.001). The increase in latency observed in NW after lunch was not observed in OB. Negative or positive correlations were noted in all participants between GEP latencies and ghrelin, leptin, insulin plasmatic levels (P1Cz, r = -0.38, r = 0.33, r = 0.37 respectively, p < 0.0001).

Conclusions: This study highlights a slower activation in the taste cortex in OB compared with NW.

目的:大脑皮层对味觉信息处理的不同可能会改变食物摄入量,从而导致肥胖症的发生。研究的主要目的是比较肥胖症患者(OB)和正常体重者(NW)在标准午餐前后对蔗糖溶液(10 g.100 mL-1)的味觉诱发电位(GEP)特征。次要目的是评估 GEP 与血浆中酰化胃泌素、瘦素、胰岛素和血清素水平之间的相关性:每名受试者随机接受 2 次训练,每次训练间隔 2 天。在一个疗程中,受试者禁食;在另一个疗程中,受试者进食低糖午餐。在每个疗程中,受试者在第一次记录 GEP 之前进行血液测试,然后在午餐后(进食疗程)或无午餐后(禁食疗程)进行第二次 GEP 记录:28 名 OB(体重指数:38.6 ± 9.0 kg.m-2)与 22 名 NW(体重指数:22.3 ± 2.2 kg.m-2)配对。与白种人相比,OB 的 GEP 潜伏期在午餐前后的任何时段和时间都有所延长(早上的 Cz:分别为 170 ± 33 ms vs 138 ± 25 ms;p 结论:该研究突出表明,OB 的激活速度较慢:本研究表明,与西北地区相比,OB 的味觉皮层激活速度较慢。
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引用次数: 0
Effect of Helicobacter pylori on sleeve gastrectomy and gastric microbiome differences in patients with obesity and diabetes 幽门螺杆菌对袖状胃切除术的影响以及肥胖和糖尿病患者胃微生物组的差异。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-24 DOI: 10.1038/s41366-024-01611-6
Young Suk Park, Kung Ahn, Kyeongeui Yun, Jinuk Jeong, Kyung-Wan Baek, Do Joong Park, Kyudong Han, Yong Ju Ahn
Obesity and diabetes mellitus (DM) have become public health concerns worldwide. Both conditions have severe consequences and are associated with significant medical costs and productivity loss. Additionally, Helicobacter pylori infection may be a risk factor for the development of these conditions. However, whether eradicating H. pylori infection directly causes weight loss or improves insulin sensitivity is unknown. In this study, we confirmed the effect of sleeve gastrectomy according to the state of the gastric microbiota in 40 patients with obesity, DM, and H. pylori infection. Patients with obesity were divided into four groups: non-DM without H. pylori infection (ND), non-DM with H. pylori infection (ND-HP), DM, and DM with H. pylori infection (DM-HP) using 16S V3–V4 sequencing. In the DM group, ALT, hemoglobin, HbA1c, blood glucose, and HSI significantly decreased, whereas high-density lipoprotein significantly increased. However, in the H. pylori-positive group, no significant difference was observed. The diversity of gastric microbiota decreased in the order of the ND > DM > ND-HP > DM-HP groups. We also conducted a correlation analysis between the preoperative microbes and clinical data. In the ND-HP group, most of the top 20 gastric microbiota were negatively correlated with glucose metabolism. However, H. pylori infection was positively correlated with pre-insulin levels. Therefore, these findings indicate that patients with obesity and diabetes clearly benefit from surgery, but H. pylori infection may also affect clinical improvement.
背景:肥胖症和糖尿病(DM)已成为全球关注的公共卫生问题。这两种疾病都会造成严重后果,并带来巨大的医疗成本和生产力损失。此外,幽门螺杆菌感染可能是导致这些疾病的风险因素。然而,根除幽门螺杆菌感染是否会直接导致体重减轻或改善胰岛素敏感性还不得而知:在这项研究中,我们根据 40 名肥胖、DM 和幽门螺杆菌感染患者的胃微生物群状况,确认了袖状胃切除术的效果。通过 16S V3-V4 测序,肥胖症患者被分为四组:无幽门螺杆菌感染的非 DM 组(ND)、有幽门螺杆菌感染的非 DM 组(ND-HP)、DM 组和有幽门螺杆菌感染的 DM 组(DM-HP):结果:在 DM 组中,ALT、血红蛋白、HbA1c、血糖和 HSI 显著降低,而高密度脂蛋白显著升高。幽门螺杆菌阳性组则无明显差异。胃微生物群的多样性按照 ND > DM > ND-HP > DM-HP 组的顺序下降。我们还对术前微生物和临床数据进行了相关性分析。在 ND-HP 组中,前 20 个胃微生物群大多与糖代谢呈负相关。然而,幽门螺杆菌感染与术前胰岛素水平呈正相关:因此,这些研究结果表明,肥胖症和糖尿病患者显然能从手术中获益,但幽门螺杆菌感染也可能影响临床改善。
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引用次数: 0
Accurate prediction of three-dimensional humanoid avatars for anthropometric modeling. 为人体测量建模准确预测三维仿人头像。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-24 DOI: 10.1038/s41366-024-01614-3
Cassidy McCarthy, Michael C Wong, Jasmine Brown, Sophia Ramirez, Shengping Yang, Jonathan P Bennett, John A Shepherd, Steven B Heymsfield

Objective: To evaluate the hypothesis that anthropometric dimensions derived from a person's manifold-regression predicted three-dimensional (3D) humanoid avatar are accurate when compared to their actual circumference, volume, and surface area measurements acquired with a ground-truth 3D optical imaging method. Avatars predicted using this approach, if accurate with respect to anthropometric dimensions, can serve multiple purposes including patient body composition analysis and metabolic disease risk stratification in clinical settings.

Methods: Manifold regression 3D avatar prediction equations were developed on a sample of 570 adults who completed 3D optical scans, dual-energy X-ray absorptiometry (DXA), and bioimpedance analysis (BIA) evaluations. A new prospective sample of 84 adults had ground-truth measurements of 6 body circumferences, 7 volumes, and 7 surface areas with a 20-camera 3D reference scanner. 3D humanoid avatars were generated on these participants with manifold regression including age, weight, height, DXA %fat, and BIA impedances as potential predictor variables. Ground-truth and predicted avatar anthropometric dimensions were quantified with the same software.

Results: Following exploratory studies, one manifold prediction model was moved forward for presentation that included age, weight, height, and %fat as covariates. Predicted and ground-truth avatars had similar visual appearances; correlations between predicted and ground-truth anthropometric estimates were all high (R2s, 0.75-0.99; all p < 0.001) with non-significant mean differences except for arm circumferences (%Δ ~ 5%; p < 0.05). Concordance correlation coefficients ranged from 0.80-0.99 and small but significant bias (p < 0.05-0.01) was present with Bland-Altman plots in 13 of 20 total anthropometric measurements. The mean waist to hip circumference ratio predicted by manifold regression was non-significantly different from ground-truth scanner measurements.

Conclusions: 3D avatars predicted from demographic, physical, and other accessible characteristics can produce body representations with accurate anthropometric dimensions without a 3D scanner. Combining manifold regression algorithms into established body composition methods such as DXA, BIA, and other accessible methods provides new research and clinical opportunities.

目的评估一个假设,即从一个人的流形回归预测的三维(3D)仿人头像得出的人体测量尺寸,与通过地面真实三维光学成像方法获得的实际周长、体积和表面积测量值相比,是否准确。使用这种方法预测的头像,如果在人体测量尺寸方面准确无误,则可用于多种用途,包括临床环境中的病人身体成分分析和代谢疾病风险分层:方法:对完成三维光学扫描、双能 X 射线吸收测量(DXA)和生物阻抗分析(BIA)评估的 570 名成人样本进行了多重回归三维头像预测方程的开发。一个由 84 名成年人组成的新的前瞻性样本使用 20 个摄像头的三维参考扫描仪对 6 个体围、7 个体积和 7 个表面积进行了地面实况测量。在这些参与者身上生成了三维仿人头像,并将年龄、体重、身高、DXA 脂肪率和 BIA 阻抗等多方面回归作为潜在的预测变量。使用同一软件对地面实况和预测的头像人体测量尺寸进行量化:结果:经过探索性研究,我们提出了一个多方面预测模型,其中包括年龄、体重、身高和脂肪率。预测的头像与地面实况头像具有相似的视觉外观;预测的人体测量值与地面实况人体测量值之间的相关性都很高(R2,0.75-0.99;均为 p):根据人口、身体和其他可获取特征预测的三维头像可以在没有三维扫描仪的情况下生成具有准确人体测量尺寸的身体表征。将流形回归算法与 DXA、BIA 等成熟的身体成分测量方法及其他可获得的方法相结合,可提供新的研究和临床机会。
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引用次数: 0
Likely causal effects of insulin resistance and IGF-1 bioaction on childhood and adult adiposity: a Mendelian randomization study 胰岛素抵抗和 IGF-1 生物作用对儿童和成人肥胖的可能因果效应:孟德尔随机研究。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-22 DOI: 10.1038/s41366-024-01605-4
Duaa I. Olwi, Lena R. Kaisinger, Katherine A. Kentistou, Marc Vaudel, Stasa Stankovic, Pål R. Njølstad, Stefan Johansson, John R. B. Perry, Felix R. Day, Ken K. Ong
Circulating insulin and insulin-like growth factor-1 (IGF-1) concentrations are positively correlated with adiposity. However, the causal effects of insulin and IGF-1 on adiposity are unclear. We performed two-sample Mendelian randomization analyses to estimate the likely causal effects of fasting insulin and IGF-1 on relative childhood adiposity and adult body mass index (BMI). To improve accuracy and biological interpretation, we applied Steiger filtering (to avoid reverse causality) and ‘biological effect’ filtering of fasting insulin and IGF-1 associated variants. Fasting insulin-increasing alleles (35 variants also associated with higher fasting glucose, indicative of insulin resistance) were associated with lower relative childhood adiposity (P = 3.8 × 10−3) and lower adult BMI (P = 1.4 × 10−5). IGF-1-increasing alleles also associated with taller childhood height (351 variants indicative of greater IGF-1 bioaction) showed no association with relative childhood adiposity (P = 0.077) or adult BMI (P = 0.562). Conversely, IGF-1-increasing alleles also associated with shorter childhood height (306 variants indicative of IGF-1 resistance) were associated with lower relative childhood adiposity (P = 6.7 × 10−3), but effects on adult BMI were inconclusive. Genetic causal modelling indicates negative effects of insulin resistance on childhood and adult adiposity, and negative effects of IGF-1 resistance on childhood adiposity. Our findings demonstrate the need to distinguish between bioaction and resistance when modelling variants associated with biomarker concentrations.
背景:循环中胰岛素和胰岛素样生长因子-1(IGF-1)的浓度与脂肪率呈正相关。然而,胰岛素和 IGF-1 对肥胖的因果效应尚不清楚:我们进行了双样本孟德尔随机分析,以估计空腹胰岛素和 IGF-1 对相对儿童脂肪率和成人体重指数(BMI)的可能因果效应。为了提高准确性和生物学解释,我们对空腹胰岛素和IGF-1相关变异进行了Steiger过滤(以避免反向因果关系)和 "生物效应 "过滤:结果:空腹胰岛素增加等位基因(35 个变异也与空腹血糖升高有关,表明胰岛素抵抗)与较低的儿童相对脂肪率(P = 3.8 × 10-3)和较低的成人体重指数(P = 1.4 × 10-5)有关。同样与儿童身高有关的 IGF-1 增高等位基因(351 个表明 IGF-1 生物作用更强的变体)与儿童相对脂肪率(P = 0.077)或成人体重指数(P = 0.562)没有关联。相反,IGF-1增加的等位基因也与儿童身高较矮有关(306个变异表明IGF-1抗性),但与较低的儿童相对脂肪率有关(P = 6.7 × 10-3),但对成人体重指数的影响尚无定论:遗传因果建模表明,胰岛素抵抗对儿童期和成年期肥胖有负面影响,IGF-1抵抗对儿童期肥胖有负面影响。我们的研究结果表明,在建立与生物标志物浓度相关的变异模型时,需要区分生物作用和抵抗作用。
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引用次数: 0
Prioritising patients for publicly funded bariatric surgery in Queensland, Australia. 澳大利亚昆士兰州优先考虑接受政府资助的减肥手术的患者。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-22 DOI: 10.1038/s41366-024-01615-2
Paul Scuffham, Megan Cross, Srinivas Teppala, George Hopkins, Viral Chikani, Katie Wykes, Jody Paxton

Objectives: This study reports the development and pilot application of the Bariatric Surgery Assessment and Prioritisation Tool (BAPT) for use in a public health system. The BAPT was designed as a patient prioritisation instrument to assess patients with excessive weight and type 2 diabetes suitable for bariatric surgery. We assessed whether the instrument successfully identified those who gained the greatest benefits including weight loss, diabetes remission, reduction in comorbidities, and health-related quality of life (HR-QoL).

Methods: The BAPT instrument was applied to score 292 patients referred for bariatric surgery in Queensland between 2017 and 2020 based on their, body mass index, diabetes status, surgical risk (e.g. pulmonary embolism) and comorbidities (e.g. non-alcoholic steatohepatitis). These data were collected at referral and at 12-months post-surgery for 130 patients and stratified by BAPT scores. Outcomes included clinical and HR-QoL.

Results: Patients' BAPT scores ranged from 12 to 78 (possible range 2-98). Those with higher scores tended to be younger (p < 0.001), have higher BMI (p < 0.001) or require insulin to manage diabetes (p < 0.01). All patients lost similar percentages of body weight (20-25%, p = 0.73) but higher-scoring patients were more likely to discontinue oral diabetes medications (p < 0.001) and the improvement in glycated haemoglobin was four times greater in patients scoring 70-79 points compared to those scoring 20-29 (p < 0.05). Those who scored ≥ 50 on the BAPT were substantially more likely to obtain diabetes remission (57% vs 31%). BAPT scores of 40 and above tended to have greater improvement in HR-QoL.

Conclusions: The BAPT prioritised younger patients with higher BMIs who realised greater improvements in their diabetes after bariatric surgery. Higher-scoring BAPT patients should be prioritised for bariatric surgery as they have a greater likelihood of attaining diabetes remission.

研究目的本研究报告了减肥手术评估和优先排序工具(BAPT)的开发和在公共卫生系统中的试点应用情况。BAPT 被设计为一种患者优先排序工具,用于评估体重超标和 2 型糖尿病患者是否适合进行减肥手术。我们评估了该工具是否能成功识别体重减轻、糖尿病缓解、并发症减少和健康相关生活质量(HR-QoL)等方面获益最大的患者:在 2017 年至 2020 年期间,对昆士兰转诊的 292 名减肥手术患者应用 BAPT 工具进行评分,评分依据包括患者的体重指数、糖尿病状况、手术风险(如肺栓塞)和合并症(如非酒精性脂肪性肝炎)。这些数据是在 130 名患者转诊时和术后 12 个月时收集的,并按 BAPT 评分进行了分层。结果包括临床和 HR-QoL:患者的 BAPT 评分从 12 分到 78 分不等(可能范围为 2-98)。得分较高的患者往往更年轻(p 结论:BAPT 优先考虑年轻患者:BAPT优先考虑体重指数(BMI)较高的年轻患者,他们在减肥手术后的糖尿病得到了更大的改善。BAPT评分较高的患者应优先考虑接受减肥手术,因为他们更有可能获得糖尿病缓解。
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引用次数: 0
Effect of physical activity intervention on weight change in rural older Chinese: a cluster randomized controlled trial. 体育锻炼干预对中国农村老年人体重变化的影响:分组随机对照试验。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-21 DOI: 10.1038/s41366-024-01616-1
Qian Deng, Nanyan Li, Shiyi Li, Jie Peng, Na Ji, Yufei Wang, Julinling Hu, Xing Zhao, Junmin Zhou

Background: Current randomized trial evidence for the effects of physical activity intervention on weight change in adults was mainly from western countries, with little reliable evidence from low- and middle-income countries, such as China, where lifestyle factors and obesity patterns differ substantially from those in western countries. We examined the effects of physical activity intervention on weight change using cluster randomized trial data among Chinese older adults.

Methods: The cluster randomized controlled trial included an 8-week physical activity intervention period and was followed up to 24 months. Eight villages were randomly assigned to the intervention group (4 villages, n = 240) or the control group (4 villages, n = 268). The intervention group received physical activity intervention based on the socio-ecological model, while the control group did not. The intervention involved three levels: individual, interpersonal, and community levels, which aimed to promote leisure-time physical activity of participants. The primary outcome of the present study was the difference in percentage weight change at 24 months from baseline. We used Tanita BC-601 analyzer scales to measure weight and recorded it to the nearest 0.1 kg.

Results: Among the 508 participants, the mean age was 70.93 (SD, 5.69) years, and 55.5% were female. There were significant differences in percentage weight change between the intervention group and the control group with a mean change of -1.78% (95% CI, -2.67% to -0.90%; p < 0.001) in the total sample, -1.94% (95% CI, -3.14% to -0.73%; p = 0.002) in participants with overweight/obesity, and -1.45% (95% CI, -2.73% to -0.18%; p = 0.027) among participants with underweight/healthy weight in favor of the intervention group at 24 months.

Conclusions: Physical activity intervention resulted in weight loss in rural older sample at 24 months. This suggested that physical activity interventions are feasible for weight loss among older adults, especially for those with overweight/obesity or aged under 80.

Trial registration: The study has been registered on the Chinese Clinical Trial Registry on April 20, 2021 (ChiCTR2100045653), https://www.chictr.org.cn/showproj.html?proj=123704 .

背景:目前有关体育锻炼干预对成年人体重变化影响的随机试验证据主要来自西方国家,而中国等中低收入国家的可靠证据很少,因为这些国家的生活方式和肥胖模式与西方国家有很大不同。我们利用中国老年人的分组随机试验数据研究了体育锻炼干预对体重变化的影响:分组随机对照试验包括为期 8 周的体育锻炼干预期,并随访 24 个月。八个村被随机分配到干预组(4 个村,n = 240)或对照组(4 个村,n = 268)。干预组接受基于社会生态模式的体育锻炼干预,对照组则不接受干预。干预涉及三个层面:个人层面、人际层面和社区层面,旨在促进参与者的闲暇体育活动。本研究的主要结果是 24 个月后体重变化百分比与基线的差异。我们使用谷田 BC-601 分析秤测量体重,并记录到最接近的 0.1 千克:在 508 名参与者中,平均年龄为 70.93 岁(标准差为 5.69 岁),55.5% 为女性。干预组与对照组的体重变化百分比存在明显差异,平均变化率为-1.78%(95% CI,-2.67%至-0.90%;P 结论:体育锻炼干预可使体重减轻:体育锻炼干预使农村老年人的体重在 24 个月后有所下降。这表明体育锻炼干预对老年人,尤其是超重/肥胖或年龄在 80 岁以下的老年人减轻体重是可行的:该研究已于 2021 年 4 月 20 日在中国临床试验注册中心注册(ChiCTR2100045653),https://www.chictr.org.cn/showproj.html?proj=123704 。
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引用次数: 0
Hidden barriers: obesity bias in hypertension treatment 隐藏的障碍:高血压治疗中的肥胖偏见。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-19 DOI: 10.1038/s41366-024-01613-4
Guilherme Heiden Telo, Lucas Strassburger Matzenbacher, Lucas Friedrich Fontoura, Georgia Oliveira Avila, Vicenzo Gheno, Maria Antônia Bertuzzo Brum, Julia Belato Teixeira, Isadora Nunes Erthal, Josiane Schneiders, Beatriz D. Schaan, Janine Alessi, Gabriela Heiden Telo
Individuals with obesity often face obesity bias, which may influence the delivery of appropriate medical care. Our aim is to evaluate the adequacy of therapeutic decisions regarding the pharmacological treatment for hypertension in patients with diabetes, both with and without obesity. This is a multicentric cross-sectional study of patients with type 2 diabetes and arterial hypertension who received outpatient care in Southern Brazil. Participants were stratified into two groups according to their body mass index (BMI): lower weight (BMI < 25.0 kg/m2) and with obesity (BMI ≥ 30.0 kg/m2). The primary outcome evaluated was the difference in pharmacological treatment decisions for hypertension between groups, considering individualized hypertension targets from American Diabetes Association (ADA), European Society of Hypertension (ESH), and European Society of Cardiology (ESC) guidelines. Data were analyzed as a binary endpoint (failure to receive treatment intensification vs. receiving treatment intensification when necessary) and groups were compared using multivariable logistic regression. This study included 204 participants, of which 53 were at a lower weight and 151 had obesity. Patients with obesity more frequently failed to receive appropriate treatment intensification when compared to individuals with lower weight. The differences between the study groups were observed when considering the blood pressure target of three societies: ESH (adjusted OR 2.28 [95% CI 1.12–4.63], p = 0.022), ESC (adjusted OR 2.13 [95% CI 1.05–4.31], p = 0.035), and ADA (adjusted OR 2.33 [95% CI 1.13–4.77], p = 0.021). These findings suggest that patients with obesity may face potential disparities in hypertension management, and obesity status may be related to therapeutic inertia in the management of arterial hypertension in this group.
背景和目的:肥胖症患者经常面临肥胖偏见,这可能会影响适当医疗护理的提供。我们的目的是评估有无肥胖症的糖尿病患者高血压药物治疗决策的适当性:这是一项多中心横断面研究,研究对象是在巴西南部接受门诊治疗的 2 型糖尿病和动脉高血压患者。研究人员根据体重指数(BMI)将患者分为两组:体重较轻(BMI 结果)、体重较重(BMI 结果)和体重较重(BMI 结果):这项研究包括 204 名参与者,其中 53 人体重较轻,151 人肥胖。与体重较轻的患者相比,肥胖症患者更经常未能得到适当的强化治疗。当考虑到三个协会的血压目标时,研究组之间出现了差异:ESH(调整后 OR 2.28 [95% CI 1.12-4.63],p = 0.022)、ESC(调整后 OR 2.13 [95% CI 1.05-4.31],p = 0.035)和 ADA(调整后 OR 2.33 [95% CI 1.13-4.77],p = 0.021):这些研究结果表明,肥胖患者在高血压治疗中可能面临潜在的差异,肥胖状况可能与该群体动脉高血压治疗中的治疗惰性有关。
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引用次数: 0
Inulin supplementation in pediatric obesity management: a critical appraisal of efficacy and limitations. 在儿科肥胖症治疗中补充菊粉:对疗效和局限性的批判性评估。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-18 DOI: 10.1038/s41366-024-01620-5
Yanggang Hong, Yi Wang
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引用次数: 0
Polygenic score for body mass index in relation to mortality among patients with renal cell cancer. 肾细胞癌患者体重指数的多基因评分与死亡率的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-17 DOI: 10.1038/s41366-024-01609-0
Zhengyi Deng, Rebecca E Graff, Ken Batai, Benjamin I Chung, Marvin E Langston, Linda Kachuri

Background: The association between body mass index (BMI) and mortality among individuals with renal cell cancer (RCC) is debated, with some observational studies suggesting a lower mortality associated with higher BMI. However, methodological issues such as confounding and reverse causation may bias these findings. Using BMI-associated genetic variants can avoid these biases and generate more valid estimates.

Methods: In this prospective cohort study, we included 1264 RCC patients (446 deaths) from the UK Biobank. We created a BMI polygenic score (PGS) based on 336 BMI-associated genetic variants. The association between the PGS and mortality (all-cause and RCC-specific) was evaluated by logistic regression (all RCC cases) and Cox regression (906 incident cases). For comparison, the associations of measured pre-diagnostic BMI and waist-to-hip ratio (WHR) with mortality were quantified by Cox regression among incident cases. We stratified these analyses by time between anthropometric measurement and RCC diagnosis to assess the influence of reverse causation.

Results: We did not observe an association between the BMI PGS and all-cause mortality among RCC patients (hazard ratio (HR) per SD increase = 0.98, 95% CI: 0.88,1.10). No association was found for pre-diagnostic BMI (HR per 5 kg/m2 increase = 0.93, 95% CI: 0.83,1.04) or WHR (HR per 0.1 increase = 0.97, 95% CI: 0.83,1.13) with mortality. In patients with anthropometrics measured within 2 years before RCC diagnosis, we observed associations of higher BMI (HR per 5 kg/m2 = 0.76, 95% CI: 0.59,0.98) and WHR (HR = 0.67 per 0.1 increase, 95% CI: 0.45,0.98) with a lower risk of death. Similar patterns were observed for RCC-specific mortality.

Conclusion: We found no association between either genetic variants for high BMI or measured pre-diagnostic body adiposity and mortality among RCC patients, and our results suggested a role for reverse causation in the association of obesity with lower mortality. Future studies should be designed carefully to produce unbiased estimates that account for confounding and reverse causation.

背景:体重指数(BMI)与肾细胞癌(RCC)患者死亡率之间的关系存在争议,一些观察性研究表明,体重指数越高,死亡率越低。然而,混杂和反向因果关系等方法学问题可能会使这些研究结果产生偏差。使用与 BMI 相关的基因变异可避免这些偏差,并得出更有效的估计结果:在这项前瞻性队列研究中,我们纳入了英国生物库中的 1264 例 RCC 患者(死亡 446 例)。我们根据 336 个与 BMI 相关的遗传变异创建了 BMI 多基因评分(PGS)。我们通过逻辑回归(所有 RCC 病例)和 Cox 回归(906 例发病病例)评估了 PGS 与死亡率(全因死亡率和 RCC 特异性死亡率)之间的关系。为了进行比较,我们通过 Cox 回归量化了诊断前体重指数(BMI)和腰臀比(WHR)与病例死亡率之间的关系。我们按照人体测量与 RCC 诊断之间的时间间隔对这些分析进行了分层,以评估反向因果关系的影响:结果:我们没有观察到 BMI PGS 与 RCC 患者的全因死亡率之间存在关联(每增加 SD 的危险比 (HR) = 0.98,95% CI:0.88,1.10)。诊断前 BMI(每增加 5 kg/m2 的 HR = 0.93,95% CI:0.83,1.04)或 WHR(每增加 0.1 的 HR = 0.97,95% CI:0.83,1.13)与死亡率没有关联。在 RCC 诊断前 2 年内测量过人体测量指标的患者中,我们观察到较高的 BMI(每增加 5 kg/m2 的 HR = 0.76,95% CI:0.59,0.98)和 WHR(每增加 0.1 的 HR = 0.67,95% CI:0.45,0.98)与较低的死亡风险相关。RCC特异性死亡率也观察到类似的模式:我们没有发现高体重指数的遗传变异或诊断前身体脂肪含量的测量值与 RCC 患者的死亡率之间存在关联,我们的研究结果表明,肥胖与降低死亡率之间存在反向因果关系。今后的研究应精心设计,以得出考虑到混杂因素和反向因果关系的无偏估计值。
{"title":"Polygenic score for body mass index in relation to mortality among patients with renal cell cancer.","authors":"Zhengyi Deng, Rebecca E Graff, Ken Batai, Benjamin I Chung, Marvin E Langston, Linda Kachuri","doi":"10.1038/s41366-024-01609-0","DOIUrl":"https://doi.org/10.1038/s41366-024-01609-0","url":null,"abstract":"<p><strong>Background: </strong>The association between body mass index (BMI) and mortality among individuals with renal cell cancer (RCC) is debated, with some observational studies suggesting a lower mortality associated with higher BMI. However, methodological issues such as confounding and reverse causation may bias these findings. Using BMI-associated genetic variants can avoid these biases and generate more valid estimates.</p><p><strong>Methods: </strong>In this prospective cohort study, we included 1264 RCC patients (446 deaths) from the UK Biobank. We created a BMI polygenic score (PGS) based on 336 BMI-associated genetic variants. The association between the PGS and mortality (all-cause and RCC-specific) was evaluated by logistic regression (all RCC cases) and Cox regression (906 incident cases). For comparison, the associations of measured pre-diagnostic BMI and waist-to-hip ratio (WHR) with mortality were quantified by Cox regression among incident cases. We stratified these analyses by time between anthropometric measurement and RCC diagnosis to assess the influence of reverse causation.</p><p><strong>Results: </strong>We did not observe an association between the BMI PGS and all-cause mortality among RCC patients (hazard ratio (HR) per SD increase = 0.98, 95% CI: 0.88,1.10). No association was found for pre-diagnostic BMI (HR per 5 kg/m<sup>2</sup> increase = 0.93, 95% CI: 0.83,1.04) or WHR (HR per 0.1 increase = 0.97, 95% CI: 0.83,1.13) with mortality. In patients with anthropometrics measured within 2 years before RCC diagnosis, we observed associations of higher BMI (HR per 5 kg/m<sup>2</sup> = 0.76, 95% CI: 0.59,0.98) and WHR (HR = 0.67 per 0.1 increase, 95% CI: 0.45,0.98) with a lower risk of death. Similar patterns were observed for RCC-specific mortality.</p><p><strong>Conclusion: </strong>We found no association between either genetic variants for high BMI or measured pre-diagnostic body adiposity and mortality among RCC patients, and our results suggested a role for reverse causation in the association of obesity with lower mortality. Future studies should be designed carefully to produce unbiased estimates that account for confounding and reverse causation.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995719","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
Effects of high fat diet on metabolic health vary by age of menopause onset. 高脂肪饮食对代谢健康的影响因绝经年龄而异。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-17 DOI: 10.1038/s41366-024-01618-z
Abigail E Salinero, Harini Venkataganesh, Charly Abi-Ghanem, David Riccio, Richard D Kelly, Olivia J Gannon, Avi Sura, Heddwen L Brooks, Damian G Zuloaga, Kristen L Zuloaga

Menopause accelerates metabolic dysfunction, including (pre-)diabetes, obesity and visceral adiposity. However, the effects of endocrine vs. chronological aging in this progression are poorly understood. We hypothesized that menopause, especially in the context of middle-age, would exacerbate the metabolic effects of a high fat diet. Using young-adult and middle-aged C57BL/6J female mice, we modeled diet-induced obesity via chronic administration of high fat (HF) diet vs. control diet. We modeled peri-menopause/menopause via injections of 4-vinylcyclohexene diepoxide, which accelerates ovarian failure vs. vehicle. We performed glucose tolerance tests 2.5 and 7 months after diet onset, during the peri-menopausal and menopausal phases, respectively. Peri-menopause increased the severity of glucose intolerance and weight gain in middle-aged, HF-fed mice. Menopause increased weight gain in all mice regardless of age and diet, while chronological aging drove changes in adipose tissue distribution towards more visceral vs. subcutaneous adiposity. These data are in line with clinical data showing that post-menopausal women are more susceptible to metabolic dysfunction and suggest that greater chronological age exacerbates the effects of endocrine aging (menopause). This work highlights the importance of considering both chronological and endocrine aging in studies of metabolic health.

更年期会加速代谢功能障碍,包括(前期)糖尿病、肥胖和内脏脂肪过多。然而,人们对内分泌衰老与时间衰老在这一过程中的影响还知之甚少。我们假设,更年期,尤其是中年更年期,会加剧高脂肪饮食对新陈代谢的影响。我们利用年轻成年和中年的 C57BL/6J 雌性小鼠,通过长期摄入高脂肪(HF)饮食与对照饮食的对比,建立了饮食诱导肥胖的模型。我们通过注射会加速卵巢功能衰竭的 4-乙烯基环己烯二环氧化物与药物,模拟了围绝经期/更年期。我们分别在围绝经期和绝经期开始节食后 2.5 个月和 7 个月进行了葡萄糖耐量测试。围绝经期增加了中年高密度脂蛋白喂养小鼠葡萄糖不耐受的严重程度和体重增加。更年期会增加所有小鼠的体重增加,与年龄和饮食无关,而慢性衰老会促使脂肪组织分布发生变化,内脏脂肪增加,皮下脂肪减少。这些数据与临床数据相符,临床数据显示绝经后妇女更容易出现代谢功能障碍,并表明更大的计时年龄会加剧内分泌衰老(绝经)的影响。这项工作强调了在代谢健康研究中同时考虑计时衰老和内分泌衰老的重要性。
{"title":"Effects of high fat diet on metabolic health vary by age of menopause onset.","authors":"Abigail E Salinero, Harini Venkataganesh, Charly Abi-Ghanem, David Riccio, Richard D Kelly, Olivia J Gannon, Avi Sura, Heddwen L Brooks, Damian G Zuloaga, Kristen L Zuloaga","doi":"10.1038/s41366-024-01618-z","DOIUrl":"10.1038/s41366-024-01618-z","url":null,"abstract":"<p><p>Menopause accelerates metabolic dysfunction, including (pre-)diabetes, obesity and visceral adiposity. However, the effects of endocrine vs. chronological aging in this progression are poorly understood. We hypothesized that menopause, especially in the context of middle-age, would exacerbate the metabolic effects of a high fat diet. Using young-adult and middle-aged C57BL/6J female mice, we modeled diet-induced obesity via chronic administration of high fat (HF) diet vs. control diet. We modeled peri-menopause/menopause via injections of 4-vinylcyclohexene diepoxide, which accelerates ovarian failure vs. vehicle. We performed glucose tolerance tests 2.5 and 7 months after diet onset, during the peri-menopausal and menopausal phases, respectively. Peri-menopause increased the severity of glucose intolerance and weight gain in middle-aged, HF-fed mice. Menopause increased weight gain in all mice regardless of age and diet, while chronological aging drove changes in adipose tissue distribution towards more visceral vs. subcutaneous adiposity. These data are in line with clinical data showing that post-menopausal women are more susceptible to metabolic dysfunction and suggest that greater chronological age exacerbates the effects of endocrine aging (menopause). This work highlights the importance of considering both chronological and endocrine aging in studies of metabolic health.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995718","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
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International Journal of Obesity
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