International Journal of Obesity最新文献

Background/objectives: Obesity was previously perceived to be a lifestyle issue; however, it was declared a chronic disease by the American Medical Association (AMA) in 2013. However, family physician's views and actions toward managing obesity remain ambiguous and occasionally conflicting.

Subjects/methods: This cross-sectional study explores the acceptance and knowledge of 171 family medicine physicians regarding obesity as a chronic disease. Family physicians were recruited through different channels, including members of professional scientific societies of family medicine that belong to the World Organization of Family Doctors (WONCA) Eastern Mediterranean Regional Office EMRO, a publicly available list of United States (US) family physicians, and authors' personal Facebook and LinkedIn connections. Data was collected across various countries through an anonymous online survey.

Results: While most participants acknowledged obesity as a chronic condition with multifactorial origins, there was a notable discrepancy in treatment practices compared to other chronic diseases. A dual perspective emerged, as family physicians often emphasized self-responsibility and behavioral change over medical interventions, potentially hindering effective management. Lower initiation rates for obesity management was exhibited compared to other chronic diseases.

Conclusion: There is a gap between recognition and effective management of obesity as a chronic disease within family practice. The findings underscore the need for comprehensive obesity education in medical training to bridge knowledge gaps and reduce weight stigma, enabling physicians to provide optimal care for patients with obesity.

Activation of Fas (CD95) in adipocytes inhibits browning and may contribute to body weight gain in mice. Moreover, Fas expression in white adipose tissue (WAT) correlates positively with body mass index (BMI) in humans. However, molecular pathways involved in the inhibitory effect of Fas on energy metabolism remain incompletely understood. Herein, we report that protein levels of the tumor suppressor p53 were reduced in primary white adipocytes of adipocyte-specific Fas-knockout mice. Moreover, Fas ligand (FasL) treatment increased p53 concentrations in cultured adipocytes and decreased mitochondrial oxygen consumption in control but not in p53-depleted cells, indicating that Fas activation reduces energy expenditure in a p53-dependent manner. In line, in differentiated human mesenchymal stem cells and WAT derived from different anatomical depots, FAS expression was positively associated with p53. Furthermore, p53 expression in human subcutaneous and visceral WAT correlated positively with BMI, whereas its expression in visceral WAT was inversely associated with insulin sensitivity (as assessed by hyperinsulinemic-euglycemic clamp). Taken together, our data suggest that Fas regulates p53 expression in adipocytes, and may thereby affect body weight gain and insulin sensitivity.

Objective: Copy number variations (CNVs) may contribute to medical conditions. However, research on the impact of individual CNVs on endocrine disease is limited. This study aimed to provide new data on obesity and metabolic syndrome (MetS) in adults with microdeletion 22q11.2, the pathogenic CNV associated with 22q11.2 deletion syndrome.

Methods: We examined prevalence rates of obesity and MetS in 103 adults with a typical 22q11.2 deletion (45.2% male, at median age 30.0 (range 17-71) years) and compared these rates with population-based data. Generalized obesity was defined by a body mass index (BMI) ≥ 30 kg/m², abdominal obesity by a waist circumference (WC) of ≥102 cm in males and ≥88 cm in females, and MetS by standard Joint Interim Statement criteria. General linear models were used to examine the independent associations of age, sex, congenital heart defect, smoking, and antipsychotic use with BMI, WC, and the presence of MetS.

Results: Prevalence rates of generalized obesity (32.0%), abdominal obesity (51.5%), and MetS (33.0%) were significantly higher compared to a population-based cohort (15.7% (P < 0.0001), 36.1% (P = 0.002), and 15.2% (P < 0.0001), respectively). In antipsychotic naïve subjects, significant correlations were observed between age and BMI (r = 0.54, P < 0.001), and age and WC (r = 0.60, P < 0.001). These correlations were not present in individuals taking antipsychotic medication. The models predicting BMI (F(5, 97) = 3.083, R² = 0.137, P = 0.01) and WC (F(5, 92) = 5.985, R² = 0.245, P < 0.001) were significant. Only age was individually predictive of outcomes (P < 0.05 and P < 0.001). The model predicting MetS was also significant (P < 0.001), with higher age being the only factor associated with MetS (OR = 1.07, 95% CI = 1.03-1.12, P < 0.001).

Conclusions: Generalized and abdominal obesity, as well as MetS, appear to be common in adults with 22q11.2 deletion syndrome, emphasizing the importance of careful monitoring from a young age. These findings contribute to the limited knowledge about the association between pathogenic CNVs, obesity, and MetS.

Background: Postoperative nausea and vomiting (PONV) is the most common side effect after laparoscopic sleeve gastrectomy (LSG), affecting patients' postoperative recovery and increasing the medical and economic burden. This study aimed to analyze the relationship between serum pepsinogen and PONV.

Methods: Patients with obesity who underwent LSG in our center between January 2021 and December 2022 were divided into PONV and NoPONV groups and analyzed retrospectively. Binary logistic regression analysis was used to determine the independent risk factors for PONV.

Results: 219 female patients were enrolled, with an average BMI of 36.74 ± 8.34 kg/m² and aged 32.61 ± 6.18 years. PONV occurred in 157 patients (71.7%). The influencing factors of PONV with different severity were analyzed, and the results showed that the severity of postoperative pain (χ2 = 13.169, p-values = 0.004), PGI (χ2 = 14.625, p-values = 0.002), PGII (χ2 = 25.916, p-values = 0.000), and PGR (χ2 = 17.697, p-values = 0.001) had statistical significance. Binary logistic regression showed that PGI was a risk factor for PONV with a OR (ng/mL) value of 1.013 (95% CI: 1.001-1.024, p-values = 0.037), while PGR was a protective factor for PONV with an OR(ng/mL) value of 0.952 (95% CI: 0.925-0.979, p-values = 0.001).

Conclusions: The incidence of PONV after LSG is high. Higher PGI may be a risk factor for promoting PONV after LSG. The higher the preoperative PGI, the later the onset of PONV; the longer the duration, the more serious the degree.

Background: X (formerly Twitter) is a unique social medium where many famous people and health institutions post and interact with casual users. We aimed to explore reactions to tweets about obesity and weight loss from accounts representing celebrities, politicians, sportsmen, and health authorities.

Methods: We collected tweets from n = 2444 X profiles representing seven categories: celebrities, politicians, sportsmen, medical specialists, medical journals, medical universities, and health institutions. We retrieved tweets from the accounts and selected tweets about, e.g., obesity, overweight, body mass index, and weight loss. We conducted sentiment analysis, descriptive statistics, and multivariable quantile regression modeling. In quantile regression models, each tau represents a decile from 0.1 to 0.9 of the dependent variable (number of likes or retweets). Therefore, a tau value of 0.5 represents the 5th decile, the 50th percentile, and the median of the dependent variable.

Results: The final dataset consisted of n = 8989 tweets. Achieving a large number of likes (taus 0.7, 0.8, and 0.9) was positively associated with posts written by celebrities, politicians, medical journals, and universities, while it was negatively associated with tweets authored by health institutions or medical specialists. In the case of a significant number of retweets, a positive association was observed for all account types, except for health institutions, for which the relationship was negative. These relationships were independent of verification status, the number of followers, tweet length, and sentiment.

Conclusions: Tweets concerning obesity and weight loss originating from accounts representing health institutions garnered fewer likes and retweets compared to other types of accounts, including non-medical ones. A limitation of the study is the relatively small number of tweets emanating from non-medical accounts. A X informational campaign about obesity should engage non-medical accounts with many followers to reach as many users as possible.

Backgrounds: The association between weight change in patients with diabetes, and the development of infective endocarditis (IE) has never been studied. Therefore, we evaluated the associations of weight changes in patients with diabetes with the development of IE.

Methods: In this Korean population-based cohort study, we included patients with diabetes aged ≥20 years who underwent health screenings twice in a 2-year interval between 2009 and 2012. Patients were categorized into five groups according to the degree of weight change between the two health screenings and were followed up until December 2018. A patient with a weight change of ≤-10% was designated to the severe weight loss group, -10 to ≤-5% to the moderate weight loss group, -5 to ≤5% to the stable weight group, 5 to ≤10% to the moderate weight gain group, and ≥10% to the severe weight gain group. The primary outcome was the incidence of IE.

Results: A total of 1,762,108 patients with diabetes were included. There were 67,580 (3.9%) individuals with severe weight loss, 247,969 (14.1%) with moderate weight loss, 1,267,849 (72.0%) with stable weight, 135,774 (7.7%) with moderate weight gain, 42,936 (2.4%) with severe weight gain. During the follow-up (median, 5.21 years), 828 cases of IE occurred. After adjusting for covariates, both weight loss (HR: 2.41, 95% CI: 1.87-3.12 for the severe weight loss group; HR: 1.28, 95% CI: 1.05-1.55 for the moderate weight loss group) and weight gain (HR: 1.17, 95% CI: 0.91-1.50 for the moderate weight gain group; HR: 1.59, 95% CI: 1.11-2.28 for the severe weight gain group) were associated with an increased risk of IE compared to those for the stable weight group.

Conclusion: Both weight gain and weight loss are associated with an increased incidence of IE, and the greater the degree of weight change, the greater the risk.