Journal of Obesity最新文献

Objective: We aimed to compare the molecular mechanisms and metabolic outcomes of Roux-en-Y gastric bypass (RYGB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) using a preclinical model.

Methods: Otsuka Long-Evans Tokushima Fatty rats with diet-induced obesity underwent RYGB, SADI-S, or sham surgery. Metabolic parameters, including glucose tolerance, body weight, and 18F-fluorodeoxyglucose biodistribution, were assessed at 1- and 2-month postsurgery. The expression of Glucose transporter 1 (GLUT1) and glucose metabolism-related genes in intestinal segments was analyzed.

Results: Although RYGB and SADI-S yielded comparable improvements in glucose tolerance and body weight at 1 month postsurgery, they exerted their effects through distinct mechanisms. RYGB enhanced GLUT1-mediated glucose excretion in the common limb, whereas SADI-S upregulated the expression of the glycolytic genes Hk2, Fbp2, Aldob, and Ldha in the colon. Two months postsurgery, the observed metabolic improvements diminished despite sustained weight loss, which coincided with decreased expression of GLUT1 and glycolytic genes.

Conclusions: RYGB and SADI-S achieve similar benefits through distinct glucose handling pathways; however, these effects decline over time. Our data do not support the superiority of SADI-S over RYGB, particularly given its higher complication rate, and instead highlight the need for strategies aimed at prolonging the therapeutic benefits of metabolic surgeries.

Background: Obesity has emerged as a pressing global health challenge, and therapies based on glucagon-like Peptide 1 receptor agonists (GLP-1RAs) have transformed its management. Currently, liraglutide, semaglutide, and tirzepatide are FDA-approved for obesity treatment, while other agents are used off-label. These drugs not only provide unprecedented efficacy and acceptable safety in weight reduction and glycemic control for patients with obesity and Type 2 diabetes but also hold promise in broader indications, including neurodegenerative disorders, fatty liver disease, dyslipidemia, atherosclerosis, and cardiovascular conditions.

Methods: This narrative review examined the therapeutic applications of GLP-1RAs for obesity, emphasizing their efficacy, safety profile, challenges with patient adherence, and limitations. The review also explored emerging innovations such as ultralong-acting formulations, combination therapies, and the integration of digital health and artificial intelligence in advancing antiobesity drug development.

Results: GLP-1RAs represent a paradigm shift in the treatment of obesity and metabolic diseases, with rapidly expanding indications and global uptake. Recent evidence highlights improvements in tolerability, global accessibility, and the potential of novel technologies to optimize patient outcomes. By 2025, GLP-1RAs are anticipated to receive FDA approval for new indications, such as chronic kidney disease, heart failure with preserved ejection fraction, and metabolic dysfunction-associated steatohepatitis. Novel agents including CagriSema and higher dose oral semaglutide are advancing through clinical trials, while pivotal trial results for orforglipron, mazdutide, retatrutide, and survodutide are anticipated to further expand the therapeutic landscape. At the same time, the arrival of generic liraglutide and evolving insurance coverage are reshaping access and affordability.

Conclusion: The convergence of pharmacological innovation, digital health strategies, and equitable care initiatives is expected to revolutionize obesity therapeutics in the coming decade. Priorities for future research include sustaining long-term weight loss, establishing disease-modifying potential in nonmetabolic disorders, and addressing health equity concerns to ensure broader global benefit.

Some studies suggest that body fat distribution differs between sexes; there remains a gap regarding the exact mechanisms that regulate these differences and their cardiometabolic consequences. This study investigated sex-specific differences influencing the concentration and metabolic risk associated with visceral abdominal adipose tissue (VAT) and subcutaneous adipose tissue (SAT). This cross-sectional study includes outpatients from a university-affiliated public hospital. Consecutive patients aged ≥ 20 years were included in our sample. VAT and SAT were measured using ultrasound (the mean of three attempts). Intra- and interevaluator reproducibility was tested, demonstrating high reliability (> 0.90) for both VAT and SAT. Demographic (age, sex, and self-reported race), anthropometric, behavioral, and biochemical variables were assessed. A total of 253 patients were included. They had a mean age of 46.3 ± 11.6 years (64.4% females and 68.7% non-white). Although the mean total abdominal adipose tissue was similar between sexes (p=0.125), males exhibited a higher mean VAT (7.3 ± 3.0 vs. 6.0 ± 2.1 cm; p < 0.001), while women presented with a higher mean SAT (3.4 ± 1.2 vs. 2.7 ± 1.4 cm; p < 0.001). Among females, VAT was directly associated with serum triglycerides (TG), TG/HDL ratio, blood glucose, and glycated hemoglobin (HbA1c), and inversely associated with HDL. VAT/SAT ratio predicted higher levels of total cholesterol (TC), LDL, TG, TG/HDL ratio, glucose, and HbA1c (p < 0.05). Among males, VAT did not significantly affect metabolic alterations. In conclusion, within the same mean BMI, males had higher VAT concentrations, whereas in females, despite lower VAT, a worse adverse metabolic profile was observed.

Objective: This systematic review aimed to assess the efficacy and safety of GLP-1 RAs in adults with obesity or overweight, by comparing different GLP-1 RAs, identifying the most effective agents, and evaluating adverse effects.

Methods: We systematically searched Embase, MEDLINE, and Cochrane for phase 3 and 4 randomized controlled trials (RCTs) with a minimum duration of 40 weeks. Included studies compared GLP-1 RAs to placebo or to each other in adults with obesity (BMI ≥ 30 kg/m²) or overweight (BMI ≥ 27 kg/m²), with or without type 2 diabetes (T2DM). We excluded crossover trials, open-label studies, early-phase trials, and studies focusing on specific subpopulations.

Results: A total of 22 RCTs involving 41,757 participants were included. Among adults with T2DM, the greatest weight reductions were observed with tirzepatide 15 mg (-9.5 kg at 40 weeks; 72% lost ≥ 5% of baseline weight) and semaglutide 2.4 mg (-9.6% body weight at 68 weeks; 69% lost ≥ 5%). In participants without T2DM, semaglutide 2.4 mg (-14.9% body weight at 68 weeks) and tirzepatide 15 mg (-20.9% at 72 weeks) produced the most substantial effects, while semaglutide 50 mg was also effective in nondiabetic patients. Liraglutide 3 mg showed modest efficacy. Across trials, GLP-1 RAs were consistently associated with a higher frequency of gastrointestinal adverse events compared to placebo, including nausea (14%-28% vs. 5%-10%), vomiting (6%-12% vs. 2%-4%), and diarrhea (8%-20% vs. 4%-7%). The risk of pancreatitis and serious adverse events remained comparable to placebo.

Conclusions: GLP-1 RAs, especially semaglutide and tirzepatide, are effective for weight management. Liraglutide may remain a viable, cost-effective alternative.

Background/objective: Macrosomia is associated with overweight and obesity across the life course. Most research to date has been based on cross-sectional analyses, and longitudinal investigations between macrosomia and developmental trajectories of growth throughout the first decade of life are lacking. This research aimed to examine associations between macrosomia and postnatal growth trajectories from birth to 10 years of age.

Subjects: Children (n = 337) from the ROLO longitudinal birth cohort, who were born to mothers with previous macrosomic delivery.

Methods: Birthweight was recorded at delivery and dichotomised using the cut-off criteria for macrosomia (birthweight ≥ 4 kg and < 4 kg). Child weight, length/height, body mass index (BMI) and waist circumference were measured at birth, 6 months, 2, 5 and 10 years of age. Postnatal growth trajectories were developed using these longitudinal measurements from birth up to 10 years of age. Linear spline multilevel models were used to examine associations between macrosomia and postnatal trajectories with adjustment for confounders (maternal ethnicity, socioeconomic status, maternal age at delivery, maternal smoking in pregnancy, paternal BMI, adherence to gestational weight gain guidelines in pregnancy, sex of the child, original study group allocation, adherence to a special diet in pregnancy, maternal physical activity levels, metabolic complications in pregnancy and breastfeeding).

Results: In this cohort, 53.7% (n = 181) had a birthweight ≥ 4 kg. The median (IQR) early pregnancy BMI was 25.4 (23.1, 28.6) kg/m², and mothers were 33.1 (30.6, 35.3) years old at delivery. We found no strong evidence of associations between macrosomia and trajectories of childhood growth from birth to 10 years of age. Significant findings in crude and adjusted models were close to the null and provide limited evidence for a meaningful association.

Conclusion: Macrosomia was associated with early, but not later, childhood growth trajectories. Associations were weak and varied according to definition and growth measurement. The lack of strong results indicates uncertain clinical relevance and warrant additional future research in a larger cohort.

Objective: The combination of genetic and environmental contributors to obesity can be studied through intergenerational associations as previously shown in studies of parents and their children and adolescents. Few studies have investigated this in adulthood. This study aims to explore sex-specific associations in body mass index (BMI) and obesity status between parents and their adult offspring.

Methods: We used cross-sectional data from two surveys in the population-based Tromsø Study. Individuals participating in the seventh (Tromsø7 2015-2016) survey were linked to their parents in the fourth (Tromsø4 1994-1995) survey. Data were analyzed using linear mixed models and generalized estimating equations adjusting for sibling clusters, parents' age and education level, and offspring's sex, age, education, and physical activity level. The analytical sample included 2068 parent-offspring trios, both parents and offspring aged 40-59 years.

Results: Results showed strong associations between parents' and adult offspring's BMI and obesity status, which remained strong after adjustments. Having two parents with obesity (compared to normal weight) showed a 3 times higher risk of obesity in the offspring. Mother-daughter relationships tended to be stronger than mother-son relationships.

Conclusion: Our study adds to previous studies of familial transmission of obesity from parents to their young children and adolescents, confirming these associations persist into middle age.

The increasing prevalence of pediatric obesity is a significant public health issue, with conventional diagnostic methods often overlooking its psychological, social, and lifestyle consequences. This study aimed to create and confirm the validity of the obesity-related well-being (ORWB) scale, a new tool designed to evaluate the diverse impacts of obesity on children and adolescent's physical, psychological, social, and lifestyle well-being. The scale was developed through extensive literature analysis and consultations with experts in the field. The study included 672 students aged 12-18 years, predominantly overweight, from a pool of 19,876 students across four Tunisian governorates. The scale's internal consistency was evaluated using robust measures such as McDonald's omega, Cronbach's alpha, and Guttman's lambda 6. Construct validity was supported by factor analyses, with RMSEA approaching zero and CFI/TLI exceeding the 0.95 benchmark. The scale's multidimensional structure was validated, corresponding to its theoretical notion. The ORWB scale is a significant advancement in pediatric obesity, offering healthcare providers, researchers, and policymakers a comprehensive tool to evaluate and enhance the well-being of children affected by obesity.

[This corrects the article DOI: 10.1155/2023/4178121.].

Objective: To determine whether metabolic syndrome is associated with an elevated risk of cervical cancer.

Methods: We retrospectively analyzed data on 1,410,650 women without a history of cancer, using the JMDC Claims Database, a nationwide epidemiological database in Japan, between 2005 and 2022. The look-back period was set at 2 years. Cox regression analyses were conducted to assess cervical cancer risk associated with metabolic syndrome and its components (waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting plasma glucose). Further, we conducted age-stratified analyses.

Results: Metabolic syndrome was diagnosed in 43,029 participants (median age: 53 years), and 1579 cervical cancer cases were recorded over a median follow-up of 942 days. Multivariable Cox regression analyses showed that metabolic syndrome was associated with a higher cervical cancer incidence (hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.04-1.82). Among the metabolic factors, cancer risk was associated with higher plasma glucose (per 10 mg/dL increase) (HR, 1.04; 95% CI, 1.01-1.08) and lower high-density lipoprotein cholesterol levels (per 10 mg/dL decrease) (HR, 1.06; 95% CI, 1.02-1.10), whereas waist circumference, blood pressure, or triglyceride levels showed no significant relationship. Metabolic syndrome was associated with an increased risk of cervical cancer, with a stronger association observed in younger women in age-stratified analyses (p for interaction = 0.004).

Conclusion: Metabolic syndrome was associated with an increased risk of cervical cancer, with a stronger association observed among younger women. Elevated plasma glucose and low high-density lipoprotein cholesterol levels were identified as significant contributing factors.

Children of families with low socioeconomic status (SES) are at higher risk for obesity and obesity-related lifestyle behaviors, i.e., unhealthy eating and low physical activity. This review aims to identify changeable determinants of obesity and obesity-related lifestyle behaviors in children aged 0-12, with a focus on those specific to low SES. A literature search was conducted in PsycINFO/Ovid and PubMed, using terms related to SES, obesity, and individual or environmental determinants. We included 42 systematic review/meta-analysis articles, written in English, that focused on children (0-12 years) and assessed obesity or obesity-related lifestyle behavior outcomes. We extracted modifiable individual and environmental determinants, and the role of SES in their association with obesity and obesity-related lifestyle behaviors in children. Nine reviews examined the relationship between determinants and obesity and obesity-related lifestyle behaviors in children, and the role of SES. These reviews focused mainly on environmental determinants (n = 8), particularly family and peer factors (n = 6). The findings suggest that SES may influence obesity and lifestyle behaviors indirectly through parental factors, such as parental BMI, maternal smoking during pregnancy, and parental TV viewing behaviors. SES may also moderate the impact of parental factors, such as parental BMI, maternal depression, or permissive/indulgent parenting. Our review showed that research on determinants of obesity and obesity-related lifestyle behaviors of children with low SES is limited, with scarce and inconsistent evidence and lacking theoretical explanations. The (parent-related) mechanisms which influence child obesity in families with low SES are still unclear. To develop effective (family) interventions to prevent or decrease obesity in children of families with low SES, future research needs to examine individual and environmental determinants and underlying mechanisms through which SES has its influence on childhood obesity.