Journal of Obesity最新文献

Introduction: Various anthropometric and dietary indicators influence insulin resistance (IR), and lipid biomarkers may play a pivotal mediating role in these relationships. To investigate the mediating effects of lipid biomarkers on the relationships between anthropometric, dietary indicators, and IR, and the moderating role of sex in these associations.

Methods: A hospital-based cross-sectional study was conducted with 169 participants. Parallel mediation models assessed the mediating effects of lipid biomarkers (triglycerides, HDL, LDL, and total cholesterol) on the relationships between anthropometric (BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio) and dietary indicators (at least one starchy staple, at least one fruit, consumed all five recommended food groups (ALL-5), global dietary recommendations (GDR) score, and noncommunicable disease risk/protect scores) and IR. Moderated mediation analyses evaluated the moderating effect of sex. Statistical analyses were bootstrapped.

Results: The cumulative effect of lipid biomarkers fully mediated the relationship between WHtR and IR (Indirect Coef. = 0.65; 95% CI [0.02, 1.70]). TG significantly mediated the associations between WHR and IR (indirect Coef. = 0.55; 95% CI [0.11, 2.63]), BMI and IR (indirect Coef. = 0.76; 95% CI [0.17, 2.27]), and WC and IR (indirect Coef. = 0.72; 95% CI [0.04, 2.63]). Furthermore, LDL-C (Indirect Coef. = 1.99; 95% CI [0.24, 9.61]) and HDL-C (Indirect Coef. = 0.55; 95% CI [0.03, 2.57]) mediated the relationships of starchy staple and fruit intake with IR, respectively. Sex moderated the direct effect of WC on IR (interaction Coef. = 5.11, p = 0.002) but did not moderate the indirect pathways involving lipid biomarkers.

Conclusions: These findings elucidate the intricate interplay between body composition, diet, lipid biomarkers, sex, and IR, providing insights for developing targeted prevention and intervention strategies to combat IR.

Introduction: Imagine a surgeon's critical decision: Should the gallbladder be removed now, along with the planned bariatric surgery, or risk the complication and necessity of a second surgery later? This clinical dilemma is central to treating morbidly obese patients, who face a high prevalence of gallstone disease exacerbated by rapid postoperative weight loss. The best approach to managing existing gallstones in bariatric candidates remains debated, with debate focusing on whether combining laparoscopic cholecystectomy (LC) with bariatric surgery is both safe and advantageous. In this pilot study, we provide randomized evidence to guide this decision.

Methods: In this prospective randomized controlled pilot study, 58 morbidly obese patients with ultrasound-confirmed gallstones were randomly assigned to two groups: Group I (n = 30) received bariatric surgery and LC; Group II (n = 28) had bariatric surgery only, with LC delayed for symptoms. The primary outcomes were clearly defined as operative time, intraoperative complications, and postoperative morbidity, providing a focused measure of safety and efficacy. Secondary outcomes included hospital stay, pain, and follow-up gallstone symptoms.

Results: Baseline demographics and comorbidities were similar across groups. Operative time was longer in Group I (98.93 ± 11.58 min) than in Group II (75.18 ± 11.26 min, p < 0.001). An extra port was used in 20% of Group I patients, compared with none in Group II (p = 0.012). No significant differences were observed in bleeding, bile leakage, postoperative complications, or hospital stay. Group I reported higher pain scores (p < 0.001). During follow-up, 79.3% of Group II developed symptomatic gallstones, requiring later cholecystectomy.

Conclusion: Concomitant LC during bariatric surgery in morbidly obese patients with pre-existing gallstones is demonstrated to be safe and feasible, with acceptable increases in operative time and postoperative pain. The high rate (79.3%) of symptomatic gallstone development in patients who did not undergo concomitant cholecystectomy supports adopting routine concomitant LC to prevent future morbidity, thereby influencing clinical decision-making and standard practice. Trial Registration: ClinicalTrials.gov: NCT04567890.

Background: Orlistat is a potent lipase inhibitor utilized as a preventive agent for obesity and fat absorption control. Existing literature presents conflicting findings regarding its impact on lipid parameters.

Methods: This systematic review followed the PRISMA guidelines and was registered in PROSPERO (ID: CRD42024550889). A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Register of Controlled Trials was conducted for studies published before January 19, 2025. Eligible studies included randomized controlled trials (RCTs) evaluating orlistat in adults (≥ 18 years) with dyslipidemia. Furthermore, the Grading of Recommendations, Assessment, Development, and Evaluations assessment tool was employed to analyze the certainty of evidence or each outcome.

Results: A total number of 1369 participants, with 682 in treatment and 687 in control categories, were included in our study. Orlistat reduced body mass index (BMI) (SMD [95% CI]: -0.30 [-0.58, -0.03], p value (heterogeneity) = 0.026), and also it was associated with a decrease in high-density lipoprotein cholesterol (SMD (95% CI): -0.31 [-0.48, -0.13], p value (heterogeneity) = 0.436). Changes in waist circumference (WC) and triglycerides (TGs) did not reach statistical significance in the primary analysis (WC: SMD [95% CI] -0.1562 [-0.3138; 0.0015], I ² = 0.0%, p-value (heterogeneity) = 0.7572; TG: SMD [95% CI] -0.1668 [-0.7979; 0.4642], I ² = 97.7% p value (heterogeneity) < 0.0001); however, after publication-bias adjustment using the trim-and-fill sensitivity analysis, meaningful reductions were discovered for WC (SMD (%95CI): -0.1712 [-0.3248; -0.0176], I ² = 0.0%, p value (heterogeneity) = 0.7696) and TG (SMD (%95CI): -0.8900 [-1.6619; -0.1181], I ² = 97.9%, p value (heterogeneity) < 0.0001). The secondary analysis demonstrated that follow-up duration accounted for 30% of TG heterogeneity, suggesting a small but significant decline in orlistat's TG-lowering effect over time (slope: -0.1239; 95% CI: -0.2355, -0.0123; p value = 0.0295). No significant changes were observed in other parameters of the study. Besides, gastrointestinal issues were the most frequently reported adverse events among the studies.

Conclusion: Our findings suggest that orlistat meaningfully reduces BMI but is associated with decreased HDL-C, which may be undesirable given HDL-C's protective role in cardiovascular health. Evidence for reductions in TG and WC is uncertain: the primary meta-analysis showed no statistically significant effects, whereas trim-and-fill sensitivity analysis suggested potential reductions. No significant short-term impact on TG was observed, though a modest reduction may emerge with prolonged use.

Purpose: This randomized controlled trial aimed to evaluate the impact of intermittent fasting (IF) during resistance training (RT) on body composition, muscular strength, and the testosterone:cortisol ratio in obese males.

Methods: Twenty obese males (aged 20-30, BMI 30-36 kg/m²) were selected from eligible volunteers and randomly assigned to control (regular diet) and IF (4:3 IF) groups. All subjects participated in RT 3 days/week for 8 weeks. Forty-eight hours before and after the protocol, blood sampling and anthropometric measurements were done in a fasting state, and data were analyzed at a significance level of p < 0.05.

Results: The IF/RT group lost twofold more weight and fat, had higher arm and chest measurements, and had less waist circumference than the C/RT group. The testosterone levels and muscle strength improved with RT, and there was no difference between the C/RT and IF/RT groups.

Conclusion: It appears that intermittent fasting may enhance the efficacy of RT in obese males and is unlikely to have any detrimental effects on muscular strength or the anabolic index. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20190213042702N4.

Background: The global obesity epidemic challenges health systems, driving people to seek metabolic and bariatric surgery (MBS), especially laparoscopic sleeve gastrectomy (LSG). Many MBS centers have limited resources for patient education, creating knowledge gaps that lead patients to search online. AI chatbots, such as ChatGPT, can provide reliable medical information, though concerns about accuracy and completeness remain.

Methods: The study involved four fellowship-trained minimally invasive surgeons (MISs), nine fellows (MIFs), and two general practitioners (GPs) in the MBS multidisciplinary team from March 1, 2024, to March 30, 2024. Seven AI chatbots were selected, including ChatGPT 3.5 and 4, Bard, Bing, Claude, Llama, and Perplexity, based on their public availability on December 1, 2023. Forty patient questions regarding LSG were sourced from social media, MBS organizations, and online forums. Experts and chatbots answered these questions, with their responses evaluated for accuracy and comprehensiveness on a 5-point scale. Statistical analyses compared groups' performance.

Results: Chatbots demonstrated a higher overall performance score (2.55 ± 0.95) compared to the expert group (1.92 ± 1.32, p < 0.001). Among chatbots, ChatGPT-4 achieved the highest performance (2.94 ± 0.24), while Llama had the lowest (2.15 ± 1.23). Expert group scores were highest for MISs (2.36 ± 1.09), followed by GPs (1.90 ± 1.36) and MIFs (1.75 ± 1.36). The readability of chatbot responses was assessed using Flesch-Kincaid scores, revealing that most responses required reading levels between the 11th grade and college level. Furthermore, chatbots exhibited fair reliability and reproducibility in response consistency, with ChatGPT-4 showing the highest test-retest reliability.

Conclusion: AI chatbots generated accurate and comprehensive answers to common bariatric patient questions, suggesting promise as a scalable aid for patient education. However, readability often exceeds recommended levels, performance varies by model, occasional inaccuracies occur, and medicolegal considerations remain unresolved. Accordingly, chatbots should complement clinician counseling, and future work should improve readability and reliability and evaluate real-world safety and impact.

This study evaluated the safety and economic impact of discharging bariatric surgery patients on Postoperative day (POD) 1 compared to the institutional POD 2 discharge protocol. A retrospective review of 115 patients who underwent laparoscopic or robot-assisted sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) revealed no significant differences in complications or readmissions between the groups. Discharge on POD 1 demonstrated a cost difference of approximately $1571. Our findings support the safety, feasibility, and financial benefits of implementing POD 1 discharge as standard practice for bariatric patients in underserved urban populations.

[This corrects the article DOI: 10.1155/jobe/3897161.].

Objective: Body mass index (BMI) has been criticised for its inability to differentiate between fat and nonfat tissues and to reflect body fat distribution. Body Roundness Index (BRI) and A Body Shape Index (ABSI) are novel indices addressing these limitations, yet their mortality risk-stratification utility remains understudied in Asian populations.

Methods: In this retrospective cohort study using a nationally representative Japanese claims database (2014-2022), we analysed 778,812 individuals who underwent healthcare checkups. Anthropometric indices were categorised into five groups based on restricted cubic spline curve-derived cutoffs. Multivariate Cox proportional hazards models, adjusted for demographic factors, lifestyle variables and comorbidities, assessed associations between these categorical variables and all-cause mortality.

Results: Among participants (mean [standard deviation] age of 62.8 [9.6] years and 445,250 [57.2%] women), 14,690 deaths occurred during a median [interquartile range] follow-up of 4.53 [3.28-6.23] years. While BMI and BRI showed U-shaped relationships with all-cause mortality, ABSI demonstrated a J-shaped relationship. Significant differences in mortality risk compared with the reference category were observed in three categories for BMI, four categories for BRI and four categories for ABSI.

Conclusions: BRI and ABSI identified mortality risk differences across more categories than BMI, indicating that these indices may provide additional insights beyond BMI for mortality risk assessment.

Background: The World Health Organization estimates that more than 500 million people will be affected by diseases related to physical inactivity in the next decade. Individuals with overweight or obesity are particularly vulnerable, making exercise adherence a critical public health concern. This review aimed to evaluate the efficacy of interventions designed to improve adherence to exercise in this population.

Methods: A systematic search was conducted in MEDLINE, Embase, Virtual Health Library, Cochrane Library, and SPORTDiscus. Two independent researchers performed screening, data extraction, and synthesis of studies including adults aged 18-59 years with overweight or obesity. Eligible interventions lasted at least 12 weeks, included a control group, and reported adherence-related outcomes. Methodological quality was assessed using the Cochrane Risk of Bias tool. When possible, meta-analysis was performed.

Results: Seventeen studies met the inclusion criteria. Group-based programs and interventions supervised by trained professionals were consistently associated with higher adherence. Factors, such as body weight, exercise frequency, session duration, intensity, and type of intervention, showed no consistent influence. However, most studies presented a moderate to high risk of bias.

Conclusion: Group and supervised interventions appear effective in improving exercise adherence among adults with overweight or obesity, but further high-quality studies are needed.

Background: Butterfly pea flowers (Clitoria ternatea L.) and lemon fruits (Citrus limon) are rich in phytochemicals and have shown potential anti-obesity effects. However, the combination of these two medicinal plants as an herbal beverage has not been extensively studied.

Objective: This study aimed to evaluate the effects of an herbal beverage composed of butterfly pea flowers and lemon fruits (BPL) on body weight (BW), Lee index (LI), body fat content (BFC), lipid profile (total cholesterol, low-density lipoprotein-cholesterol [LDL-C], high-density lipoprotein-cholesterol [HDL-C], and triglycerides [TGs]), leptin levels, and DPP4 activity in obese male Wistar rats.

Methods: A pre- and post-test experimental design was conducted using 40 obese male Wistar rats, divided into five groups: NC (negative control, given 3 mL/day mineral water), positive control (PC, given 3 mL/day plant stanol ester), BPL1 received 3 mL/day BPL 75:25%, BPL2 received 3 mL/day BPL 80:20%, and BPL3 received 3 mL/day BPL 85:15%. All treatments were administered orally via gastric probe for 21 days. Data were analyzed using appropriate statistical tests to assess significant differences.

Results: The BPL3 group showed the greatest reduction in BW and LI. The BPL1 group had the greatest reduction in TG levels, followed by the BPL3 group. The greatest reduction in leptin levels was found in the BPL2 group, followed by the BPL3 group.

Conclusion: Oral administration of BPL herbal beverage with 85:15% formulation reduces BW and LI through the modulation of lipid metabolism and hormonal regulation.