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Developing a Socioculturally Nuanced Systems Model of Childhood Obesity in Manhattan's Chinese American Community via Group Model Building. 基于群体模型构建的曼哈顿美籍华人社区儿童肥胖社会文化差异系统模型
IF 3.3 Q1 Medicine Pub Date : 2020-06-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/4819143
Ewelina Swierad, Terry T-K Huang, Ellis Ballard, Karen Flórez, Sheng Li

The purpose of this study was to develop a qualitative and socioculturally tailored systems model of childhood obesity in the Chinese American community in Manhattan's Chinatown. We utilized group model building (GMB) methodology as a form of participatory systems modeling. The study was conducted in Manhattan's Chinatown community. We recruited 16 Chinese American adults from the community. GMB workshops engendered a causal loop diagram (CLD), the visualization of a complex systems model illustrating the structures, feedbacks, and interdependencies among socioculturally specific pathways underlying childhood obesity, in Manhattan's Chinatown community. The analysis of CLD revealed that participants considered the following factors to influence childhood obesity: (1) traditional social norms affecting body image, how children are raised, parental pressure to study, and trust in health of traditional foods; (2) grandparents' responsibility for children; (3) limited time availability of parents at home; and (4) a significant amount of children's time spent indoors. GMB represents a novel method to understand the complexity of childhood obesity in culturally specific populations and contexts. The study identified sociocultural subsystems that may underlie the development and perpetuation of childhood obesity among Chinese American children. Insights from the study can be useful in the design of future empirical studies and interventions.

本研究的目的是开发一个定性和社会文化量身定制的系统模型在曼哈顿唐人街的华裔美国社区儿童肥胖。我们利用群体模型构建(GMB)方法作为参与式系统建模的一种形式。这项研究是在曼哈顿的唐人街社区进行的。我们从社区中招募了16名美籍华人。GMB研讨会产生了一个因果循环图(CLD),这是一个复杂系统模型的可视化,说明了曼哈顿唐人街社区儿童肥胖的社会文化特定途径之间的结构、反馈和相互依赖性。CLD分析显示,参与者认为影响儿童肥胖的因素有:(1)影响身体形象的传统社会规范、儿童的成长方式、父母的学习压力和对传统食品健康的信任;(二)祖父母对子女的责任;(3)家长在家的时间有限;(4)儿童在室内度过的时间相当长。GMB代表了一种新的方法来理解儿童肥胖在文化特定人群和背景下的复杂性。该研究确定了可能导致华裔美国儿童肥胖发展和持续存在的社会文化子系统。该研究的见解可用于设计未来的实证研究和干预措施。
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引用次数: 12
Explaining the Inverse Association between Altitude and Obesity. 解释海拔高度和肥胖之间的负相关关系。
IF 3.3 Q1 Medicine Pub Date : 2020-05-31 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1946723
Ray M Merrill

Purpose: To better understand the inverse association between altitude and adult obesity.

Methods: An ecological study design was used, involving 3,108 counties in the contiguous United States. Data were from several national sources, and assessment involved various statistical techniques, including multiple regression analysis.

Results: Living in counties at higher altitude is associated with lower adult obesity. Compared with counties <500 meters, the percent of adult obesity decreases by 5.18% at 500-999 meters, 9.69% at 1,000-1,499 meters, 16.77% at 1,500-1,999 meters, 24.14% at 2,000-2,499 meters, and 35.28% at ≥2,500 meters. After adjusting for physical inactivity, smoking, and other variables, corresponding decreases in adult obesity with higher altitude groupings are 3.87%, 5.64%, 8.03%, 11.41%, and 17.54%, respectively. Various mechanisms are presented as possible explanations for the association between higher altitude and lower obesity. In addition, altitude may indirectly influence adult obesity, primarily through its relationship with physical inactivity and smoking. In an adjusted regression model, adult obesity was most strongly associated with physical inactivity followed by adult smoking and then altitude. Together they explain 39.04% of the variation in adult obesity. After accounting for these variables, sunlight, precipitation, ambient air temperature, education, income, food insecurity, limited access to healthy foods, race, sex, and rural living explain an additional 4.68% of the variation in adult obesity.

Conclusions: The inverse association between altitude and adult obesity remains significant after adjustment for several variables.

目的:更好地了解海拔与成人肥胖的负相关关系。方法:采用生态学研究设计,涉及美国连片的3108个县。数据来自几个国家来源,评估涉及各种统计技术,包括多元回归分析。结果:居住在高海拔地区的成人肥胖率较低。结论:经若干变量调整后,海拔高度与成人肥胖呈显著负相关。
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引用次数: 13
Epidemiology, Predisposing Factors, Biomarkers, and Prevention Mechanism of Obesity: A Systematic Review. 肥胖症的流行病学、诱发因素、生物标志物和预防机制:系统回顾。
IF 3.3 Q1 Medicine Pub Date : 2020-05-31 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6134362
Melese Linger Endalifer, Gedefaw Diress

Background. Globally, obesity is becoming a public health problem in the general population. Various determinants were reported by different scholars even though there are inconsistencies. Different biomarkers of obesity were identified for the prediction of obesity. Even though researchers speculate the factors, biomarkers, consequences, and prevention mechanisms, there is a lack of aggregate and purified data in the area of obesity. Summary. In this review, the epidemiology, predisposing factors, biomarkers, consequences, and prevention approaches of obesity were reviewed. Key Messages. The epidemiology of obesity increased in low-, middle-, and high-income countries. Even if the factors vary across regions and socioeconomic levels, sociodemographic, behavioral, and genetic factors were prominent for the development of obesity. There are a lot of biomarkers for obesity, of which microRNA, adipocytes, oxidative stress, blood cell profile, nutrients, and microbiota were promising biomarkers for determination of occurrence of obesity. Since the consequences of obesity are vast and interrelated, multidimensional prevention strategy is mandatory in all nations.

背景。在全球范围内,肥胖正成为普通人群的一个公共健康问题。不同学者对肥胖的各种决定因素进行了研究,但研究结果并不一致。不同的肥胖生物标志物被确定用于预测肥胖。尽管研究人员对肥胖的因素、生物标志物、后果和预防机制进行了推测,但在肥胖领域仍缺乏综合和纯化的数据。总结。本综述对肥胖症的流行病学、诱发因素、生物标志物、后果和预防方法进行了综述。关键信息。肥胖症的流行病学在低收入、中等收入和高收入国家都有所增加。即使不同地区和社会经济水平的因素各不相同,但社会人口、行为和遗传因素在肥胖症的发生中占突出地位。肥胖症的生物标志物很多,其中微小核糖核酸、脂肪细胞、氧化应激、血细胞谱、营养素和微生物群是确定肥胖症发生的有希望的生物标志物。由于肥胖症的影响范围广泛且相互关联,因此各国都必须采取多维度的预防策略。
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引用次数: 0
Banded Sleeve Gastrectomy Improves Weight Loss Compared to Nonbanded Sleeve: Midterm Results from a Prospective Randomized Study. 与非袖带胃切除术相比,袖带胃切除术可改善体重减轻:一项前瞻性随机研究的中期结果。
IF 3.3 Q1 Medicine Pub Date : 2020-05-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9792518
Paolo Gentileschi, Emanuela Bianciardi, Leandro Siragusa, Valeria Tognoni, Domenico Benavoli, Stefano D'Ugo

Background: Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give benefits in the short term. We report the results of a randomized study comparing LSG and laparoscopic banded sleeve gastrectomy (LBSG) over a 4-year follow-up.

Objectives: To evaluate the efficacy of banded sleeve gastrectomy compared to standard sleeve in the midterm.

Methods: Between 01/2014 and 01/2015, we randomly assigned 50 patients to receive one of the two procedures. Patients' management was exactly the same, apart from the band placement. We analyzed differences in weight loss, operative time, complication rate, and mortality, with a median follow-up of 4 years.

Results: Twenty five patients were assigned to receive LSG (Group A) and 25 LBSG (Group B). The mean preoperative BMI (body mass index) was 47.3 ± 6.58 kg/m2 and 45.95 ± 5.85 kg/m2, respectively. There was no significant difference in the operative time. No intraoperative or postoperative complications occurred. At 12-month follow-up, the mean BMI was 29.72 ± 4.40 kg/m2 in Group A and 27.42 ± 4.47 kg/m2 in Group B (p=0.186). After a median follow-up of 4 years, the mean BMI in Group B was significantly lower than Group A (24.10 ± 4.52 kg/m2 vs 28.80 ± 4.62 kg/m2; p=0.00199).

Conclusions: LBSG is a safe procedure, with no impact on postoperative complications. The banded sleeve showed a significant greater weight loss in the midterm follow-up. Considering the issue of weight regain observed after LSG, the placement of a perigastric ring during the first procedure may be a strategy to improve the results. This trial is registered with NCT04228185.

背景:腹腔镜袖胃切除术(LSG)后体重恢复是目前越来越关注的问题。套筒膨胀和失去食物限制被认为是主要机制。在胃管周围放置一个硅环似乎在短期内有好处。我们报告了一项随机研究的结果,比较了LSG和腹腔镜带状袖胃切除术(LBSG)超过4年的随访。目的:评价带状袖套胃切除术与标准袖套胃切除术的中期疗效。方法:在2014年1月至2015年1月期间,我们随机选择50例患者接受两种方法中的一种。患者的处理是完全相同的,除了带放置。我们分析了体重减轻、手术时间、并发症发生率和死亡率的差异,中位随访时间为4年。结果:25例患者接受LBSG治疗(A组),25例患者接受LBSG治疗(B组),术前平均BMI(体质量指数)分别为47.3±6.58 kg/m2和45.95±5.85 kg/m2。两组手术时间差异无统计学意义。无术中、术后并发症发生。随访12个月时,A组平均BMI为29.72±4.40 kg/m2, B组平均BMI为27.42±4.47 kg/m2 (p=0.186)。中位随访4年后,B组平均BMI显著低于a组(24.10±4.52 kg/m2 vs 28.80±4.62 kg/m2;p = 0.00199)。结论:LBSG是一种安全的手术,对术后并发症无影响。在中期随访中,带状套筒组显示出更显著的体重减轻。考虑到LSG术后体重反弹的问题,在第一次手术中放置腹周环可能是改善结果的一种策略。该试验注册号为NCT04228185。
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引用次数: 18
Predictors of One-Year Change in How Youth Perceive Their Weight. 年轻人如何看待自己的体重一年变化的预测因素。
IF 3.3 Q1 Medicine Pub Date : 2020-05-15 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7396948
Karen A Patte, Wei Qian, Scott T Leatherdale

Overall, perceptions of being at "about the right weight" appear advantageous for youth physical and mental health, regardless of BMI classification, whereas perceptions at either extreme (overweight or underweight) may negatively impact health behaviours and mental health. Instead of considering weight misperceptions as problematic, some researchers have proposed that underestimations of weight status may offer resiliency among individuals with overweight or obesity. Promoting "about right" WPs and preventing change to overweight or underweight perceptions may offer an effective public health strategy for supporting youth health over time. However, limited prospective evidence exists on factors that shape perceptions of weight status over time. The current study examined modifiable predictors of one-year change in weight perception among youths. We used 2-year linked data of 18,112 grade 9-12 students from Year 3 (Y3:2014-2015) and Year 4 (Y4:2015-2016) of the COMPASS study. Generalized Estimating Equation models tested screen use, physical activity, and bullying victimization as predictors of change from perceptions of "about the right weight" to "overweight" or "underweight" perceptions, adjusting for Y3 covariates (body mass index, ethnicity, and grade) and school cluster. Results support the value of team sports among females and resistance exercise among males as protective against changes to overweight or underweight perceptions over one year. Also, various forms of bullying victimization predicted overweight perceptions in males and females. Watching TV/movies or messaging/texting for over 2 hours/day was associated with overweight and underweight perceptions, respectively, in females only. Playing video/computer games for over 2 hours/day was associated with overweight perceptions in males and underweight perceptions in females. Findings support the potential of bullying prevention, limiting certain screen use, and supporting engagement in team sports for females and resistance exercise for males as strategies to maintain perceptions of being at "about the right weight."

总体而言,无论BMI分类如何,“体重适中”的观念似乎有利于青少年的身心健康,而极端的观念(超重或体重不足)可能对健康行为和心理健康产生负面影响。一些研究人员提出,低估体重状况可能会给超重或肥胖的人带来弹性,而不是将体重误解视为问题。促进“大致正确”的饮食习惯和防止改变对超重或体重不足的看法,可能是一项有效的公共卫生战略,可长期支持青年健康。然而,随着时间的推移,影响人们对体重状况看法的因素的前瞻性证据有限。目前的研究调查了一年内青少年体重认知变化的可变预测因素。我们使用了COMPASS研究的3年级(3年级:2014-2015)和4年级(4年级:2015-2016)的18112名9-12年级学生的2年关联数据。广义估计方程模型测试了屏幕使用、身体活动和欺凌受害作为从“大约正确体重”感知到“超重”或“体重不足”感知变化的预测因子,调整了三年级协变量(体重指数、种族和年级)和学校群。研究结果支持了团队运动在女性中的价值,以及抵抗运动在男性中对一年内超重或体重过轻观念的改变的保护作用。此外,各种形式的欺凌受害者预示着男性和女性的超重认知。每天看电视/电影或发短信/短信超过2小时分别与超重和体重不足的感觉有关,这仅在女性中存在。每天玩2小时以上的视频/电脑游戏与男性超重和女性体重不足的感觉有关。研究结果支持预防欺凌的潜力,限制某些屏幕使用,支持女性参与团队运动和男性抵抗运动,作为保持“适当体重”的策略。
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引用次数: 8
Weight Change and Its Association with Cardiometabolic Risk Markers in Overweight and Obese Women. 超重和肥胖妇女体重变化及其与心脏代谢危险标志物的关系
IF 3.3 Q1 Medicine Pub Date : 2020-04-13 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3198326
Liyana Ahmad Zamri, Geeta Appannah, Siti Yazmin Zahari Sham, Fazliana Mansor, Rashidah Ambak, Noor Safiza Mohd Nor, Tahir Aris

Objectives: To examine the association of weight loss magnitude with changes in cardiometabolic risk markers in overweight and obese women from low socioeconomic areas engaged in a lifestyle intervention.

Methods: Analyses were performed on 243 women (mean body mass index 31.27 ± 4.14 kg/m2) who completed a 12-month lifestyle intervention in low socioeconomic communities in Klang Valley, Malaysia. Analysis of covariance (ANCOVA) was used to compare changes of cardiometabolic risk factors across weight change categories (2% gain, ±2% maintain, >2 to <5% loss, and 5 to 20% loss) within intervention and control group.

Results: A graded association for changes in waist circumference, fasting insulin, and total cholesterol (p=0.002, for all variables) across the weight change categories were observed within the intervention group at six months postintervention. Participants who lost 5 to 20% of weight had the greatest improvements in those risk markers (-5.67 cm CI: -7.98 to -3.36, -4.27 μU/mL CI: -7.35, -1.19, and -0.59 mmol/L CI: -.99, -0.19, respectively) compared to those who did not. Those who lost >2% to <5% weight reduced more waist circumference (-4.24 cm CI: -5.44 to -3.04) and fasting insulin (-0.36 μU/mL CI: -1.95 to 1.24) than those who maintained or gained weight. No significant association was detected in changes of risk markers across the weight change categories within the control group except for waist circumference and adiponectin.

Conclusion: Weight loss of >2 to <5% obtained through lifestyle intervention may represent a reasonable initial weight loss target for women in the low socioeconomic community as it led to improvements in selected risk markers, particularly of diabetes risk.

目的:研究来自低社会经济地区的超重和肥胖妇女进行生活方式干预时,体重减轻程度与心脏代谢危险标志物变化的关系。方法:对马来西亚巴生谷低社会经济社区完成12个月生活方式干预的243名妇女(平均体重指数31.27±4.14 kg/m2)进行分析。采用协方差分析(ANCOVA)比较不同体重变化类别(增加2%,维持±2%,>2)中心脏代谢危险因素的变化。结果:干预组在干预后6个月观察到不同体重变化类别中腰围、空腹胰岛素和总胆固醇的变化呈分级关联(所有变量p=0.002)。体重减轻5%至20%的参与者在这些风险指标上有最大的改善(-5.67 cm CI: -7.98至-3.36,-4.27 μU/mL CI: -7.35, -1.19和-0.59 mmol/L CI: -)。99,分别为-0.19)。体重减轻>2% (μU/mL CI: -1.95 ~ 1.24)者比体重维持或增加者多。在对照组中,除了腰围和脂联素外,在体重变化类别的风险指标变化中没有发现显著的关联。结论:体重减轻>2 ~ 2
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引用次数: 4
Metabolomic Links between Sugar-Sweetened Beverage Intake and Obesity. 含糖饮料摄入与肥胖之间的代谢组学联系。
IF 3.3 Q1 Medicine Pub Date : 2020-04-13 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7154738
Bingjie Zhou, Reiko Ichikawa, Laurence D Parnell, Sabrina E Noel, Xiyuan Zhang, Shilpa N Bhupathiraju, Caren E Smith, Katherine L Tucker, Jose M Ordovas, Chao-Qiang Lai

Background: Sugar-sweetened beverage (SSB) consumption is highly associated with obesity, but the metabolic mechanism underlying this correlation is not understood.

Objective: Our objective was to examine metabolomic links between SSB intake and obesity to understand metabolic mechanisms.

Design: We examined the association of plasma metabolomic profiles with SSB intake and obesity risk in 781 participants, aged 45-75 y, in the Boston Puerto Rican Health Study (BPRHS) using generalized linear models, controlling for potential confounding factors. Based on identified metabolites, we conducted pathway enrichment analysis to identify potential metabolic pathways that link SSB intake and obesity risk. Variants in genes encoding enzymes known to function in identified metabolic pathways were examined for their interactions with SSB intake on obesity.

Results: SSB intake was correlated with BMI (β = 0.607, P=0.045). Among 526 measured metabolites, 86 showed a significant correlation with SSB intake and 148 with BMI (P ≤ 0.05); 28 were correlated with both SSB intake and BMI (P ≤ 0.05). Pathway enrichment analysis identified the phosphatidylcholine and lysophospholipid pathways as linking SSB intake to obesity, after correction for multiple testing. Furthermore, 8 of 10 genes functioning in these two pathways showed strong interaction with SSB intake on BMI. Our results further identified participants who may exhibit an increased risk of obesity when consuming SSB.

Conclusions: We identified two key metabolic pathways that link SSB intake to obesity, revealing the potential of phosphatidylcholine and lysophospholipid to modulate how SSB intake can increase obesity risk. The interaction between genetic variants related to these pathways and SSB intake on obesity further supports the mechanism.

背景:含糖饮料(SSB)的摄入与肥胖高度相关,但这种相关性背后的代谢机制尚不清楚。目的:我们的目的是研究SSB摄入和肥胖之间的代谢组学联系,以了解代谢机制。设计:在波士顿波多黎各健康研究(BPRHS)中,我们使用广义线性模型检查了781名年龄在45-75岁的参与者的血浆代谢组学特征与SSB摄入量和肥胖风险的关系,控制了潜在的混杂因素。基于已确定的代谢物,我们进行了途径富集分析,以确定将SSB摄入与肥胖风险联系起来的潜在代谢途径。研究人员检查了已知在已确定的代谢途径中起作用的编码酶基因的变异与SSB摄入量对肥胖的相互作用。结果:SSB摄入量与BMI呈正相关(β = 0.607, P=0.045)。526种代谢物中,86种与SSB摄入量显著相关,148种与BMI显著相关(P≤0.05);28例与SSB摄入量和BMI均相关(P≤0.05)。途径富集分析确定了磷脂酰胆碱和溶血磷脂途径与SSB摄入与肥胖之间的联系,经过多次测试校正。此外,在这两种途径中起作用的10个基因中,有8个与SSB摄入量对BMI的影响有很强的相互作用。我们的研究结果进一步确定了食用SSB可能会增加肥胖风险的参与者。结论:我们确定了将SSB摄入与肥胖联系起来的两个关键代谢途径,揭示了磷脂酰胆碱和溶血磷脂调节SSB摄入如何增加肥胖风险的潜力。与这些途径相关的遗传变异与SSB摄入对肥胖的影响之间的相互作用进一步支持了这一机制。
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引用次数: 10
Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals. 肥胖个体心脏自主调节相关的危险因素。
IF 3.3 Q1 Medicine Pub Date : 2020-03-26 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7185249
Camila Oliveira, Erika Aparecida Silveira, Lorena Rosa, Annelisa Santos, Ana Paula Rodrigues, Carolina Mendonça, Lucas Silva, Paulo Gentil, Ana Cristina Rebelo

Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m2) were collected. Results. 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.

肥胖导致自主神经系统失衡,特别是交感神经调节增加和迷走神经张力降低,一些人体测量学、代谢和生活方式变量可能增加患心血管疾病的风险。目标。分析严重肥胖者心血管自主调节与生化和人体测量指标、食物摄入和身体活动水平之间的关系。方法。本研究是一项随机临床试验“营养干预和橄榄油对严重肥胖的影响”(DieTBra试验)的摘录,该试验分析了基线数据。收集肥胖患者(体重指数BMI≥35 kg/m2)的人体测量数据、生化检查、心率变异性(HRV)、加速度测量和24小时召回率(R24H)。结果:本组肥胖患者64例,平均年龄(27 ~ 58岁)39.10±7.74岁。通过HRV分析,在频域上,肥胖者交感自主神经调节(低频(LF) 56.44±20.31 nu)和副交感神经调节(高频(HF) 42.52±19.18 nu)的优势较高。动态平衡评价模型(HOMA-IR)与HF呈负相关(p = 0.049)。在体力活动分析中,中高强度体力活动与交感神经成分呈负相关(p = 0.043),久坐时间(ST)与HF呈负相关(p = 0.049),与LF/HF呈负相关(p = 0.036),与LF呈正相关(p = 0.014)。经多元线性回归分析,腰围(WC)和HOMA-IR值与HF呈负相关(β = -0.685, p = 0.010;β = -14.989, p = 0.010;分别)。HOMA-IR (β = 0.141, p = 0.003)和脂质摄取百分比(β = -0.030, p = 0.043)与LF/HF呈负相关。结论。在研究的心血管危险变量中,胰岛素抵抗和中心性肥胖对心脏自主调节肥胖的影响最大,增加了心血管疾病的风险。
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引用次数: 25
Physical Activity and Insulin Resistance in 6,500 NHANES Adults: The Role of Abdominal Obesity. 6500名NHANES成年人的体力活动和胰岛素抵抗:腹部肥胖的作用。
IF 3.3 Q1 Medicine Pub Date : 2020-03-26 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3848256
James R Fowler, Larry A Tucker, Bruce W Bailey, James D LeCheminant

This cross-sectional investigation studied differences in insulin resistance across levels of physical activity in 6,500 US adults who were randomly selected as part of the National Health and Nutrition Examination Survey (NHANES). Another important objective was to determine the influence of abdominal obesity on the physical activity and insulin resistance relationship. MET-minutes were utilized to quantify total activity based on participation in 48 different physical activities. Two strategies were employed to categorize levels of physical activity: one was based on relative MET-minutes (quartiles), and the other approach was based on the US physical activity guidelines. Insulin resistance was indexed using the homeostatic model assessment (HOMA). Abdominal obesity was indexed using waist circumference. Effect modification was tested by dividing waist circumferences into sex-specific quartiles and then evaluating the relationship between physical activity and HOMA-IR within each quartile separately. Results showed that relative physical activity level was associated with HOMA-IR after controlling for demographic and demographic and lifestyle covariates (F = 11.5, P < 0.0001 and F = 6.0, P=0.0012, respectively). Adjusting for demographic and demographic and lifestyle covariates also resulted in significant relationships between guideline-based activity and HOMA-IR (F = 8.0, P < 0.0001 and F = 4.9, P=0.0017, respectively). However, statistically controlling for differences in waist circumference with the other covariates nullified the relationship between total physical activity and HOMA-IR. Effect modification testing showed that when the sample was delimited to adults with abdominal obesity (Quartile 4), relative (F = 5.6, P=0.0019) and guideline-based physical activity (F = 3.7, P=0.0098) and HOMA-IR were significantly associated. Physical activity and HOMA-IR were not related within the other three quartiles. In conclusion, it appears that differences in physical activity may play a meaningful role in insulin resistance in those with abdominal obesity, but total activity does not seem to account for differences in insulin resistance among US adults with smaller waists.

这项横断面调查研究了6500名美国成年人在不同体力活动水平下胰岛素抵抗的差异,这些成年人是随机选择的,作为国家健康与营养检查调查(NHANES)的一部分。另一个重要目的是确定腹部肥胖对身体活动和胰岛素抵抗的影响。met分钟被用来量化基于48种不同体育活动的总活动量。采用了两种策略来对身体活动水平进行分类:一种是基于相对met分钟(四分位数),另一种是基于美国身体活动指南。使用稳态模型评估(HOMA)对胰岛素抵抗进行索引。腹部肥胖以腰围为指标。通过将腰围分为性别特异性四分位数,然后在每个四分位数内分别评估体力活动与HOMA-IR之间的关系,来检验效果的改变。结果显示,在控制人口统计学、人口统计学和生活方式协变量后,相对体力活动水平与HOMA-IR相关(F = 11.5, P < 0.0001和F = 6.0, P=0.0012)。调整人口统计学、人口统计学和生活方式协变量也导致基于指南的活动与HOMA-IR之间存在显著关系(分别为F = 8.0, P < 0.0001和F = 4.9, P=0.0017)。然而,在统计上控制腰围与其他协变量的差异,使总体力活动与HOMA-IR之间的关系无效。效应修正检验显示,当样本被划分为腹部肥胖的成年人(四分位数4)时,相对(F = 5.6, P=0.0019)和基于指南的体力活动(F = 3.7, P=0.0098)与HOMA-IR显著相关。体力活动和HOMA-IR在其他三个四分位数内没有相关性。总之,体力活动的差异可能在腹部肥胖患者的胰岛素抵抗中发挥重要作用,但总运动量似乎并不能解释美国腰围较小的成年人胰岛素抵抗的差异。
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引用次数: 16
A Digital Health Weight Loss Program in 250,000 Individuals. 25万人的数字健康减肥计划。
IF 3.3 Q1 Medicine Pub Date : 2020-03-26 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9497164
Conor Senecal, Robert Jay Widmer, Beth R Larrabee, Mariza de Andrade, Lilach O Lerman, Amir Lerman, Francisco Lopez-Jimenez

Importance: Obesity is a worsening epidemic worldwide. Effective and accessible weight loss programs to combat obesity on a large scale are warranted, but a need for frequent face-to-face care might impose a limitation.

Objective: To evaluate whether individuals following a weight loss program based on a mobile application, wireless scale, and nutritional program but no face-to-face care can achieve clinically significant weight loss in a large cohort.

Design: Retrospective observational analysis. Setting. China from October 2016 to December 2017. Participants. Mobile application users with a minimum of 2 weights (baseline and ≥35 days). Intervention. A commercial (Weijian Technologies) weight loss program consisting of a dietary replacement, self-monitoring using a wireless home scale, and frequent guidance via mobile application. Main Outcome. Mean weight change around 42, 60, 90, and 120 days after program initiation with subgroup analysis by gender, age, and frequency of use.

Results: 251,718 individuals, with a mean age of 37.3 years (SD: 9.86) (79% female), were included with a mean weight loss of 4.3 kg (CI: ±0.02) and a mean follow-up of 120 days (SD: 76.8 days). Mean weight loss at 42, 60, 90, and 120 d was 4.1 kg (CI: ±0.02), 4.9 kg (CI: ±0.02), 5.6 kg (CI: ±0.03), and 5.4 kg (CI: ±0.04), respectively. At 120 d, 62.7% of participants had lost at least 5% of their initial weight. Both genders and all usage frequency tertiles showed statistically significant weight loss from baseline at each interval (P < 0.001), and this loss was greater in men than in women (120 d: 6.5 vs. 5.2 kg; P < 0.001). The frequency of recording (categorized as high-, medium-, or low-frequency users) was associated with greater weight loss when comparing high, medium, and low tertile use groups at all time intervals investigated (e.g., 120 d: -8.6, -5.6, and -2.2 kg, respectively; P < 0.001).

Conclusions: People following a commercially available hybrid weight loss program using a mobile application, wireless scale, and nutritional program without face-to-face interaction on average achieved clinically significant short- and midterm weight loss. These results support the implementation of comparable technologies for weight control in a large population.

重要性:肥胖在世界范围内是一种日益恶化的流行病。有效和容易获得的减肥计划可以大规模地对抗肥胖,但需要频繁的面对面护理可能会造成限制。目的:在一个大的队列研究中,评估个体是否遵循基于移动应用程序、无线秤和营养计划的减肥计划,但没有面对面的护理,可以实现临床显著的体重减轻。设计:回顾性观察分析。设置。2016年10月至2017年12月在中国。参与者。至少有2个体重的移动应用程序用户(基线≥35天)。干预。一个商业减肥计划(维健科技),包括饮食替代,使用无线家用秤进行自我监测,以及通过移动应用程序进行频繁指导。主要的结果。根据性别、年龄和使用频率进行亚组分析,在项目开始后42、60、90和120天的平均体重变化。结果:纳入251,718例患者,平均年龄37.3岁(SD: 9.86),其中79%为女性,平均体重减轻4.3 kg (CI:±0.02),平均随访120天(SD: 76.8天)。42、60、90和120 d的平均体重减轻分别为4.1 kg (CI:±0.02)、4.9 kg (CI:±0.02)、5.6 kg (CI:±0.03)和5.4 kg (CI:±0.04)。在第120天,62.7%的参与者至少减掉了最初体重的5%。在每个时间间隔内,男女和所有的使用频率都显示出与基线相比有统计学意义的体重减轻(P < 0.001),并且男性的体重减轻大于女性(120 d: 6.5 vs 5.2 kg;P < 0.001)。在调查的所有时间间隔(例如,120天:分别为-8.6、-5.6和-2.2 kg)比较高、中、低频率使用组时,记录频率(分为高、中、低频用户)与更大的体重减轻有关;P < 0.001)。结论:使用移动应用程序、无线秤和营养计划进行市售混合减肥计划的人,在没有面对面互动的情况下,平均实现了临床显着的短期和中期体重减轻。这些结果支持在大量人群中实施可比较的体重控制技术。
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引用次数: 11
期刊
Journal of Obesity
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