Background: Obesity has become a significant public health issue worldwide, and it is a major risk factor for many noncommunicable diseases. This systematic review aimed to identify the prevalence of obesity and overweight in the Middle East region and different countries in this region.
Materials and methods: PubMed, Google Scholar, and MEDLINE databases were searched from 2000-2020 to identify relevant studies in the Middle East area. The survey was carried out using combinations of Medical Subject Headings (Mesh) keywords like "body mass index", "obesity", "overweight", "prevalence", "Middle-East", and "Countries in the Middle East area". Analysis of the data was done using STATA-14, and a random-effects model was used to estimate the pooled prevalence.
Results: A total of 101 studies with 698905 participants have been identified that met inclusion criteria for this meta-analysis. The pooled estimates of the prevalence of obesity and overweight in the Middle East area were 21.17 (95% CI: 17.05-26.29) and 33.14 (95% CI: 26.87-40.87), respectively. The findings showed that obesity prevalence increased with age so that the highest prevalence of obesity and overweight was observed in people >40 years old. Obesity prevalence in the Middle East area remained steady between 2000-2006 and 2014-2020 (23%). During these time intervals, the prevalence of overweight decreased from 34.83 (95% CI: 32.40-37.45) to 32.85 (95% CI: 31.39-34.38).
Conclusions: Despite the relative stabilization of the overweight and obesity trend in the Middle East, current interventions to combat the overweight epidemic need to be maintained and strengthened because the prevalence of overweight and obesity in this region is still very high. The prevalence of obesity increases with age so that people over 40 have the highest percentage of obesity and overweight. Therefore, implementing intervention programs to prevent and control obesity and overweight in the Middle East is essential.
Introduction: Laparoscopic one anastomosis gastric bypass (LOAGB) is a relatively new procedure for the treatment of morbid obesity and related comorbidities. On average, this procedure results in good postoperative weight loss with a low complication rate. Recent publications suggest that dumping syndrome and weight regain might be reduced by placing a silicone ring over the gastric pouch during the procedure, so called laparoscopic banded one anastomosis gastric bypass (LBOAGB).
Methods: 86 patients undergoing LBOAGB between 2018 and 2020 were enrolled in this retrospective study. Hospital records were used to assess weight loss, comorbidity resolution, and any complications either in the short or medium term.
Results: 54 Female and 32 male patients were included with a mean age of 43 years (25-64), preoperative body mass index of 42 kg/m2 (35-49), and preoperative weight of 114 kg (86-162). Thirty-four patients presented with type 2 diabetes (39.5%), 42 patients (49%) diagnosed with hypertension, 24 presented with OSAS (28%), and 21 (24%) hypercholesterolaemia patients were included. In total, 36 patients were diagnosed with multiple comorbidities. The operative data showed an average operative time of 48 minutes with 3.4% of patients suffering from early (minor) complications and 2.3% with a late (minor) complication. One patient required reoperation due to intra-abdominal bleeding. The median length of hospital stay was 2.5 days. Median follow-up was 18 months (5-36). In that period, no patient required ring removal or conversion to Roux-en-Y gastric bypass surgery. Food intolerance/vomiting was present in 1 patient (1.1%), bile reflux was present in 1 patient (1.1%), and no stomal ulcers were observed. Mean % excess weight loss at 12 and 24 months was 72% and 80%, respectively. Fifty-two out of 86 patients (60%) had a complete resolution of comorbidities. A CONUT score >2 (mild malnutrition) was found in 40% of patients, while a CONUT score 0-1 was found in 60% of patients.
Conclusion: LBOAGB shows promising results in terms of safety and efficacy in the short term. Further prospective studies will be required to evaluate the consistency of the results in the long term.
Background: Over the last few years, the importance of leptin in energy metabolism has been extensively studied in both animal models and in humans. Very few results are available on the association between human leptin gene (LEP) variants and obesity traits in India. We designed this study to analyse the polymorphisms in human leptin gene and the association of sequence variants with obesity among the population in Kerala, South India.
Methods: In this case-control design of 148 study participants, data were collected on socioeconomic aspects and anthropometric measurements. Plasma glucose, insulin, leptin, and lipid profile were measured. Genotyping was done by automated DNA sequencing.
Results: The common Single Nucleotide Polymorphism (SNP) of 5'-UTR of LEP - 2548G/A was found to be present in the study population with "A" variant as dominant allele. A novel synonymous mutation Thr5Thr of exon 2 of LEP was identified in heterozygous form in one subject with morbid obesity with hyperleptinemia. A novel missense mutation Phe17Leu was observed in two subjects with obesity in heterozygous condition. A novel missense mutation Lys36Arg in exon 2 of LEP was observed in one subject with abdominal obesity and decreased serum leptin level.
Conclusion: LEP - 2548G/A at 5'-untranslated region was found to be common with the mutant "A" variant in the study population. SNPs of exons in LEP were found to be rare but associated with morbid obesity and altered levels of serum leptin in the study population in Kerala, India.
[This retracts the article DOI: 10.1155/2021/8837319.].
Uncontrolled prediabetes can develop into Type 2 Diabetes mellitus (T2DM). The incidence of T2DM among adults in Pontianak, Indonesia was reported remarkably high. Therefore, this study aimed to investigate the risk factors for prediabetes in adults living in urban areas of Pontianak, Indonesia. A cross-sectional study was conducted in 5 subdistricts of Pontianak. A total of 506 adults underwent screening to obtain subjects with fasting blood glucose (FBS) of ≤124 mg/dL and aged >30 years. Blood pressure and body mass index (BMI) were measured. Interview using a structured questionnaire were performed to obtain data on predictor variables (age, sex, education, income, health insurance, tobacco use, history of hypertension, gout, high cholesterol level, frequency of exercise per week, and diabetic education). The prevalence of prediabetes among subjects was significantly high (76.4%). Subjects were predominantly above 40 years, female, had low income, low education level, and had health insurance. About a third of the subjects had a history of hypertension, gout, and high cholesterol level, respectively. The exercise frequency was mostly less than 3 times/week, and the BMI was mainly classified as overweight and obese. The result of spearman's rho correlation showed that age (r = 0.146; p=0.022) and BMI (r = 0.130; p=0.041) significantly correlated with prediabetes incidence. Moreover, the chi-square analysis demonstrated that health insurance ownership (OR = 4.473; 95% CI 1.824-10.972; p ≤ 0.001), history of hypertension (OR = 3.096; 95% CI 1.542-6.218; p=0.001), and history of gout (OR = 2.419; 95% CI 1.148-5.099; p=0.018), were associated with prediabetes incidence. For all these significant risk predictors except BMI, the significant associations were found only among female subjects after specific sex analysis. Moreover, multivariate logistic regression showed that health insurance ownerships (OR = 5.956; 95% CI 2.256-15.661; p ≤ 0.001) and history of hypertension (OR = 3.257; 95% CI 1.451-7.311; p=0.004), and systolic blood pressure (OR = 2.141; 95% CI 1.092-4.196; p=0.027) were the risk factors for prediabetes. It is concluded that the prevalence of prediabetes is probably high especially among urban people in Pontianak, Indonesia. Health insurance ownership and hypertension may have an important role in prediabetes management. The risk factors might be different between male and female.
Objective: To examine changes in measures of adiposity and determine the prevalence of excess adiposity in relation to height in school children between 2010 and 2020.
Methods: 5-12-year-old urban school-age children participated in two cross-sectional surveys in 2010 (n = 1274) and 2020 (n = 1550). Standard procedures were used for anthropometric measurements. Changes in BMI, waist circumference (WC), and waist-to-height ratio (WHtR) and the corresponding proportions of children with excess adiposity were analyzed and adjusted for design variables (class and school type) and age. Children were classified according to quartiles of height z-score and prevalence of excess adiposity estimated across each quartile.
Results: There was a 2.4% and 3.3% increase in adjusted mean BMI and WC, respectively, between 2010 and 2020. The prevalence of central overweight/obesity (WC) and WHtR ≥ 0.5 increased by 7.3% (X 2 = 27.151, p < 0.001) and 5.3% (X 2 = 26.117, p < 0.001), respectively, between the two surveys except BMI overweight/obesity. The odds of excess adiposity significantly increased in 2020 for central overweight/obesity (WC) (OR 2.8, 95% CI 2.0-3.6) and WHtR ≥ 0.5 (OR 1.8, 95% CI 1.3-2.4) and not for BMI overweight/obesity (OR 1.3, 95% CI 0.8-1.7). The prevalence of BMI overweight/obesity significantly increased from 33% in 2010 to 51.5% in 2020 in the fourth quartile of height z-score (X 2 = 19.198, p < 0.001). Similarly, the prevalence of central overweight/obesity (WC) significantly increased from 23.5% in 2010 to 42.4% in 2020 in the fourth quartile of height z-score (X 2 = 18.733, p < 0.001).
Conclusion: Central overweight/obesity has increased more than BMI overweight/obesity over the last decade. Children with a higher height-for-age tend to accumulate more adiposity. Objective monitoring of adiposity levels and height of children is needed in future to identify groups for targeted intervention and prevention of chronic diseases.
Background: Similar to the general population, the prevalence of central obesity is increasing among HIV-infected persons. There are little data on the burden of abdominal obesity using the waist-to-hip ratio measurement in HIV-infected patients in resource-limited settings, including Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of central obesity among HIV patients taking ART in an armed force comprehensive and specialized hospital, Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted from March to April 2018. A systematic sampling method was used to select 353 study participants. Pretested World Health Organization stepwise questionnaire, document review, and anthropometric and biochemical measurements were used to collect data on different variables under the study. The collected data were entered into EpiData version 3 and analyzed by SPSS version 21. An adjusted odds ratio with 95% CI was considered to declare a statistically significant association.
Results: The prevalence of central obesity in this study was 71.7% (95% CI: 67%-76.4%). Besides, the odds of central obesity were associated with being female (AOR: 85.6; 95% CI: 20.09, 364.6), among merchants (AOR: 18.8; 95% CI: 1.39, 255.7), CD4 count <200 cells/mm3 (AOR: 0.03; 95% CI: 0.007, 0.160), among respondents taking AZT + 3TC + EFV-based ART regimen (AOR: 8.73; 95% CI: 1.33, 57.17), ABC + 3TC + ATV/r-based regimen (AOR: 0.18; 95% CI: 0.03, 0.94), increased BMI (AOR: 3.50; 95% CI: 1.36, 3.89), and abnormal blood pressure (AOR: 2.53; 95%: 1.13, 5.67).
Conclusion: It is possible to conclude that central obesity is a huge public health problem among the HIV-infected population in the study area. Being female, increased BMI, low CD4 count, AZT + 3TC + EFV, ABC + 3TC + ATV/r-based regimen, and abnormal blood pressure were associated with central obesity. Therefore, adequate attention must be paid to primary and secondary control of these factors to reduce the prevalence of abdominal obesity among HIV-infected patients.
Abdominal obesity is associated with hypertension, increased fasting glucose, HbA1c, and cholesterol. Body mass index (BMI) is frequently used to measure and define obesity and as inclusion criteria for bariatric surgery. Sagittal abdominal diameter (SAD) has been suggested to predict the amount of visceral fat, metabolic traits, and cardiometabolic risk superior to BMI. The aim was to test whether SAD has stronger correlations to glucometabolic traits compared to BMI. One hundred and fifty-five (108 women, 47 men) morbidly obese patients undergoing bariatric surgery were evaluated before (baseline), 6 and 12 months after Roux-en-Y gastric bypass (RYGBP). BMI was reduced from 43.7 kg/m2 (baseline) to 31.3 kg/m2 (12 months) and SAD from 32.6 to 23.2 cm (both p<0.001). SAD correlated with CRP (p=0.04), fasting glucose (p=0.008), HbA1c (p=0.016), triglycerides (p=0.017), systolic blood pressure (p=0.032), and vitamin D (p=0.027). BMI correlated with CRP (p=0.006), triglycerides (p=0.016), vitamin D (p=0.002), and magnesium (p=0.037). Despite RYGBP surgery, vitamin D was significantly increased. Liver enzymes were significantly lowered after RYGBP and the change over time in SAD correlated with gamma-glutamyltransferase. SAD was superior to BMI to predict glucose disturbance and dyslipidemia implying increased use of SAD as it is cost effective and simple to perform in the clinic and could be of value when considering patients for bariatric surgery.