Journal of Obesity最新文献

[This retracts the article DOI: 10.1155/2021/8837319.].

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.

The determinants of body composition are likely to vary geographically due to the diversity of genetic and environmental factors between populations. Age-related trends in body composition in a population help understanding the health issues that are linked with different body compartments. In general, such studies are scarce in the South Asian region and this cross-sectional study examined the age-related trends in body composition in a selected group of healthy women aged 20-80 years in Sri Lanka. The study included randomly selected 784 healthy women aged 20-80 years from the Southern province, Sri Lanka. Women were divided into five age groups: 20-29 years (n = 79), 30-39 years (n = 144), 40-49 years (n = 185), 50-59 years (n = 281), and ≥60 years (n = 85). Total body bone mineral density (TBBMD, g/cm²), total body bone mineral content (TBBMC, g), total body fat mass (TBFM, kg), and total body lean mass (TBLM, kg) were measured with central-type dual-energy X-ray absorptiometry (DXA). Multivariate analysis of variance with Bonferroni post hoc test was performed. The age-related trends of TBBMD and TBBMC were similar with a peak in 40-49-year age group. Between 50 and 59 and ≥60 age categories, TBBMD and TBBMC showed a rapid decline: 16% and 23%, respectively. The rate of TBBMD decline was 0.008 g/cm² per year after 50 years. TBFM increased by 14% between age categories 20-29 and 40-49 years and remained unchanged after 49 years. TBLM increased by 15% between age groups 20-29 and 40-49 years and then decreased by 13% between age categories 50-59 and ≥60 years. Of the 13% decrease in TBLM after 50 years, 9% loss occurred after 59 years. The trends observed help to understand the occurrence of diseases linked with body composition.

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.

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 the associations between patient struggles, health, and weight management changes during the COVID-19 pandemic.

Methods: 585 patients attending a publicly funded clinical weight management program responded to an electronic survey.

Results: Over half of the patients reported worsened overall health, mental health, physical activity, or diet during the pandemic. Approximately 30% of patients lost ≥3% of their body weight and 21% gained ≥3% of their body weight between March and July of the pandemic. Reports of social isolation was associated with increased odds for weight loss in women (OR = 2.0, 1.2-3.3), while low motivation (OR = 1.9, 1.0-3.7), depression (OR = 2.5, 1.0-6.3), and struggles with carbohydrate intake (OR = 2.1, 1.0-4.3) were associated with weight gain. Cooking more at home/eating less take out was associated with increased likelihood of weight loss (OR = 2.1, 1.1-3.9) and lower odds for weight gain (OR = 0.2, 0.1 to 0.97). Working from home was not associated with weight loss or weight gain (P > 0.6).

Conclusion: The COVID-19 pandemic is associated with certain factors that may facilitate weight loss and other factors that promote weight gain. Thus, depending on the patient experience during the pandemic, prevention of weight gain may be more appropriate than weight loss.

Osteoporosis (OP) has been observed to have a deleterious effect on postmenopausal women's life quality by increasing the risk of fragility fractures. The current research was adopted to verify the role of serum adiponectin, a cytokine released by adipose tissue, as a marker for OP across different body mass index groups, for a better understanding of fatty tissue role in OP. A case-control study recruited 210 eligible postmenopausal women and subgrouped into three groups based on their DEXA scan results: osteoporotic group, osteopenia group, and healthy controls; each includes 70 patients. Three datasets were collected: anthropometric, age, menopause duration, weight, height, body mass index (BMI), waist circumference, and fat percentage. Radiological examination estimated the bone mineral density (BMD) for the femoral neck and lumbar spines with their respective T-score. From blood, we measured alkaline phosphatase and calcium by a spectrophotometer and serum adiponectin, phosphate, CTX, and PICP by ELIZA. Total BMD, T-score, serum phosphate, and PICP were significantly higher among healthy controls. Serum adiponectin, CTX, and ALP scored higher levels among OP cases. A strong inverse relationship was proved between serum adiponectin and T-score in osteoporotic and osteopenia groups (-0.427, -0.301). A strong negative relationship was found between serum adiponectin and total BMD in healthy controls (-0.204). All correlations were statistically significant, P value <0.001. Serum adiponectin can be a valuable marker for reduced bone mineral density among the general populace, irrespective of the body mass index. Further research is warranted to explore therapeutic and preventive applications for this adipocytokine.

Introduction: Bariatric surgery performed at high volume centers decreases length of stay, cost, and morbidity and mortality. The effect of a high volume of bariatric surgery procedures on outcomes may extend not just to bariatric surgery but to any general surgical procedure in morbidly obese patients. We hypothesized that patients with morbid obesity (body mass index >40 kg/m²) undergoing common, nonbariatric general surgery would have decreased morbidity and mortality at centers performing high volumes of bariatric surgery.

Methods: The 2016 National Inpatient Sample (NIS) was used to identify the number of laparoscopic gastric bypass and sleeve gastrectomy performed at each hospital. Hospitals were classified as high volume bariatric hospitals (HVBH) ≥10 reported cases (50 actual)/year or low volume bariatric hospitals (LVBH) <10 reported cases (50 actual)/year, as NIS reports a 20% sample of actual cases. Patients with morbid obesity undergoing laparoscopic or open appendectomy, cholecystectomy, or ventral hernia repair were included for analysis. Propensity scores were developed based on available demographics, comorbidities, and hospital procedure volume. Postoperative complications during the index hospital admission, determined by ICD-10 code, were compared using inverse propensity weights. Differences were considered significant with a p value of <0.05.

Results: The total number of general surgery patient cases analyzed was 14,028 from 2,482 hospitals, representing 70,140 admissions. The cohort of patients undergoing operations treated at HVBH were younger (p=0.03) with higher rates of COPD (p=0.04). Patients at LVBH had higher rates of nicotine dependence (p=0.0001) and obstructive sleep apnea (p < 0.001). On propensity-weighted analysis adjusting for preoperative comorbidities and hospital procedure volume, there were significantly higher rates of multiple postprocedure complications at LVBH, specifically, postprocedure respiratory failure for patients undergoing elective laparoscopic cholecystectomy, elective ventral hernia repair with mesh and appendectomy.

Conclusion: Patients with morbid obesity may have an advantage in having general surgery procedures at HVBH. HVBH may have a volume-outcomes relationship where the hospital and staff familiarity with the management principles required to minimize the postoperative risk associated with morbid obesity and improve patient outcomes.

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.