Obesity Facts最新文献

Objective: To describe a biopsy procedure to obtain subcutaneous adipose tissue (SAT) samples for fibrosis assessment in patients with adipose-based chronic disease (ABCD) and to explore potential associations between SAT fibrosis and comorbidities.

Methods: Single-center, cross-sectional study conducted at the Arnau de Vilanova University Hospital (Lleida, Spain) between January and December 2024. We included patients aged 18-65 years attending their first appointment in the Obesity Unit. Between-group comparisons were performed using Student's t-test for continuous variables and chi-square tests for categorical variables, and correlations were assessed using Spearman's rank correlation coefficient.

Results: 58 patients were recruited and 50 were included in the final analysis. Most were female (76.0%), with a mean age of 47.1 years (SD: 10.8), and a mean BMI of 46.3 kg/m2 (SD: 5.0). The biopsy technique evolved over time, reducing the procedure duration from 55 minutes to under 10 minutes without any adverse events. SAT fibrosis was observed in 10 patients (20.0%), who showed a higher prevalence of type 2 diabetes (50.0% vs. 15.0%, P=0.017), significantly higher aspartate transaminase and gamma-glutamyl transferase, and elevated signs of liver fibrosis.

Conclusions: SAT fibrosis was associated with ABCD comorbidities and could serve as a tool for risk stratification beyond traditional indicators.

Objective: Within the kidney transplant community, there is growing recognition of the importance of treating obesity to improve access to and outcomes of kidney transplant. We sought to assess kidney transplant professionals' attitudes and practices regarding obesity management.

Methods: The American Society of Transplantation Kidney Pancreas Community of Practice Obesity Workgroup developed and administered a web-based survey to a broad audience of healthcare professionals working with potential kidney transplant candidates and recipients.

Results: With 275 respondents from 113 kidney transplant programs representing >70% of US kidney transplant volume, we found that only 68% of kidney transplant programs with a weight management program reported access to an obesity medicine specialist. Among programs that prescribe anti-obesity medications, the majority prescribe nutrient-stimulated hormones, while few utilize other agents. Most kidney transplant professionals prefer obesity medicine physicians lead obesity management in their patients; however, 74% reported that access to weight management programs was extremely or somewhat difficult, with 64% citing long wait times for an appointment as the main barrier to care.

Conclusions: Kidney transplant professionals believe that obesity medicine physicians are best suited to lead obesity treatment for their patients, though access to this care appears to be a major barrier.

Introduction: This study aimed to describe the demographic and clinical characteristics of individuals with obesity (IWO) in Germany and to explore weight loss methods and their effectiveness.

Methods: Data were drawn from a cross-sectional survey of adults with obesity (≥18 years of age) conducted in Germany between November and December 2022 through an online consumer panel. Data were captured using a self-administered questionnaire and included demographic and clinical characteristics, weight loss methods attempted in the last 12 months, and how successful these attempts were. Logistic regression analysis assessed the effect of variables including age, sex, and weight loss method on the odds of weight reduction. Data were presented as odds ratios, p values and confidence intervals. For descriptive statistics, continuous variables were presented as means and standard deviations (SDs). Categorical variables were presented as frequency counts and percentages.

Results: Overall, the 1,000 IWO in this study had a mean age (SD) of 42.8 (10.7) years, 94% were White, 45% were female, and mean (SD) body mass index was 37.6 (8.3) kg/m2. In total, 73% had ≥1 comorbid conditions, the most common being musculoskeletal pain (19%). Just 43% were being managed for a weight condition; however, 95% had attempted to lose weight over the previous 12 months, with 33% utilizing an anti-obesity medication and 26% utilizing a calorie-controlled diet. IWO on a calorie-controlled diet or a digital health application was more likely to lose weight than people using other methods (p < 0.05).

Conclusion: Our results highlight gaps in obesity recognition and management in Germany, underscoring the importance of enhancing access to effective interventions and improving support systems for this population.

Introduction: During a normal pregnancy, the body undergoes several physiological adaptations, and a woman's body weight and size change rapidly over a short period of time. Pregnancy may be associated with increased susceptibility to developing body image dissatisfaction, which can have negative consequences for the mother (e.g., depression, eating disorders) and the child (e.g., childhood obesity). Women who were already overweight/obese prepregnancy appear to be particularly at risk, as they are often dissatisfied with their body image already before pregnancy. This study aims to investigate the relationship between prepregnancy overweight/obesity, gestational weight gain (GWG), and body image as assessed immediately after birth.

Methods: This is a cross-sectional observational study. Body image was assessed in healthy pregnant women (N = 197) using the German version of the Body Image in Pregnancy Scale (BIPS-G). Univariate analyses of variance and hierarchical linear regression analyses were conducted to examine the association between prepregnancy weight, GWG, and the subscales of the BIPS-G. Additionally, a latent profile analysis (LPA) was conducted.

Results: Overall, women with prepregnancy obesity and GWG above recommendations were more dissatisfied with certain aspects of their body image during pregnancy. The strongest association was found between prepregnancy obesity and the subscale preoccupation with appearance. The LPA revealed three distinct profiles. Women with obesity and overweight and with GWG above recommendations were more likely to have a profile characterized by increased body image concerns during pregnancy.

Conclusion: It is important to implement psychological, behavioral, and weight-related interventions in women who are already overweight and obese prior to pregnancy.

Introduction: Sub-Saharan African migrant populations are exposed to new environmental factors, both of which have been linked to increased rates of obesity and insulin resistance. Given the complex relationship between adipokines and cardiometabolic traits, we hypothesized that these associations may vary depending on geographical context. Our aim was to examine the influence of geographic location on the association between serum leptin and adiponectin and cardiometabolic traits.

Methods: This is a cross-sectional analysis among 2,640 participants from the RODAM study living in Amsterdam, the Netherlands, and urban and rural Ghana. Correlation and linear regression models were used to examine the relationship between adipokines and cardiometabolic traits, including body mass, insulin resistance, inflammation, and lipid metabolism per location.

Results: Body mass was the key determinant of serum leptin, less so for serum adiponectin. There was a significant (p < 0.001) interaction in the association between BMI and serum leptin according to geographic location in women and in the association between waist circumference and serum leptin in men, suggesting increased leptin resistance during rural to urban transition, but with similar slopes for urban Ghanaians living in tropical and temperate climates. There was no significant interaction with location in the association between body mass and adiponectin. Inflammation and lipid metabolism explained the least amount of variance in serum adipokines across the locations.

Conclusion: There was significant variability in the relationship between serum leptin and the cardiometabolic traits examined across locations. These findings suggest that rural to urban transition significantly affects this relationship. Future studies may help to further delineate the effects of environmental factors on adipokine production, obesity, and cardiometabolic disease.

Background: Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that impacts both metabolic functions and reproductive health in women. PCOS pathophysiology is characterized by insulin resistance and chronic inflammation, which contribute to disrupted gonadotropin secretion, elevated androgen levels, and irregular ovulation. There is a bidirectional relationship between obesity and PCOS. Obesity contributes to the pathophysiology of PCOS, particularly by exacerbating insulin resistance - a core feature of the condition. Insulin resistance can lead to further weight gain and hinder successful weight loss. Summary: According to the latest international guidelines, improving insulin sensitivity and promoting weight loss are key strategies in the effective management of PCOS. GLP-1 receptor analogs (GLP-1 RAs) are a group of agents that are used in type 2 diabetes mellitus to regulate blood glucose levels, in addition to being indicated for weight loss in obesity. Thus, GLP-1 RAs may play a role in the management of PCOS, both due to weight loss effect and through pleiotropic effects like ameliorating insulin resistance, decreasing inflammation, and modulation of adiposity. Key Messages: In light of these effects, this review aimed to perform a systematic search and narrative synthesis on the impact of GLP-1 receptor agonists (GLP-1 RAs) on the metabolic and reproductive outcomes in PCOS, with the goal of elucidating the mechanistic link between the action of GLP-1 RAs and the underlying pathophysiology of the condition.

Introduction: Türkiye has the highest obesity prevalence in Europe. Obesity not only causes type 2 diabetes mellitus (T2DM) but also impairs glycemic control in patients with T2DM. There is insufficient information about the demographic and clinical differences between individuals with T2DM who are living with or without obesity. The second TEMD survey across Türkiye investigated the latest overweight and obesity prevalence in patients with T2DM. The present study evaluated the 5-year changes in the prevalence, factors associated with an obesity diagnosis, and the association between obesity and metabolic control.

Methods: Patients under follow-up in tertiary units specialized for diabetes care were consecutively enrolled. The sociodemographic, anthropometric, and clinical variables were recorded. Metabolic targets were defined as hemoglobin A1c <7%, home arterial blood pressure <135/85 mm Hg, or low-density lipoprotein cholesterol <100 mg/dL or <70 mg/dL or <55 mg/dL according to the risk factors or complications of patients. Metabolic target attainment rates were investigated across normal-weight, overweight, and obesity body mass index (BMI) classes.

Results: The TEMD Obesity Study enrolled 4,935 patients with T2DM (age 58.9 ± 10.1 years; women 59.8%). The prevalence of overweight and obesity was 33.4% and 55.1%, respectively. Obesity was more frequent in women with T2DM than men (66.2% vs. 38.1%; p ≤ 0.001). From 2017 to 2022, the obesity rate decreased from 59.0% to 55.1%, while the overweight rate increased from 31.0% to 33.4%. As BMI class increased, the achievement of three metabolic targets decreased while the incidence of microvascular complications rose. Significant associations were found between obesity and sociodemographic characteristics (age, sex, education level) and lifestyle measures (diet, exercise, smoking) in multivariable logistic regression analysis.

Conclusion: The TEMD Obesity study showed a decrease in obesity rates among patients with T2DM between 2017 and 2022. Also, the findings suggest that obesity poses an important barrier to the achievement of metabolic goals.

Introduction: Soluble vascular adhesion protein-1 (sVAP-1), which is identical to semicarbazide-sensitive amine oxidase (SSAO), contributes to oxidative stress and vascular dysfunction. The AOC3 gene that encodes VAP-1 is mainly expressed in vascular endothelial and smooth muscle cells, but AOC3 expression in adipose tissue and vascular implications remain unclear. The aim of this study was to investigate the association of adipose AOC3 expression and circulating sVAP-1/SSAO with arterial stiffness in patients with severe obesity.

Methods: We studied 49 Japanese patients who underwent laparoscopic sleeve gastrectomy. AOC3 expression was measured in visceral and subcutaneous adipose tissues obtained during surgery. Circulating sVAP-1 concentration, SSAO activity, oxidative stress markers, and cardio-ankle vascular index (CAVI) were assessed. Correlation and multiple regression analyses were performed.

Results: Serum sVAP-1 concentration correlated strongly with SSAO activity (rs = 0.683, p < 0.001) and was directly associated with CAVI. Visceral AOC3 Gene Index (AOC3 expression × visceral fat area) was independently associated with serum sVAP-1 concentration, whereas subcutaneous AOC3 expression was not. Subcutaneous fat area showed an inverse association with SSAO activity. In stratified analysis, patients with visceral-dominant obesity had higher CAVI, serum sVAP-1 concentration, and SSAO activity than those with subcutaneous-dominant obesity.

Conclusions: Visceral fat-derived AOC3 expression correlates with serum sVAP-1 concentration that appears to contribute to arterial stiffness in obesity. In contrast, subcutaneous fat may be associated with reduced SSAO activity. These findings highlight the fat depot-specific role of adipose tissue in vascular health and implicate VAP-1 as a potential mediator of obesity-related atherosclerosis.

Introduction: Assessing the nutritional and morphofunctional status of patients with obesity (PwO) is essential for optimizing their management. Nutritional ultrasound (NU) is a noninvasive, portable technique that offers insights into muscle and adipose tissue status. Combining NU with bioelectrical impedance analysis (BIA) and handgrip strength (HGS) may improve the assessment of body composition and muscle functionality. This study aimed to evaluate the usefulness of NU as a primary tool for morphofunctional assessment in PwO while comparing and complementing it with BIA and HGS.

Methods: A cross-sectional observational study was conducted including 178 PwO. Body composition was assessed using NU, single-frequency BIA, and HGS dynamometry. Correlations and multiple linear regression models were used to evaluate associations between NU, BIA, and HGS parameters.

Results: Significant correlations were found between NU-measured quadriceps rectus femoris-cross-sectional area (RF-CSA) and BIA-derived fat-free mass markers, such as body cell mass (BCM) (r = 0.638, p < 0.001) and appendicular skeletal muscle mass (r = 0.591, p < 0.001). Additionally, leg subcutaneous adipose tissue measured by NU was highly correlated with BIA-calculated fat mass (r = 0.656, p < 0.001). Linear regression analyses further confirmed the importance of RF-CSA as a strong predictor of BCM, along with HGS and body mass index, explaining 78.2% of the variability in BCM (R2 = 0.782, Akaike Information Criterion = 672).

Conclusion: These findings suggest that NU, combined with BIA and HGS, provides a comprehensive, practical tool for assessing body composition and muscle function in obesity management, with the potential for routine application in clinical settings.

Introduction: Accumulation of fat in omental visceral adipose tissue (OVAT) is strongly linked to metabolic diseases. Our recent findings show a distinct and more accessible chromatin landscape of the visceral depot compared to its subcutaneous counterpart. Based on integrated analysis of chromatin accessibility and transcriptomics, we identified previously unrecognised genes linked with obesity. Here, we performed in-depth analyses of one of the candidates, HOOK1, and tested for depot-specific gene expression, correlation with clinical traits and regulatory mechanisms including DNA methylation.

Methods: We utilised intra-individually paired adipose tissue samples of human OVAT and subcutaneous adipose tissue (SAT) from our in-house cohort (N = 78). Gene expression was measured using real-time quantitative PCR and pyrosequencing was used to determine DNA methylation levels. Data were analysed for differential gene expression and DNA methylation differences between SAT and OVAT, along with correlation analyses with clinical variables related to obesity. Results were validated in adipose tissue samples from 1,618 donors of the Leipzig Obesity Biobank.

Results: We observed consistently higher HOOK1 gene expression in OVAT compared to SAT and successfully confirmed this effect direction in several validation cohorts. We further identified that HOOK1 gene expression correlated with body mass index and hip circumference. We discovered a relationship between DNA methylation of the HOOK1 promoter with clinical variables important for liver function.

Conclusion: Our data show that HOOK1 gene expression is adipose tissue depot-specific. We observed that gene expression and DNA methylation are correlated to clinical variables of obesity, suggesting that HOOK1 may play a role in obesity and its sequelae.