Obesity Facts最新文献

Introduction: Several anthropometric indices reflecting cardiometabolic risks have been developed, but the relationship of body composition with arterial stiffness remains unclear. We aimed to determine the interaction between age-related anthropometric changes and progression of arterial stiffness.

Methods: This research analyzed cross-sectional data (N=13,672) and 4-year longitudinal data (N=5,118) obtained from a healthy Japanese population without metabolic disorders. The relationship of age with anthropometric indices comprising estimated lean body mass index (eLBMI), body mass index (BMI), waist circumference (WC) and a body shape index (ABSI) was examined. The mediating effects of the indices on the association between age and arterial stiffness assessed by cardio-ankle vascular index (CAVI) was analyzed.

Results: Unlike BMI and WC, ABSI (Rs=0.284) and CAVI (Rs=0.733) showed a positive linear relationship with aging in stratified analyses. Especially in the middle-older age groups, eLBMI showed a declining trend with aging. An increase in ABSI was associated with a decrease in eLBMI, whereas increase in BMI or WC was related to increased eLBMI. In cross-sectional analyses, age was associated with CAVI, partially mediated by ABSI or eLBMI after adjusting confounders. Baseline CAVI correlated negatively with 4-year change in (Δ)eLBMI (Rs=-0.120 in men, -0.161 in women). ΔCAVI correlated negatively with ΔeLBMI (Rs=-0.031).

Conclusion: ABSI is a modifiable index that well reflects age-related changes in arterial stiffness and body composition including lean body mass. Since arterial stiffening may cause skeletal muscle loss, potentially creating a vicious cycle, prioritizing CAVI and anthropometric indices in clinical practice may be a useful strategy.

Introduction There are controversies about whether women with polycystic ovary syndrome (PCOS) show a disproportionately higher visceral adiposity, and its relevance to their higher cardiometabolic risks. We investigated in women of Asian Indian descent in Mauritius, a population inherently prone to abdominal obesity, whether those with PCOS will show a more adverse cardiometabolic risk profile that could be explained by abnormalities in fat distribution. Methods Young women newly diagnosed with PCOS (n=25) were compared with a reference control cohort (n =139) for the following measurements made after an overnight fast: body mass index (BMI), waist circumference (WC), body composition by dual-energy x-ray absorptiometry, blood pressure and blood assays for glycemic (glucose, HbA1c, insulin) and lipid (triglycerides, cholesterols) profiles. Results Compared to controls, women with PCOS showed, on average, higher BMI, WC, fat mass and lean mass (p<0.01), but linear regression analyses indicate that, for the same BMI (or same WC), the two groups showed no significant differences in fat mass and lean mass. By contrast, linear regression plots indicate that for the same total fat mass, women with PCOS showed higher trunk, android and visceral fat (p<0.01), no difference in abdominal subcutaneous fat, and lower peripheral (gynoid or limb) fat (p<0.05). Furthermore, the women with PCOS showed higher fasting plasma insulin, insulin resistance (HOMA-IR) index and lower insulin sensitivity index QUICKI (all p<0.001), which were completely or markedly abolished after adjusting for visceral fat or central-to-peripheral fat ratios. Conclusion In Mauritius, young women of Asian Indian descent with PCOS show altered fat distribution characterized by a disproportionately higher visceral (hazardous) adiposity in parallel to lower peripheral (protective) adiposity, which together explain their exacerbated state of hyperinsulinemia and insulin resistance.

Introduction: Excess skin after bariatric metabolic surgery may negatively impact quality of life. Nevertheless, not every eligible patient undergoes body contouring surgery, which may be explained by differences in quality of life. The objective of this study was to assess the differences in quality of life between patients with and without a desire for body contouring surgery after bariatric metabolic surgery, and to identify predictive factors that contribute to this desire.

Methods: Patients completed the BODY-Q and a question regarding any desire for body contouring surgery, 6 months and yearly after bariatric metabolic surgery. BODY-Q outcomes were compared between patients with and without a desire for body contouring surgery and corrected for excess skin.

Results: A total of 380 patients who completed 3 years of follow-up were included. Of these patients, 69.5% desired body contouring surgery. Patients who did not desire body contouring surgery demonstrated significantly higher quality of life scores across all domains at every follow-up moment compared to patients who desired body contouring surgery (except physical functioning at 3 years). These associations were largely explained by the amount and burden of excess skin. Younger age was the only significant predictor for desiring body contouring surgery when correcting for excess skin.

Conclusion: Patients with a desire for body contouring surgery demonstrated significantly lower quality of life compared to patients without a desire due to a high burden of excess skin, which emphasizes the need for effective treatments aiming to improve quality of life such as body contouring surgery.

Introduction: Strategies to address suboptimal weight loss after Roux-en-Y gastric bypass (RYGB) can be developed if at-risk patients are identified in advance. This study aimed to build a pre-surgery prediction nomogram for early prediction of insufficient weight loss (IWL) or weight regain (WR) after bariatric surgery in Chinese patients.

Methods: In this retrospective study, 187 patients with obesity and type 2 diabetes who underwent laparoscopic RYGB were followed yearly for 3 years. Suboptimal weight loss included IWL and WR. IWL was defined as a total weight loss percentage of <25% at 1 year postoperatively, and WR was defined as a maximum weight loss percentage of >20% at 3 years postoperatively. Multivariate logistic regression was performed to identify independent predictors and to establish a nomogram to predict the occurrence of suboptimal weight loss.

Results: Multivariate logistic regression revealed that male sex (OR 4.268, 95% CI: 1.413-12.890), body mass index (OR 0.816, 95% CI: 0.705-0.946), and glycated hemoglobin (OR 1.493, 95% CI: 1.049-2.126) were independent predictors of IWL/WR. The AUC value of the nomogram constructed from the above three factors was 0.781. The Hosmer-Lemeshow test showed that the model had a good fit (p = 0.143). The calibration curve of the nomogram is close to an ideal diagonal line. Furthermore, the decision curve analysis demonstrated the good net benefits of the model.

Conclusions: A nomogram based on pre-surgery factors was developed to predict postoperative IWL/WR. This provides a convenient and useful tool for predicting suboptimal weight loss before surgery.

Context: Some clinical resemblance may exist between obesity, particularly abdominal obesity, and Cushing's syndrome. This has stimulated ongoing interest in the role of cortisol's secretion pattern, control and metabolism in obesity.

Goals: To investigate whether basal and stimulated levels of cortisol differ between healthy people with obesity and individuals with normal weight Design: Total, free, and salivary cortisol were tested at baseline state and after 1 g ACTH stimulation in 60 healthy subjects with obesity and 54 healthy lean controls.

Results: Baseline total cortisol was lower in subjects with obesity compared to lean controls 347 (265-452(nmol/L vs. [422 (328-493) nmol/L respectively ; p<0.05]. Similarly, basal salivary cortisol was significantly lower in subjects with obesity [7.5 (5.2-9.7) nmol/L vs 10.7 (7.5-17.6) nmol/L; p<0.05]. Upon challenge with ACTH, total peak serum and salivary peak cortisol responses were significantly lower in people with obesity than in lean subjects [665.16±151.8 vs. 728.64±124.2 nmol/L, p<0.05; and 31.66 (19-38.64) vs. 40.05 (31.46-46.64) nmol/L, p<0.05, respectively]. Additionally, baseline total cortisol and salivary cortisol were inversely related to BMI (r=-0.24, r=-0.27; p<0.05 for both) and waist circumference (r=-0.27, r= -0.34; p<0.05 for both).

Conclusion: Baseline as well as peak stimulated total serum and salivary cortisol were significantly lower in subjects with obesity. It thus appears that obesity is not associated with enhanced basal or ACTH-stimulated cortisol.

Introduction: Little is known about how the COVID-19 situation affected weight development among Indonesian adolescents. This longitudinal study examined whether, and for whom, the COVID-19 situation affected weight outcomes over time among adolescents from private schools and higher socio-economic positions in Indonesia, where being overweight is a rather prevalent characteristic. This study specifically examined whether appetitive traits (i.e., emotional overeating, food responsiveness) as well as baseline zBMI, sex, and urban area could explain changes in zBMI.

Methods: At baseline, 411 adolescents from 5 private schools in Indonesia (53.3% males, Mage = 12.02 years, SD = 0.45) filled out questionnaires on appetitive traits and background characteristics. In addition, their height and weight were measured. Of these, 336 adolescents (81.8%) also participated at follow-up. At follow-up, height and weight were measured or reported. We used linear regression to analyze the association between predictors and interactions with zBMI.

Results: The results showed a significant decrease in zBMI over time, with a lower average zBMI during COVID-19 compared to before COVID-19. Female adolescents and adolescents with higher baseline zBMI values particularly tended to show this zBMI decreasing pattern. We did not find statistically significant main effects of baseline emotional overeating, food responsiveness, and urban area or any interactions.

Conclusions: Indonesian adolescents appeared to decrease in terms of zBMI during COVID-19, particularly females and adolescents with higher pre-COVID-19 zBMI. Our findings suggest that (culturally-specific) contextual changes (i.e., less exposure to the Indonesian food environment at schools and more exposure to the home environment) might have a beneficial impact in terms of preventing overweight among Indonesian adolescents, particularly among those being more vulnerable (i.e., having higher baseline zBMI).

Introduction: Obesity is considered not only a public health issue on a global scale but also a disease adversely affecting the world economies. Economic impact of overweight and obesity has not yet been investigated in Türkiye at a national level. This study aimed to investigate the impact of obesity on the healthcare costs in Türkiye and to estimate the overall national economic burden of obesity.

Methods: The study was based on a cross-sectional analysis of retrospectively pooled data from 2009-2014 payer claims data (PCD) and 2014-2019 Türkiye Health Survey(THS). In the first step, obesity-related annual per person overall health expenditures in adults with obesity were calculated and calculations were also made in subgroups of payer and healthcare categories. In the second step, using the developed model, national economic disease burden of adult obesity was estimated, along with the projections for the estimated expenditures over the next 30 years. Economic values were adjusted according to US Dollar values of 2021 purchasing power parities (PPP) (PPP 1.0= 2.782 TRY).

Results: The annual healthcare costs were significantly higher in individuals with obesity than in those with normal body mass index (OR 1.243; 95% CI 1.206-1.281), and the cost increment was positively correlated with higher BMI (by 117% in class I obesity vs. 169% in class III obesity, p<0.001). In the year 2021, obesity-related direct and indirect costs in adults were estimated to be PPP 27.4 billion and 39.5 billion, respectively. The total economic burden was estimated to be PPP 66.9 billion, which is equivalent to 2.6% of gross national product. Direct medical cost of obesity corresponds to 8.4% of total health expenditure in Türkiye.

Conclusions: Obesity is both an individual and social health problem, which emphasizes the potential role of a range of stakeholders, besides the health sector, in addressing this problem. The indirect costs comprise the key cost driver of the total national cost of obesity, which forms the rationale for population-wide policy interventions towards prevention or reduction of obesity.

Introduction: Fat distribution is a stronger predictor for cardiometabolic morbidity and mortality. We aimed to investigate the association of elevated iron stores, measured as serum ferritin levels, with total and regional body fat.

Methods: Data from 2,646 adults from the National Health and Nutrition Examination Survey 2017-2018 was analyzed. Dual-energy X-ray absorptiometry was used to measure overall and regional body fat. The fat mass index (FMI) was calculated by dividing the fat mass (kg) by the square of body height (m²). The leg fat mass to trunk fat mass ratio (LTR) was used to assess the relative distribution of leg fat compared to trunk fat.

Results: Medians (IQR) of serum ferritin levels were 0.168 μg/mL (0.104-0.269) for men and 0.053 μg/mL (0.026-0.102) for women. After adjusting for sociodemographic, lifestyle, and metabolic factors, serum ferritin showed a significant positive association with total FMI (β=2.662) and trunk FMI (β=0.983), and a negative association with leg FMI (β=-0.324) and LTR (β=-0.160) in men. In women, serum ferritin showed a significant positive association with total FMI (β=4.658), trunk FMI (β=2.085), and negative association with LTR (β=-0.312). Significant positive trends were observed for serum ferritin with total and trunk FMI in men and women, using the lowest serum ferritin quartile as the reference group. Additionally, significant negative trends were observed for serum ferritin with leg FMI and LTR in men. The mediation analysis revealed that C-reactive protein mediated 16.4% and 22.6% of the potential effects of serum ferritin on trunk FMI in men and women, respectively.

Conclusion: Higher ferritin levels were associated with greater total and trunk fat but lower leg fat. Further prospective and mechanistic studies are warranted to confirm the study results.

Introduction: The purpose of the review was to examine the impact of maternal body mass index (BMI) on outcomes of cervical cerclage for cervical insufficiency.

Methods: This prospectively registered review (CRD42024512436) searched PubMed, Embase, Scopus, and Web of Science for comparative studies published before 6 March 2024. Maternal and neonatal outcomes of females undergoing cerclage were compared based on BMI.

Results: Seven studies were included. Pooled data showed that the risk of preterm birth (PTB) (<37 weeks) was significantly increased in the obese vs. non-obese group (odds ratio 1.32, 95% confidence interval [CI]: 1.15, 1.51; I2 = 36%). Gestation age at delivery in weeks was also found to be significantly lower in the obese group (MD: -2.47, 95% CI: -4.83, -0.12; I2 = 96%). There was no significant difference in the risk of preterm premature rupture of membranes and chorioamnionitis between the two groups. Still, the rate of cesarean sections was significantly higher in the obese group. Neonatal birth weight in grams was not found to be significantly different between obese and non-obese groups but the risk of neonatal intensive care unit (NICU) admission was significantly increased in the obese group.

Conclusion: Low-quality evidence indicates that obesity may lead to an increased risk of PTB in women undergoing cervical cerclage. The risk of cesarean section and NICU admission is also increased in obese females.

Introduction: In Sweden, glucagon-like peptide-1 (GLP-1) receptor agonists are subsidized for diabetes indication but not for obesity. Unregulated off-label prescription of GLP-1 receptor agonists for obesity treatment may raise concerns about potential inequalities for both patient groups. This study aimed to describe socioeconomic and demographic characteristics of on- and off-label users of GLP-1 receptor agonists in persons without a diagnosis of diabetes.

Methods: This is a Swedish descriptive register-based cohort study of persons who filled a prescription of a GLP-1 receptor agonist at least once during 2018-2022. Individuals were excluded from the study population if they had a diagnosis of diabetes or previous prescription fills of insulin/analogs at any time prior to the first filled prescription of a GLP-1 receptor agonist. Socioeconomic and demographic characteristics were described overall and stratified by sex and prior use of anti-obesity medications. Off-label use was defined by filled prescriptions of GLP-1 receptor agonists which are indicated for diabetes treatment.

Results: The study population included 16,436 individuals, of which 70.1% were women, 30.7% had previously filled a prescription of anti-obesity medications, and 65.3% had Sweden as country of origin and 17.2% an Asian country. In the analyses stratified by sex, women were more likely to have an education longer than 9 years (84.8% vs. 78.3% in men). Nonetheless, women had lower annual individual (2,891.3 vs. 4,004.9 in men) and family disposable income (5,645.5 vs. 6,092.5 in men). Overall, on-label prescription was higher in women (49.2% vs. 30.9% in men), while off-label was more common among men (69% vs. 51% in women). Trends of GLP-1 users per 1,000 inhabitants showed four-fold variation between counties.

Conclusion: High family disposable income and male sex are common among off-label GLP-1 receptor agonist users compared to users of the only on-label GLP-1 receptor agonist available in Sweden during the study period. Large variation between counties indicates different clinical practices and guideline interpretations.