Obesity Facts最新文献

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.

Introduction: Research on the incidence of diabetes, hypertension, and dyslipidemia resulting from weight gain remains limited. This study examined the association between weight gain and the occurrence of cardiometabolic diseases over a mean follow-up duration of 14.5 years, considering baseline BMI categories. Additionally, we analyzed the factors contributing to weight gain in Korean adults.

Methods: We analyzed the incidence of type 2 diabetes, hypertension, and dyslipidemia according to weight gain using the Cox proportional hazards model and the associated factors of weight gain through multivariable logistic regression analysis among 66,603 adults aged 19-64 years, using data from the Korean National Health Insurance Service. Baseline body mass index (BMI) was classified into three categories: < 23, 23-24.9, and ≥ 25 kg/m2. BMI increase was categorized as < 0.3, 0.3-0.69, and ≥ 0.7 kg/m2/year.

Results: The hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiometabolic diseases increased in proportion to BMI and BMI increase. The HRs (95% CIs) ranged from 1.08 (1.01-1.16) to 2.77 (2.54-3.02) for type 2 diabetes, 1.14 (1.08-1.19) to 2.60 (2.43-2.78) for hypertension, and 1.08 (1.04-1.13) to 1.85 (1.73-1.99) for dyslipidemia. Even individuals with a normal weight who experienced greater weight gain were at a higher risk of cardiometabolic diseases. The cumulative incidence rates increased proportionally with BMI and BMI increase. Younger age and lower income were risk factors in both sexes, while not being obese, heavy drinking, current smoking, and no regular exercise were risk factors for weight gain in men.

Conclusion: The management of weight gain, even in adults who do not have obesity, is necessary to prevent cardiometabolic diseases.

Introduction: Metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity. However, the optimal approach for patients with a BMI ≥ 50 kg/m2 remains unclear. This study compares the perioperative and long-term outcomes of one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) in this high-risk population.

Methods: A retrospective analysis of a prospectively maintained database was conducted, including all patients with BMI ≥ 50 kg/m2 who underwent OAGB or SG at a tertiary center between 2015 and 2024. Patients with previous MBS were excluded. Baseline characteristics, perioperative complications, weight loss outcomes, and resolution of obesity-related diseases were analyzed.

Results: A total of 121 patients were included: 76 underwent SG, and 45 underwent OAGB. The mean preoperative BMI was higher, and the rate of men was lower in the SG group (55 ± 5.4 vs. 52.2 ± 2.7, p = 0.0009, and 38.2% vs. 60%, p = 0.024, respectively). Overall, 90-day postoperative complications did not differ between the groups (SG: 14.5% vs. OAGB: 11.1%, p = 0.78), nor did major complications rate (SG: 2.6% vs. OAGB: 0%, p = 0.53). One perioperative mortality was observed in the SG group (1.3%). At 5-year follow-up, OAGB patients showed significantly greater total weight loss (36.7 ± 11.3% vs. 27.1 ± 13%, p = 0.01). Conversion surgery trends were higher in SG (9.1% vs. 2.6%, p = 0.13), primarily for weight regain. Obesity-related disease resolution rates were high and comparable between groups except for hypertension resolution, which was higher in OAGB (p = 0.04).

Conclusions: Both OAGB and SG are safe and effective for patients with BMI ≥ 50 kg/m2, providing substantial weight loss and disease improvement. In this study, OAGB was associated with higher weight loss outcomes. Larger multi-institutional studies are needed to confirm these findings.

Introduction: Long-term air pollution exposure is associated with obesity, but its impact on visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) distribution remains unclear. This study investigated the association between air pollution and abdominal fat indicators, including total adipose tissue, VAT, SAT, and the visceral-to-subcutaneous fat ratio (VSR), stratified by sex and obesity status based on body mass index (BMI).

Methods: A total of 8,912 Korean adults who underwent health checkups at Seoul National University Hospital were included. Abdominal fat was measured using CT scans. Annual average air pollution exposure levels, including particulate matter ≤2.5 μm in diameter, particulate matter ≤10 μm in diameter (PM₁₀), NO₂, SO₂, CO, and O₃, were estimated using the Community Multiscale Air Quality model. Ambient air pollution exposure and abdominal adiposity-related traits were analyzed using multiple linear and logistic regression, stratified by sex.

Results: Annual exposure to PM₁₀ and SO₂ was positively associated with VAT (PM₁₀: β = 2.29, 95% CI: 0.53-4.04, p = 0.01; SO₂: β = 4.19, 95% CI: 2.43-5.94, p < 0.001) and VSR (PM₁₀: β = 0.03, 95% CI: 0.01-0.05, p = 0.001; SO₂: β = 0.05, 95% CI: 0.03-0.07, p < 0.001) in men. These associations were stronger in men with high BMI, but no significant associations were found in women. Negative associations with SAT were observed for PM₁₀ (β = -1.94, 95% CI: -3.44 to -0.45, p = 0.01) and SO₂ (β = -2.47, 95% CI: -3.97 to -0.98, p = 0.001) in men and for PM₁₀ (β = -4.58, 95% CI: -7.23 to -1.93, p = 0.001) and SO₂ (β = -8.13, 95% CI: -10.78 to -5.48, p < 0.001) in women.

Conclusion: Long-term exposure to air pollutants, including PM₁₀ and SO₂, may have detrimental effects by increasing visceral fat accumulation and reducing beneficial subcutaneous fat, especially in men with obesity.

Introduction: The aim of this study was to describe the design and methodological aspects of the upcoming European Association for the Study of Obesity (EASO) Framework for the Pharmacological Treatment of Obesity utilizing currently available evidence, which is grounded in a rigorous and transparent approach to evidence synthesis and guideline development. Methods: An expert panel of 13 members, selected by EASO, has developed the framework using the GRADE methodology to ensure transparent, evidence-based guideline development. Clinical questions were formulated using the population, intervention, comparator, outcomes (PICO) framework, focusing on the effectiveness and safety of European Medicines Agency-approved obesity management medications, including orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide. A comprehensive literature search is being conducted using Medline and Embase, including randomized controlled trials with a minimum duration of 48 weeks. Meta-analyses and network meta-analyses are planned to compare treatment effectiveness and safety profiles across various patient subgroups. The guidelines will target adults with a body mass index (BMI) ≥27 kg/m2 and at least one weight-related comorbidity or a BMI ≥30 kg/m2. The primary endpoint will be total body weight loss. Secondary outcomes include changes in body composition (i.e., fat mass, fat-free mass), metabolic improvements (i.e., glucose levels, HbA1c, lipid profile), remission of obesity-related comorbidities (i.e., type 2 diabetes, obstructive sleep apnea syndrome, metabolic dysfunction-associated steatotic liver disease, cardiovascular disease, and knee osteoarthritis), and improvements in mental health and quality of life. The methodological framework ensures that recommendations are tailored, evidence-based, and applicable across clinical settings. Conclusions: The EASO framework provides a structured and individualized approach to optimize pharmacological treatment for obesity. Its methodological rigor, based on GRADE and PICO, enhances the reliability, reproducibility, and clinical relevance of the guidelines. By integrating clinical efficacy, safety outcomes, and patient-specific factors, this framework offers solid, actionable guidance to support healthcare professionals in delivering high-quality, personalized obesity care.

Introduction: Emotional eating is more common in individuals with obesity and is a predictor of increased body mass index (BMI). This study aimed to identify the types of emotions associated with the urge to eat in subjects with varying BMI levels.

Methods: Adult participants were recruited as part of a validity study for a new questionnaire designed to assess an individual's relationship with their body. The emotional eating scale of the Dutch Eating Behavior Questionnaire (DEBQ), as well as questions on past and current eating disorders, body weight status and history, health, and sociodemographic data, were assessed through an online questionnaire.

Results: Six hundred participants were included, comprising 80.5% women. A total of 27.0% were living with overweight and 21.2% with obesity. The urge to eat was significantly more frequent in response to diffuse emotions than to defined emotions, independent of sex and BMI level. The frequency of emotional eating was positively associated with BMI for all emotions explored by the DEBQ. The defined emotion "depressed/discouraged" induced an urge to eat more often in individuals with obesity. "Feeling abandoned" was the diffuse emotion most associated with obesity (53.5% of subjects with obesity ate often or very often versus 28.6% of subjects with normal weight).

Conclusion: This study highlights the need to explore diffuse emotions in subjects with obesity.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is overrepresented among children and adults with obesity, but knowledge about how ADHD may affect outcomes following metabolic and bariatric surgery (MBS) is limited. The aim of this study was to examine mental health and weight outcomes after undergoing MBS during adolescence in individuals with and without ADHD.

Methods: In a multicenter prospective study, 81 adolescents (13-18 years; mean BMI 45.5 kg/m2) underwent Roux-en-Y gastric bypass between 2006 and 2009. ADHD and autism spectrum disorder (ASD) were assessed using the Adult ADHD Self-Report Scale and Autism Quotient 10, respectively, or clinical diagnosis. BMI, anxiety, depression, and binge eating were measured before MBS and at 1-, 2-, 5-, and 10-year follow-ups.

Results: ADHD was present in 33 of 81 participants (41%). At 10-year follow-up, 91% of individuals with ADHD reported anxiety or depression, compared to 21% in the group without ADHD (p = 0.002), despite no reported difference at baseline. A significant time-by-group interaction (p = 0.018) indicated increasing differences between groups over time. Binge eating returned to preoperative levels in the ADHD group (p < 0.001) after 10 years following initial improvement. No significant difference in BMI was observed at 10 years, but weight loss was significantly lower in the ADHD group at 2- and 5-year follow-ups. At the 10-year follow-up, significantly more participants with clinical diagnosis of ADHD had dropped out (56% vs. 25%, p = 0.013). ASD was present in 14 of 81 participants (17%) and showed a high degree of overlap with ADHD (79%).

Conclusions: ADHD was associated with higher levels of anxiety, depression, and binge eating 10 years after MBS during adolescence. Weight loss was lower for the ADHD group at 2 and 5 years but not at 10 years, potentially due to a high dropout in the ADHD group at 10 years. Preoperative screening for ADHD in adolescents may improve long-term outcomes by early initiation of treatment for ADHD and tailored postoperative follow-up.

Introduction: The aim of this study was to examine associations between psychological and behavioural factors and body weight, appetite, satiety, and food cravings in individuals with obesity receiving incretin therapy.

Methods: Between January and February 2025, 411 adults completed an online survey. They provided data using the Weight Efficacy Lifestyle Questionnaire - Short Form, the Three-Factor Eating Questionnaire, and the Salzburg Emotional Eating Scale, and rated their perceptions of satiety, appetite, and food cravings. Multivariable linear and logistic regression analyses were used to assess associations between psychological factors and these outcomes, adjusting for relevant confounders.

Results: The sample was mainly female (71.8%), with a median age of 40 years (Q1-Q3: 33-47). Participants had a median treatment duration of 43 weeks (Q1-Q3: 30-58) and a median body mass index (BMI) difference of 5.9 kg/m2 (Q1-Q3: 4.0-7.4). In fully adjusted models, higher self-efficacy was associated with lower BMI values (β = -0.22; p < 0.001) and greater satiety (adjusted odds ratio [AOR] = 1.46; p < 0.001). Emotional eating in response to happiness was related to higher BMI (β = 0.46; p < 0.001) but also to higher satiety and lower cravings (AOR = 1.31-1.41; p < 0.05).

Conclusion: Eating self-efficacy and emotion-related eating patterns were linked to body weight, appetite, satiety, and cravings. Considering these psychological profiles may help tailor behavioural support, improve adherence, and enhance the effectiveness of incretin-based therapy.

Introduction: This study investigated associations between weight-related impairment (WrI), degree of overweight/obesity, and health-related quality of life (HrQoL) in children and adolescents with overweight or obesity.

Methods: Data were collected within the LIFE Child cohort study conducted in Leipzig, Germany. We used a repeated cross-sectional dataset containing 539 data points of 270 10- to 17-year-old children with overweight (n = 83 data points), obesity (n = 276 data points), or severe obesity (n = 180 data points) who had completed questionnaires on WrI (Kindl-R, total score) and HrQoL (Kidscreen-27, scores physical wellbeing, psychological wellbeing, peer relations, family relations, school). Associations between weight status, WrI, and HrQoL were assessed using regression analyses, adjusting for age, sex, and socioeconomic status.

Results: Children with obesity or severe obesity showed significantly more WrI than children with overweight. Regarding HrQoL, however, only physical and psychological wellbeing were significantly associated with weight group. Higher WrI was strongly associated with lower HrQoL in all domains (b ranging between -6.07 and -3.16, all p < 0.001). The association between WrI and psychological wellbeing was stronger in children with obesity or severe obesity than in children with overweight. In multivariate models, only WrI, but not the degree of overweight/obesity was associated with the different domains of HrQoL.

Conclusion: The findings suggest that WrI and not weight per se impacts HrQoL of children and adolescents with overweight and obesity.