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The Association between a Recorded Diagnosis of Obesity and Clinically Significant Weight Loss in the Primary Care Setting: A Nationwide Registry. 基层医疗机构中肥胖症诊断记录与临床显著体重减轻之间的关联:全国范围内的登记
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-21 DOI: 10.1159/000542080
Michal Kasher Meron, Nira Koren-Morag, Dan Oieru

Introduction: Overweight and obesity (OW/OB) are underdiagnosed. The primary aim was to assess whether a diagnosis of OW/OB recorded by a primary care physician (PCP) is associated with clinically significant weight loss, compared to a missed diagnosis. The secondary aim was to investigate the association between OW/OB diagnosis and patient attendance at dietary consultations.

Methods: This retrospective, observational cohort study was conducted using a nationwide healthcare database. The study included a random sample of 200,000 adults with BMI ≥25 kg/m2, recorded on a primary care visit, between 2014 and 2020. Patients with prior diagnosis of OW/OB or obesity-related complications were excluded. The independent variable was OW/OB diagnosis recorded by the PCP immediately after BMI measurement. The outcome variable was ≥5% weight loss at a second weight measurement within 9-15 months. Multivariate regression analysis was applied.

Results: Of the 200,000 people with OW/OB, 36,033 (18.0%) had a diagnosis of OW/OB, and 37,368 (18.7%) had a second body weight measurement, of which 7,635 (20.4%) lost ≥5% of their baseline body weight. The prescription rate of anti-obesity medication was 1.2% and did not differ between patients who achieved weight loss and those who did not. Those with a recorded diagnosis were 2.6 times more likely to visit a dietitian (odds ratio [OR] 2.57, 95% confidence interval [CI]: 2.56-2.64) and 2.5 times more likely to achieve weight loss (OR 2.53, 95% CI: 2.46-2.60). After adjusting for multiple confounders, including attendance at dietary consultation, people who received OW/OB diagnosis were 32% more likely to achieve weight loss (OR 1.32, 95% CI: 1.28-1.36, p < 0.001) compared to people with missed diagnosis.

Conclusions: Recording a diagnosis of obesity among relatively healthy people is associated with clinically significant weight loss at 1-year follow-up, independent of attendance at dietary consultation. Early obesity diagnosis is a significant opportunity to promote weight loss in the primary care setting and may affect weight trajectory.

简介超重和肥胖症(OW/OB)的诊断率很低。研究的主要目的是评估与漏诊相比,由初级保健医生(PCP)记录的超重/肥胖诊断是否与临床上显著的体重减轻有关。次要目的是调查OW/OB诊断与患者参加饮食咨询之间的关联:这项回顾性、观察性队列研究是利用一个全国性的医疗保健数据库进行的。研究随机抽取了 20 万名体重指数(BMI)≥ 25 kg/m2 的成年人,这些人在 2014-2020 年间接受了初级保健就诊记录。之前诊断出OW/OB或肥胖相关并发症的患者被排除在外。自变量为 BMI 测量后初级保健医生立即记录的 OW/OB 诊断。结果变量是在9-15个月内第二次测量体重时体重下降≥5%。采用多变量回归分析:在 20000 名 OW/OB 患者中,有 36 033 人(18.0%)确诊为 OW/OB,有 37 368 人(18.7%)进行了第二次体重测量,其中有 7 635 人(20.4%)的体重下降≥基线体重的 5%。抗肥胖药物处方率为 1.2%,体重减轻和体重未减轻的患者之间没有差异。有诊断记录的患者去看营养师的几率是前者的 2.6 倍(OR 2.57,95%CI 2.56-2.64),体重减轻的几率是前者的 2.5 倍(OR 2.53,95%CI 2.46-2.60)。在对包括参加饮食咨询在内的多种混杂因素进行调整后,获得 OW/OB 诊断的人与漏诊的人相比,体重减轻的可能性要高出 32% (OR 1.32 95%CI 1.28-1.36,p<0.001):结论:在相对健康的人群中记录肥胖诊断与随访 1 年的临床显著体重减轻有关,与参加饮食咨询无关。早期肥胖诊断是初级保健中促进体重减轻的一个重要机会,并可能影响体重轨迹。
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引用次数: 0
Association between Obesity and Dental Caries in Adults: An Analysis of WHR, and DMFT Score. 肥胖与成人龋齿之间的关系:对 WHR 和 DMFT 评分的分析。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-21 DOI: 10.1159/000541899
Alaa Jameel Kabbarah, Meyassara Samman, Abdulraheem A Alwafi, Heba Ashi, Layla Waleed Abuljadayel, Lina O Bahanan, Mona T Rajeh, Nada J Farsi

Introduction: The relationship between obesity and dental caries in adults presents inconsistent findings in current literature, which necessitates further research to clarify this relationship. This study aimed to examine the association between obesity and dental caries in adults using a nationally representative sample.

Methods: This study employed data of US adults aged >20 years from the National Health and Nutrition Examination Survey (NHANES) pre-pandemic cycle. Obesity was defined using the waist-to-hip ratio (WHR), body mass index (BMI), and waist circumference. Dental caries were assessed using the Decayed, Missing, Filled Teeth (DMFT) scores.

Results: Most participants were categorized as individuals with obesity based on the WHR (74.5%) or BMI (72.7%). A significant difference in the DMFT scores and missing teeth was observed between individuals with normal weight and individuals with obesity. After adjusting for the sociodemographic variables, individuals with obesity had a 0.11 higher DMFT score (95% confidence interval [CI]: -0.01 to 0.23). A significant association was observed between the WHR and DMFT scores when age was excluded from the model, demonstrating a higher coefficient of 0.17 (95% CI: 0.05-0.30).

Conclusions: A positive association was observed between obesity and dental caries in the US adult population. However, age was found to be a confounding factor in this relationship. This study highlights the relationship between oral and general health, advocating healthcare providers for an integrated health promotion strategy, through comprehensive campaigns addressing obesity, diet, lifestyle, and dental health, aiming for raising awareness and a more effective public health strategy.

导言:肥胖与成人龋齿之间的关系在现有文献中的研究结果并不一致,因此有必要开展进一步的研究来澄清这种关系。本研究旨在利用具有全国代表性的样本,研究肥胖与成人龋齿之间的关系:本研究采用了美国国家健康与营养调查(NHANES)大流行前周期中 20 岁美国成年人的数据。肥胖的定义是腰臀比(WHR)、体重指数(BMI)和腰围。龋齿采用龋坏、缺失、填充牙(DMFT)评分进行评估:结果:大多数参与者根据体重指数(74.5%)或腰围指数(72.7%)被归类为肥胖。体重正常者与肥胖者在 DMFT 评分和缺牙情况方面存在明显差异。在对社会人口学变量进行调整后,肥胖者的 DMFT 分数高出 0.11(95% CI:-0.01-0.23)。如果将年龄排除在模型之外,则可以观察到WHR和DMFT得分之间存在明显的关联,系数较高,为0.17(95% CI:0.05-0.30):结论:在美国成年人群中,肥胖与龋齿之间存在正相关。结论:在美国成年人群中观察到肥胖与龋齿之间存在正相关,但年龄被认为是这一关系中的一个混杂因素。这项研究强调了口腔健康与一般健康之间的关系,倡导医疗保健提供者通过针对肥胖、饮食、生活方式和牙齿健康的综合宣传活动,采取综合的健康促进策略,以提高人们的意识和采取更有效的公共卫生策略。
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引用次数: 0
Perceived Stress, Hair Cortisol, and Hair Cortisone in Relation to Appetite-Regulating Hormones in Patients with Obesity. 肥胖症患者感知到的压力、毛发皮质醇和毛发皮质酮与食欲调节激素的关系。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-21 DOI: 10.1159/000542079
Susanne Kuckuck, Robin Lengton, Renate E H Meeusen, Eline S van der Valk, Manon H J Hillegers, Brenda W J H Penninx, Maryam Kavousi, Jenny A Visser, Mariëtte R Boon, Sjoerd A A van den Berg, Elisabeth F C van Rossum

Introduction: Stress predicts unhealthy eating, obesity, and metabolic deterioration, likely mediated by altered levels of appetite-regulating hormones. Yet, evidence regarding the association between long-term stress and levels of appetite-regulating hormones in humans is lacking.

Methods: We included 65 patients with obesity (44 women) to investigate the cross-sectional association of long-term biological stress (scalp hair cortisol and cortisone) and long-term psychological stress (Perceived Stress Scale) with overnight-fasted serum levels of the hormonal appetite regulators leptin, adiponectin, insulin, pancreatic polypeptide, gastric-inhibitory peptide, peptide tyrosine-tyrosine, cholecystokinin and agouti-related protein, adjusted for age, sex, and body mass index.

Results: Hair cortisone and, in trend, hair cortisol were positively associated with cholecystokinin (p = 0.003 and p = 0.058, respectively). No other associations between stress measures and hormonal appetite regulators were observed.

Conclusion: Long-term biological stress, measured using scalp hair glucocorticoid levels, is associated with elevated levels of circulating cholecystokinin. More research is needed to pinpoint potential effects on appetite.

简介压力会导致不健康饮食、肥胖和新陈代谢恶化,这可能是由食欲和新陈代谢调节激素水平的改变引起的。然而,有关人类长期压力与食欲调节激素水平之间关系的证据还很缺乏:我们纳入了 65 名肥胖症患者(44 名女性),研究生物压力(头皮毛发皮质醇和可的松)和心理压力(知觉压力量表)与隔夜空腹血清中食欲调节激素瘦素、脂肪连蛋白、胰岛素、胰高血糖素和胰岛素水平之间的横断面关系、脂肪连素、胰岛素、胰多肽、胃抑制肽、酪氨酸-酪氨酸肽、胆囊收缩素和激动相关蛋白的关系,并对年龄、性别和体重指数进行了调整。结果显示毛发皮质酮与胆囊收缩素呈正相关(p=0.003),毛发皮质醇与胆囊收缩素呈负相关(p=0.058)。没有观察到压力测量值与荷尔蒙食欲调节器之间存在其他关联:结论:利用头皮毛发糖皮质激素水平测量的长期生物压力与循环胆囊收缩素水平升高有关,表明长期压力与激素食欲信号之间存在联系。
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引用次数: 0
Clinical Characteristics of Sarcopenia in Nonalcoholic Fatty Liver Disease: A Systemic Scoping Review. 非酒精性脂肪肝患者 "肌少症 "的临床特征:系统性范围界定综述
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-16 DOI: 10.1159/000541650
Tingdan Ye, Ke Mi, Lin Zhu, Jonathan Li, Calvin Q Pan

Introduction: This systematic scoping review aimed to synthesize existing research findings on the clinical manifestations in patients with nonalcoholic fatty liver disease (NAFLD) and sarcopenia.

Methods: Adhering to scoping review guidelines, we comprehensively searched five databases for literature on sarcopenia's clinical manifestations in NAFLD patients from December 2013 to December 2023, meticulously compiling and synthesizing the findings.

Results: A total of 312 articles were identified, with 9 studies included in the final review. Of these, 90% were cross-sectional investigations, with 70% from Asian cohorts. Comparative analysis between patients solely afflicted with NAFLD and those additionally experiencing sarcopenia revealed discernible trends. Individuals with both conditions tended to be older, have a higher body mass index, and show a higher prevalence among females, underscoring the influence of unhealthy lifestyles and obesity. Furthermore, comorbidities like metabolic syndrome, hypertension, and diabetes have been implicated in sarcopenia manifestation among NAFLD patients. Nonetheless, the lack of standardized diagnostic criteria and patterns poses an ongoing clinical challenge for this subgroup.

Conclusions: Our review highlights distinct clinical characteristics evident in NAFLD patients with sarcopenia. However, comprehensive investigations remain scarce, impeding accurate early detection and intervention. Future research should prioritize bridging these gaps and fostering enhanced clinical management strategies.

背景:本系统性范围界定综述旨在综合非酒精性脂肪肝(NAFLD)和肌肉疏松症患者临床表现的研究结果,重点关注2013年12月至2023年12月期间发表的研究。摘要:我们对五个数据库进行了全面的系统性范围界定综述,确定了312篇文章,最终综述纳入了9项研究。大部分为横断面调查,70%来自亚洲队列。对比分析显示,患有非酒精性脂肪肝和肌肉疏松症的患者往往年龄较大,体重指数较高,女性发病率较高。这些发现强调了不健康的生活方式和肥胖的作用。常见的合并症包括代谢综合征、高血压和糖尿病。然而,标准化诊断标准的缺乏对准确识别这一患者亚群构成了重大挑战:本综述强调了患有肌肉疏松症的非酒精性脂肪肝患者的独特临床特征,如年龄较大、体重指数较高以及女性发病率较高。合并症也在其中发挥了重要作用。然而,缺乏全面的研究限制了早期检测和干预。未来的研究应针对这一患者群体制定标准化的诊断标准和有效的管理策略,以弥补这些不足。
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引用次数: 0
Postprandial Symptoms in a Mixed-Meal-Test after Bariatric Surgery: Clinical Experience and a Critical Review of Dumping Syndrome Definition and Management. 减肥手术后混合餐测试中的餐后症状--临床经验以及对倾倒综合征定义和管理的批判性回顾。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-15 DOI: 10.1159/000541780
Azat Samigullin, Julia Weihrauch, Mirko Otto, Andrea Rech, Sandra Buchenberger, Michael Morcos, Per M Humpert

Introduction: Despite recent attempts to reach a consensus on the diagnostic criteria and treatment of dumping syndrome (DS) after bariatric surgery, many questions about the clinical applicability and significance of standardized provocation tests remain unanswered. The objective of this study was to retrospectively evaluate a mixed-meal-test (MMT) based on general nutritional recommendations after bariatric surgery and its clinical value in diagnosing DS.

Methods: The MMT contained 15.5 g of protein, 10 g of fat, 20.7 g of carbohydrates, and 3.1 g of dietary fiber, totaling 241 kcal. Symptoms based on the Sigstad Score, along with blood sugar, hematocrit, pulse rate, and blood pressure, were collected as primary readouts. The analysis included 58 MMTs from 56 patients who reported postprandial symptoms indicative of DS and were referred to the clinic by surgeons or general practitioners.

Results: Although all individuals reported significant symptoms at home, the MMT showed a positive symptom score (Sigstad Score ≥7) in only 16 cases (28%). Neither a heart rate increase >10 BPM nor the 3% hematocrit increase suggested as cut-offs for early DS by the consensus paper were associated with the Sigstad Score or individually reported symptoms. None of the participants had a postprandial glucose decrease below 50 mg/dL; one fell below 60 mg/dL and 14 fell below 70 mg/dL. A blood glucose decrease below 70 mg/dL was not associated with symptoms.

Conclusion: The MMT showed that only a minority of patients reported classical DS symptoms under controlled conditions. Changes in hematocrit, heart rate, and blood sugar decrease below 70 mg/dL did not help to predict symptoms in the individuals studied. The data, in the context of existing evidence, suggest that provocation tests have little value in clinical practice and that DS as a clinical entity after bariatric surgery should be reevaluated.

导言:尽管最近人们试图就减肥手术后倾倒综合征(Dumping Syndrome,DS)的诊断标准和治疗方法达成共识,但关于标准化激惹试验的临床适用性和意义的许多问题仍未得到解答。本研究的目的是对基于减肥手术后一般营养建议的混合餐试验(MMT)及其在诊断 Dumping 综合征方面的临床价值进行回顾性评估。方法 MMT 含有 15.5 克蛋白质、10 克脂肪、20.7 克碳水化合物和 3.1 克膳食纤维,总热量为 241 千卡。主要读数包括基于 Sigstad 评分的症状、血糖、血细胞比容、脉搏和血压。分析包括 56 名患者的 58 份 MMT,这些患者报告的餐后症状提示 DS,并由外科医生或全科医生转介到诊所。结果 虽然所有患者在家中都报告了明显的症状,但只有 16 例(28%)患者的 MMT 显示出阳性症状评分(Sigstad 评分≥7)。共识文件建议的早期 DS 临界值--心率增加 10 BPM 或血细胞比容增加 3% 都与 Sigstad 评分或个人报告的症状无关。没有一位参与者的血糖降至 50 mg/dl 以下;1 人降至 60 mg/dl 以下,14 人降至 70 mg/dl 以下。血糖降至 70 毫克/分升以下与症状无关。结论 MMT 显示,在受控条件下,只有少数患者报告了典型的 DS 症状。血细胞比容、心率和血糖下降到 70 毫克/分升以下的变化无助于预测研究对象的症状。从现有证据来看,这些数据表明激惹试验在临床实践中价值不大,因此应重新评估减肥手术后 DS 这一临床实体。
{"title":"Postprandial Symptoms in a Mixed-Meal-Test after Bariatric Surgery: Clinical Experience and a Critical Review of Dumping Syndrome Definition and Management.","authors":"Azat Samigullin, Julia Weihrauch, Mirko Otto, Andrea Rech, Sandra Buchenberger, Michael Morcos, Per M Humpert","doi":"10.1159/000541780","DOIUrl":"10.1159/000541780","url":null,"abstract":"<p><strong>Introduction: </strong>Despite recent attempts to reach a consensus on the diagnostic criteria and treatment of dumping syndrome (DS) after bariatric surgery, many questions about the clinical applicability and significance of standardized provocation tests remain unanswered. The objective of this study was to retrospectively evaluate a mixed-meal-test (MMT) based on general nutritional recommendations after bariatric surgery and its clinical value in diagnosing DS.</p><p><strong>Methods: </strong>The MMT contained 15.5 g of protein, 10 g of fat, 20.7 g of carbohydrates, and 3.1 g of dietary fiber, totaling 241 kcal. Symptoms based on the Sigstad Score, along with blood sugar, hematocrit, pulse rate, and blood pressure, were collected as primary readouts. The analysis included 58 MMTs from 56 patients who reported postprandial symptoms indicative of DS and were referred to the clinic by surgeons or general practitioners.</p><p><strong>Results: </strong>Although all individuals reported significant symptoms at home, the MMT showed a positive symptom score (Sigstad Score ≥7) in only 16 cases (28%). Neither a heart rate increase >10 BPM nor the 3% hematocrit increase suggested as cut-offs for early DS by the consensus paper were associated with the Sigstad Score or individually reported symptoms. None of the participants had a postprandial glucose decrease below 50 mg/dL; one fell below 60 mg/dL and 14 fell below 70 mg/dL. A blood glucose decrease below 70 mg/dL was not associated with symptoms.</p><p><strong>Conclusion: </strong>The MMT showed that only a minority of patients reported classical DS symptoms under controlled conditions. Changes in hematocrit, heart rate, and blood sugar decrease below 70 mg/dL did not help to predict symptoms in the individuals studied. The data, in the context of existing evidence, suggest that provocation tests have little value in clinical practice and that DS as a clinical entity after bariatric surgery should be reevaluated.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-8"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Challenges of Diagnosing Gestational Diabetes after Bariatric Surgery: Where Do We Stand? 减肥手术后诊断妊娠糖尿病的挑战:我们的现状如何?
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1159/000541623
Diana Rodrigues-Martins, Inês Nunes, Mariana P Monteiro

Background: Obesity, gestational diabetes mellitus (GDM), and bariatric metabolic surgery (BMS) are increasingly common conditions during pregnancy.

Summary: However, clinical knowledge regarding GDM that occurs after BMS remains full of uncertainties. Given its prevalence and potential consequences for the dyad pregnant and offspring, it is imperative to increase knowledge about GDM after BMS, define diagnostic criteria and consequently strategies capable of improving pregnancy outcomes.

Key messages: This paper aimed to review GDM screening methods after BMS and gives insights regarding new paths of research on this paramount obstetric condition.

背景:肥胖、妊娠糖尿病(GDM)和减肥代谢手术(BMS)在妊娠期间越来越常见。鉴于其发病率及其对孕妇和后代的潜在影响,当务之急是增加对 BMS 术后 GDM 的了解,明确诊断标准,并制定能够改善妊娠结局的相应策略:本文旨在回顾 BMS 后 GDM 的筛查方法,并就这一重要产科疾病的新研究路径提出见解。
{"title":"The Challenges of Diagnosing Gestational Diabetes after Bariatric Surgery: Where Do We Stand?","authors":"Diana Rodrigues-Martins, Inês Nunes, Mariana P Monteiro","doi":"10.1159/000541623","DOIUrl":"10.1159/000541623","url":null,"abstract":"<p><strong>Background: </strong>Obesity, gestational diabetes mellitus (GDM), and bariatric metabolic surgery (BMS) are increasingly common conditions during pregnancy.</p><p><strong>Summary: </strong>However, clinical knowledge regarding GDM that occurs after BMS remains full of uncertainties. Given its prevalence and potential consequences for the dyad pregnant and offspring, it is imperative to increase knowledge about GDM after BMS, define diagnostic criteria and consequently strategies capable of improving pregnancy outcomes.</p><p><strong>Key messages: </strong>This paper aimed to review GDM screening methods after BMS and gives insights regarding new paths of research on this paramount obstetric condition.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-6"},"PeriodicalIF":3.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations between Type of Bariatric Surgery and Obstructive Sleep Apnoea, Employment Outcomes, and Body Image Satisfaction: A Systematic Review and Meta-Analysis. 减肥手术类型与阻塞性睡眠呼吸暂停、就业结果和身体形象满意度之间的关系:系统回顾和荟萃分析。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1159/000541782
Beatrice Leyaro, Daniel Boakye, Lyz Howie, Abdulmajid Ali, Raymond Carragher

Introduction: Bariatric surgery has been shown to provide significant patient benefits in terms of weight loss and mitigation of obesity-linked comorbidities, as well as providing improvements in occupational productivity and patient quality of life. However, the choice of which bariatric surgery procedure provides the most patient benefit in each of these cases is still in question. In this review, we provide a systematic review, with the objective of evaluating associations between different bariatric surgery procedures and mitigation of obesity-linked comorbidities, improvement in occupational productivity, and patient quality of life, concentrating on three areas: obstructive sleep apnoea (OSA), employment prospects, and body image.

Methods: The CINAHL, PubMed, Web of Science, and CENTRAL databases were searched for eligible studies. Summary risk ratio (RR) and 95% confidence intervals were estimated using random-effects models. Thirty-three studies were included in this review, including 29 cohort studies and 4 randomised clinical trials (RCTs).

Results: Pooled analysis of the observational studies showed significantly lower OSA remission in sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB) across both short-term (1-2 years) and longer term (3+ years) follow-up periods (RR = 0.91, 95% CI = 0.84-0.99, p = 0.02; and RR = 0.88, 95% CI = 0.65-0.99, p = 0.03, respectively). In contrast, a meta-analysis of the RCT studies found no difference in OSA remission between SG and RYGB (RR = 1.01, 95% CI = 0.81-1.25, p = 0.93). An analysis of four studies showed significantly higher OSA remission for SG versus adjustable gastric banding (RR = 1.83, 95% CI = 1.57-2.14, p < 0.001). No significant difference was observed regarding improvement in employment status between SG and RYGB (RR = 0.77, 95% CI = 0.32-1.87, p = 0.57). A narrative synthesis of studies on body image reported no significant differences between body image scores and surgery types.

Conclusion: This review found significantly lower OSA remission in SG as compared to RYGB across different follow-up periods, while no significant statistical difference was observed in RCT studies. Further studies are recommended to assess the effectiveness of the various bariatric surgeries in relation to improving employment status and body image, where primary studies are lacking.

简介减肥手术在减轻体重、缓解与肥胖相关的并发症、提高工作效率和患者生活质量方面为患者带来了显著的益处。然而,在每种情况下,选择哪种减肥手术能为患者带来最大益处仍是个问题。在本研究中,我们进行了一项系统性回顾,目的是评估不同减肥手术与减轻肥胖相关并发症、提高职业生产率和患者生活质量之间的关系,主要集中在三个方面:阻塞性睡眠呼吸暂停(OSA)、就业前景和身体形象:方法:在 CINAHL、PubMed、Web of Science 和 CENTRAL 数据库中搜索符合条件的研究。采用随机效应模型估算了总风险比(RR)和 95% 置信区间。本综述共纳入 33 项研究,包括 29 项队列研究和 4 项随机临床试验(RCT):观察性研究的汇总分析显示,袖带胃切除术(SG)的 OSA 缓解率在短期(1-2 年)和长期(3 年以上)随访期间均显著低于 Roux-en-Y 胃旁路术(RYGB)(RR=0.91,95% CI = 0.84-0.99,p=0.02;RR=0.88,95% CI = 0.65-0.99,p=0.03)。与此相反,RCT 研究的荟萃分析发现,SG 和 RYGB 的 OSA 缓解率没有差异(RR=1.01,95% CI = 0.81-1.25,p=0.93)。对四项研究的分析表明,SG 的 OSA 缓解率明显高于可调节胃束带(RR=1.83,95% CI = 1.57-2.14,p<0.001)。在就业状况的改善方面,SG 与 RYGB 之间无明显差异(RR=0.77,95% CI = 0.32-1.87,p = 0.57)。对身体形象研究的叙述性综合报告显示,身体形象评分与手术类型之间无明显差异:本综述发现,在不同的随访期内,SG 的 OSA 缓解率明显低于 RYGB,而在 RCT 研究中未观察到明显的统计学差异。建议进一步开展研究,以评估各种减肥手术在改善就业状况和身体形象方面的效果,因为目前还缺乏这方面的初步研究。
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引用次数: 0
Food and Health Literacy in Patients Awaiting Metabolic-Bariatric Surgery. 等待代谢减重手术患者的饮食与健康知识。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1159/000541408
Anne Jacobs, Leontien M G Nijland, Ingrid H M Steenhuis, Ruben N van Veen, Ronald S L Liem, Hanno Pijl, Lies Ter Beek, Rob A E M Tollenaar, Valerie M Monpellier

Introduction: Specialized lifestyle programmes for patients undergoing metabolic-bariatric surgery (MBS) are provided to facilitate adjustment and adherence to a healthy lifestyle after surgery. However, pre-programme food and health literacy in MBS patients is often unknown. In the general population, approximately three-quarters of people exhibit sufficient health literacy. This study aimed to examine food and health literacy of patients awaiting MBS and to identify patient-specific factors associated with these literacies.

Methods: Patients awaiting MBS completed questionnaires on food literacy (Self-Perceived Food Literacy scale) and health literacy (European Health Literacy Survey Questionnaire-16) at the start of a preoperative lifestyle programme. Linear and logistic regression analyses were used to identify associations between multiple variables and preoperative food and health literacy.

Results: Among 216 patients, the preoperative mean food literacy score was 3.49 ± 0.44, on a five-point scale. Furthermore, 96.3% of patients showed sufficient health literacy, with scores of 13 or more out of 16. Patients with sufficient health literacy had higher food literacy scores (β 0.508; 95% CI: 0.208-0.809, p < 0.001).

Conclusion: This study among people living with obesity awaiting MBS suggests that food literacy is comparable, and health literacy is higher than in the general population. These findings emphasize the complexity of the aetiology of obesity due to factors that extend beyond food and health literacy.

导言:为接受代谢减肥手术(MBS)的患者提供专门的生活方式计划,以帮助他们在术后适应并坚持健康的生活方式。然而,代谢减重手术患者在手术前的饮食和健康知识往往不为人知。在普通人群中,大约四分之三的人具有足够的健康知识。本研究旨在调查等待接受乳房下垂矫正术的患者的食物和健康知识,并确定与这些知识相关的患者特定因素:方法:等待接受口腔手术的患者在术前生活方式计划开始时填写了关于食物知识(自我感觉食物知识量表)和健康知识(欧洲健康知识调查问卷-16)的问卷。采用线性和逻辑回归分析来确定多个变量与术前食物和健康素养之间的关系:结果:在 216 名患者中,术前食物知识平均得分为 3.49±0.44(5 分制)。此外,96.3%的患者表现出足够的健康素养,满分为 16 分,得分在 13 分或以上。具有足够健康素养的患者具有更高的食物素养得分(β 0.508; 95% CI: 0.208 - 0.809, p<.001):这项针对等待 MBS 的肥胖症患者的研究表明,与普通人群相比,他们的食物知识水平相当,而健康知识水平较高。这些发现强调了肥胖症病因的复杂性,其因素超出了食物和健康素养的范围。
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引用次数: 0
Validation of the 40-Item and 24-Item Short Version of the Person-Centred Obesity Care Instrument for Patients Living with Obesity. 验证针对肥胖症患者的 40 项以人为中心的肥胖症护理(PCOC)工具和 24 项简易版。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-24 DOI: 10.1159/000541499
Paige I Crompvoets, Anna Petra Nieboer, Elisabeth F C van Rossum, Jane M Cramm

Introduction: Person-centred care (PCC) may hold promise for improved healthcare experiences and outcomes among patients living with obesity. A validated instrument to assess the delivery of PCC to patients living with obesity is, however, currently lacking. This study aimed to validate such an instrument. In this article, we describe the development and psychometric testing of the 40-item and 24-item short version of the Person-Centred Obesity Care (PCOC) instrument.

Methods: A total of 590 individuals living with obesity (BMI 33.4 ± 3.9) from a representative Dutch sample completed the 49-item PCOC instrument measuring the eight dimensions of PCC (patient preferences, physical comfort, coordination of care, emotional support, access to care, continuity and transition, information and education, and family and friends), and two measures of satisfaction with care. We performed confirmatory factor analyses to verify the factor structure of the instrument and examined its reliability and validity.

Results: Fit indicators of the first model with all 49 items showed that the model left room for improvement (comparative fit index [CFI] <0.90). A 40-item version was obtained with satisfactory-to-good fit (standardized root mean square residual [SRMR] = 0.05, root mean square error of approximation [RMSEA] = 0.06, CFI = 0.90). The instrument demonstrated good reliability, and the relationship between the PCOC and two indicators of satisfaction with care supported the validity of the scale. Shortening the instrument only further improved the fit indicators, resulting in the development of a 24-item short version (SRMR = 0.04, RMSEA = 0.05, CFI = 0.96), with similar results in terms of reliability and validity.

Conclusion: The 40-item PCOC instrument and the 24-item short version showed to be reliable and valid instruments for the assessment of PCC among patients living with obesity. Based on the results, the 40 and 24-item PCOC are promising tools that can be used by clinicians and researchers to explore PCC delivery for patients living with obesity.

引言 以人为本的护理(PCC)有望改善肥胖症患者的医疗体验和治疗效果。然而,目前尚缺乏一种经过验证的工具来评估向肥胖症患者提供以人为中心的护理的情况。本研究旨在验证这样一种工具。在这篇文章中,我们介绍了以人为中心的肥胖症护理(PCOC)工具的 40 个项目和 24 个项目简版的开发和心理测试情况。方法 共有 590 名来自荷兰代表性样本的肥胖症患者(体重指数为 33.4 ± 3.9)填写了 49 个项目的 PCOC 工具,该工具测量了 PCC 的八个方面(患者偏好、身体舒适度、护理协调、情感支持、获得护理的途径、持续性和过渡性、信息和教育以及家人和朋友)以及两项护理满意度测量。我们进行了确认性因子分析以验证该工具的因子结构,并检验了其信度和效度。结果 第一个模型与全部 49 个项目的拟合指标显示,该模型还有改进的余地(CFI <0.90)。40 个条目版本的拟合结果令人满意至良好(SRMR = 0.05,RMSEA = 0.06,CFI = 0.90)。该量表显示出良好的可靠性,PCOC 与护理满意度的两个指标之间的关系证明了该量表的有效性。缩短量表后,各项指标的拟合程度进一步提高,最终形成了一个 24 个项目的简短版本(SRMR = 0.04,RMSEA = 0.05,CFI = 0.96),其信度和效度结果相似。结论 40 个项目的 PCOC 工具和 24 个项目的简易版在评估肥胖症患者的 PCC 方面是可靠和有效的工具。根据研究结果,40 个项目的 PCOC 和 24 个项目的 PCOC 是很有前途的工具,临床医生和研究人员可用来探索肥胖症患者的 PCC 提供情况。
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引用次数: 0
Youths with extreme obesity: A high-risk group for pain and mental health impairments. 极度肥胖的青少年:疼痛和心理健康受损的高危人群。
IF 3.6 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1159/000540888
Hannah Schmidt,Ingo Menrath,Susanna Wiegand,Thomas Reinehr,Wieland Kiess,Johannes Hebebrand,Julia von Schnurbein,Reinhard W Holl,Rolf Holle,André Scherag,Martin Wabitsch,Stephanie Brandt-Heunemann
BACKGROUNDYouths with extreme obesity (Body mass index (BMI)>40) are at increased risk for physical and mental health impairments but this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI=30-39.9) by considering gender differences.METHODSCross-sectional data of 431 youths (M=16.6; SD=2.3; 53.1% female) were analyzed. Of these, 159 (36.8%) youths were characterized by extreme obesity. Self-reported sociodemographic data, pain-related variables, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models.RESULTSYouths with extreme obesity reported more pain in the last 4 weeks (p=.018), increased pain-related impairments in daily life (p=.009), more pain-related days of absence (p=.030), higher depression scores (p = .030), and reduced HRQoL (p=.005) compared to youths with mild and moderate obesity. In regression models, extreme obesity and pain in the last 4 weeks were associated when additionally including sex and age in the model (odds ratio 1.88; 95 % confidence interval 1.16 - 30.40, p=.010). In the subgroup of extreme obesity (n=159), women (n=83) reported more pain in the last 4 weeks (p=.001), higher depression scores (p<.001), and lower HRQoL (p<.001) compared to men (n=76).CONCLUSIONThese findings underpin the need for standardized assessments of pain and mental health, especially in the treatment of female youths with extreme obesity. Upcoming studies may analyze reciprocal interactions since both aspects are important barriers for lifestyle changes and weight loss.
背景极度肥胖(体重指数(BMI)40)的青少年出现身体和心理健康损害的风险更高,但这一患者群体在研究中却很少受到关注。本研究旨在通过考虑性别差异,分析极度肥胖与轻度和中度肥胖(BMI=30-39.9)青少年的疼痛体验和心理健康损害。方法分析了 431 名青少年(男=16.6;女=2.3;53.1%)的横断面数据。其中,159 名(36.8%)青少年具有极度肥胖的特征。通过标准化问卷对自我报告的社会人口学数据、疼痛相关变量、抑郁和健康相关生活质量(HRQoL)进行了评估。结果与轻度和中度肥胖的青少年相比,极度肥胖的青少年在过去 4 周内报告的疼痛次数更多 (p=.018),与疼痛相关的日常生活障碍增加 (p=.009),与疼痛相关的缺勤天数增加 (p=.030),抑郁评分更高 (p=.030) 以及 HRQoL 降低 (p=.005)。在回归模型中,如果将性别和年龄也纳入模型,则极度肥胖与最近 4 周的疼痛有关联(几率比 1.88;95 % 置信区间 1.16 - 30.40,p=.010)。在极度肥胖亚组(n=159)中,与男性(n=76)相比,女性(n=83)在过去 4 周内报告的疼痛次数更多(p=.001),抑郁评分更高(p<.001),HRQoL 更低(p<.001)。接下来的研究可能会对相互影响进行分析,因为这两方面都是改变生活方式和减轻体重的重要障碍。
{"title":"Youths with extreme obesity: A high-risk group for pain and mental health impairments.","authors":"Hannah Schmidt,Ingo Menrath,Susanna Wiegand,Thomas Reinehr,Wieland Kiess,Johannes Hebebrand,Julia von Schnurbein,Reinhard W Holl,Rolf Holle,André Scherag,Martin Wabitsch,Stephanie Brandt-Heunemann","doi":"10.1159/000540888","DOIUrl":"https://doi.org/10.1159/000540888","url":null,"abstract":"BACKGROUNDYouths with extreme obesity (Body mass index (BMI)&gt;40) are at increased risk for physical and mental health impairments but this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI=30-39.9) by considering gender differences.METHODSCross-sectional data of 431 youths (M=16.6; SD=2.3; 53.1% female) were analyzed. Of these, 159 (36.8%) youths were characterized by extreme obesity. Self-reported sociodemographic data, pain-related variables, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models.RESULTSYouths with extreme obesity reported more pain in the last 4 weeks (p=.018), increased pain-related impairments in daily life (p=.009), more pain-related days of absence (p=.030), higher depression scores (p = .030), and reduced HRQoL (p=.005) compared to youths with mild and moderate obesity. In regression models, extreme obesity and pain in the last 4 weeks were associated when additionally including sex and age in the model (odds ratio 1.88; 95 % confidence interval 1.16 - 30.40, p=.010). In the subgroup of extreme obesity (n=159), women (n=83) reported more pain in the last 4 weeks (p=.001), higher depression scores (p&lt;.001), and lower HRQoL (p&lt;.001) compared to men (n=76).CONCLUSIONThese findings underpin the need for standardized assessments of pain and mental health, especially in the treatment of female youths with extreme obesity. Upcoming studies may analyze reciprocal interactions since both aspects are important barriers for lifestyle changes and weight loss.","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":"13 1","pages":"1-25"},"PeriodicalIF":3.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Obesity Facts
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