Obesity Facts最新文献

Introduction: The relationship between the metabolically healthy obesity (MHO) phenotype and the occurrence of gastroesophageal reflux disease (GERD) and inefficient esophageal motility (IEM) is still unclear. Thus, we assessed the association between different metabolic obesity phenotypes and GERD and IEM using empirical data.

Methods: We collected clinical and test data of 712 patients, including 24-h multichannel intraluminal impedance-pH (24-h MII-pH) monitoring, high-resolution manometry (HRM), and endoscopy. We divided 567 individuals into four categories according to their metabolic obesity phenotype: metabolically unhealthy non-obesity (MUNO), metabolically unhealthy obesity (MUO), metabolically healthy non-obesity (MHNO), and MHO. We compared differences in the 24-h MII-pH monitoring, HRM, and endoscopy findings among the four metabolic obesity phenotypes.

Results: Patients with the MUNO, MHO, or MUO phenotype showed a greater risk of IEM and GERD (pathologic acid exposure time [AET] >6%) compared with patients with the MHNO phenotype. Regarding the HRM results, patients with the MHNO or MUNO phenotype had a lower integrated relaxation pressure, esophageal sphincter pressure, and esophagogastric junction contractile integral, and more ineffective swallows than patients with the MHO or MUO phenotype (p < 0.05). In terms of 24-h MII-pH, patients with the MHO or MUO phenotype had a higher total, upright, and supine AET; a higher total number of reflux episodes (TRs); and a lower mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index compared with those with the MHNO or MUNO phenotype (all p < 0.05). Considering the odds ratio of 19.086 (95% confidence interval 6.170-59.044) for pathologic AET and 3.659 (95% confidence interval 1.647-8.130) for IEM, patients with the MUO phenotype had the greatest risk after adjusting for all confounding variables.

Conclusion: Obesity and metabolic disorders increase the risk of GERD and IEM. Obesity has a greater impact on esophageal dysmotility and pathologic acid exposure than metabolic diseases.

Introduction: The aim of this study was to estimate the time to pregnancy and live birth and evaluate the effect of weight regain in women with a history of bariatric surgery (BS) who underwent in vitro fertilization (IVF) treatments.

Methods: This is a retrospective cohort study. All patients with previous BS who underwent IVF treatment in a tertiary university-affiliated hospital between 2013 and 2022 were included. Time to pregnancy and live birth were compared between patients who regained less than or greater than three points of body mass index (BMI) from the nadir weight after BS. Kaplan-Meier curves and log-rank tests were used to compare groups.

Results: A total of 78 patients were included in this study. The positive β-hCG, clinical pregnancy, and live birth rates following BS were 89.4%, 78.9%, and 50.8%, respectively. The median time from the beginning of IVF treatments to a positive β-hCG test was 2.97 months (95% CI: 1.04-4.89 months), to a clinical pregnancy was 7.1 months (95% CI: 3.56-10.91), and to a live birth was 20.2 months. Women who maintained their nadir BMI following BS had nearly twice the chance of achieving a clinical pregnancy (HR 1.967, 95% CI: 1.026-3.771, p = 0.042) and were approximately three times more likely to achieve a live birth (2.864, 95% CI: 1.196-6.859, p = 0.018) than those who regained at least three points of BMI.

Conclusion: Weight regain after BS is associated with a lower rate of live births and prolonged time to achieve clinical pregnancy and live birth.

Introduction: Obesity has arisen as a prominent risk factor for COVID-19 severity and long COVID, potentially owed in part to the obesity-induced proinflammatory state. This study aimed to examine relationships among circulating inflammatory biomarkers and body mass index in nonhospitalized adults recently diagnosed with COVID-19.

Methods: This analysis included participants who completed a randomized placebo-controlled trial conducted in October 2020-March 2021. Participants (19-53 years) were unvaccinated and enrolled following COVID-19 diagnosis as allowed by CDC return-to-work guidance. Anthropometrics and biomarkers were assessed at study baseline and week four. We examined the associations between body mass index (BMI) and inflammatory biomarkers via multiple regression models.

Results: At study baseline (i.e., the point of enrollment following COVID-19 diagnosis) across all participants (N = 60), a higher BMI was associated with elevations in several inflammatory biomarkers including IL-6 (β = 7.63, 95% CI = 3.54, 11.89, p = 0.0004), ferritin (β = 6.31, 95% CI = 1.97, 10.83, p = 0.0047), high sensitivity C-reactive protein (β = 13.1, 95% CI = 8.03, 18.42, p = < 0.0001), tumor necrosis factor-α (β = 3.23, 95% CI = 0.91, 5.60, p = 0.0069), IL-12p40 (β = 3.69, 95% CI = 0.93, 6.52, p = 0.0094), IL-13 (β = 5.11, 95% CI = 1.00, 9.40, p = 0.0154), and IL-1Ra (β = 7.57, 95% CI = 3.61, 11.70, p = 0.0003). In control group participants (n = 30) after 4 weeks, a higher BMI was associated with elevations in IL-4 (β = 17.8, 95% CI = 0.84, 37.6, p = 0.0397) and sP-selectin (β = 1.16, 95% CI = 0.22, 2.11, p = 0.0182), controlling for baseline and covariates.

Conclusions: Here, BMI was positively associated with circulating biomarkers of platelet activation and inflammation in adults recently diagnosed with COVID-19 after 4 weeks. The shift in post-acute COVID-19 inflammatory biomarkers associated with an increasing BMI noted here shares similarities to biomarkers of LC reported in the literature.

Introduction: This study explores the under-investigated area of obesity-related discrimination and stigmatization across different countries, specifically comparing Spain (Europe) and Egypt (Middle East).

Methods: We conducted a cross-sectional observational study involving 2,090 participants from both countries. Participants completed three well-validated questionnaires to assess their attitudes toward obesity, experiences of weight-related stigma, and internalization of weight bias: Antifat Attitudes Scale (AFA), Stigmatizing Situations Inventory (SSI), and Weight Bias Internalization Scale (WBIS). Participants were categorized into four groups based on body mass index (BMI) and history bariatric surgery.

Results: Egyptian participants (BMI = 30.2 ± 6.7 kg/m2 [range: 18.5-69.0 kg/m2]) showed significantly higher aversion toward obesity, as indicated by higher AFA score, compared to their Spanish counterparts (BMI = 35.4 ± 10.1 kg/m2 [18.5-71.9 kg/m2]). In contrast, Spanish participants reported higher levels of weight bias internalization with increasing BMI, while in Egypt, this association was negative. The association of bariatric surgery on stigma reduction also differed between the countries. Multivariate analysis revealed that residing in Egypt was an independent risk factor for higher scores in AFA and WBIS (odds ratio 8.20 [95% confidence interval: 6.78-9.62], p < 0.001 and odds ratio (OR) 6.28 [95% CI: 4.78-7.78], p < 0.001, respectively). In contrast, Spaniards experienced more stigmatizing situations than Egyptians (OR -2.54 [95% CI: 6.78-9.62], p < 0.001).

Conclusion: Our study underscores the complex and diverse nature of obesity-related attitudes across cultures. Understanding these cultural differences is crucial for developing effective, culturally sensitive strategies to tackle weight stigma. This research opens avenues for further studies and interventions tailored to cultural contexts.

Introduction: Short educational programs prior to metabolic and bariatric surgery (MBS) provide information to prepare patients adequately for surgery and subsequent changes. Our knowledge of the beneficial effects of these programs on stabilizing and improving mental health of patients with obesity awaiting surgery is incomplete. The objective of this study was to assess the effects of a group-based educational program before MBS on three key factors: i) patients' mental health, ii) the program's perceived helpfulness from the patients' perspective, and iii) the effectiveness of delivering the program online via videoconferencing.

Methods: Validated questionnaires for anxiety, depression, stress, and quality of life before and after the program were assessed. Additionally, participants' perspectives of benefits were assessed. Two subgroups, one participating in face-to-face classes, the other participating online via videoconferencing, were compared.

Results: Three hundred five patients with obesity waiting for MBS participated in the program. The dropout rate was 3%. On mean average, symptoms of anxiety (-1.1 units (SD 4.6), p < 0.001), depression (-0.9 units (SD 4.6), p < 0.001), and stress (-4.6 units (SD 15.6), p < 0.001) improved, while physical quality of life (+1.7 (SD 9.7), p = 0.016) and body weight (-0.3 kg (SD 8.7), p = 0.57) remained stable. Patients perceived the program as very beneficial. The results were similar between delivery methods (face-to-face versus videoconferencing).

Conclusion: The educational program proved to be effective in bridging the gap in preoperative preparation while also stabilizing participants' mental health. In addition, participants perceived the program as supportive. Online participation via video conferencing can be offered as an equivalent option to face-to-face classes.

Introduction: In obesity-related type 2 diabetes mellitus (T2DM), M1 macrophages aggravate chronic inflammation and insulin resistance. ISG15-conjugation enzyme E2L6 (Ube2L6) has been demonstrated as a promoter of obesity and insulin resistance. This study investigated the function and mechanism of Ube2L6 in M1 macrophage polarization in obesity.

Methods: Obesity was induced in Ube2L6AKO mice and age-matched Ube2L6flox/flox control mice by high-fat diet (HFD). Stromal vascular cells were isolated from the epididymal white adipose tissue of mice. Polarization induction was performed in mouse bone marrow-derived macrophages (BMDMs) by exposure to IFN-γ, lipopolysaccharide, or IL-4. F4/80 expression was assessed by immunohistochemistry staining. Expressions of M1/M2 macrophage markers and target molecules were determined by flow cytometry, RT-qPCR, and Western blotting, respectively. Protein interaction was validated by co-immunoprecipitation (Co-IP) assay. The release of TNF-α and IL-10 was detected by ELISA.

Results: The polarization of pro-inflammatory M1 macrophages together with an increase in macrophage infiltration was observed in HFD-fed mice, which could be restrained by Ube2L6 knockdown. Additionally, Ube2L6 deficiency triggered the repolarization of BMDMs from M1 to M2 phenotypes. Mechanistically, Ube2L6 promoted the expression and activation of signal transducer and activator of transcription 1 (STAT1) through interferon-stimulated gene 15 (ISG15)-mediated ISGlylation, resulting in M1 macrophage polarization.

Conclusion: Ube2L6 exerts as an activator of STAT1 via post-translational modification of STAT1 by ISG15, thereby triggering M1 macrophage polarization in HFD-fed obese mice. Overall, targeting Ube2L6 may represent an effective therapeutic strategy for ameliorating obesity-related T2DM.

Introduction: Overweight and obesity lead to numerous complications and their treatment. The associated costs represent a health and sociopolitical burden. Therefore, the development of overweight and obesity is of great importance for health policy.

Methods: The Gutenberg Health Study (GHS), a population-based observational study of individuals aged 35-74 years in the city of Mainz and the district of Mainz-Bingen, examined current data on the prevalence and development of overweight and obesity and their association with concomitant diseases and medication use.

Results: Among men, 48.1% were overweight and 26.3% had obesity. Among women, these proportions were 32.1% and 24.1%, respectively. Elevated body mass index (BMI) was associated with numerous complications, particularly insulin resistance and type 2 diabetes, arterial hypertension, elevated triglycerides and low HDL cholesterol, and cardiovascular disease. Accordingly, medications to treat these conditions were used significantly more often in individuals with elevated BMI. During the 10-year observation period, mean weight increased in the population. Both men and women had a moderate but significant increase in BMI compared to men and women of the same age at baseline. Individual weight changes over the 10-year observation period, on the other hand, were age-dependent. In the two younger age decades, weight gain was observed, while in the oldest age decade, mean body weight decreased.

Conclusion: These current data confirm that overweight and obesity are associated with relevant complications and that these complications lead to significant use of appropriate medications. The study also suggests that there is a significant trend toward increased prevalence of obesity (BMI ≥30) over the 10-year period.

Introduction: Almost 25% of German adults have obesity and numbers are rising, making it an important health issue. Bariatric-metabolic surgery reduces body weight and complications for persons with obesity, but therapeutic success requires long-term postoperative care. Since no German standards for follow-up by family physicians exist, follow-up is provided by surgical obesity centers, but they are reaching their limits. The ACHT study, funded by the German Innovation Fund, is designed to establish and evaluate the follow-up program, with local physicians following patients supported remotely by obesity centers.

Methods: ACHT is a multicenter, prospective, non-randomized control group study. The 18-month ACHT follow-up program is a digitally supported, structured, cross-sectoral, and close-to-home program to improve success after bariatric-metabolic surgery. Four groups are compared: intervention group 1 starts the program immediately (3 weeks) after Roux-en-Y gastric bypass or sleeve gastrectomy (months 1-18 postoperatively), intervention group 2 begins the program 18 months after surgery (months 19-36 postoperatively). Intervention groups are compared to respective control groups that had surgery 18 and 36 months previously. In total, 250 patients, enrolled in the intervention groups, are compared with 360 patients in the control groups, who only receive standard care.

Results: The primary endpoint to compare intervention and control groups is the adapted King's score, a composite tool evaluating physical, psychological, socioeconomic, and functional health status. Secondary endpoints include changes in care structures and care processes for the intervention groups. Multivariate regression analyses adjusting for confounders (including the type of surgery) are used to compare intervention and control groups and evaluate determinants in longitudinal analyses. The effect of the intervention on healthcare costs will be evaluated based on health insurance billing data of patients who had bariatric-metabolic surgery in the 3 years prior to the start of the study and of patients who undergo bariatric-metabolic surgery during the study period.

Conclusions: ACHT will be the one of the first evaluated structured, close-to-home follow-up programs for bariatric surgery in Germany. It will evaluate the effectiveness of the implemented program regarding improvements in health status, mental health, quality of life, and the feasibility of such a program outside of specialized obesity centers.

Introduction: The Weight Bias Internalization Scale and the Modified Weight Bias Internalization Scale are well-established self-report questionnaires for assessing weight bias internalization, which is widespread among bariatric patients. However, among this group, psychometric properties of the Weight Bias Internalization Scale have only been examined in small samples showing unsatisfactory model fit and have not been explored for the modified questionnaire.

Methods: This study psychometrically evaluated and compared the Weight Bias Internalization Scale and Modified Weight Bias Internalization Scale in a large sample of prebariatric patients (N = 825, mean age = 46.75 years, SD = 11.55) regarding item characteristics, model fit to unidimensionality, reliability, construct validity, and measurement invariance.

Results: Item 4 of both questionnaires showed low corrected item-total correlations (<0.40) and was therefore removed from the scales. The new 10-item versions showed improved item characteristics, internal consistency, model fit to unidimensionality, and convergent and divergent validity when compared to the 11-item versions. The best psychometric properties were found for the 10-item version of the Modified Weight Bias Internalization Scale.

Conclusion: The 10-item version of the Modified Weight Bias Internalization Scale surpasses the other versions studied in all psychometric properties. Therefore, it should be used in prebariatric patients to detect weight bias internalization and provide them with psychological interventions that could improve bariatric surgery outcomes.

Introduction: The purpose of this study was to compare the difference in abdominal fat distribution between different metabolic groups and find the ectopic fat with the most risk significance.

Methods: A total of 98 subjects were enrolled; there were 53 cases in the normal glucose metabolism group and 45 cases in the abnormal glucose metabolism group. Chemical shift-encoded magnetic resonance imaging was applied for quantification of pancreatic fat fraction (PFF) and hepatic fat fraction (HFF), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT). The correlation and the difference of fat distribution between different metabolism groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the suggestive effect of different body fat fraction.

Results: Correlation analysis showed that body mass index (BMI) had the strongest correlation with fasting insulin (r = 0.473, p < 0.001), HOMA-IR (r = 0.363, p < 0.001), and C-reactive protein (r = 0.245, p < 0.05). Pancreatic fat has a good correlation with fasting blood glucose (r = 0.247, p < 0.05) and HbA1c (r = 0.363, p < 0.001). With the increase of BMI, PFF, VAT, and SAT showed a clear upward trend, but liver fat was distributed relatively more randomly. The pancreatic fat content in the abnormal glucose metabolism group is significantly higher than that in the normal group, and pancreatic fat is also a reliable indicator of abnormal glucose metabolism, especially in the normal and overweight groups (the area under the curve was 0.859 and 0.864, respectively).

Conclusion: MR-based fat quantification techniques can provide additional information on fat distribution. There are differences in fat distribution among people with different metabolic status. People with more severe pancreatic fat deposition have a higher risk of glucose metabolism disorders.