Obesity Facts最新文献

Introduction: Acute mesenteric ischemia (AMI) is a rare but lethal disease. Mesenteric vein thrombosis (VAMI) is a subtype of AMI. Morbid obesity is usually accompanied by hypertension, hyperlipidemia, or diabetes mellitus, which are risk factors associated with AMI.

Case presentation: We present a 28-year-old man with VAMI post-laparoscopic sleeve gastrectomy. He was first misdiagnosed with intestinal obstruction. Superior VAMI was confirmed after computed tomography angiography. Laparotomy, resection of the necrotic small bowel, and ostomy were performed immediately.

Conclusion: Patients with morbid obesity accompanied by hypertension, hyperlipidemia, or diabetes mellitus have a high risk of AMI. Abdominal pain with sudden onset should be considered AMI. Anticoagulation therapy post-sleeve gastrectomy might help reduce the incidence of AMI.

Introduction: With the rapid development of treatment modalities for obesity management, there is an increasing demand for guidance to facilitate the prioritization of interventions. In 2020, the Swedish National Board of Health and Welfare started the process of producing the first national guidelines for obesity care directed to decision makers who allocate resources to the best knowledge-based care. The main aim of this paper was to describe the systematic development of these guidelines, designed to guarantee uniformly high standards of care throughout the whole country.

Methods: The standardized procedures of the National Board of Health and Welfare were applied to construct guidelines in a systematic and transparent way, including priority setting of recommendations and quality indicators to evaluate the progress of implementation. The process involved independent expert committees including professionals and patient representatives, and the guidelines were reviewed through an open public consultation.

Results: National guidelines were issued in 2023, encompassing a broad scope, from identification and diagnosis to multiple treatment modalities, embedded in a life-course perspective from pregnancy to the elderly, as well as highlighting the need for improved knowledge and competence of health care providers.

Conclusions: National guidelines for improved standard care and evidence-based and efficient use of health care resources for obesity treatment can be developed in a systematic way with professionals and patient representatives.

Introduction: Primary prevention is a public health strategy that hitherto has not been widely applied in obesity prevention research. The objectives were to examine the long-term effects of the Healthy Start primary obesity prevention study, an intervention conducted among healthy weight children susceptible to develop obesity.

Methods: At baseline, children (2-6 years) were allocated to the intervention group (n = 271), the control group (n = 272), or the shadow control group (n = 383). Children in the shadow control group had no contact with project staff during the intervention period (1.3 years on average). The intervention was designed to deliver individually tailored improvements in diet and physical activity habits, optimization of sleep quantity and quality and reduce family stress. After the intervention was completed, height and weight at school entry were obtained from the Danish National Child Health Register when children were around 7 years. The average follow-up time was 2.7 years after baseline. Linear regression analyses on annual changes in BMI (ΔBMI) and BMI z-scores (ΔBMIz) were conducted.

Results: At mean 2.7 years after the baseline examination, no differences were observed between the intervention and control group in ΔBMI (β = 0.07 [-0.02; 0.15], p = 0.14) or ΔBMIz (β = 0.04 [-0.02; 0.10], p = 0.19). Likewise, no differences were observed between the intervention and shadow control group in ΔBMI (β = -0.03 [-0.12; 0.06], p = 0.50) or in ΔBMIz (β = -0.02 [-0.08; 0.05], p = 0.62).

Conclusion: We are still in urgent need of more primary overweight prevention interventions to begin to understand how to prevent that healthy weight children develop overweight.

Introduction: Given the lack of research on the relationship of post-surgery dumping syndrome and eating disturbances, the purpose of the present longitudinal study was to investigate whether dumping after obesity surgery is associated with pre-/postoperative eating disorder symptoms or addiction-like eating beyond the type of surgery, gender, health-realted quality of life (HRQoL) and anxiety/depressive symptoms.

Methods: The study included 220 patients (76% women) before (t0) and 6 months after (t1) obesity surgery (sleeve gastrectomy [n = 152], Roux-en-Y gastric bypass [n = 53], omega loop gastric bypass [n = 15]). The Sigstad Dumping Score was used to assess post-surgery dumping syndrome. Participants further answered the Eating Disorder Examination Questionnaire (EDE-Q), Yale Food Addiction Scale 2.0 (YFAS 2.0), Short-Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) at t0 and t1.

Results: The point prevalence of symptoms suggestive of post-surgery dumping syndrome was 33%. Regression analyses indicate an association of dumping with surgical procedure (bypass), female gender, reduced HRQoL, more anxiety/depressive symptoms, and potentially with binge eating but not with eating disorder symptoms in general or with addiction-like eating.

Conclusion: The current study failed to show a close relationship between the presence of self-reported dumping syndrome and eating disorder symptoms or addiction-like eating following obesity surgery. Further studies with longer follow-up periods should make use of clinical interviews to assess psychosocial variables and of objective measures to diagnose dumping in addition to standardized self-ratings.

Introduction: Elevated levels of serum uric acid (SUA) are strongly associated with several components of the metabolic syndrome, particularly obesity. Previous studies have reported the correlation between SUA levels, xanthine oxidoreductase (XOR) activity, and the imbalanced adipokine levels that are characteristic of obesity. In this study, we explored the effect of febuxostat on circulating adipokine profiles in patients with overweight or obesity and asymptomatic hyperuricemia.

Methods: This study was a single-center, randomized, and controlled clinical trial that enrolled 130 participants with asymptomatic hyperuricemia and obesity. One hundred seventeen participants were included in the final analysis, with 60 participants in the febuxostat group and 57 in the control group. We compared the circulating adipokine levels at 3 and 6 months, including high molecular weight (HMW) adiponectin, chemerin, omentin, monocyte chemotactic protein-1, asprosin, fibroblast growth factor 21, neuregulin-4, leptin, resistin, vaspin, visfatin, adipsin, and assessed the correlation between changes in adipokine levels (Δadipokines) and changes in XOR activity (ΔXOR) after febuxostat treatment.

Results: The results showed that an increase in HMW adiponectin and omentin levels and a decrease in chemerin and asprosin levels at 3 or 6 months compared to the control group. Additionally, a positive correlation was observed between ΔXOR activity and Δasprosin. Furthermore, after adjusting for triglyceride (ΔTG) and serum uric acid (ΔSUA) in multiple linear regression analyses, we found that ΔXOR activity was independently correlated with Δasprosin.

Conclusion: This study may provide important evidence that febuxostat could alleviate the imbalance in circulating adipokine levels in patients with overweight or obesity and asymptomatic hyperuricemia. Furthermore, we observed a positive correlation between changes in asprosin levels and changes in XOR activity after febuxostat treatment.

Introduction: Over 25% of the world's population has non-obese or lean non-alcoholic fatty liver disease (NAFLD), and the prevalence is higher than average in Asia. The present study focused on the relationship between body mass index (BMI) and non-obese NAFLD in non-overweight people in China, particularly the influence of triglycerides (TG) in the pathogenesis of non-obese NAFLD. The findings suggest new treatments for NAFLD patients with normal BMI, as well as provide an early warning system for the understanding and prevention of NAFLD in non-obese patients.

Methods: This cross-sectional study enrolled 159,959 Chinese subjects with BMI <24 kg/m2 and normal levels of low-density lipoprotein cholesterol (LDL-c). The average age was 40.21 ± 13.88 years, and males accounted for 45.7%. A total of 15,907 (9.94%) patients with NAFLD were diagnosed by ultrasonography. Biochemical indicators were measured using an automated analyzer (Abbott AxSYM). The BMI (kg/m2) was calculated from the weight (kg)/height in square meters (m2). The BMI quartile was used as the column-stratified variable to determine the baseline distribution, and logistic regression analysis was used to assess the relationship between NAFLD and its risk factors, with multiple logistic regression used to assess the relationships between BMI or TG and NAFLD and multivariate linear regression used to analyze the association between BMI and TG, while mediation analysis was used to assess the mediation effect of TG.

Results: After adjustment of all covariates, the odds ratios were 1.788 (95% CI: 1.749-1.829; p < 0.00001) and 1.491 (95% CI: 1.451-1.532; p < 0.00001) for the association between BMI and TG with NAFLD incidence. The multivariate linear regression coefficient of BMI and TG was β = 0.027 (95% CI: 0.023-0.030; p < 0.00001). Mediation analysis showed that BMI contributed to 10.81% of lean NAFLD with a mediation effect of 2.98%.

Conclusion: In a Chinese population with BMI <24 kg/m2 and normal LDL-c levels, BMI and TG were found to be independent predictors of NAFLD. The direct effect of BMI on non-obese NAFLD was 10.41%. The TG level was found to partially mediate the association.

Introduction: Nonalcoholic fatty liver disease (NAFLD), now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is an escalating health concern linked to obesity and type 2 diabetes. Despite liver biopsy being the gold standard, its invasiveness underscores the need for noninvasive diagnostic methods.

Methods: A cross-sectional study was performed to assess MASLD using the noninvasive OWLiver® serum lipidomics test in a cohort of 117 patients with severe obesity undergoing bariatric surgery, comparing outcomes with liver biopsy. Exclusions (n = 24) included insufficient data, liver disease etiology other than MASLD, corticosteroid treatment, excessive alcohol consumption, low glomerular filtration rate, and declination to participate. Comprehensive laboratory tests, demographic assessments, and liver biopsies were performed. Serum metabolites were analyzed using OWLiver®, a serum lipidomic test that discriminates between healthy liver, steatosis, metabolic dysfunction-associated steatohepatitis (MASH), and MASH with fibrosis ≥2 by means of three algorithms run sequentially.

Results: Liver biopsy revealed a MASLD prevalence of 95.7%, with MASH present in 28.2% of cases. OWLiver® demonstrated a tendency to diagnose more severe cases. Body mass index (BMI), rather than the presence of type 2 diabetes, emerged as the sole independent factor linked to the probability of concordance. Therefore, the all-population concordance of 63.2% between OWLiver® and liver biopsy notably raised to 77.1% in patients with a BMI <40 kg/m2. These findings suggest a potential correlation between lower BMI and enhanced concordance between OWLiver® and biopsy.

Conclusion: This study yields valuable insights into the concordance between liver biopsy and the noninvasive serum lipidomic test, OWLiver®, in severe obesity. OWLiver® demonstrated a tendency to amplify MASLD severity, with BMI values influencing concordance. Patients with BMI <40 kg/m2 may derive optimal benefits from this noninvasive diagnostic approach.

Introduction: Overweight/obesity and strenuous working conditions are associated with work disability, but their joint contributions to sickness absence (SA) are unknown. We aimed to examine their joint contributions to SA periods of 1-7 and ≥8 days.

Methods: Self-reported data on body mass index and working conditions, including perceived physically and mentally strenuous work and hours per day spent in heavy physical work, were linked to the employer's SA register for the City of Helsinki, Finland, employees (n = 4,323, women 78%) who were 19-39 years old at baseline. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for SA periods using negative binomial regression models among participants with healthy weight and overweight/obesity, with and without exposure to strenuous working conditions. The mean follow-up time was 2.1 years.

Results: Participants with overweight/obesity and exposure to physically strenuous working conditions had the highest age- and gender-adjusted RRs for SA periods of both 1-7 and ≥8 days (physically strenuous work: RR: 1.38, CI: 1.25-1.52, and RR: 1.87, CI: 1.60-2.18, respectively; ≥3 h per day spent in physical work: RR: 1.40, CI: 1.26-1.55 and 2.04, CI: 1.73-2.40, respectively). The interaction between overweight/obesity and physically strenuous working conditions was additive for SA periods of 1-7 days and weakly synergistic for SA periods of ≥8 days. For mentally strenuous work, participants with overweight/obesity and exposure to mentally strenuous work had the highest age-adjusted RRs for SA periods of ≥8 days, and the interaction was additive.

Conclusion: The joint contributions of overweight/obesity and exposure to strenuous working conditions to SA should be considered when aiming to reduce employees' SA. Employers might benefit from providing employees adequate support for weight management and adherence to healthy lifestyles while improving employees' working conditions.

Introduction: It is controversial whether obesity and periodontitis are related. A representative US population was examined for the relationship between obesity and periodontitis.

Methods: In the National Health and Nutrition Examination Survey (NHANES) 2011-2014, participants (n = 6,662) aged 30 years or older and who underwent periodontal examinations were chosen for analysis. An assessment of obesity was based on body mass index (BMI) and waist circumference (WC). Estimates of obesity and periodontal disease were made using univariate and multivariate logistic regression models.

Results: According to an adjusted odds ratio (OR) for periodontitis, BMI (OR = 1.01, 95% CI: 1.01∼1.02) and WC (OR = 1.01, 95% CI: 1∼1.01) were significantly associated with periodontitis, respectively. After adjusting for confounding factors, the OR for patients with high WC with periodontitis was 1.18 (1.04∼1.33) compared to normal WC. BMI and WC subgroups showed no significant interaction (p for interaction >0.05), except for the age interaction in BMI. Among young adults aged 30-44 years, obesity was significantly associated with periodontitis in subgroups; the adjusted OR for having periodontal disease was 1.02 (1∼1.03) and 1.01 (1∼1.02) for subjects with BMI and WC, respectively. When all covariates were adjusted, BMI ≥30 kg/m2 was statistically significantly associated with prevalence of periodontal disease among people aged 30-44 years (p < 0.001).

Conclusions: BMI and WC are significantly associated with periodontitis, even after adjusting for many variables, and were equally significant in obese (BMI ≥30 kg/m2) young people (30-44 years).

Introduction: The present study aimed to investigate whether and how normobaric intermittent hypoxic training (IHT) or remote ischemic preconditioning (RIPC) plus normoxic training (RNT) has a synergistic protective effect on lipid metabolism and vascular function compared with normoxic training (NT) in overweight or obese adults.

Methods: A total of 37 overweight or obese adults (36.03 ± 10.48 years) were randomly assigned to 3 groups: NT group (exercise intervention in normoxia), IHT group (exercise intervention in normobaric hypoxic chamber), and RNT group (exercise intervention in normoxia + RIPC twice daily). All participants carried out the same 1-h exercise intervention for a total of 4 weeks, 5 days per week. Physical fitness parameters were evaluated at pre- and postexercise intervention.

Results: After training, all three groups had a significantly decreased body mass index (p < 0.05). The IHT group had reduced body fat percentage, visceral fat mass (p < 0.05), blood pressure (p < 0.01), left ankle-brachial index (ABI), maximal heart rate (HRmax) (p < 0.05), expression of peroxisome proliferator-activated receptor-γ (PPARγ) (p < 0.01) and increased expression of SIRT1 (p < 0.05), VEGF (p < 0.01). The RNT group had lowered waist-to-hip ratio, visceral fat mass, blood pressure (p < 0.05), and HRmax (p < 0.01).

Conclusion: IHT could effectively reduce visceral fat mass and improve vascular elasticity in overweight or obese individuals than pure NT with the activation of SIRT1-related pathways. And RNT also produced similar benefits on body composition and vascular function, which were weaker than those of IHT but stronger than NT. Given the convenience and economy of RNT, both intermittent hypoxic and ischemic training have the potential to be successful health promotion strategies for the overweight/obese population.