Obesity Facts最新文献

Introduction: Body mass index (BMI) ≥50 kg/m2 is more challenging for the metabolic bariatric surgeon because of a thicker abdominal wall, more visceral fat, and hepatomegaly by liver steatosis. This study aimed to give an overview of 5-year outcomes after one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) in these patients in terms of weight loss, remission of comorbidities, and complications.

Methods: This retrospective single-center cohort study focused on patients with BMI ≥50 kg/m2 undergoing OAGB or RYGB between 2015 and 2017 at a nonacademic teaching hospital in the Netherlands. A 1:1 propensity score-matched (PSM) comparison was conducted.

Results: In total, 158 patients underwent OAGB and 32 patients RYGB. After performing a 1:1 PSM, we obtained two nearly identical cohorts of 28 patients. Follow-up data after 5 years were available in 79% of the patients after OAGB and 82% of the patients after RYGB. Both procedures resulted in equal weight loss, remission of comorbidities, and short-term complications. More minor midterm complications were seen after OAGB (50% versus 18%; p = 0.011) due to reflux complaints (50% versus 7%; p < 0.001). The number of patients with major midterm complications did not differ (7% after OAGB versus 14% after RYGB; p = 0.388). The only major complication after OAGB was conversion to RYGB due to reflux in 7.1% of the patients. In contrast, major complications following RYGB were more diverse.

Conclusion: Both procedures resulted in similar weight loss, remission of comorbidities, short-term and major midterm complications, making OAGB a suitable alternative to RYGB for patients with a BMI ≥50 kg/m2.

Introduction: Omentin (intelectin-1) is an adipokine produced by the stromal vascular fraction of visceral adipose tissue and has been positively associated with insulin sensitivity. The underlying mechanism of action, however, is largely unknown. It has been described that omentin may increase insulin sensitivity and glucose uptake of adipocytes, but effects on other insulin-sensitive tissues such as skeletal muscle are unexplored. We therefore investigated effects of omentin on insulin sensitivity and metabolism of primary human myotubes.

Methods: Primary human myotubes were treated with 0.5 or 2 µg/mL omentin and subsequently protein detection, glucose uptake assay, lactate assay, and lipidomics analysis were performed.

Results: Omentin did not affect skeletal muscle insulin signaling, as assessed by basal and insulin-stimulated phosphorylation of IRS1 and AKT. Omentin increased basal, but not insulin-stimulated glucose uptake. While increased glycolytic activity was confirmed by elevated lactate release after omentin treatment, effects on cellular lipid composition were limited to an increase in total triacylglycerol concentration. Increased glucose uptake by omentin was counteracted by addition of extracellular lactotransferrin, which can bind to omentin.

Conclusions: Overall, increased basal glucose uptake in skeletal muscle cells suggests differential effects of omentin on insulin-sensitive tissues. Moreover, an involvement of lactotransferrin in omentin's mechanism of action may partially explain contradictory results of epidemiological studies on the role of omentin in different diseases.

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) were 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.

Book.

Introduction: This study was to explore the causal association between gestational and perinatal factors and the risk of childhood obesity based on two-sample Mendelian randomization (MR).

Methods: The single-nucleotide polymorphisms (SNPs) associated with exposure were selected. MR Egger regression was used for the evaluation of the horizontal pleiotropy in SNPs. F-statistic reflects the strength of instrumental variables. Cochran's Q statistic was used to investigate the heterogeneity of SNPs. The primary MR method exploring the causal association between gestational and perinatal factors and the risk of childhood obesity was inverse variance weighted (IVW). Leave-one-out analysis was employed to identify whether the MR results were affected by single SNPs. Odds ratio (OR) and 95% confidence interval (CI) were imputed.

Results: IVW indicated that birth weight was a risk factor for childhood body mass index (BMI) (OR = 1.347, 95% CI: 1.212-1.498) and childhood obesity (OR = 1.793, 95% CI: 1.300-2.473). Increased risk of childhood obesity was identified in mother with gestational diabetes (OR = 1.059, 95% CI: 1.006-1.116). Gestational diabetes was causally related to elevated childhood BMI. Gestational diabetes was causally related to elevated risk of childhood obesity (OR = 1.249, 95% CI: 1.044-1.495).

Conclusions: Birth weight and gestational diabetes were causally related to childhood BMI and childhood obesity.

Obesity is the world's most dangerous and rapidly growing health problem. Treating people living with obesity is not limited to the weight-loss process. They should also be followed up with a multidisciplinary approach to maintain the weight loss achieved. There is a lack of structural and functional standardization in obesity centers that undertake medical and surgical treatment. This consensus report, prepared by professional organizations for treating obesity, aimed to ensure that all obesity centers can perform standard patient management using evidence-based workflow diagrams. The report covers all the steps, starting from the initial evaluation process. It describes how to make treatment decisions jointly, defines the responsibilities of obesity councils, and designates the follow-up procedures of medically or surgically treated patients. The consensus report underlines that all healthcare professionals treating obesity are complementary. No discipline can achieve absolute success in treating people with obesity on its own. It is mandatory to implement a sustainable and practical collaboration based on current scientific evidence in treating and following up individuals with obesity.

Introduction: The aim of this study was to investigate the impact of the COVID-19 pandemic on psychosocial well-being in adolescents with obesity compared to those with type 1 diabetes.

Methods: As part of the German KICK-COVID Study, adolescents aged 12-21 with overweight or obesity from the German/Austrian Adiposity Follow-up Registry (APV) completed well-being, anxiety, and depression questionnaires (WHO-5, GAD-7, PHQ-9) during routine visits amidst the COVID-19 pandemic. By multivariable linear regression models, adjusted for age, gender, and immigration background, the association between psychosocial distress, anthropometrics, and cardiometabolic risk factors was analyzed. Data were compared to those of youth with type 1 diabetes from the German/Austrian Diabetes Follow-up Registry (DPV) and normative values from the general population. Additionally, a mediation analysis examined the impact of loneliness on mental health through media consumption.

Results: From June 2021 to September 2023, 235 adolescents from 6 German and 1 Austrian pediatric obesity centers were enrolled. Results were compared to 235 age- and gender-matched participants from the DPV registry (54.04% males; mean age 15.21 ± 1.66 years) and normative values. Youth with type 1 diabetes were more anxious about their health risk, but distress factors were more pronounced in the APV group (p < 0.001). Girls from the APV group showed higher mental distress than boys across all applied questionnaires, but not for age, BMI-SDS, and migration background as predictors. Perception of loneliness correlated with poorer mental health outcomes, but it was not associated to media consumption. Comparisons with normative values revealed significantly higher depression and anxiety scores (p < 0.001) and lower well-being scores in the APV group (p < 0.01).

Conclusions: Youth with obesity and diabetes experienced significant psychosocial distress during the COVID-19 pandemic. Disease-specific differences were observed on the level of single items: Adolescents with type 1 diabetes expressed heightened concern about their health risks, while those with obesity reported lower self-esteem, increased suicidal thoughts, and fluctuating appetite. Female gender appeared to pose an additional risk factor. Media consumption was notably higher in the APV cohort. Healthcare providers should be vigilant regarding psychological comorbidities in youth with chronic conditions, particularly during periods of heightened stress.

Introduction: Pregnancies after bariatric surgery (BS) are considered at risk because of increased rate of maternal micronutrient deficiencies, small for gestational age, and prematurity. Longer-term data on child health are scarce and conflicting. The objective of the NUMASURG project is to understand the consequences of micronutrient deficiencies during pregnancy after BS for the mother and the offspring and to better document the child's health outcomes after maternal BS. Methods: NUMASURG is a collaborative project bringing together clinicians, biologists, epidemiologists, clinical researchers, and the French Obesity Research Center of Excellence network. The project is organized into four specific tasks: (1) establish a cohort of 1,000 pregnant women with a history of BS; (2) establish reference values for nutritional biomarkers during pregnancy (vitamins A, B9, B12, 25[OH]-D, zinc, ferritin) from two birth cohorts of the French general population (EDEN and ELFE); (3) compare the nutritional status between pregnant women after BS and women from the general population and investigate the associations between nutritional biomarkers and small for gestational age and prematurity in both populations; and (4) describe the health of children born from mothers with a history of BS using the French national health data system. Started in September 2023, the project will run for 4 years. Conclusion: The NUMASURG project will allow for implementing updated recommendations concerning the monitoring and nutritional supplementation of pregnant women with a history of BS. Ultimate objective are to improve the nutritional status of these women and consequently limit the main risks currently observed during pregnancy after BS. Structuring a clinical database will help standardize practices and enable future research projects in this area and will be a key first step in creating a prospective cohort of children born from mothers with a history of BS.

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.

Introduction: Adjustable intragastric balloon (aIGB), known as a novel minimally invasive therapy for obesity, provides a sustained alternative for weight loss. Weight loss is achieved by implanting a balloon into the patient's stomach, with the volume of the balloon being adjustable through the injection or extraction of physiological saline. Its key distinction from other intragastric balloons lies in post-implantation volume control. Currently, the efficacy and safety of aIGB have not been well described.

Methods: MEDLINE, Embase, and the Cochrane Library were searched for relevant articles. Efficacy and safety of aIGB were evaluated by total body weight loss (TWL) after treatment and severe adverse events.

Results: A total of 12 eligible studies with 4,981 patients were included. The average inserting time was 9.9 months, and the pooled mean TWL was 16.4% (95% CI: 0.153-0.175, I2 = 91.2%). The pooled prevalence of patients choosing upward balloon adjustment was 34.2% (95% CI: 0.220-0.485, I2 = 96.5), and all reported additional weight loss with a mean of 6.3 (4.8-9.3) kg. The pooled prevalence of patients choosing downward balloon adjustment was 9.2% (95% CI: 0.065-0.119, I2 = 73.9%), and the pooled prevalence of alleviating intolerance in these patients was 90.8% (95% CI: 0.817-0.974, I2 = 53.4%). The pooled prevalence of intolerance and early removal within 3 months was 5.7% (95% CI: 0.035-0.078, I2 = 79.8%), and the pooled prevalence of stomach ulcer was 1.1% (95% CI: 0.008-0.014, I2 = 5.1%). There was no obvious publication bias detected for these outcomes. Leave-one-out and subgroup analysis demonstrated the results were statistically reliable.

Conclusion: aIGB has the ability of significant and sustained weight loss and can effectively manage both intolerance and weight loss plateaus by adjusting the balloon volume during treatment.