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Effects of traditional Chinese medicines on weight management among adults with overweight or obesity: A systematic review and network meta-analysis. 传统中药对超重或肥胖成人体重控制的影响:系统综述和网络荟萃分析。
IF 2.2 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-10 eCollection Date: 2024-06-01 DOI: 10.1002/osp4.763
Meifang Chen, Jiaqi Liu

Increasing evidence has reported the anti-obesity effects of traditional Chinese medicines (TCMs) and their potential advantages in weight loss, such as fewer side effects and lower costs compared to the current recommended treatments like Western medicines. Previous review studies have examined the effects of a few commonly used TCM therapies such as acupuncture and herbal medicines on weight loss. This network meta-analysis (NMA) study aims to review and rank the effects of currently available TCMs on weight loss and to compare the effects of TCMs with different intervention durations. Eligible Randomized controlled trials (RCTs) conducted among Chinese adults with overweight or obesity were searched on electronic databases (PubMed, Embase, CNKI, WanFang, VIP, and SinoMed) up to 1 March 2023. Pairwise meta-analysis was performed to examine the pooled effects of TCMs on weight loss, and NMA was conducted to rank different types of TCMs. Subgroup analysis stratified by intervention duration was performed. Forty-six RCTs were eligible for inclusion in the review. The results showed that TCMs, especially when the treatment duration was ≤6 months, were more effective in both body weight and Body Mass Index (BMI) reduction than non-pharmacological interventions and placebo/no treatment. Acupotomy was ranked as the most effective TCM treatment in reducing both body weight and BMI. Traditional Chinese medicines have promising potential for weight loss and could be included in future clinical guidance as a standalone or supplementary treatment for obesity. Future studies need to further investigate under-researched TCMs, examine the long-term effects and safety of TCMs in obesity treatment, and validate the findings from this study among other ethnic populations.

越来越多的证据表明,传统中药具有抗肥胖的作用,而且与目前推荐的西药等治疗方法相比,传统中药在减肥方面具有副作用少、成本低等潜在优势。以往的综述研究考察了针灸和中药等几种常用中医疗法的减肥效果。这项网络荟萃分析(NMA)研究旨在对目前可用的中医药减肥效果进行回顾和排序,并比较不同干预持续时间的中医药减肥效果。研究人员在电子数据库(PubMed、Embase、CNKI、万方、VIP和SinoMed)中检索了截至2023年3月1日在中国超重或肥胖成人中进行的随机对照试验(RCT)。进行配对荟萃分析以检验中医药对减肥的总体效果,并对不同类型的中医药进行NMA排序。根据干预持续时间进行了分组分析。46项研究符合纳入研究的条件。结果显示,与非药物干预和安慰剂/不治疗相比,中医药在减轻体重和降低体质指数(BMI)方面更有效,尤其是当治疗时间≤6个月时。在减轻体重和降低体重指数方面,穴位疗法被评为最有效的中医疗法。中药在减肥方面具有广阔的前景,可作为肥胖症的独立或辅助治疗方法纳入未来的临床指南。今后的研究需要进一步调查研究不足的中药,检查中药在肥胖症治疗中的长期效果和安全性,并在其他种族人群中验证本研究的结果。
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引用次数: 0
Short sleep duration is associated with higher risk of central obesity in adults: A systematic review and meta-analysis of prospective cohort studies. 睡眠时间短与成人中心性肥胖风险较高有关:前瞻性队列研究的系统回顾和荟萃分析。
IF 2.2 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-04 eCollection Date: 2024-06-01 DOI: 10.1002/osp4.772
Ali Kohanmoo, Masoumeh Akhlaghi, Najmeh Sasani, Fatemeh Nouripour, Caterina Lombardo, Asma Kazemi

Background and objective: The relationship between sleep duration and obesity has been the focus of numerous investigations. This systematic review and meta-analysis of prospective cohort studies aimed to assess the relationship between sleep duration, abdominal obesity, and body composition.

Methods: PubMed, Scopus, and Web of Science were searched until February 2024. Cohort studies that assessed the relationship between sleep duration at night and central obesity measures or body composition indices in adults were included. The quality of studies was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was conducted on studies that reported risk ratio (RR) and 95% confidence intervals (CIs).

Results: Eighteen studies were eligible to be included. Eleven out of the 18 studies were not included in the analysis as 10 studies did not report RR, and in one study, the definition of short and normal sleep duration was different from others. The results of the meta-analysis indicated that short sleep duration was significantly associated with abdominal obesity (RR = 1.08; 95% CI: 1.04-1.12; I 2 = 49.1%, n = 7), but long sleep duration was not (RR = 1.02; 95% CI: 0.83-1.24; I 2 = 98.2%, n = 6).

Conclusions: Short sleep duration was associated with a slightly higher risk of central obesity, while long sleep duration was not.

背景和目的:睡眠时间与肥胖之间的关系一直是众多研究的焦点。本研究对前瞻性队列研究进行了系统回顾和荟萃分析,旨在评估睡眠时间、腹部肥胖和身体成分之间的关系:方法:检索了截至 2024 年 2 月的 PubMed、Scopus 和 Web of Science。方法:检索了截至 2024 年 2 月的 PubMed、Scopus 和 Web Science,纳入了评估成人夜间睡眠时间与中心肥胖测量或身体成分指数之间关系的队列研究。研究质量采用纽卡斯尔-渥太华量表进行评估。对报告了风险比(RR)和95%置信区间(CI)的研究进行了随机效应荟萃分析:有 18 项研究符合纳入条件。18 项研究中有 11 项未纳入分析,原因是 10 项研究未报告风险比,一项研究对短睡眠时间和正常睡眠时间的定义与其他研究不同。荟萃分析结果表明,睡眠时间短与腹部肥胖显著相关(RR = 1.08;95% CI:1.04-1.12;I 2 = 49.1%,n = 7),但睡眠时间长与腹部肥胖无关(RR = 1.02;95% CI:0.83-1.24;I 2 = 98.2%,n = 6):结论:睡眠时间短与中心性肥胖的风险略高有关,而睡眠时间长则无关。
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引用次数: 0
What are Internal medicine residents' attitudes toward obesity as a disease, people living with obesity, and obesity treatment? 内科住院医师对肥胖这种疾病、肥胖患者和肥胖治疗持什么态度?
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-04-01 DOI: 10.1002/osp4.748
Kacey Chae, Jashalynn German, Karla Kendrick, Sean Tackett, Paul O'Rourke, Kimberly A Gudzune, Marci Laudenslager

Objective: Despite the rising prevalence of people living with obesity, physicians are providing suboptimal care to these individuals, which may be a consequence of inadequate education in weight management and negative attitudes toward people living with obesity. Internal Medicine (IM) residency is an ideal setting to address physicians' attitudes toward people living with obesity. However, there is a paucity of recent literature on this topic. This study sought to assess the current attitudes of IM residents toward obesity as a disease, people living with obesity, and obesity treatment.

Methods: A cross-sectional survey was conducted in 2020 across two IM programs assessing residents' attitudes toward obesity as a disease, people living with obesity, and obesity treatment.

Results: Among 42 residents who participated in the survey, 64% were women; 31 percent were Post Graduate Year 1, 31% PGY-2, and 38% PGY-3. Mean attitude scores were high on statements regarding obesity as a chronic disease [4.7 (SD 0.4)] and its association with serious medical conditions [4.9 (SD 0.3)]. Residents had overall positive attitudes toward people living with obesity. In contrast, residents felt negatively regarding their level of success in helping patients lose weight [2.0 (SD 0.7)].

Conclusions: While residents recognized obesity as a chronic disease and had positive attitudes toward people living with obesity, their low ratings regarding weight management success suggest that targeted educational efforts are needed to increase obesity treatment self-efficacy.

目的:尽管肥胖症患者的发病率不断上升,但医生为这些人提供的医疗服务却不尽如人意,这可能是体重管理教育不足以及对肥胖症患者持消极态度的结果。内科住院医师培训是解决医生对肥胖症患者态度问题的理想场所。然而,近期有关这一主题的文献却很少。本研究旨在评估内科住院医师目前对肥胖这种疾病、肥胖症患者以及肥胖症治疗的态度:2020年,在两个综合医学项目中开展了一项横断面调查,评估住院医师对肥胖这种疾病、肥胖患者和肥胖治疗的态度:在参与调查的42名住院医师中,64%为女性;31%为研究生一年级,31%为研究生二年级,38%为研究生三年级。在有关肥胖是一种慢性疾病[4.7 (SD 0.4)]及其与严重医疗状况的关联[4.9 (SD 0.3)]的陈述中,平均态度得分较高。居民总体上对肥胖症患者持积极态度。与此相反,居民对自己帮助患者减肥的成功程度持消极态度[2.0 (SD 0.7)]:虽然住院医师认识到肥胖是一种慢性疾病,并对肥胖患者持积极态度,但他们对体重管理成功率的低评价表明,需要开展有针对性的教育工作,以提高肥胖治疗的自我效能。
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引用次数: 0
A low-burden, self-weighing intervention to prevent weight gain in adults with obesity who do not enroll in comprehensive treatment. 对未参加综合治疗的成人肥胖症患者进行低负担的自我称重干预,以防止体重增加。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-03-20 eCollection Date: 2024-04-01 DOI: 10.1002/osp4.745
Megan A McVay, Montserrat Carrera Seoane, Melinda Rajoria, Marissa Dye, Natalie Marshall, Sofia Muenyi, Anas Alkanderi, Kellie B Scotti, Jaime Ruiz, Corrine I Voils, Kathryn M Ross

Background: For individuals who are eligible but unlikely to join comprehensive weight loss programs, a low burden self-weighing intervention may be a more acceptable approach to weight management.

Methods: This was a single-arm feasibility trial of a 12-month self-weighing intervention. Participants were healthcare patients with a BMI ≥25 kg/m2 with a weight-related comorbidity or a BMI >30 kg/m2 who reported lack of interest in joining a comprehensive weight loss program, or did not enroll in a comprehensive program after being provided program information. In the self-weighing intervention, participants were asked to weigh themselves daily on a cellular connected scale and were sent text messages every other week with tailored weight change feedback, including messages encouraging use of comprehensive programs if weight gain occurred.

Results: Of 86 eligible patients, 39 enrolled (45.3%) in the self-weighing intervention. Self-weighing occurred on average 4.6 days/week (SD = 1.4). At 12 months, 12 participants (30.8%) lost ≥3% baseline weight, 11 (28.2%) experienced weight stability (±3% baseline), 6 (15.4%) gained ≥3% of baseline weight, and 10 (25.6%) did not have available weight data to evaluate. Three participants reported joining a weight loss program during the intervention (7.7%). Participants reported high intervention satisfaction in quantitative ratings (4.1 of 5), and qualitative interviews identified areas of satisfaction (e.g., timing and content of text messages) and areas for improvement (e.g., increasing personalization of text messages).

Conclusion: A low-burden self-weighing intervention can reach adults with overweight/obesity who would be unlikely to engage in comprehensive weight loss programs; the efficacy of this intervention for preventing weight gain should be further evaluated in a randomized trial.

背景:对于符合条件但不太可能参加综合减肥计划的人来说,低负担的自我称重干预可能是一种更容易接受的体重管理方法:这是一项为期 12 个月的自我称重干预的单臂可行性试验。参与者为体重指数(BMI)≥25 kg/m2且合并体重相关疾病或体重指数(BMI)>30 kg/m2的医护人员,他们表示对参加综合减肥计划缺乏兴趣,或在获得计划信息后未参加综合计划。在自我称重干预中,要求参与者每天用手机连接的体重秤称重,并每隔一周发送一次短信,提供量身定制的体重变化反馈,包括在体重增加时鼓励使用综合计划的信息:在 86 名符合条件的患者中,39 人(45.3%)参加了自我称重干预。平均每周自我称重 4.6 天(SD = 1.4)。12 个月时,12 名参与者(30.8%)体重下降≥3%,11 名参与者(28.2%)体重稳定(±3%),6 名参与者(15.4%)体重增加≥3%,10 名参与者(25.6%)没有可用的体重数据可供评估。有 3 名参与者表示在干预期间参加了减肥计划(7.7%)。在定量评分中,参与者对干预的满意度较高(4.1 分,满分为 5 分),定性访谈则指出了满意的方面(如短信的时间和内容)和需要改进的方面(如增加短信的个性化):低负担的自我称重干预措施可以帮助那些不太可能参与全面减肥计划的超重/肥胖成年人;这种干预措施在防止体重增加方面的效果应在随机试验中进一步评估。
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引用次数: 0
Age-wise examination of the association of obesity based on body mass index and waist circumference with metabolic diseases in comprehensive health checkup participants. 根据体重指数和腰围对全面健康体检者中肥胖症与代谢性疾病的关系进行分年龄检查。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-03-18 eCollection Date: 2024-04-01 DOI: 10.1002/osp4.746
Yuiko Yamamoto, Kentaro Ikeue, Megumi Kanasaki, Hajime Yamakage, Noriko Satoh-Asahara, Izuru Masuda, Kojiro Ishii

Aim: Body mass index and waist circumference are used for obesity diagnosis and screening of visceral fat; however, their evidence in older adults is insufficient. This study investigated the age-specific association of body mass index and waist circumference with metabolic diseases, assessing their applicability as diagnostic criteria for individuals aged ≥65 years.

Methods: Analysis included 46,324 individuals aged ≥18 years, categorized into five age groups: 18-44, 45-54, 55-64, 65-74, and ≥75 years. Logistic regression analyses identified associations between obesity and metabolic diseases, stratified by age and sex.

Results: Men with obesity based on body mass index had a significantly high risk of hypertension, diabetes mellitus, and dyslipidemia across all age groups (all, p < 0.05). Obesity based on waist circumference was significantly positively associated with all metabolic diseases (all, p < 0.05). Women with obesity based on body mass index and waist circumference had a significantly high risk of all metabolic diseases across all age groups (all, p < 0.05), except for diabetes mellitus in individuals aged ≥75 years.

Conclusions: Participants with obesity based on body mass index and waist circumference exhibited a high risk of hypertension, diabetes mellitus, and dyslipidemia among those aged 18-74 years and men aged ≥75 years. This study contributes to the early prevention and control of metabolic diseases.

目的:体重指数和腰围被用于肥胖诊断和内脏脂肪筛查;然而,它们在老年人中的应用证据不足。本研究调查了体重指数和腰围与代谢性疾病的年龄相关性,评估了它们作为诊断标准对年龄≥65 岁者的适用性:分析对象包括 46,324 名年龄≥18 岁的人,分为五个年龄组:18-44 岁、45-54 岁、55-64 岁、65-74 岁和≥75 岁。逻辑回归分析确定了肥胖与代谢性疾病之间的关系,并按年龄和性别进行了分层:结果:在所有年龄组中,以体重指数为基础的肥胖男性患高血压、糖尿病和血脂异常的风险都很高(所有年龄组,P P P 结论:在所有年龄组中,以体重指数为基础的肥胖男性患高血压、糖尿病和血脂异常的风险都很高(所有年龄组,P以体重指数和腰围为依据的肥胖症患者在 18-74 岁和年龄≥75 岁的男性中患高血压、糖尿病和血脂异常的风险较高。这项研究有助于及早预防和控制代谢性疾病。
{"title":"Age-wise examination of the association of obesity based on body mass index and waist circumference with metabolic diseases in comprehensive health checkup participants.","authors":"Yuiko Yamamoto, Kentaro Ikeue, Megumi Kanasaki, Hajime Yamakage, Noriko Satoh-Asahara, Izuru Masuda, Kojiro Ishii","doi":"10.1002/osp4.746","DOIUrl":"10.1002/osp4.746","url":null,"abstract":"<p><strong>Aim: </strong>Body mass index and waist circumference are used for obesity diagnosis and screening of visceral fat; however, their evidence in older adults is insufficient. This study investigated the age-specific association of body mass index and waist circumference with metabolic diseases, assessing their applicability as diagnostic criteria for individuals aged ≥65 years.</p><p><strong>Methods: </strong>Analysis included 46,324 individuals aged ≥18 years, categorized into five age groups: 18-44, 45-54, 55-64, 65-74, and ≥75 years. Logistic regression analyses identified associations between obesity and metabolic diseases, stratified by age and sex.</p><p><strong>Results: </strong>Men with obesity based on body mass index had a significantly high risk of hypertension, diabetes mellitus, and dyslipidemia across all age groups (all, <i>p</i> < 0.05). Obesity based on waist circumference was significantly positively associated with all metabolic diseases (all, <i>p</i> < 0.05). Women with obesity based on body mass index and waist circumference had a significantly high risk of all metabolic diseases across all age groups (all, <i>p</i> < 0.05), except for diabetes mellitus in individuals aged ≥75 years.</p><p><strong>Conclusions: </strong>Participants with obesity based on body mass index and waist circumference exhibited a high risk of hypertension, diabetes mellitus, and dyslipidemia among those aged 18-74 years and men aged ≥75 years. This study contributes to the early prevention and control of metabolic diseases.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 2","pages":"e746"},"PeriodicalIF":1.9,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference. 双能 X 射线吸收测量法与生物电阻抗分析法测量脂肪和无脂肪质量的一致性:姿势和腰围的影响
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-03-11 eCollection Date: 2024-04-01 DOI: 10.1002/osp4.744
Katie M Ellison, Sarah E Ehrlicher, Aseel El Zein, R Drew Sayer

Background: Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC).

Aims: The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM).

Materials & methods: Baseline data were collected from 28 adults (mean = 61.4 ± 6.9 years, 64.3% female) with obesity (BMI 38.6 ± 5.0 kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement.

Results: Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3 cm).

Discussion: Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC.

Conclusion: Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

背景:生物电阻抗分析(BIA)的工作假设是导体具有均匀的圆柱形。目的:本研究旨在确定姿势(仰卧、站立和坐姿)和腰围是否会影响 BIA 与双能 X 射线吸收仪(DXA)测量脂肪量(FM)和无脂肪量(FFM)的一致性:收集了 28 名肥胖成人(平均 61.4 ± 6.9 岁,64.3% 为女性)(体重指数 38.6 ± 5.0 kg/m2)的基线数据。在仰卧、站立和坐位时使用 BIA 测量身体成分,在仰卧时使用 DXA 测量身体成分。采用双向混合效应和绝对一致的类内相关系数(ICC)分析来确定一致性:结果:仰卧位时,FM 和 FFM 的点估计极佳;站立位时,FM 和 FFM 的点估计良好;坐位时,FM 和 FFM 的点估计适中。与其他体位相比,仰卧位的 BIA 测量结果的 95% 置信区间最窄。在所有体位中,观察到WC低于中位数(118.3 cm)的参与者的一致性更好:讨论:尽管在坐姿下使用 BIA 测量具有潜在的实用价值,但本分析结果表明 DXA 和 BIA 方法之间的一致性最差,尤其是在高 WC 的个体中:本研究结果表明,在测量肥胖症患者的身体成分时,BIA(尤其是在仰卧位测量时)可作为 DXA 的可行替代方法。
{"title":"Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference.","authors":"Katie M Ellison, Sarah E Ehrlicher, Aseel El Zein, R Drew Sayer","doi":"10.1002/osp4.744","DOIUrl":"10.1002/osp4.744","url":null,"abstract":"<p><strong>Background: </strong>Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC).</p><p><strong>Aims: </strong>The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM).</p><p><strong>Materials & methods: </strong>Baseline data were collected from 28 adults (mean = 61.4 ± 6.9 years, 64.3% female) with obesity (BMI 38.6 ± 5.0 kg/m<sup>2</sup>). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement.</p><p><strong>Results: </strong>Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3 cm).</p><p><strong>Discussion: </strong>Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC.</p><p><strong>Conclusion: </strong>Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 2","pages":"e744"},"PeriodicalIF":1.9,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Orforglipron, a novel non-peptide oral daily glucagon-like peptide-1 receptor agonist as an anti-obesity medicine: A systematic review and meta-analysis. 作为抗肥胖药物的新型非肽类口服日用胰高血糖素样肽-1 受体激动剂 Orforglipron:系统综述和荟萃分析。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-26 eCollection Date: 2024-04-01 DOI: 10.1002/osp4.743
Deep Dutta, Lakshmi Nagendra, Beatrice Anne, Manoj Kumar, Meha Sharma, A B M Kamrul-Hasan

Background: Orforglipron is a novel once-daily oral non-peptide glucagon-like peptide-1 receptor agonist with several recently published randomized controlled trials (RCTs) evaluating its role in diabetes and obesity. No meta-analysis has analyzed the efficacy and safety of orforglipron; this meta-analysis aimed to address this knowledge gap.

Methods: A systematic search was conducted in electronic databases to identify RCTs that included individuals with obesity who were administered orforglipron and compared to either a placebo or an active comparator. The primary outcome of interest was the percent change in body weight.

Results: From 12 initially screened articles, data from three RCTs involving 774 people were analyzed with a follow-up duration of up to 36 weeks. Compared to placebo, patients receiving orforglipron 12 mg/day (mean difference (MD), MD -5.48%, 95% CI [-7.64, -3.33], p < 0.01), 24 mg/day (MD -8.51%, 95% confidence interval (CI) [-9.88, -7.14], p < 0.01), 36 mg/day (MD -8.84%, 95% CI [-11.68, -6.00], p < 0.01) and 45 mg/day (MD -8.24%, 95% CI [-12.84, -3.63], p < 0.01) had a significantly greater percent reduction in body weight. The percentage of patients being able to achieve >15% weight loss from baseline was significantly higher with orforglipron 24 mg/day [Odds ratio (OR) 21.90 (95% CI [4.06, 118.15], p = 0.0003), 36 mg/day (OR 17.43, 95% CI [3.18, 95.66], p = 0.001) and 45 mg/day (OR 23.17, 95% CI [4.37, 123.03], p = 0.0002). Total but not severe adverse events were significantly higher with all the doses of orforglipron compared to placebo, with the hazard ratios being higher with higher doses. Gastrointestinal side-effects were predominant side effects, being dose-dependent, with nausea, vomiting, constipation, and gastroesophageal reflux being the predominant ones.

Conclusion: Orforglipron at 24-45 mg/day doses is an effective weight loss medication. The efficacy versus side effect profile suggests that 24-36 mg/day is the most optimal dose for orforglipron as an anti-obesity medicine.

背景:奥福格列酮是一种新型的每日一次口服非肽类胰高血糖素样肽-1受体激动剂,最近发表的几项随机对照试验(RCT)对其在糖尿病和肥胖症中的作用进行了评估。目前还没有荟萃分析对奥锻利戎的疗效和安全性进行分析;本荟萃分析旨在填补这一知识空白:方法:我们在电子数据库中进行了系统性检索,以确定包含肥胖症患者的 RCTs,这些患者服用了奥福曲普隆,并与安慰剂或活性比较物进行了比较。主要研究结果为体重变化百分比:从最初筛选出的 12 篇文章中,对涉及 774 人的三项 RCT 数据进行了分析,随访时间长达 36 周。与安慰剂相比,接受奥福列朋 12 毫克/天治疗的患者(平均差 (MD),MD -5.48%,95% CI [-7.64, -3.33],p p p p 奥福列朋 24 毫克/天治疗的患者体重从基线下降 15%的比例明显更高[比值比 (OR) 21.90(95% CI [4.06,118.15],p = 0.0003)、36 毫克/天(OR 17.43,95% CI [3.18,95.66],p = 0.001)和 45 毫克/天(OR 23.17,95% CI [4.37,123.03],p = 0.0002)。与安慰剂相比,所有剂量的奥福列普隆总不良反应显著增加,但不包括严重不良反应,剂量越大危险比越高。胃肠道副作用是主要的副作用,与剂量有关,主要有恶心、呕吐、便秘和胃食管反流:结论:奥福来普隆的剂量为 24-45 毫克/天,是一种有效的减肥药物。结论:奥福来普隆的剂量为 24-45 毫克/天,是一种有效的减肥药物。疗效与副作用的对比表明,24-36 毫克/天是奥福来普隆作为抗肥胖药物的最佳剂量。
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引用次数: 0
Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review. 减肥手术后坚持改变生活方式的心理预测因素:系统综述。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-24 eCollection Date: 2024-02-01 DOI: 10.1002/osp4.741
Jade K Y Chan, Lenny R Vartanian

Objective: Adherence to lifestyle changes after bariatric surgery is associated with better health outcomes; however, research suggests that patients struggle to follow post-operative recommendations. This systematic review aimed to examine psychological factors associated with adherence after bariatric surgery.

Methods: PubMed, PsycInfo, and Embase were searched (from earliest searchable to August 2022) to identify studies that reported on clinically modifiable psychological factors related to adherence after bariatric surgery. Retrieved abstracts (n = 891) were screened and coded by two raters.

Results: A total of 32 studies met the inclusion criteria and were included in the narrative synthesis. Appointment attendance and dietary recommendations were the most frequently studied post-operative instructions. Higher self-efficacy was consistently predictive of better post-operative adherence to diet and physical activity, while pre-operative depressive symptoms were commonly associated with poorer adherence to appointments, diet, and physical activity. Findings were less inconsistent for anxiety and other psychiatric conditions.

Conclusions: This systematic review identified that psychological factors such as mood disorders and patients' beliefs/attitudes are associated with adherence to lifestyle changes after bariatric surgery. These factors can be addressed with psychological interventions; therefore, they are important to consider in patient care after bariatric surgery. Future research should further examine psychological predictors of adherence with the aim of informing interventions to support recommended lifestyle changes.

目的:减肥手术后坚持改变生活方式与更好的健康结果相关;然而,研究表明,患者在遵循术后建议方面存在困难。本系统综述旨在研究与减肥手术后坚持治疗相关的心理因素:方法:检索了PubMed、PsycInfo和Embase(从最早可检索到2022年8月),以确定报道了与减肥手术后依从性相关的临床可调整心理因素的研究。检索到的摘要(n = 891)由两名评分员进行筛选和编码:结果:共有 32 项研究符合纳入标准,并被纳入叙述性综述。预约就诊和饮食建议是最常被研究的术后指导。自我效能感越高,术后对饮食和体育锻炼的依从性就越好,而术前抑郁症状通常与较差的预约、饮食和体育锻炼依从性有关。焦虑和其他精神疾病的研究结果则不太一致:本系统综述发现,情绪障碍和患者的信念/态度等心理因素与减肥手术后坚持改变生活方式有关。这些因素可以通过心理干预来解决;因此,在减肥手术后的患者护理中必须考虑到这些因素。未来的研究应进一步检查坚持治疗的心理预测因素,以便为支持建议的生活方式改变的干预措施提供信息。
{"title":"Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review.","authors":"Jade K Y Chan, Lenny R Vartanian","doi":"10.1002/osp4.741","DOIUrl":"10.1002/osp4.741","url":null,"abstract":"<p><strong>Objective: </strong>Adherence to lifestyle changes after bariatric surgery is associated with better health outcomes; however, research suggests that patients struggle to follow post-operative recommendations. This systematic review aimed to examine psychological factors associated with adherence after bariatric surgery.</p><p><strong>Methods: </strong>PubMed, PsycInfo, and Embase were searched (from earliest searchable to August 2022) to identify studies that reported on clinically modifiable psychological factors related to adherence after bariatric surgery. Retrieved abstracts (<i>n</i> = 891) were screened and coded by two raters.</p><p><strong>Results: </strong>A total of 32 studies met the inclusion criteria and were included in the narrative synthesis. Appointment attendance and dietary recommendations were the most frequently studied post-operative instructions. Higher self-efficacy was consistently predictive of better post-operative adherence to diet and physical activity, while pre-operative depressive symptoms were commonly associated with poorer adherence to appointments, diet, and physical activity. Findings were less inconsistent for anxiety and other psychiatric conditions.</p><p><strong>Conclusions: </strong>This systematic review identified that psychological factors such as mood disorders and patients' beliefs/attitudes are associated with adherence to lifestyle changes after bariatric surgery. These factors can be addressed with psychological interventions; therefore, they are important to consider in patient care after bariatric surgery. Future research should further examine psychological predictors of adherence with the aim of informing interventions to support recommended lifestyle changes.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 1","pages":"e741"},"PeriodicalIF":1.9,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10893879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations between adverse childhood experiences and history of weight cycling. 不良童年经历与体重循环史之间的关系。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-16 eCollection Date: 2024-02-01 DOI: 10.1002/osp4.736
Caitlin E Smith, Kelsey L Sinclair, Temitope Erinosho, Andrew C Pickett, Vanessa M Martinez Kercher, Lucia Ciciolla, Misty A W Hawkins

Background: Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity.

Methods: The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds.

Results: Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, p = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, p = 0.135) in this sample.

Conclusions: The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.

背景:童年的不良经历(ACEs)可预测肥胖症的发生;然而,ACEs 与体重循环史之间的关系尚未得到充分探讨。考虑到维持体重的难度以及 ACE 对肥胖发展、慢性化和相关体重污名化的影响,这一空白是有问题的。本研究的目的是在寻求减肥治疗的超重/肥胖成人样本中,研究自我报告的ACE史与体重循环之间的关联:分析样本的参与者人数为78人,大部分为受过高等教育的白人成年女性(80%为女性,81%为白种人,75%≥学士学位),她们都参加了 "肥胖的认知和自我调节机制研究"(Cognitive and Self-regulatory Mechanisms of Obesity Study)。基线时使用 ACE 量表测量 ACE。使用体重和生活方式调查表测量体重循环史,该调查表记录了体重减轻10磅或10磅以上的情况:结果:ACE 分数越高,报告体重循环史的可能性越大。与无 ACE 的参与者相比,有 4 项或更多 ACE 的参与者报告体重循环的几率高出 8 倍(OR = 8.301,95% CI = 2.271-54.209,p = 0.027)。在该样本中,有一到三个 ACEs 的参与者的体重与循环相关性并不显著(OR = 2.3,95% CI = 0.771-6.857,p = 0.135):ACE对健康的影响可能与体重循环有关。结果表明,与无 ACEs 的人相比,报告了四次或四次以上 ACEs 的人报告体重循环的几率明显更高。还需要进一步研究,以进一步探索 ACE 如何预测体重循环的可能性,这可能是持续减肥治疗反应和体重耻辱影响的预兆。
{"title":"Associations between adverse childhood experiences and history of weight cycling.","authors":"Caitlin E Smith, Kelsey L Sinclair, Temitope Erinosho, Andrew C Pickett, Vanessa M Martinez Kercher, Lucia Ciciolla, Misty A W Hawkins","doi":"10.1002/osp4.736","DOIUrl":"10.1002/osp4.736","url":null,"abstract":"<p><strong>Background: </strong>Adverse childhood experiences (ACEs) predict obesity onset; however, the relationship between ACEs and history of weight cycling has not been adequately explored. This gap is problematic given the difficulty in weight loss maintenance and the impact of ACEs on obesity development, chronicity, and associated weight stigma. The objective of this study was to examine associations between self-reported history of ACEs and weight cycling in a sample of weight loss treatment-seeking adults with overweight/obesity.</p><p><strong>Methods: </strong>The number of participants in the analyzed sample was 78, mostly white educated adult women (80% female, 81% Caucasian, 75% ≥ bachelor's degree) with excess adiposity enrolled in the Cognitive and Self-regulatory Mechanisms of Obesity Study. ACEs were measured at baseline using the ACEs Scale. History of weight cycling was measured using the Weight and Lifestyle Inventory that documented weight loss(es) of 10 or more pounds.</p><p><strong>Results: </strong>Higher ACE scores were associated with a greater likelihood of reporting a history of weight cycling. Participants with four or more ACEs had 8 times higher odds (OR = 8.301, 95% CI = 2.271-54.209, <i>p</i> = 0.027) of reporting weight cycling compared with participants with no ACEs. The association of weight cycling for those who endorsed one to three ACEs was not significant (OR = 2.3, 95% CI = 0.771-6.857, <i>p =</i> 0.135) in this sample.</p><p><strong>Conclusions: </strong>The role of ACEs in health may be related to associations with weight cycling. Results indicated that those who reported four or more ACEs had significantly higher odds of reporting weight cycling compared with those with no ACEs. Further research is needed to further explore how ACEs predict the likelihood of weight cycling, which may be prognostic for sustained weight loss treatment response and weight stigma impacts.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 1","pages":"e736"},"PeriodicalIF":1.9,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of prescription medication changes following sleeve gastrectomy surgery. 评估袖状胃切除术后处方药的变化。
IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-13 eCollection Date: 2024-02-01 DOI: 10.1002/osp4.742
Gina Arena, Alex Kitsos, Jeffrey M Hamdorf, Mike D'Arcy-Evans, Michelle Kilpatrick, Alison Venn, David B Preen

Objective: The increasing global prevalence of obesity, coupled with its association with chronic health conditions and rising healthcare costs, highlights the need for effective interventions; however, despite the availability of treatment options, the ongoing success of primary interventions in maintaining long-term weight loss remains limited. This study examined the prescription medication dispensing changes following sleeve gastrectomy in Australians aged 45 years and over.

Methods: In a retrospective analysis of 847 bariatric surgery patients from the New South Wales 45 and Up Study, the assessment of medication patterns categorizing into three groups: gastrointestinal, metabolic, cardiorespiratory, musculoskeletal, and nervous systems was conducted. Each drug class was analyzed, focusing on patients with dispensing records within the 12 months before surgery. This study employed interrupted time-series analysis to compare pre- and post-surgery medication usage.

Results: With a predominantly female population (76.9%) and an average age of 57.2 (standard deviation 5.71), there were statistically significant reductions in both unique medications (12.5% decrease, p = 0.004) and total medications dispensed (15.9% decrease, p = 0.003) from 12 months before surgery to 13-24 months after bariatric surgery. All medication categories, except opioids, showed reductions. Notably, the most significant reductions were observed in diabetes (38.6%), agents acting on the renin-angiotensin system (40.4%), lipid modifying agents (26.5%), anti-inflammatory products (46.3%), and obstructive airway diseases (53.3%) medications during this time frame.

Conclusion: These findings suggest that sleeve gastrectomy provides an effective therapeutic intervention for patients with comorbidities requiring multiple medications, especially for obesity-related diseases such as diabetes, cardiovascular, respiratory and musculoskeletal disorders.

目的:肥胖症在全球的发病率越来越高,再加上肥胖症与慢性疾病和医疗成本上升的关系,凸显了采取有效干预措施的必要性;然而,尽管有各种治疗方案可供选择,但在维持长期减肥效果方面,初级干预措施的持续成功率仍然有限。本研究调查了 45 岁及以上澳大利亚人袖状胃切除术后的处方配药变化:在对新南威尔士州 45 岁及以上研究中的 847 名减肥手术患者进行的回顾性分析中,评估了分为三组的用药模式:胃肠道系统、代谢系统、心肺系统、肌肉骨骼系统和神经系统。对每一类药物都进行了分析,重点是手术前 12 个月内有配药记录的患者。这项研究采用了间断时间序列分析法来比较手术前后的用药情况:患者以女性为主(76.9%),平均年龄为 57.2 岁(标准偏差为 5.71),从手术前 12 个月到减肥手术后 13-24 个月,独特药物(减少 12.5%,p = 0.004)和配药总量(减少 15.9%,p = 0.003)均有统计学意义上的显著减少。除阿片类药物外,所有药物类别均有所减少。值得注意的是,在这段时间内,糖尿病药物(38.6%)、肾素-血管紧张素系统药物(40.4%)、调脂药物(26.5%)、抗炎产品(46.3%)和阻塞性气道疾病药物(53.3%)的减少幅度最大:这些研究结果表明,袖带胃切除术为需要服用多种药物的合并症患者提供了有效的治疗干预,尤其是与肥胖相关的疾病,如糖尿病、心血管疾病、呼吸系统疾病和肌肉骨骼疾病。
{"title":"Evaluation of prescription medication changes following sleeve gastrectomy surgery.","authors":"Gina Arena, Alex Kitsos, Jeffrey M Hamdorf, Mike D'Arcy-Evans, Michelle Kilpatrick, Alison Venn, David B Preen","doi":"10.1002/osp4.742","DOIUrl":"10.1002/osp4.742","url":null,"abstract":"<p><strong>Objective: </strong>The increasing global prevalence of obesity, coupled with its association with chronic health conditions and rising healthcare costs, highlights the need for effective interventions; however, despite the availability of treatment options, the ongoing success of primary interventions in maintaining long-term weight loss remains limited. This study examined the prescription medication dispensing changes following sleeve gastrectomy in Australians aged 45 years and over.</p><p><strong>Methods: </strong>In a retrospective analysis of 847 bariatric surgery patients from the New South Wales 45 and Up Study, the assessment of medication patterns categorizing into three groups: gastrointestinal, metabolic, cardiorespiratory, musculoskeletal, and nervous systems was conducted. Each drug class was analyzed, focusing on patients with dispensing records within the 12 months before surgery. This study employed interrupted time-series analysis to compare pre- and post-surgery medication usage.</p><p><strong>Results: </strong>With a predominantly female population (76.9%) and an average age of 57.2 (standard deviation 5.71), there were statistically significant reductions in both unique medications (12.5% decrease, <i>p</i> = 0.004) and total medications dispensed (15.9% decrease, <i>p</i> = 0.003) from 12 months before surgery to 13-24 months after bariatric surgery. All medication categories, except opioids, showed reductions. Notably, the most significant reductions were observed in diabetes (38.6%), agents acting on the renin-angiotensin system (40.4%), lipid modifying agents (26.5%), anti-inflammatory products (46.3%), and obstructive airway diseases (53.3%) medications during this time frame.</p><p><strong>Conclusion: </strong>These findings suggest that sleeve gastrectomy provides an effective therapeutic intervention for patients with comorbidities requiring multiple medications, especially for obesity-related diseases such as diabetes, cardiovascular, respiratory and musculoskeletal disorders.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 1","pages":"e742"},"PeriodicalIF":1.9,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Obesity Science & Practice
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