Pub Date : 2024-01-01eCollection Date: 2024-02-01DOI: 10.1002/osp4.727
Sonali Shambhu, Qinli Ma, Aliza S Gordon, David Pryor, Joseph A Karam, Andrea DeVries
Objective: Bariatric procedures have become safer in recent years, warranting new data on long-term costs. This study examined the impact of bariatric procedures on a person's long-term healthcare costs up to 10 years and if it differed by socio-economic status (SES).
Methods: This retrospective observational study compared the downstream health care cost of patients with obesity who had undergone bariatric surgery (BS) between 2009 and 2018 to a 1:1 matched group of members with obesity but no surgery.
Results: 167,764 individuals from administrative claims data with an obesity diagnosis were included; 83,882 in the BS group and 83,882 in the non-surgical group. In follow-up years 2-10, the BS group was associated with lower total medical healthcare cost compared to the non-surgical group (cost ratios ranged 0.85-0.93, p values < 0.05). When stratifying the BS group by SES quartiles, there were no significant cost differences by SES (cost ratios ranged from 0.96 to 1.05, most p values > 0.05).
Conclusions: BS was associated with lower long-term follow-up medical cost and cost savings appeared similar among the SES quartiles in the BS group. The study results may help policy makers and employers in designing benefits and extending coverage for bariatric surgical procedures.
{"title":"Long term cost outcomes among commercially insured patients undergoing bariatric surgical procedures.","authors":"Sonali Shambhu, Qinli Ma, Aliza S Gordon, David Pryor, Joseph A Karam, Andrea DeVries","doi":"10.1002/osp4.727","DOIUrl":"10.1002/osp4.727","url":null,"abstract":"<p><strong>Objective: </strong>Bariatric procedures have become safer in recent years, warranting new data on long-term costs. This study examined the impact of bariatric procedures on a person's long-term healthcare costs up to 10 years and if it differed by socio-economic status (SES).</p><p><strong>Methods: </strong>This retrospective observational study compared the downstream health care cost of patients with obesity who had undergone bariatric surgery (BS) between 2009 and 2018 to a 1:1 matched group of members with obesity but no surgery.</p><p><strong>Results: </strong>167,764 individuals from administrative claims data with an obesity diagnosis were included; 83,882 in the BS group and 83,882 in the non-surgical group. In follow-up years 2-10, the BS group was associated with lower total medical healthcare cost compared to the non-surgical group (cost ratios ranged 0.85-0.93, <i>p</i> values < 0.05). When stratifying the BS group by SES quartiles, there were no significant cost differences by SES (cost ratios ranged from 0.96 to 1.05, most <i>p</i> values > 0.05).</p><p><strong>Conclusions: </strong>BS was associated with lower long-term follow-up medical cost and cost savings appeared similar among the SES quartiles in the BS group. The study results may help policy makers and employers in designing benefits and extending coverage for bariatric surgical procedures.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"10 1","pages":"e727"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10766043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378025","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}
Dale S. Bond, Kathryn E. Smith, Leah M. Schumacher, Sivamainthan Vithiananthan, Daniel B. Jones, Pavlos Papasavas, Jennifer Webster, J. Graham Thomas
Abstract Objective Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight‐related behaviors over time is unknown. Using smartphone‐based Ecological Momentary Assessment, this study evaluated pre‐to 1‐year post‐MBS changes in daily weight management‐focused PSS and associations with weight loss, device‐measured activity behaviors, and eating regulation before and during the initial year after MBS. Method Adult MBS patients ( n = 71) received (1) an accelerometer to measure daily moderate‐to‐vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight‐focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi‐random times daily for 10 days at pre‐ and 3, 6, and 12‐month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes. Results Participants on average reported relatively stable moderate‐to‐high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps < 0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels ( p = 0.009). Conclusions MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight‐focused PSS appeared to hold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year. Clinical Trial Registration NCT02777177.
{"title":"Associations of daily weight management‐focused social support with weight loss, activity behaviors, and eating regulation in the context of metabolic and bariatric surgery","authors":"Dale S. Bond, Kathryn E. Smith, Leah M. Schumacher, Sivamainthan Vithiananthan, Daniel B. Jones, Pavlos Papasavas, Jennifer Webster, J. Graham Thomas","doi":"10.1002/osp4.717","DOIUrl":"https://doi.org/10.1002/osp4.717","url":null,"abstract":"Abstract Objective Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight‐related behaviors over time is unknown. Using smartphone‐based Ecological Momentary Assessment, this study evaluated pre‐to 1‐year post‐MBS changes in daily weight management‐focused PSS and associations with weight loss, device‐measured activity behaviors, and eating regulation before and during the initial year after MBS. Method Adult MBS patients ( n = 71) received (1) an accelerometer to measure daily moderate‐to‐vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight‐focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi‐random times daily for 10 days at pre‐ and 3, 6, and 12‐month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes. Results Participants on average reported relatively stable moderate‐to‐high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps < 0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels ( p = 0.009). Conclusions MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight‐focused PSS appeared to hold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year. Clinical Trial Registration NCT02777177.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"74 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135088363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew Skeldon, David Harris, Robert Dent, Judy Y Shiau
Abstract Objective Full meal replacement (FMR) Intensive Lifestyle Interventions (ILI) have been used for weight management. However, predictors of efficacy with these programs are less clear. The primary objective was to assess weight loss predictors in a community‐based FMR ILI program. A secondary objective was to determine if weight loss was different between virtual and in person ILI. Methods This was a retrospective cohort study involving 234 patients who started the program between 1 January 2016 and 3 March 2021. In the 24‐week program, patients spent 12 weeks on FMR and then transitioned back to food for the remainder, with weekly follow up with a physician and group sessions with a dietitian. Visits were in person prior to March 2020 and virtual afterward. Results Patients' average age was 47.5 years (SD = 12.0) and 73.5% were female. Average weight loss was 14.3% (SD = 6.2%). There was no significant difference in weight loss between virtual and in person programs. Patients on a Glucagon‐like Peptide‐1 Receptor Agonist prior lost less weight. Other significant associations between groups were baseline Hemoglobin A 1 C, classes attended, as well as the age since peak weight. Conclusion Weight loss from virtual ILI was not significantly different from person ILI. More research is needed to determine how to best stratify care as virtual or in person using FMR programs.
{"title":"A comparison of virtual and in person delivery of a full meal replacement program for obesity","authors":"Matthew Skeldon, David Harris, Robert Dent, Judy Y Shiau","doi":"10.1002/osp4.718","DOIUrl":"https://doi.org/10.1002/osp4.718","url":null,"abstract":"Abstract Objective Full meal replacement (FMR) Intensive Lifestyle Interventions (ILI) have been used for weight management. However, predictors of efficacy with these programs are less clear. The primary objective was to assess weight loss predictors in a community‐based FMR ILI program. A secondary objective was to determine if weight loss was different between virtual and in person ILI. Methods This was a retrospective cohort study involving 234 patients who started the program between 1 January 2016 and 3 March 2021. In the 24‐week program, patients spent 12 weeks on FMR and then transitioned back to food for the remainder, with weekly follow up with a physician and group sessions with a dietitian. Visits were in person prior to March 2020 and virtual afterward. Results Patients' average age was 47.5 years (SD = 12.0) and 73.5% were female. Average weight loss was 14.3% (SD = 6.2%). There was no significant difference in weight loss between virtual and in person programs. Patients on a Glucagon‐like Peptide‐1 Receptor Agonist prior lost less weight. Other significant associations between groups were baseline Hemoglobin A 1 C, classes attended, as well as the age since peak weight. Conclusion Weight loss from virtual ILI was not significantly different from person ILI. More research is needed to determine how to best stratify care as virtual or in person using FMR programs.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"34 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135769513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Craig HC, Alsaeed D, Norris S, Holian J, Kennedy C, Feldman A, CW le Roux
Abstract Objective Obesity and many of its comorbidities can be improved by nutritional therapy, lifestyle modification, pharmacotherapy, and surgical intervention. Relatively little is known about patients' preferences for the range of obesity treatments. The present study was undertaken to identify factors that may influence these preferences. By evaluating patient‐preferred treatment options and factors influencing patients, treatment adherence and efficacy may be improved. Our objective was to identify factors that influence patient preferences and subsequent choice of obesity treatment among those seeking treatment for obesity‐related complications. Methods Participatory action research, using purposeful sampling, was used to recruit 33 patients with obesity complications. Recruitment took place in specialist clinics for non‐alcoholic fatty liver disease, diabetes, hypertension, and chronic kidney disease. Sixteen males and 17 females aged 18–70 years with a BMI>35 kg/m 2 were recruited. Prior to the interview, participants watched a 60‐min video explaining nutritional therapies, pharmacotherapies, and surgical therapies in equipoise. Data were collected in one‐to‐one semi‐structured interviews using zoom or the telephone; reflective thematic analysis was used. Results Four themes emerged: 1) structural factors, 2) autonomy, 3) interaction with formal care, and 4) the emotional and physical consequences of obesity. 39% of participants preferred nutritional therapy with support from medical professionals. 27% chose bariatric surgery. 24% chose pharmacotherapy alone, while 6% chose pharmacotherapy combined with nutritional therapy, 3% of participants wanted no intervention. Conclusion The challenges can be addressed by increasing support for healthcare professionals toward enhancing both their knowledge and the health literacy of patients. Future research should focus on improving access to treatment pathways for patients as well as developing health literacy programs and educational programs for healthcare professionals.
{"title":"Patient perspectives about treatment preferences for obesity with complications","authors":"Craig HC, Alsaeed D, Norris S, Holian J, Kennedy C, Feldman A, CW le Roux","doi":"10.1002/osp4.720","DOIUrl":"https://doi.org/10.1002/osp4.720","url":null,"abstract":"Abstract Objective Obesity and many of its comorbidities can be improved by nutritional therapy, lifestyle modification, pharmacotherapy, and surgical intervention. Relatively little is known about patients' preferences for the range of obesity treatments. The present study was undertaken to identify factors that may influence these preferences. By evaluating patient‐preferred treatment options and factors influencing patients, treatment adherence and efficacy may be improved. Our objective was to identify factors that influence patient preferences and subsequent choice of obesity treatment among those seeking treatment for obesity‐related complications. Methods Participatory action research, using purposeful sampling, was used to recruit 33 patients with obesity complications. Recruitment took place in specialist clinics for non‐alcoholic fatty liver disease, diabetes, hypertension, and chronic kidney disease. Sixteen males and 17 females aged 18–70 years with a BMI>35 kg/m 2 were recruited. Prior to the interview, participants watched a 60‐min video explaining nutritional therapies, pharmacotherapies, and surgical therapies in equipoise. Data were collected in one‐to‐one semi‐structured interviews using zoom or the telephone; reflective thematic analysis was used. Results Four themes emerged: 1) structural factors, 2) autonomy, 3) interaction with formal care, and 4) the emotional and physical consequences of obesity. 39% of participants preferred nutritional therapy with support from medical professionals. 27% chose bariatric surgery. 24% chose pharmacotherapy alone, while 6% chose pharmacotherapy combined with nutritional therapy, 3% of participants wanted no intervention. Conclusion The challenges can be addressed by increasing support for healthcare professionals toward enhancing both their knowledge and the health literacy of patients. Future research should focus on improving access to treatment pathways for patients as well as developing health literacy programs and educational programs for healthcare professionals.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"63 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136134075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fiona Curran, Carol Brennan, James Matthews, Grainne O’ Donoghue
Abstract Introduction Both obesity and sedentary behaviour (SB), are associated with negative health consequences including cardiovascular disease, diabetes, certain cancers and all‐cause mortality. To date, perceived barriers and facilitators to interrupting SB in adults living with obesity have not been identified. Objective This study aimed to identify these perceived barriers and facilitators by conducting a behavioural analysis underpinned by the theoretical domains framework (TDF) and the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model, to enhance knowledge and inform future intervention development. Methods A purposive and snowball sample (N=21) of adults living with obesity took part in semi‐structured interviews, guided by the TDF, to investigate perceived barriers or facilitators to interrupting SB. Transcribed interviews were inductively coded using reflexive thematic analysis. Key themes and subthemes were generated by grouping similar and recurring codes. Finally, subthemes were mapped to the TDF and COM‐B. Results Five key themes were identified, which influence SB across all domains of living. These relate to (i) physical and mental wellbeing; (ii) motivational readiness; (iii) roles, responsibilities and support; (iv) weight bias and stigma and (v) the environment. These themes were then deductively mapped to all 14 TDF domains and all six of the COM‐B constructs. Conclusion A complex interplay of individual, societal and policy factors contribute to the development and habituation of SB patterns for adults living with obesity. Factors identified in this study could assist in the development of interventions, strategies and policies designed to interrupt or reduce sedentary behaviour for this population. This article is protected by copyright. All rights reserved.
{"title":"A qualitative study of perceived barriers and facilitators to interrupting sedentary behaviour among adults living with obesity","authors":"Fiona Curran, Carol Brennan, James Matthews, Grainne O’ Donoghue","doi":"10.1002/osp4.721","DOIUrl":"https://doi.org/10.1002/osp4.721","url":null,"abstract":"Abstract Introduction Both obesity and sedentary behaviour (SB), are associated with negative health consequences including cardiovascular disease, diabetes, certain cancers and all‐cause mortality. To date, perceived barriers and facilitators to interrupting SB in adults living with obesity have not been identified. Objective This study aimed to identify these perceived barriers and facilitators by conducting a behavioural analysis underpinned by the theoretical domains framework (TDF) and the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model, to enhance knowledge and inform future intervention development. Methods A purposive and snowball sample (N=21) of adults living with obesity took part in semi‐structured interviews, guided by the TDF, to investigate perceived barriers or facilitators to interrupting SB. Transcribed interviews were inductively coded using reflexive thematic analysis. Key themes and subthemes were generated by grouping similar and recurring codes. Finally, subthemes were mapped to the TDF and COM‐B. Results Five key themes were identified, which influence SB across all domains of living. These relate to (i) physical and mental wellbeing; (ii) motivational readiness; (iii) roles, responsibilities and support; (iv) weight bias and stigma and (v) the environment. These themes were then deductively mapped to all 14 TDF domains and all six of the COM‐B constructs. Conclusion A complex interplay of individual, societal and policy factors contribute to the development and habituation of SB patterns for adults living with obesity. Factors identified in this study could assist in the development of interventions, strategies and policies designed to interrupt or reduce sedentary behaviour for this population. This article is protected by copyright. All rights reserved.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"9 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Authors Britta Pehlke, Filipa Oliveira, Charalampos Varnava, Fabian Nehls, Philipp Wiebringhaus, Maximilian Kueckelhaus, Tobias Hirsch, Alexander Frederik Dermietzel
Abstract Objective This study investigates whether psychological well‐being in post‐bariatric patients seeking body contouring procedures differ from those who do not seek body contouring procedures, those who have already undergone body contouring procedures, and those who are unsure about body contouring procedures. Methods An anonymous, nonrandomized, cross‐sectional survey study was designed. Psychological well‐being of four groups of post‐bariatric‐patients (undergone body contouring procedures, seeking body contouring procedures, not seeking body contouring procedures, unsure about body contouring procedures) was compared. Results A total of 345 patients were included in this study. No significant difference between patients seeking body contouring procedures and those not seeking body contouring procedures was found with regard to depressive symptoms, self‐esteem, and body image. Patients who had already undergone body contouring procedures scored lower on depressive symptoms (p=.035), and reported to feel more attractive (p<.001) and less insecure (p=.030) than patients who had not undergone body contouring procedures yet but seeked it. Satisfaction with the result of the body contouring procedures was associated with lower depression levels (p<.001), higher self‐esteem (p<.001) and a more positive body‐image (p<.001). Conclusions Depressive symptoms or a low self‐esteem are not motivational factors for post‐bariatric patients to seek body contouring procedures. body contouring procedures is, however, associated with improvement in psychological well‐being in post‐bariatric patients. The patients’ satisfaction with the result of the body contouring procedures is significantly associated with positive psychological well‐being. This article is protected by copyright. All rights reserved.
{"title":"“Psychological well‐being as a motive for and result of post‐bariatric body contouring procedures”","authors":"Authors Britta Pehlke, Filipa Oliveira, Charalampos Varnava, Fabian Nehls, Philipp Wiebringhaus, Maximilian Kueckelhaus, Tobias Hirsch, Alexander Frederik Dermietzel","doi":"10.1002/osp4.719","DOIUrl":"https://doi.org/10.1002/osp4.719","url":null,"abstract":"Abstract Objective This study investigates whether psychological well‐being in post‐bariatric patients seeking body contouring procedures differ from those who do not seek body contouring procedures, those who have already undergone body contouring procedures, and those who are unsure about body contouring procedures. Methods An anonymous, nonrandomized, cross‐sectional survey study was designed. Psychological well‐being of four groups of post‐bariatric‐patients (undergone body contouring procedures, seeking body contouring procedures, not seeking body contouring procedures, unsure about body contouring procedures) was compared. Results A total of 345 patients were included in this study. No significant difference between patients seeking body contouring procedures and those not seeking body contouring procedures was found with regard to depressive symptoms, self‐esteem, and body image. Patients who had already undergone body contouring procedures scored lower on depressive symptoms (p=.035), and reported to feel more attractive (p<.001) and less insecure (p=.030) than patients who had not undergone body contouring procedures yet but seeked it. Satisfaction with the result of the body contouring procedures was associated with lower depression levels (p<.001), higher self‐esteem (p<.001) and a more positive body‐image (p<.001). Conclusions Depressive symptoms or a low self‐esteem are not motivational factors for post‐bariatric patients to seek body contouring procedures. body contouring procedures is, however, associated with improvement in psychological well‐being in post‐bariatric patients. The patients’ satisfaction with the result of the body contouring procedures is significantly associated with positive psychological well‐being. This article is protected by copyright. All rights reserved.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samira Ezzati‐Mobaser, Sahar Yarahmadi, Nikta Dadkhah Nikroo, Mohammad Hasan Maleki, Zeynab Yousefi, Pegah Golpour, Mona Nourbakhsh, Mitra Nourbakhsh
Abstract Introduction Adipose triglyceride lipase (ATGL) is a crucial enzyme responsible for the release of fatty acids from various tissues. The expression of ATGL is regulated by insulin and this enzyme is linked to insulin resistance. On the other hand, ATGL‐mediated lipolysis is connected to macrophage function and thus ATGL is involved in inflammation and the pathogenesis of lipid‐related disorders. This study aims to investigate the correlation between ATGL, obesity, metabolic syndrome, and inflammation. Methods A total of 100 participants, including 50 individuals with obesity and 50 healthy particiapnts, were recruited for this study and underwent comprehensive clinical evaluations. Blood samples were collected to measure plasma lipid profiles, glycemic indices, and liver function tests. Additionally, peripheral blood mononuclear cells (PBMCs) were isolated and used for the assessment of the gene expression of ATGL, using real‐time PCR. Furthermore, PBMCs were cultured and exposed to lipopolysaccharides (LPS) with simultaneous ATGL inhibition, and the gene expression of inflammatory cytokines, along with the secretion of prostaglandin E2 (PGE2), were measured. Results The gene expression of ATGL was significantly elevated in PBMCs obtained from participants with obesity and was particularly higher in those diagnosed with metabolic syndrome. It exhibited a correlation with insulin levels and Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR), and it was associated with lipid accumulation in the liver. Stimulation with LPS increased ATGL expression in PBMCs, while inhibition of ATGL attenuated the inflammatory responses induced by LPS. Conclusions Obesity and metabolic syndrome were associated with dysregulation of ATGL. ATGL might play a role in the upregulation of inflammatory cytokines and act as a significant contributor to the development of metabolic abnormalities related to obesity. This article is protected by copyright. All rights reserved.
{"title":"Adipose triglyceride lipase gene expression in peripheral blood mononuclear cells of subjects with obesity and its association with insulin resistance, inflammation and lipid accumulation in liver","authors":"Samira Ezzati‐Mobaser, Sahar Yarahmadi, Nikta Dadkhah Nikroo, Mohammad Hasan Maleki, Zeynab Yousefi, Pegah Golpour, Mona Nourbakhsh, Mitra Nourbakhsh","doi":"10.1002/osp4.716","DOIUrl":"https://doi.org/10.1002/osp4.716","url":null,"abstract":"Abstract Introduction Adipose triglyceride lipase (ATGL) is a crucial enzyme responsible for the release of fatty acids from various tissues. The expression of ATGL is regulated by insulin and this enzyme is linked to insulin resistance. On the other hand, ATGL‐mediated lipolysis is connected to macrophage function and thus ATGL is involved in inflammation and the pathogenesis of lipid‐related disorders. This study aims to investigate the correlation between ATGL, obesity, metabolic syndrome, and inflammation. Methods A total of 100 participants, including 50 individuals with obesity and 50 healthy particiapnts, were recruited for this study and underwent comprehensive clinical evaluations. Blood samples were collected to measure plasma lipid profiles, glycemic indices, and liver function tests. Additionally, peripheral blood mononuclear cells (PBMCs) were isolated and used for the assessment of the gene expression of ATGL, using real‐time PCR. Furthermore, PBMCs were cultured and exposed to lipopolysaccharides (LPS) with simultaneous ATGL inhibition, and the gene expression of inflammatory cytokines, along with the secretion of prostaglandin E2 (PGE2), were measured. Results The gene expression of ATGL was significantly elevated in PBMCs obtained from participants with obesity and was particularly higher in those diagnosed with metabolic syndrome. It exhibited a correlation with insulin levels and Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR), and it was associated with lipid accumulation in the liver. Stimulation with LPS increased ATGL expression in PBMCs, while inhibition of ATGL attenuated the inflammatory responses induced by LPS. Conclusions Obesity and metabolic syndrome were associated with dysregulation of ATGL. ATGL might play a role in the upregulation of inflammatory cytokines and act as a significant contributor to the development of metabolic abnormalities related to obesity. This article is protected by copyright. All rights reserved.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136185516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Fakhrolmobasheri, Amir Parsa Abhari, Maryam Heidarpour, Saina Paymannejad, Mahsa Pourmahdi‐Boroujeni, Amir Sepehr Saffari, Paria Okhovat, Hamidreza Roohafza, Masoumeh Sadeghi, Najmeh Rabanipour, Davood Shafie, Nizal Sarrafzadehgan
Abstract Background /Aims: Visceral adiposity index (VAI) and lipid accumulation product (LAP) are novel anthropometric indices that have shown an association with metabolic syndrome; however, limited data are available regarding the predictive performance of these indices for the incidence of cardiovascular diseases (CVD) and mortality. Methods This study was performed on the data retrieved from Isfahan Cohort Study (ICS). ICS is an ongoing population‐based cohort study conducted in 3 counties in central Iran. Pearson correlation analysis was performed between LAP, VAI, and metabolic parameters. Cox regression analysis and receiver operative characteristics (ROC) curve analysis were performed in order to evaluate the ability of VAI and LAP for the incidence of CVD, CVD‐associated mortality, and all‐cause mortality. We further compared the predictive performance of VAI and LAP with body mass index (BMI). Results LAP and VAI were significantly correlated with all metabolic variables, including blood pressure, fasting blood glucose, and lipid profile components. Univariate regression analysis indicated a significant association between LAP and VAI and CVD incidence. In multivariate analysis, only VAI was significantly associated with CVD incidence. Regarding CVD mortality, only VAI in the multivariate analysis revealed a significant association. Interestingly, Both VAI and LAP were negatively associated with all‐cause mortality. ROC curve analysis indicated the superior performance of LAP and VAI for predicting CVD incidence compared to BMI; however, BMI was better in predicting all‐cause mortality. Conclusion Compared to BMI, LAP and VAI have better predictive performance for the incidence of CVD. In contrast, BMI was superior to VAI and LAP in the prediction of all‐cause mortality.
{"title":"Lipid Accumulation Product and Visceral Adiposity Index for Incidence of Cardiovascular Diseases and Mortality; Results From 13 Years Follow‐up in Isfahan Cohort Study","authors":"Mohammad Fakhrolmobasheri, Amir Parsa Abhari, Maryam Heidarpour, Saina Paymannejad, Mahsa Pourmahdi‐Boroujeni, Amir Sepehr Saffari, Paria Okhovat, Hamidreza Roohafza, Masoumeh Sadeghi, Najmeh Rabanipour, Davood Shafie, Nizal Sarrafzadehgan","doi":"10.1002/osp4.713","DOIUrl":"https://doi.org/10.1002/osp4.713","url":null,"abstract":"Abstract Background /Aims: Visceral adiposity index (VAI) and lipid accumulation product (LAP) are novel anthropometric indices that have shown an association with metabolic syndrome; however, limited data are available regarding the predictive performance of these indices for the incidence of cardiovascular diseases (CVD) and mortality. Methods This study was performed on the data retrieved from Isfahan Cohort Study (ICS). ICS is an ongoing population‐based cohort study conducted in 3 counties in central Iran. Pearson correlation analysis was performed between LAP, VAI, and metabolic parameters. Cox regression analysis and receiver operative characteristics (ROC) curve analysis were performed in order to evaluate the ability of VAI and LAP for the incidence of CVD, CVD‐associated mortality, and all‐cause mortality. We further compared the predictive performance of VAI and LAP with body mass index (BMI). Results LAP and VAI were significantly correlated with all metabolic variables, including blood pressure, fasting blood glucose, and lipid profile components. Univariate regression analysis indicated a significant association between LAP and VAI and CVD incidence. In multivariate analysis, only VAI was significantly associated with CVD incidence. Regarding CVD mortality, only VAI in the multivariate analysis revealed a significant association. Interestingly, Both VAI and LAP were negatively associated with all‐cause mortality. ROC curve analysis indicated the superior performance of LAP and VAI for predicting CVD incidence compared to BMI; however, BMI was better in predicting all‐cause mortality. Conclusion Compared to BMI, LAP and VAI have better predictive performance for the incidence of CVD. In contrast, BMI was superior to VAI and LAP in the prediction of all‐cause mortality.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135790227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ken Fujioka, Jacob Fujioka, Kaley Mafong, Nicole Wetherhold, Sally Kim, Amin Rasul, Alyssa Lopez, Kevin Cummins
Abstract Background Daily weighing has been shown to help with weight management. In primary care, the majority of virtual visits will ask patients about their weight. However, little is known about whether patients, especially those in the Hispanic/Latino population, have access to a weight scale. Our aim was to determine scale access and perceived height and weight in the Hispanic/Latino population attending a volunteer, no cost, community clinic. Methods Questionnaires were issued to patients attending the community clinic and a comparator group attending a medically insured primary care practice. Results Only 52% of the Hispanic/Latino patients attending the community clinic had access to a scale compared with 85% of patients in the primary care office. Patients underreported weight and overreported height leading to underreporting body mass index by 0.6 ± 3.2 kg/m 2 . Conclusions Healthcare providers who care for uninsured Hispanic/Latino patients in community clinics may need to be aware that patients may not have access to a scale.
{"title":"Home access to a weight scale in the Hispanic/Latino population attending a community‐based free clinic","authors":"Ken Fujioka, Jacob Fujioka, Kaley Mafong, Nicole Wetherhold, Sally Kim, Amin Rasul, Alyssa Lopez, Kevin Cummins","doi":"10.1002/osp4.711","DOIUrl":"https://doi.org/10.1002/osp4.711","url":null,"abstract":"Abstract Background Daily weighing has been shown to help with weight management. In primary care, the majority of virtual visits will ask patients about their weight. However, little is known about whether patients, especially those in the Hispanic/Latino population, have access to a weight scale. Our aim was to determine scale access and perceived height and weight in the Hispanic/Latino population attending a volunteer, no cost, community clinic. Methods Questionnaires were issued to patients attending the community clinic and a comparator group attending a medically insured primary care practice. Results Only 52% of the Hispanic/Latino patients attending the community clinic had access to a scale compared with 85% of patients in the primary care office. Patients underreported weight and overreported height leading to underreporting body mass index by 0.6 ± 3.2 kg/m 2 . Conclusions Healthcare providers who care for uninsured Hispanic/Latino patients in community clinics may need to be aware that patients may not have access to a scale.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136277029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background The potential for developing frailty exists in middle‐aged and older adults. While obesity and metabolic syndrome (MetS) increase the risk of frailty in older adults, this relationship remains unclear in middle‐aged adults, who are prone to developing lifestyle‐related diseases. Objective To examine the effect of overweight/obesity and MetS on frailty development in middle‐aged and older Japanese adults using real‐world data. Methods This nationwide cohort study used exhaustive health insurance claims data of 3,958,708 Japanese people from 2015 to 2019 provided by the Japan Health Insurance Association. Participants aged ≥35 and < 70 years who received health checkups in 2015 were included. Multivariate logistic regression was used to assess the effect of body mass index (BMI) and MetS or MetS components (i.e., diabetes, hypertension, and dyslipidemia) in 2015 on frailty risk assessed using the hospital frailty risk score in 2019. Additionally, a subgroup analysis was performed to examine the interaction effects of MetS components and 4‐year weight change (%) on frailty risk among participants who were overweight and obese (BMI ≥25 kg/m 2 ). Results In 2019, 7204 (0.2%) and 253,671 (6.4%) participants were at high and intermediate frailty risks, respectively. Obesity and MetS were independently associated with intermediate/high frailty risk (odds ratio (OR) 1.36, p < 0.05; OR 1.23, p < 0.05, respectively) and high frailty risk (OR 1.80, p < 0.05; OR 1.37, p < 0.05, respectively) in all participants. Although all MetS components were frailty risk factors, these effects diminished with age in both sexes. Subgroup analysis of patients with diabetes revealed that 5%–10% weight loss was associated with reduced frailty risk in both sexes. Conclusions Obesity, MetS, and MetS components were independent frailty risk factors in middle‐aged and older Japanese adults. Weight loss of up to 10% over 4 years prevented frailty in patients with diabetes who were overweight and obese.
背景:中老年人存在发生虚弱的可能性。虽然肥胖和代谢综合征(MetS)会增加老年人的虚弱风险，但这种关系在中年人中仍不清楚，中年人容易患上与生活方式相关的疾病。目的利用真实数据研究超重/肥胖和MetS对日本中老年成年人虚弱发展的影响。方法:本全国性队列研究使用了日本健康保险协会提供的2015年至2019年3,958,708名日本人的健康保险索赔数据。参与者年龄≥35岁;其中包括2015年接受健康检查的70人。采用多变量logistic回归评估2015年体重指数(BMI)和MetS或MetS成分(即糖尿病、高血压和血脂异常)对2019年医院衰弱风险评分评估的衰弱风险的影响。此外，还进行了亚组分析，以检查超重和肥胖(BMI≥25 kg/ m2)的参与者中MetS成分和4年体重变化(%)对衰弱风险的相互作用。结果2019年，7204名(0.2%)和253671名(6.4%)参与者分别处于高度和中度虚弱风险。肥胖和MetS与中/高衰弱风险独立相关(优势比(OR) 1.36, p <0.05;OR 1.23, p <高脆弱风险(OR 1.80, p <0.05;OR 1.37, p <0.05)。尽管所有的代谢代谢成分都是脆弱的危险因素，但这些影响在两性中随着年龄的增长而减弱。糖尿病患者的亚组分析显示，在两性中，体重减轻5%-10%与衰弱风险降低有关。结论:肥胖、MetS和MetS成分是日本中老年成年人的独立衰弱危险因素。超重和肥胖的糖尿病患者在4年内体重减轻10%，可防止身体虚弱。
{"title":"Effect of overweight/obesity and metabolic syndrome on frailty in middle‐aged and older Japanese adults","authors":"Yuki Nishida, Yosuke Yamada, Satoshi Sasaki, Eiichiro Kanda, Yoshihiko Kanno, Tatsuhiko Anzai, Kunihiko Takahashi, Keita Yamauchi, Fuminori Katsukawa","doi":"10.1002/osp4.714","DOIUrl":"https://doi.org/10.1002/osp4.714","url":null,"abstract":"Abstract Background The potential for developing frailty exists in middle‐aged and older adults. While obesity and metabolic syndrome (MetS) increase the risk of frailty in older adults, this relationship remains unclear in middle‐aged adults, who are prone to developing lifestyle‐related diseases. Objective To examine the effect of overweight/obesity and MetS on frailty development in middle‐aged and older Japanese adults using real‐world data. Methods This nationwide cohort study used exhaustive health insurance claims data of 3,958,708 Japanese people from 2015 to 2019 provided by the Japan Health Insurance Association. Participants aged ≥35 and < 70 years who received health checkups in 2015 were included. Multivariate logistic regression was used to assess the effect of body mass index (BMI) and MetS or MetS components (i.e., diabetes, hypertension, and dyslipidemia) in 2015 on frailty risk assessed using the hospital frailty risk score in 2019. Additionally, a subgroup analysis was performed to examine the interaction effects of MetS components and 4‐year weight change (%) on frailty risk among participants who were overweight and obese (BMI ≥25 kg/m 2 ). Results In 2019, 7204 (0.2%) and 253,671 (6.4%) participants were at high and intermediate frailty risks, respectively. Obesity and MetS were independently associated with intermediate/high frailty risk (odds ratio (OR) 1.36, p < 0.05; OR 1.23, p < 0.05, respectively) and high frailty risk (OR 1.80, p < 0.05; OR 1.37, p < 0.05, respectively) in all participants. Although all MetS components were frailty risk factors, these effects diminished with age in both sexes. Subgroup analysis of patients with diabetes revealed that 5%–10% weight loss was associated with reduced frailty risk in both sexes. Conclusions Obesity, MetS, and MetS components were independent frailty risk factors in middle‐aged and older Japanese adults. Weight loss of up to 10% over 4 years prevented frailty in patients with diabetes who were overweight and obese.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135477021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号