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Gastric bypass elicits persistent gut adaptation and unique diabetes remission-related metabolic gene regulation 胃旁路术可引起持续的肠道适应和独特的糖尿病缓解相关代谢基因调控。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-15 DOI: 10.1002/oby.24135
Margaret A. Stefater-Richards, Courtney Panciotti, Valerie Esteva, Miriam Lerner, Carter R. Petty, William F. Gourash, Anita P. Courcoulas

Objective

We have previously shown that early intestinal adaptation precedes and relates to metabolic improvement in humans after Roux-en-Y gastric bypass surgery (RYGB). We hypothesized that intestinal adaptation would persist at the 1-year postoperative time point and that gene expression (GE) signatures would relate to type 2 diabetes remission, providing insight into potential mechanisms for intestinally mediated metabolic improvement after RYGB.

Methods

We determined GE by RNA sequencing in jejunum (Roux limb [RL]) collected from 28 patients before and 12 months after RYGB.

Results

Global GE from paired baseline and 1-year jejunal samples did not separate according to clinical phenotype (type 2 diabetes remission, sustained weight loss). In general, GE was consistent with persistent RL remodeling, and microvilli were elongated by 39%. Remodeling was not attenuated in patients with lack of diabetes remission or with weight regain. Patients with diabetes remission demonstrated greater jejunal activation of lipogenesis-related pathways driven by RXR, LXR, and SREBP.

Conclusions

RL adaptation is a key feature of RYGB in all patients, likely reflecting the dramatic alterations to gastrointestinal anatomy, but jejunal lipogenesis appears to be more strongly activated in those patients with diabetes remission. Further study is needed to understand whether these pathways may drive metabolic remission after RYGB.

目的:我们以前的研究表明,人类在接受 Roux-en-Y 胃旁路手术(RYGB)后,肠道的早期适应先于代谢改善,而且与代谢改善有关。我们假设肠道适应将持续到术后 1 年,并且基因表达(GE)特征将与 2 型糖尿病缓解相关,从而深入了解 RYGB 术后肠道介导的代谢改善的潜在机制:我们通过 RYGB 前和 RYGB 后 12 个月收集的 28 名患者空肠(Roux 肢端 [RL])的 RNA 测序确定了 GE:结果:从配对的基线和1年空肠样本中获得的全局GE并未根据临床表型(2型糖尿病缓解、体重持续下降)而有所区别。总体而言,GE 与持续的 RL 重塑一致,微绒毛拉长了 39%。在糖尿病未缓解或体重反弹的患者中,重塑作用并未减弱。糖尿病缓解患者的空肠在RXR、LXR和SREBP的驱动下激活了更多的脂肪生成相关途径:结论:RL适应是所有患者RYGB的一个主要特征,可能反映了胃肠道解剖结构的巨大变化,但糖尿病缓解患者的空肠脂肪生成似乎被更强烈地激活。要了解这些途径是否会推动 RYGB 后的代谢缓解,还需要进一步研究。
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引用次数: 0
Decoding visceral adipose tissue molecular signatures in obesity and insulin resistance: a multi-omics approach 解码肥胖和胰岛素抵抗中的内脏脂肪组织分子特征:一种多组学方法。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-13 DOI: 10.1002/oby.24146
Dipayan Roy, Raghumoy Ghosh, Ritwik Ghosh, Manoj Khokhar, Ma Yin Yin Naing, Julián Benito-León

Objective

Obesity-associated insulin resistance (IR) is responsible for considerable morbidity and mortality globally. Despite vast genomic data, many areas, from pathogenesis to management, still have significant knowledge gaps. We aimed to characterize visceral adipose tissue (VAT) in obesity and IR through a multi-omics approach.

Methods

We procured data on VAT samples from the Gene Expression Omnibus (GEO) for the following two groups: 1) populations with obesity (n = 34) versus those without (n = 26); and 2) populations with obesity and IR (n = 15) versus those with obesity but without IR (n = 15). Gene set enrichment, protein-protein interaction network construction, hub gene identification, and drug-gene interactions were performed, followed by regulatory network prediction involving transcription factors (TFs) and microRNAs (miRNAs).

Results

Interleukin signaling pathways, cellular differentiation, and regulation of immune response revealed a significant cross talk between VAT and the immune system. Other findings include cancer pathways, neurotrophin signaling, and aging. A total of 10 hub genes, i.e., STAT1, KLF4, DUSP1, EGR1, FOS, JUN, IL2, IL6, MMP9, and FGF9, 24 TFs, and approved hub gene-targeting drugs were obtained. A total of 10 targeting miRNAs (e.g., hsa-miR-155-5p, hsa-miR-34a-5p) were associated with obesity and IR-related pathways.

Conclusions

Our multi-omics integration method revealed hub genes, TFs, and miRNAs that can be potential targets for investigation in VAT-related inflammatory processes and IR, therapeutic management, and risk stratifications.

目的:肥胖相关的胰岛素抵抗(IR)是全球发病率和死亡率的重要原因。尽管有大量的基因组数据,但从发病机制到管理等许多领域仍存在重大的知识空白。我们旨在通过多组学方法描述肥胖和胰岛素抵抗中内脏脂肪组织(VAT)的特征:我们从基因表达总库(Gene Expression Omnibus,GEO)中获取了以下两类人群的内脏脂肪组织样本数据:1)肥胖人群(34 人)与非肥胖人群(26 人);2)肥胖和红外人群(15 人)与肥胖但无红外人群(15 人)。研究人员进行了基因组富集、蛋白质-蛋白质相互作用网络构建、枢纽基因鉴定和药物-基因相互作用,随后进行了涉及转录因子(TF)和微RNA(miRNA)的调控网络预测:结果:白细胞介素信号通路、细胞分化和免疫反应调控揭示了增值税与免疫系统之间的重要交叉对话。其他发现还包括癌症通路、神经营养素信号传导和衰老。共获得了 10 个枢纽基因,即 STAT1、KLF4、DUSP1、EGR1、FOS、JUN、IL2、IL6、MMP9 和 FGF9,24 个 TFs,以及已批准的枢纽基因靶向药物。共有10个靶向miRNA(如hsa-miR-155-5p、hsa-miR-34a-5p)与肥胖和红外相关通路有关:我们的多组学整合方法揭示了枢纽基因、TFs和miRNAs,这些基因、TFs和miRNAs可能成为研究与增值税相关的炎症过程和IR、治疗管理和风险分层的潜在靶点。
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引用次数: 0
Distinct functional connectivity phenotypes in preadolescent children with binge eating disorder by BMI status 青春期前暴饮暴食症儿童的功能连接表型因体重指数状况而异。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-10 DOI: 10.1002/oby.24145
Trevor Steward, Kay Jann, Stuart B. Murray

Objective

The neurobiological mechanisms underpinning binge eating disorder (BED) in children remain largely unclear, as the alterations that have been identified to date may be attributable to BED, obesity, or compound effects. This study aimed to delineate functional connectivity (FC) patterns in inhibitory control and reward networks in preadolescent children with and without BED from the Adolescent Brain Cognitive Development (ABCD) Study according to BMI.

Methods

Resting-state FC was examined in the inhibitory control network by using seeds in the dorsolateral prefrontal cortex, the anterior cingulate cortex, and the posterior cingulate cortex, whereas the reward network included seeds in the orbitofrontal cortex, nucleus accumbens, and amygdala. Seed-to-voxel analyses characterized FC differences between preadolescent children with BED with a high BMI and those with BED with a low BMI.

Results

We identified that BED was characterized by reduced connectivity between the reward network and regions in the default mode network, irrespective of weight status. Participants with BED also presented with hypoconnectivity in fronto-amygdalar circuits, which has been consistently associated with impaired emotion regulation capacity.

Conclusions

Our findings support that FC alterations between the reward network and the default mode network may be specifically impacted by the presence of BED as opposed to weight status.

目的:儿童暴饮暴食症(BED)的神经生物学机制在很大程度上仍不清楚,因为迄今为止已发现的改变可能归因于 BED、肥胖或复合效应。本研究旨在根据青少年大脑认知发展(ABCD)研究中的体重指数,对有和没有暴饮暴食症的青春期前儿童的抑制控制和奖赏网络的功能连接(FC)模式进行描述:通过使用背外侧前额叶皮层、前扣带回皮层和后扣带回皮层的种子对抑制控制网络的静息态FC进行了检测,而奖赏网络包括眶额叶皮层、伏隔核和杏仁核的种子。种子到象素分析显示了高体重指数BED和低体重指数BED青春期前儿童之间的FC差异:我们发现,无论体重状况如何,BED 的特点是奖赏网络与默认模式网络区域之间的连接性降低。BED患者还表现为前额-丘脑回路的连接性降低,这一直与情绪调节能力受损有关:我们的研究结果表明,奖赏网络和默认模式网络之间的FC改变可能会受到BED而非体重状况的特别影响。
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引用次数: 0
Response to “Nutritional considerations with antiobesity medications” 回应 "抗肥胖药物的营养考虑因素"。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-06 DOI: 10.1002/oby.24139
Gabriela de Souza Bett, Fabiana Schuelter-Trevisol, Daisson José Trevisol
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引用次数: 0
Association of continuous BMI with health-related quality of life in the United States by age and sex 美国按年龄和性别分列的连续体重指数与健康相关生活质量的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-06 DOI: 10.1002/oby.24141
Zachary J. Ward, Roxanne Dupuis, Michael W. Long, Steven L. Gortmaker

Objective

The objective of this study is to estimate health-related quality of life (HRQoL) by continuous BMI by age, sex, and demographic group in the United States.

Methods

We estimated HRQoL (overall and by domain) by continuous BMI using SF-6D (Short-Form Six-Dimension) data from 182,778 respondents ages 18 years and older from the repeated cross-sectional Medical Expenditure Panel Survey (MEPS) 2008 to 2016. We adjusted for BMI self-report bias and for potential confounding between BMI and HRQoL.

Results

We found an inverse J-shaped curve of HRQoL by BMI, with lower values for female individuals and the highest health utilities occurring at BMI of 20.4 kg/m2 (95% CI: 20.32–20.48) for female individuals and 26.5 kg/m2 (95% CI: 26.45–26.55) for male individuals. By BMI category, excess weight contributed to HRQoL loss of 0.0349 for obesity overall, rising to 0.0724 for class III obesity. By domain, pain was the largest cause of HRQoL loss for obesity (26%), followed by role limitations (22%).

Conclusions

HRQoL is lower for people with excess body weight across a broad range of ages and BMI levels, especially at high levels of BMI, with pain being the largest driver of HRQoL loss. These findings highlight the importance of promoting a healthy weight for the entire population while also targeting efforts to prevent extreme weight gain over the life course.

研究目的本研究的目的是按连续体重指数估算美国不同年龄、性别和人口群体的健康相关生活质量(HRQoL):我们使用 SF-6D(短表格六维度)数据估算了连续 BMI 的 HRQoL(总体和各领域),这些数据来自 2008 年至 2016 年重复性横截面医疗支出面板调查(MEPS)中 182,778 名 18 岁及以上受访者。我们对 BMI 自我报告偏差和 BMI 与 HRQoL 之间的潜在混杂因素进行了调整:我们发现,BMI 与 HRQoL 呈反 J 型曲线,女性的 HRQoL 值较低,女性 BMI 为 20.4 kg/m2 (95% CI: 20.32-20.48) 和男性 BMI 为 26.5 kg/m2 (95% CI: 26.45-26.55)时,健康效用最高。按体重指数(BMI)分类,体重超标导致的总体肥胖患者 HRQoL 损失为 0.0349,而 III 级肥胖患者的 HRQoL 损失则上升至 0.0724。按领域划分,疼痛是导致肥胖症患者 HRQoL 下降的最大原因(26%),其次是角色限制(22%):结论:在不同年龄和体重指数水平的人群中,体重超标者的 HRQoL 都较低,尤其是在体重指数较高的情况下,疼痛是导致 HRQoL 下降的最大原因。这些发现凸显了促进全民健康体重的重要性,同时也要有针对性地努力防止在整个生命过程中体重极度增加。
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引用次数: 0
Impact of eating behavior on 24-month weight change after treatment of severe obesity—A clinical prospective cohort study 饮食行为对重度肥胖症治疗后 24 个月体重变化的影响--一项临床前瞻性队列研究。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-06 DOI: 10.1002/oby.24131
Sofia Björkman, Gudrún Höskuldsdóttir, Karin Mossberg, Anna Laurenius, My Engström, Lars Fändriks, Björn Eliasson, Ola Wallengren, Ingrid Larsson

Objective

This study aimed to evaluate the effects of self-reported baseline eating behaviors on 24-month weight change in adults with severe obesity.

Methods

A prospective, nonrandomized clinical cohort study on surgical and medical obesity treatment included 971 adults (75% women) with a mean BMI of 42.0 (SD 4.9) kg/m2. To assess baseline eating behaviors and binge eating disorder, the Questionnaire on Eating and Weight Patterns-Revised and the Three-Factor Eating Questionnaire were used.

Results

In analyses adjusted for treatment, age, sex, baseline weight, and BMI, those with nocturnal eating lost less weight (3.5 kg [95% CI: 0.02–6.9]; p < 0.05) at 24 months compared to those without nocturnal eating. Binge eating disorder was not significantly associated with weight loss over 24 months. Emotional eating was associated with less weight loss at 12 months: 1.16 kg per z score (95% CI: 0.37–1.95; p < 0.05). Compared with completers, dropout from medical obesity treatment was associated with emotional and uncontrolled eating at baseline (both p < 0.001).

Conclusions

The association between pretreatment eating behaviors and weight change was found to be generalizable and not restricted to any specific treatment. Certain eating behaviors may affect weight loss as well as attrition. Identifying eating behaviors that may impair treatment efficacy are suggested in the treatment of severe obesity.

研究目的本研究旨在评估自我报告的基线饮食行为对重度肥胖成人 24 个月体重变化的影响:一项关于肥胖症手术和药物治疗的前瞻性、非随机临床队列研究共纳入了 971 名成年人(75% 为女性),他们的平均体重指数为 42.0 (SD 4.9) kg/m2。为了评估基线饮食行为和暴食症,研究人员使用了饮食和体重模式问卷-修订版和三因素饮食问卷:结果:在对治疗、年龄、性别、基线体重和体重指数进行调整后的分析中,夜食患者的体重减轻较少(3.5 千克 [95% CI:0.02-6.9];P 结论:治疗前饮食行为与暴饮暴食症之间存在关联:研究发现,治疗前饮食行为与体重变化之间的关系具有普遍性,并不局限于任何特定的治疗方法。某些饮食行为可能会影响体重的下降和流失。建议在治疗严重肥胖症时识别可能影响疗效的饮食行为。
{"title":"Impact of eating behavior on 24-month weight change after treatment of severe obesity—A clinical prospective cohort study","authors":"Sofia Björkman,&nbsp;Gudrún Höskuldsdóttir,&nbsp;Karin Mossberg,&nbsp;Anna Laurenius,&nbsp;My Engström,&nbsp;Lars Fändriks,&nbsp;Björn Eliasson,&nbsp;Ola Wallengren,&nbsp;Ingrid Larsson","doi":"10.1002/oby.24131","DOIUrl":"10.1002/oby.24131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the effects of self-reported baseline eating behaviors on 24-month weight change in adults with severe obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, nonrandomized clinical cohort study on surgical and medical obesity treatment included 971 adults (75% women) with a mean BMI of 42.0 (SD 4.9) kg/m<sup>2</sup>. To assess baseline eating behaviors and binge eating disorder, the Questionnaire on Eating and Weight Patterns-Revised and the Three-Factor Eating Questionnaire were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In analyses adjusted for treatment, age, sex, baseline weight, and BMI, those with nocturnal eating lost less weight (3.5 kg [95% CI: 0.02–6.9]; <i>p</i> &lt; 0.05) at 24 months compared to those without nocturnal eating. Binge eating disorder was not significantly associated with weight loss over 24 months. Emotional eating was associated with less weight loss at 12 months: 1.16 kg per <i>z</i> score (95% CI: 0.37–1.95; <i>p</i> &lt; 0.05). Compared with completers, dropout from medical obesity treatment was associated with emotional and uncontrolled eating at baseline (both <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The association between pretreatment eating behaviors and weight change was found to be generalizable and not restricted to any specific treatment. Certain eating behaviors may affect weight loss as well as attrition. Identifying eating behaviors that may impair treatment efficacy are suggested in the treatment of severe obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"32 11","pages":"2100-2110"},"PeriodicalIF":4.2,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response to the Letter to the Editor by Bett et al. 对 Bett 等人致编辑的信的回应
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1002/oby.24140
Jaime P. Almandoz, Thomas A. Wadden, Colleen Tewksbury, Caroline M. Apovian, Angela Fitch, Jamy D. Ard, Zhaoping Li, Jesse Richards, W. Scott Butsch, Irina Jouravskaya, Kadie S. Vanderman, Lisa M. Neff
<p><b>TO THE EDITOR:</b> We thank Bett and colleagues for their interest in our review, “Nutritional considerations with antiobesity medications” [<span>(1)</span>], and we appreciate the opportunity to respond to their letter.</p><p>Because obesity is a chronic disease, we recognize the importance of long-term data on outcomes of treatment with any antiobesity medication (AOM). A significant body of evidence from randomized controlled trials has supported the efficacy and safety of Food and Drug Administration (FDA)-approved AOMs for chronic weight management, including liraglutide (2014), semaglutide (2021), and tirzepatide (2023). Examples of completed randomized controlled trials of >1 year duration include, but are not limited to, the SCALE trial of liraglutide (NCT01272219; 160 weeks) [<span>(2)</span>], the SELECT trial of semaglutide (NCT03574597; 208 weeks) [<span>(3)</span>], and the SURMOUNT-4 trial of tirzepatide (NCT04660643; 88 weeks) [<span>(4)</span>]. Ongoing trials (e.g., SURMOUNT-MMO; 260 weeks) will provide additional long-term data to help inform clinical decision-making.</p><p>We aimed to present a balanced view of the benefits and potential adverse events (AEs) associated with AOMs, with a focus on common AEs that may impact nutritional status, such as gastrointestinal AEs. We recognize that other AEs, including rare but serious events, can occur during treatment, as has been detailed elsewhere [<span>(5, 6)</span>].</p><p>We agree, as noted in the manuscript, that weight regain is commonly seen on treatment cessation and is observed with various obesity treatments, including intensive lifestyle interventions [<span>(7)</span>] and AOMs [<span>(1)</span>]. This highlights the chronic and relapsing nature of the disease and suggests that chronic treatment may be necessary for maintenance of weight reduction. We recognize that limited access to obesity treatment, including but not limited to AOMs, is a major barrier. Challenges that impact access to medications must be addressed to optimize patient care over the long term.</p><p>We recognize that energy requirements vary based on many factors, including age, sex, body weight, and physical activity. We noted in our review that goals for energy intake should be personalized. However, we felt it was important to provide general guidance on minimum goals for energy intake during obesity treatment in particular. Our review of current evidence from low-calorie diets, bariatric surgery, and dietary guidelines for adults overwhelmingly presented energy intake guidance based on sex rather than weight. By contrast, when weight reduction is not the goal, as in the inpatient setting, energy prescriptions are often based on weight. Additional research may help clarify optimal energy intake during weight reduction. Our review included recommendations for liquid meal replacements and high-quality protein supplementation as needed. Whey was not specifically recommended, but these products
致编辑:感谢贝特及其同事对我们的综述 "抗肥胖药物的营养注意事项"[(1)]的关注,我们很高兴有机会对他们的来信作出回应。由于肥胖是一种慢性疾病,我们认识到任何抗肥胖药物(AOM)治疗结果的长期数据的重要性。来自随机对照试验的大量证据支持了美国食品和药物管理局(FDA)批准的用于慢性体重管理的 AOMs 的疗效和安全性,包括利拉鲁肽(2014 年)、赛马鲁肽(2021 年)和替泽帕肽(2023 年)。已完成的为期1年的随机对照试验包括但不限于利拉鲁肽的SCALE试验(NCT01272219;160周)[(2)]、塞马鲁肽的SELECT试验(NCT03574597;208周)[(3)]和替齐帕肽的SURMOUNT-4试验(NCT04660643;88周)[(4)]。正在进行的试验(如 SURMOUNT-MMO;260 周)将提供更多的长期数据,为临床决策提供参考。我们的目标是平衡地阐述与 AOMs 相关的益处和潜在不良事件 (AEs),重点关注可能影响营养状况的常见不良事件,如胃肠道不良事件。我们认识到,在治疗过程中还可能出现其他不良反应,包括罕见但严重的不良反应,这在其他文献中也有详细介绍[(5, 6)]。我们同意,正如手稿中指出的那样,体重反弹在停止治疗时很常见,而且在各种肥胖症治疗中都能观察到,包括强化生活方式干预[(7)]和AOMs[(1)]。这凸显了肥胖症的慢性和复发性特点,并表明长期治疗可能是维持体重减轻的必要条件。我们认识到,获得肥胖症治疗(包括但不限于 AOMs)的机会有限是一个主要障碍。我们认识到,能量需求因年龄、性别、体重和体力活动等多种因素而异。我们在综述中指出,能量摄入的目标应该是个性化的。但是,我们认为有必要特别就肥胖症治疗期间能量摄入的最低目标提供一般性指导。我们对低热量饮食、减肥手术和成人膳食指南中的现有证据进行了回顾,绝大多数证据都提出了基于性别而非体重的能量摄入指导。相比之下,当减轻体重不是目标时,如在住院环境中,能量处方通常是基于体重的。更多的研究可能有助于明确减重期间的最佳能量摄入。我们的综述包括关于液体代餐和根据需要补充优质蛋白质的建议。我们同意,如果没有摄入足够的水分,膳食纤维摄入可能会导致便秘,并在我们的综述中指出了同时关注纤维和液体摄入的重要性。我们的综述还强调了膳食纤维食物来源("水果、蔬菜和全谷物")的重要性,它们含有可溶性和非可溶性纤维。Jaime P. Almandoz从勃林格殷格翰公司、礼来公司和诺和诺德公司获得了咨询费;从临床护理选择、医学和护理教育研究所以及PeerView获得了讲课费或酬金;并在肥胖协会理事会担任领导或受托职务。Thomas A. Wadden 从诺和诺德公司(Novo Nordisk A/S )和 WW 国际公司(WW International, Inc.Colleen Tewksbury 曾从营养与饮食科学院 (Academy of Nutrition and Dietetics) 和饮食注册委员会 (Commission on Dietetic Registration) 领取讲座、演讲、发言人、手稿撰写或教育活动的报酬或酬金;从营养与饮食科学院 (Academy of Nutrition and Dietetics) 领取出席会议和/或差旅的资助;在营养与饮食科学院体重管理饮食实践小组执行委员会 (Academy of Nutrition and Dietetics Weight Management Dietetic Practice Group Executive Committee) 担任领导或受托职务;以及担任营养与饮食科学院 (Academy of Nutrition and Dietetics) 的发言人。Caroline M. Apovian 曾获得 GI Dynamics 公司(现为 Morphic Medical)、Novo Nordisk A/S 和以患者为中心的结果研究所的机构资助;获得 Cowen and Company, LLC 的咨询费;获得 Rhythm Pharmaceuticals, Inc 的讲课费或酬金;加入 Altimmune、CinFina Pharma、Currax Pharmaceuticals、EPG Communication Holdings、Form Health、L-Nutra、NeuroBo Pharmaceuticals, Inc、Novo Nordisk A/S 、PainScript、Palatin Technologies, Inc.
{"title":"Response to the Letter to the Editor by Bett et al.","authors":"Jaime P. Almandoz,&nbsp;Thomas A. Wadden,&nbsp;Colleen Tewksbury,&nbsp;Caroline M. Apovian,&nbsp;Angela Fitch,&nbsp;Jamy D. Ard,&nbsp;Zhaoping Li,&nbsp;Jesse Richards,&nbsp;W. Scott Butsch,&nbsp;Irina Jouravskaya,&nbsp;Kadie S. Vanderman,&nbsp;Lisa M. Neff","doi":"10.1002/oby.24140","DOIUrl":"10.1002/oby.24140","url":null,"abstract":"&lt;p&gt;&lt;b&gt;TO THE EDITOR:&lt;/b&gt; We thank Bett and colleagues for their interest in our review, “Nutritional considerations with antiobesity medications” [&lt;span&gt;(1)&lt;/span&gt;], and we appreciate the opportunity to respond to their letter.&lt;/p&gt;&lt;p&gt;Because obesity is a chronic disease, we recognize the importance of long-term data on outcomes of treatment with any antiobesity medication (AOM). A significant body of evidence from randomized controlled trials has supported the efficacy and safety of Food and Drug Administration (FDA)-approved AOMs for chronic weight management, including liraglutide (2014), semaglutide (2021), and tirzepatide (2023). Examples of completed randomized controlled trials of &gt;1 year duration include, but are not limited to, the SCALE trial of liraglutide (NCT01272219; 160 weeks) [&lt;span&gt;(2)&lt;/span&gt;], the SELECT trial of semaglutide (NCT03574597; 208 weeks) [&lt;span&gt;(3)&lt;/span&gt;], and the SURMOUNT-4 trial of tirzepatide (NCT04660643; 88 weeks) [&lt;span&gt;(4)&lt;/span&gt;]. Ongoing trials (e.g., SURMOUNT-MMO; 260 weeks) will provide additional long-term data to help inform clinical decision-making.&lt;/p&gt;&lt;p&gt;We aimed to present a balanced view of the benefits and potential adverse events (AEs) associated with AOMs, with a focus on common AEs that may impact nutritional status, such as gastrointestinal AEs. We recognize that other AEs, including rare but serious events, can occur during treatment, as has been detailed elsewhere [&lt;span&gt;(5, 6)&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We agree, as noted in the manuscript, that weight regain is commonly seen on treatment cessation and is observed with various obesity treatments, including intensive lifestyle interventions [&lt;span&gt;(7)&lt;/span&gt;] and AOMs [&lt;span&gt;(1)&lt;/span&gt;]. This highlights the chronic and relapsing nature of the disease and suggests that chronic treatment may be necessary for maintenance of weight reduction. We recognize that limited access to obesity treatment, including but not limited to AOMs, is a major barrier. Challenges that impact access to medications must be addressed to optimize patient care over the long term.&lt;/p&gt;&lt;p&gt;We recognize that energy requirements vary based on many factors, including age, sex, body weight, and physical activity. We noted in our review that goals for energy intake should be personalized. However, we felt it was important to provide general guidance on minimum goals for energy intake during obesity treatment in particular. Our review of current evidence from low-calorie diets, bariatric surgery, and dietary guidelines for adults overwhelmingly presented energy intake guidance based on sex rather than weight. By contrast, when weight reduction is not the goal, as in the inpatient setting, energy prescriptions are often based on weight. Additional research may help clarify optimal energy intake during weight reduction. Our review included recommendations for liquid meal replacements and high-quality protein supplementation as needed. Whey was not specifically recommended, but these products","PeriodicalId":215,"journal":{"name":"Obesity","volume":"32 11","pages":"1982-1984"},"PeriodicalIF":4.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coach access to digital self-monitoring data: an experimental test of short-term effects in behavioral weight-loss treatment 教练访问数字自我监测数据:行为减肥治疗短期效果的实验测试。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-02 DOI: 10.1002/oby.24138
Meghan L. Butryn, Nicole A. Miller, Charlotte J. Hagerman, Danielle Arigo, Erica LaFata, Fengqing Zhang, Bonnie Spring, Evan Forman

Objective

This study experimentally tested whether coach access to participants' digital self-monitoring data improved behavioral weight-loss outcomes.

Methods

Participants (N = 322) received 12 weeks of group-based behavioral weight-loss sessions via videoconference and were instructed to engage in daily self-monitoring of weight, physical activity (PA), and dietary intake. For participants who were randomly assigned to Coach Share ON (n = 161), coaches regularly accessed a web-based portal that displayed data from the participants' scale, PA sensor, and food record.

Results

Weight loss at 12 weeks was significantly greater in Coach Share ON versus OFF (6.2% vs. 5.3%; p = 0.04). Self-monitoring of PA (98.70% vs. 97.40% of days; p = 0.006) and eating (98.05% vs. 93.51% of days; p = 0.007) was more frequent in Coach Share ON versus OFF. There were no significant differences by condition in PA (p = 0.57), attendance (p = 0.42), working alliance (p = 0.62), or self-monitoring of weight (p = 0.12). Perceived supportive accountability was significantly greater in Coach Share ON versus OFF (p < 0.001).

Conclusions

The short-term efficacy of behavioral weight loss was greater when coaches had direct access to self-monitoring device data. Notably, there also was no evidence of iatrogenic effects of data sharing.

目的: 本研究通过实验测试了教练获取参与者的数字自我监测数据是否能改善行为减肥效果:本研究通过实验测试了教练访问参与者的数字自我监测数据是否会改善行为减肥的结果:参与者(N = 322)通过视频会议接受了为期 12 周的小组行为减肥课程,并被要求每天对体重、体力活动(PA)和饮食摄入量进行自我监测。对于随机分配到 "教练共享ON "的参与者(n = 161),教练会定期访问基于网络的门户网站,该网站会显示参与者的体重秤、体力活动传感器和食物记录数据:结果:12 周后,Coach Share ON 的体重减轻率明显高于 COACH Share OFF(6.2% 对 5.3%;P = 0.04)。Coach Share 启动版与关闭版相比,自我监测 PA(98.70% 对 97.40%;p = 0.006)和进食(98.05% 对 93.51%;p = 0.007)的频率更高。不同条件下,PA(p = 0.57)、出勤率(p = 0.42)、工作联盟(p = 0.62)或自我体重监控(p = 0.12)没有明显差异。在 "教练分享 "中,"开启 "与 "关闭 "相比,"感知到的支持性责任感 "明显更高(P当教练可以直接访问自我监测设备的数据时,行为减肥的短期效果会更好。值得注意的是,没有证据表明数据共享会产生先天性影响。
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引用次数: 0
A meta-analysis and polygenic score study identifies novel genetic markers for waist-hip ratio in African populations 一项荟萃分析和多基因评分研究发现了非洲人群腰臀比的新型遗传标记。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 DOI: 10.1002/oby.24123
Michael Zhong, Ebuka Onyenobi, Ayo Duomatey, Guanjie Chen, James Perry, Zhenyao Ye, ACCME Research Group as part of the H3Africa Consortium, Charles Rotimi, Clement A. Adebamowo, Adebowale Adeyemo, Sally N. Adebamowo
<div> <section> <h3> Objective</h3> <p>Understanding the genetic underpinnings of anthropometric traits in diverse populations is crucial for gaining insights into their biological mechanisms and potential implications for health.</p> </section> <section> <h3> Methods</h3> <p>We conducted a genome-wide association study, meta-analysis, and gene set analysis of waist-hip ratio (WHR), WHR adjusted for BMI (WHRadjBMI), waist circumference, BMI, and height using the African Collaborative Center for Microbiome and Genomics Research (ACCME) cohort (<i>n</i> = ~11,000) for discovery and polygenic score target analyses and the Africa America Diabetes Mellitus (AADM) study (<i>n</i> = ~5200) for replication and polygenic score validation. We generated and compared polygenic scores from European, African, Afro-Caribbean, and multiethnic ancestry populations.</p> </section> <section> <h3> Results</h3> <p>The top loci associated with each trait in the meta-analysis were in <i>CD36</i> (rs3211826 [<i>p</i> = 5.90 × 10<sup>−12</sup>] for WHR and rs73709003 [<i>p</i> = 1.75 × 10<sup>−13</sup>] for WHRadjBMI), <i>IFI27L1</i> (rs59775050 [<i>p</i> = 2.66 × 10<sup>−08</sup>] for waist circumference), <i>INPP4B</i> (rs2636629 [<i>p</i> = 1.44 × 10<sup>−09</sup>] for BMI), and <i>HMGA1</i> (rs6937622 [<i>p</i> = 1.40 × 10<sup>−15</sup>] for height) gene regions. A novel variant rs7797157, near <i>GNAT3</i>, was also significantly associated with WHR (<i>p</i> = 2.50 × 10<sup>−10</sup>) and WHRadjBMI (<i>p</i> = 2.66 × 10<sup>−11</sup>). The ancestry-specific parameters for the best predictive polygenic scores were European ancestry (<i>R</i><sup><i>2</i></sup> = 0.68%; <i>p</i> = 1.63 × 10<sup>−16</sup>) and multiethnic ancestry (<i>R</i><sup><i>2</i></sup> = 0.06%; <i>p</i> = 1.29 × 10<sup>−02</sup>) for WHR; European ancestry (<i>R</i><sup><i>2</i></sup> = 1.36%; <i>p</i> = 2.94 × 10<sup>−31</sup>) and multiethnic ancestry (<i>R</i><sup><i>2</i></sup> = 1.12%; <i>p</i> = 3.52 × 10<sup>−25</sup>) for BMI; and European ancestry (<i>R</i><sup><i>2</i></sup> = 3.16%; <i>p</i> = 2.95 × 10<sup>−73</sup>), African ancestry (<i>R</i><sup><i>2</i></sup> = 4.16%; <i>p</i> = 1.75 × 10<sup>−96</sup>), and African and Afro-Caribbean ancestry (<i>R</i><sup><i>2</i></sup> = 2.67%; <i>p</i> = 4.35 × 10<sup>−62</sup>) for height.</p> </section> <section> <h3> Conclusions</h3> <p>The discovery of a novel locus for WHR and genetic signals for each trait and the assessment of polygenic score performance underscore the importance of conducting well-powered studies in diverse populations
目的:了解不同人群人体测量特征的遗传基础对于深入了解其生物机制和对健康的潜在影响至关重要:了解不同人群人体测量特征的遗传基础对于深入了解其生物学机制和对健康的潜在影响至关重要:我们利用非洲微生物组和基因组研究合作中心(ACCME)队列(n = ~11,000)进行了腰臀比(WHR)、根据体重指数调整的腰臀比(WHRadjBMI)、腰围、体重指数和身高的全基因组关联研究、荟萃分析和基因组分析,并利用非洲-美洲糖尿病(AADM)研究(n = ~5200)进行了复制和多基因评分验证。我们生成并比较了来自欧洲、非洲、非洲-加勒比和多种族血统人群的多基因得分:在荟萃分析中,与每个性状相关的最高位点分别是 CD36(rs3211826 [p = 5.90 × 10-12] 表示腰围,rs73709003 [p = 1.75 × 10-13] 表示腰围adjBMI)、IFI27L1(rs59775050 [p = 2.66 × 10-08] 表示腰围)、INPP4B(rs2636629 [p = 1.44 × 10-09] 表示体重指数)和 HMGA1(rs6937622 [p = 1.40 × 10-15] 表示身高)基因区域。GNAT3 附近的一个新变异 rs7797157 也与 WHR(p = 2.50 × 10-10)和 WHRadjBMI(p = 2.66 × 10-11)显著相关。最佳预测多基因得分的祖先特异性参数为:WHR 为欧洲祖先(R2 = 0.68%;p = 1.63 × 10-16)和多民族祖先(R2 = 0.06%;p = 1.29 × 10-02);WHR 为欧洲祖先(R2 = 1.36%;p = 2.94 × 10-31)和多民族祖先(R2 = 1.12%; p = 3.52 × 10-25);身高方面,欧洲血统(R2 = 3.16%; p = 2.95 × 10-73)、非洲血统(R2 = 4.16%; p = 1.75 × 10-96)以及非洲和非洲-加勒比血统(R2 = 2.67%; p = 4.35 × 10-62):结论:发现了一个新的 WHR 基因座和每个性状的遗传信号,以及对多基因评分性能的评估,都强调了在不同人群中开展有充分动力的研究的重要性。
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引用次数: 0
Differential mitochondrial adaptation and FNDC5 production in brown and white adipose tissue in response to cold and obesity 棕色和白色脂肪组织对寒冷和肥胖的线粒体适应性和 FNDC5 的产生存在差异。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-26 DOI: 10.1002/oby.24132
Gabriela Neira, Ana Wenting Hernández-Pardos, Sara Becerril, Beatriz Ramírez, Víctor Valentí, Rafael Moncada, Victoria Catalán, Javier Gómez-Ambrosi, María A. Burrell, Camilo Silva, Javier Escalada, Gema Frühbeck, Amaia Rodríguez

Objective

Fibronectin type III domain-containing protein 5 (FNDC5) modulates adipocyte metabolism by increasing white and brown adipose tissue (WAT and BAT) browning and activity, respectively. We investigated whether FNDC5 can regulate visceral WAT and BAT adaptive thermogenesis by improving mitochondrial homeostasis in response to cold and obesity.

Methods

Adipose tissue expression of FNDC5 and factors involved in mitochondrial homeostasis were determined in patients with normal weight and obesity (n = 159) and in rats with diet-induced obesity after 1 week of cold exposure (n = 61). The effect of different FNDC5 concentrations on mitochondrial biogenesis, dynamics, and mitophagy was evaluated in vitro in human adipocytes.

Results

In human visceral adipocytes, FNDC5/irisin triggered mitochondrial biogenesis (TFAM) and fusion (MFN1, MFN2, and OPA1) while inhibiting peripheral fission (DNM1L and FIS1) and mitophagy (PINK1 and PRKN). Circulating and visceral WAT expression of FNDC5 was decreased in patients and experimental animals with obesity, whereas its receptor, integrin αV, was upregulated. Obesity increased mitochondrial fusion while decreasing mitophagy in visceral WAT from patients and rats. By contrast, in rat BAT, an upregulation of Fndc5 and genes involved in mitochondrial biogenesis and fission was observed. Cold exposure promoted mitochondrial biogenesis and healthy peripheral fission while repressing Fndc5 expression and mitophagy in BAT from rats.

Conclusions

Depot differences in FNDC5 production and mitochondrial adaptations in response to obesity and cold might indicate a self-regulatory mechanism to control thermogenesis in response to energy needs.

目的:纤连蛋白Ⅲ型结构域含蛋白5(FNDC5)分别通过增加白色和棕色脂肪组织(WAT和BAT)的褐变和活性来调节脂肪细胞的代谢。我们研究了FNDC5是否能通过改善线粒体平衡来调节内脏WAT和BAT的适应性产热,以应对寒冷和肥胖:方法:测定正常体重和肥胖患者(n = 159)以及饮食诱导肥胖大鼠(n = 61)在暴露于寒冷环境 1 周后的脂肪组织中 FNDC5 的表达和线粒体稳态相关因子。在体外人体脂肪细胞中评估了不同浓度的 FNDC5 对线粒体生物生成、动力学和有丝分裂吞噬的影响:结果:在人类内脏脂肪细胞中,FNDC5/鸢尾素触发线粒体生物生成(TFAM)和融合(MFN1、MFN2 和 OPA1),同时抑制外周裂变(DNM1L 和 FIS1)和有丝分裂(PINK1 和 PRKN)。在肥胖症患者和实验动物体内,循环和内脏脂肪中 FNDC5 的表达量减少,而其受体整合素 αV 则上调。肥胖症增加了患者和大鼠内脏脂肪的线粒体融合,同时减少了有丝分裂。相比之下,在大鼠的 BAT 中,观察到 Fndc5 以及参与线粒体生物生成和分裂的基因上调。寒冷暴露促进了线粒体的生物生成和健康的外周裂变,同时抑制了大鼠 BAT 中 Fndc5 的表达和有丝分裂:结论:FNDC5的产生和线粒体对肥胖和寒冷的适应性在大鼠体内存在差异,这可能表明大鼠体内存在一种自我调节机制,可根据能量需求控制产热。
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引用次数: 0
期刊
Obesity
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