IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-23 DOI: 10.1002/oby.24167

Kimberly B. Glazer, Teresa Janevic, Natalie Boychuk, Natalia Egorova, Paul Hebert, Jennifer Zeitlin, Elizabeth A. Howell

Objective

The objective of this study was to examine whether obesity without preexisting or gestational comorbidities is associated with postpartum hospital use (PHU).

Methods

We studied 2016 to 2018 birth certificate and discharge data on 178,729 New York City births without International Classification of Diseases, Tenth Revision (ICD-10) codes at delivery for diabetes; hypertension; placental disease; anemia; thyrotoxicosis; bariatric surgery; and pulmonary, cardiac, renal, bleeding, autoimmune, digestive, neuromuscular, mental, or substance-use disorders. We defined PHU as ≥1 readmission or emergency department visit within 30 days of delivery discharge. We used ICD-10 codes to specify postpartum hypertension, infection, or hemorrhage during PHU (i.e., “cause-specific PHU”) because these are leading mortality causes. We examined associations between prepregnancy BMI and PHU using multivariable logistic regression.

Results

PHU incidence was 3.7% for those with normal weight, 5.1% for those with overweight, 6.3% for those with class 1 or 2 obesity, and 9.1% for those with class 3 obesity. A positive association persisted after adjustment. Obesity was associated with cause-specific PHU of postpartum hypertension (adjusted odds ratio [aOR]: 2.2, 95% confidence limits [CL]: 1.8–2.7, normal weight referent) and wound infection (aOR: 1.5, 95% CL: 1.2–1.8), but not hemorrhage (aOR: 0.9, 95% CL: 0.7–1.3), mastitis, or genitourinary infection (aOR: 1.1, 95% CL: 0.9–1.3).

Conclusions

Among individuals without other comorbidities, elevated BMI was associated with PHU. Findings can inform obstetric management to reduce morbidity during the critical fourth trimester.

目的：本研究的目的是探讨无既往或妊娠期合并症的肥胖是否与产后住院（PHU）有关。方法：研究2016年至2018年纽约市178,729名出生时未患有糖尿病的新生儿的出生证明和出院数据；高血压;胎盘疾病;贫血;甲状腺功能亢进;减肥手术;以及肺部、心脏、肾脏、出血、自身免疫、消化、神经肌肉、精神或药物使用障碍。我们将PHU定义为在分娩出院后30天内再入院或急诊次数≥1次。我们使用ICD-10代码来指定产后高血压、感染或PHU期间出血（即“病因特异性PHU”），因为这些是主要的死亡原因。我们使用多变量逻辑回归检查了孕前BMI和PHU之间的关系。结果：体重正常组PHU发生率为3.7%，超重组为5.1%，1、2级肥胖组为6.3%，3级肥胖组为9.1%。调整后，正相关持续存在。肥胖与产后高血压的病因特异性PHU（调整优势比[aOR]: 2.2, 95%置信限[CL]: 1.8-2.7，正常体重参照）和伤口感染（aOR: 1.5, 95% CL: 1.2-1.8）相关，但与出血（aOR: 0.9, 95% CL: 0.7-1.3）、乳腺炎或泌尿生殖系统感染（aOR: 1.1, 95% CL: 0.9-1.3）无关。结论：在没有其他合并症的个体中，BMI升高与PHU相关。研究结果可以为产科管理提供信息，以减少关键妊娠第四个月的发病率。

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引用次数: 0

GLP1Ra-based therapies and DXA-acquired musculoskeletal health outcomes: a focused meta-analysis of placebo-controlled trials 基于glp1ra的疗法和dxa获得的肌肉骨骼健康结果：安慰剂对照试验的集中荟萃分析

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-22 DOI: 10.1002/oby.24172

Kristen M. Beavers, Tiffany M. Cortes, Colleen M. Foy, Lauren Dinkla, Fernando Reyes San Martin, Jamy D. Ard, Monica C. Serra, Daniel P. Beavers

Objective

The objective of this study was to evaluate the effect of glucagon-like peptide-1 receptor agonist (GLP1Ra)-based therapies on change in dual-energy x-ray absorptiometry (DXA)-acquired lean mass (LM) or bone mineral density (BMD).

Methods

PubMed and Web of Science were searched from database inception through January 29, 2024, for randomized, placebo-controlled trials reporting on change in DXA-acquired LM or BMD measures associated with 12+ weeks of GLP1Ra-based treatment. Of 2618 articles, 9 trials met prespecified search criteria, with 7 reporting on change in total body LM and 2 reporting on change in BMD. For LM outcomes, a hierarchical Bayesian model was used to estimate treatment mean differences. BMD outcomes were described narratively.

Results

LM was reported in a total of 659 participants (GLP1Ra-based therapies: n = 419; placebo: n = 240), with follow-up times ranging from mean (SD) 12 to 72 (33.5) weeks. At baseline, participants were aged mean (SD) 41.7 (7.6) years, and 75% were female, with BMI values ranging from 30 to 43 kg/m². Compared with placebo, GLP1Ra-based treatment was associated with significantly reduced total body weight (−6.9 kg; 95% credible interval [CI]: −10.7 to −3.0). GLP1Ra-based treatment was also associated with significantly reduced LM (−1.9 kg; 95% CI: −3.5 to −0.2).

Conclusions

Approximately 30% of body weight lost with GLP1Ra-based therapy is LM. More data are needed assessing BMD outcomes.

目的：本研究的目的是评估胰高血糖素样肽-1受体激动剂（GLP1Ra）为基础的治疗对双能x线吸收仪（DXA）获得性瘦质量（LM）或骨矿物质密度（BMD）变化的影响。方法：检索PubMed和Web of Science从数据库建立到2024年1月29日的随机、安慰剂对照试验，报告dxa获得的LM或BMD测量与12周以上glp1ra治疗相关的变化。在2618篇文章中，9篇试验符合预定的检索标准，其中7篇报道了总体LM的变化，2篇报道了BMD的变化。对于LM结果，使用分层贝叶斯模型来估计治疗平均差异。对BMD结果进行叙述。结果：共有659名参与者报告了LM(基于glp1ra的治疗：n = 419；安慰剂：n = 240)，随访时间从平均（SD） 12到72（33.5）周不等。基线时，参与者平均年龄（SD）为41.7（7.6）岁，75%为女性，BMI值在30至43 kg/m2之间。与安慰剂相比，基于glp1ra的治疗显著降低了总体重(-6.9 kg；95%可信区间[CI]: -10.7 ~ -3.0)。基于glp1ra的治疗也与显著降低的LM (-1.9 kg；95% CI: -3.5 ~ -0.2)。结论：通过glp1ra为基础的治疗，大约30%的体重减轻是LM。评估骨密度结果需要更多的数据。

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引用次数: 0

Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system 超重和肥胖的当代治疗模式：来自麻省总医院布莱根卫生保健系统的见解。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-18 DOI: 10.1002/oby.24186

John W. Ostrominski, Kavishwar B. Wagholikar, Kelly Olsson, Ozan Unlu, David Zelle, Sanjay Kumar, Austen M. Smith, Joshua C. Toliver, Wojciech Michalak, Anthony Fabricatore, Bríain Ó. Hartaigh, Heather J. Baer, Christopher P. Cannon, Caroline M. Apovian, Naomi D. L. Fisher, Jorge Plutzky, Benjamin M. Scirica, Alexander J. Blood

Objective

The objective of this study was to describe the prevalence of obesity, obesity-related conditions (ORCs), and antiobesity medication (AOM) eligibility and prescribing practice among eligible patients in a large health care system.

Methods

In this cross-sectional analysis of the multicenter Mass General Brigham health care system (Boston, Massachusetts) spanning 2018 to 2022, adults eligible for AOMs (BMI ≥ 30 kg/m² or BMI 27–29.9 kg/m² with ≥1 ORC) were identified. Among those AOM-eligible, the prevalence of prescriptions for AOMs approved for long-term weight management was evaluated.

Results

Of 2,469,474 adults (mean [SD], age 53 [19] years; 57% female; BMI 28.1 [6.3] kg/m²), a total of 1,110,251 (45.0%) were eligible for AOMs. Of these, 69.4% (31.2% of overall cohort) had BMI ≥ 30 kg/m². AOM prescription was observed in 15,214 (1.4%) of all eligible patients, with female sex, younger age, higher BMI, commercial insurance, and greater ORC burden associated with higher prevalence of AOM prescriptions. Musculoskeletal disorders (54%) were the most common ORCs, with ≥2 ORCs observed in 62% of patients. Liraglutide 3.0 mg and semaglutide 2.4 mg were the most frequently prescribed AOMs (58% and 34% of all AOMs, respectively).

Conclusions

Although nearly one-half of all patients in a large health care system were AOM-eligible by guidelines and regulatory labeling, only 1% of those who were eligible were prescribed AOMs.

目的：本研究的目的是描述大型医疗保健系统中符合条件的患者中肥胖、肥胖相关疾病（ORCs）的患病率、抗肥胖药物（AOM）的资格和处方实践。方法：通过对2018年至2022年马萨诸塞州波士顿多中心布里格姆医疗保健系统（Mass General Brigham health care system, Boston, Massachusetts）的横断面分析，确定了符合AOMs （BMI≥30 kg/m2或BMI 27-29.9 kg/m2且ORC≥1）条件的成年人。在符合aom条件的患者中，评估了aom处方被批准用于长期体重管理的流行程度。结果：2,469,474名成人(平均[SD]，年龄53岁；57%的女性;BMI 28.1 [6.3] kg/m2)，共有1,110,251例（45.0%）符合AOMs。其中，69.4%（占总队列的31.2%）的BMI≥30 kg/m2。在所有符合条件的患者中，15214例（1.4%）患者开了AOM处方，其中女性、年龄较小、BMI较高、有商业保险、ORC负担较大与AOM处方的高患病率相关。肌肉骨骼疾病（54%）是最常见的ORCs， 62%的患者观察到≥2个ORCs。利拉鲁肽3.0 mg和semaglutide 2.4 mg是最常用的AOMs（分别占所有AOMs的58%和34%）。结论：尽管根据指南和监管标签，大型医疗保健系统中近一半的患者符合aom标准，但只有1%的患者符合aom处方。

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引用次数: 0

The various associations between whole /regional fat mass and trajectory of cardiometabolic diseases: a nonlinear multistate model 整体/区域脂肪量与心脏代谢疾病轨迹之间的各种关联：一个非线性多态模型。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-16 DOI: 10.1002/oby.24185

Xinming Xu, Yi Guo, Lili Huang, Berty Ruping Song, Dan Chen, Fangfang Weng, Xueying Zheng, Yu Wen, Zhenyu Wu, Xiang Gao, Liang Sun

Objective

This study aimed to investigate the association of whole body/regional fat mass (FM) with cardiometabolic disease (CMD) trajectory.

Methods

We conducted a prospective analysis using the UK Biobank. The FM index (FMI), a surrogate for whole body FM, and regional FM (i.e., arm, leg, and trunk) were examined as exposures. A nonlinear multistate framework was used to evaluate the association between whole/regional FM and CMD trajectory.

Results

Among the 423,966 participants (mean age 56.1 [SD 8.10] years, 43.9% men) with a median follow-up of 13.5 years, varied associations were identified between whole/regional FM and transitions in the CMD trajectory. Upper body FM (i.e., arm and trunk) exhibited significant positive J-shaped associations in the transitions from first CMD (FCMD) or cardiometabolic multimorbidity to death; however, FMI and leg FM demonstrated L-shaped associations. Leg FM played a beneficial role in the transition from FCMD to death, with a hazard ratio of 0.950 (95% CI: 0.931–0.968) per 1 kg.

Conclusions

Body fat composition and distribution revealed various associations with CMD trajectory, highlighting their clinical importance. Upper body FM among those participants with FCMD or cardiometabolic multimorbidity demonstrated positive J-shaped associations toward death, providing no evidence of the “obesity paradox.”

研究目的本研究旨在调查全身/区域脂肪量（FM）与心脏代谢疾病（CMD）轨迹的关系：我们利用英国生物库进行了一项前瞻性分析。方法：我们利用英国生物库进行了前瞻性分析，将替代全身脂肪量的脂肪量指数（FMI）和区域脂肪量（即手臂、腿部和躯干）作为暴露因素进行了研究。采用非线性多态框架来评估全身/区域调频与慢性阻塞性肺病轨迹之间的关联：在中位随访 13.5 年的 423 966 名参与者（平均年龄 56.1 [SD 8.10] 岁，43.9% 为男性）中，发现了整体/区域性 FM 与 CMD 轨迹转变之间的不同关联。上半身调频（即手臂和躯干）在从首次慢性阻塞性肺病（FCMD）或心脏代谢多病到死亡的转变过程中表现出显著的正 "J "形关联；然而，FMI和腿部调频则表现出 "L "形关联。腿部脂肪含量在从首次慢性阻塞性肺病（FCMD）到死亡的转变过程中起着有益的作用，每1千克的危险比为0.950（95% CI：0.931-0.968）：结论：体脂组成和分布与慢性阻塞性肺病的发病轨迹有多种关联，突出了它们在临床上的重要性。在患有慢性阻塞性肺病或心脏代谢多病的参与者中，上半身脂肪含量与死亡呈正J形关系，没有证据表明存在 "肥胖悖论"。

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引用次数: 0

Psychological attributes and eating behaviors in 5- to 12-year-old children during periods of stress 5- 12岁儿童在压力时期的心理特征和饮食行为。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-16 DOI: 10.1002/oby.24197

Cecilia Sena, Julia Della Torre, Eshita Garg, Hao Zheng, Ivette Partida, Shaleen K. Thaker, Jennifer Woo Baidal, Deborah V. Shamsian, John C. Rausch, Vidhu V. Thaker

Objective

The objective of this study was to investigate the association between psychological attributes and obesogenic behaviors in children during the period of COVID-19 pandemic-induced stress.

Methods

This observational study collected data from caregivers of 5- to 12-year-old children from three diverse groups assessing sociodemographic, economic, and perceived stress, along with the Strengths and Difficulties Questionnaire (SDQ) and the Family Eating and Activity Habits Questionnaire, revised (FEAHQ-R), in October 2020 and June 2021. The outcome measures were SDQ and FEAHQ-R scores. The SDQ subscales were compared with US child norms. Linear mixed models were used to examine the association between the SDQ subscales and FEAHQ-R domains, adjusting for socioeconomic covariates.

Results

A total of 361 families (496 children) completed the SDQ and FEAHQ-R. The SDQ subscale scores were higher than those of age/gender norms (p = 0.006–<0.001). Eating style (p < 0.001) and food stimulus exposure scores (p = 0.005–0.01) were associated with the SDQ subscales, but not satiety response. Perceived stress was a significant covariate (p < 0.01). The baseline obesity status of the children was not statistically significant.

Conclusions

Psychological stress is associated with higher hedonic behavior in children. Food stimulus exposure and leisure access can be targeted for intervention during periods of prolonged stress.

研究目的本研究的目的是调查 COVID-19 大流行引发压力期间儿童的心理属性与肥胖行为之间的关联：本观察性研究于 2020 年 10 月和 2021 年 6 月收集了来自三个不同群体的 5 至 12 岁儿童的照顾者的数据，这些数据包括社会人口学、经济和感知压力评估，以及优势与困难问卷（SDQ）和家庭饮食与活动习惯问卷修订版（FEAHQ-R）。结果测量指标为 SDQ 和 FEAHQ-R 分数。SDQ 分量表与美国儿童标准进行了比较。线性混合模型用于研究 SDQ 分量表与 FEAHQ-R 领域之间的关联，并对社会经济协变量进行调整：共有 361 个家庭（496 名儿童）完成了 SDQ 和 FEAHQ-R。SDQ 分量表得分高于年龄/性别标准（p = 0.006-结论：心理压力与儿童较高的享乐主义行为有关。在长期压力期间，可以有针对性地对食物刺激暴露和休闲机会进行干预。

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引用次数: 0

Response to the Letter to the Editor by Athinarayanan 回应 Athinarayanan 致编辑的信。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-15 DOI: 10.1002/oby.24191

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 Dr. Athinarayanan for her interest in our review [<span>(1)</span>] and appreciate the opportunity to respond.</p><p>We agree that patients face many challenges maintaining long-term body weight reduction, including widespread misconceptions regarding the long-term effectiveness of lifestyle interventions for obesity, along with the body's physiological response to weight loss, which can lead to reduced energy expenditure and increased appetite [<span>(2)</span>]. Limited access to treatment is also a barrier to successful long-term weight management [<span>(3)</span>]. However, we dispute Dr. Athinarayanan's suggestion that dietary carbohydrate restriction (or any other lifestyle intervention) is a proven, effective strategy for weight maintenance after treatment with antiobesity medications (AOMs). Evidence from numerous randomized controlled trials (RCTs) shows that, even with ongoing lifestyle counseling, weight regain is typically observed after AOM cessation [<span>(1)</span>]. Accordingly, long-term use of pharmacotherapy is recommended for weight maintenance [<span>(1)</span>]; therefore, weight management after deprescription was outside of the scope of our review.</p><p>Our review recommended a variety of healthy dietary patterns for patients treated with AOMs and highlighted the importance of individualized lifestyle goals. A low-carbohydrate diet was not excluded from our recommendations, and we provided guidance for clinicians whose patients prefer this dietary pattern. However, when considering the potential impacts of dietary patterns on long-term health outcomes such as cardiovascular disease and mortality, there is more evidence to support a recommendation for moderate-carbohydrate dietary patterns such as the Mediterranean and healthy plant-based diets [<span>(1, 4)</span>]. Indeed, we feel that the strength of the evidence to specifically recommend a low-carbohydrate dietary pattern is low. The carbohydrate-insulin model is an interesting but controversial theoretical model that is challenged by scientific evidence that supports alternate theories of obesity pathophysiology [<span>(2, 5)</span>]. As evidence of the efficacy of low-carbohydrate dietary patterns on weight maintenance, Dr. Athinarayanan cites nonrandomized studies, including a report from the National Weight Control Registry, a prospective cohort study of individuals who, prior to study entry, had maintained a weight reduction of at least 30 lb for 1 year or more. Of note, only 11% of registry participants reported losing weight with a low-carbohydrate dietary approach [<span>(6)</span>]. We appreciate the work of Dr. Athinarayanan and colleagues, which includes descriptive, nonrandomized studies of outcomes among patients with type 2 diabetes who self-selected a telehealth-based continuous care program leveraging a low-carbohydrate dietary pattern [<span>(7, 8)</span>]. We also appreciate their recent retrospective analysis of th

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引用次数: 0

Response to “Nutritional considerations with antiobesity medications” 对“抗肥胖药物的营养考虑”的回应。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-11 DOI: 10.1002/oby.24187

Shaminie J. Athinarayanan

引用次数: 0

DNA methylation in cord blood partially mediates the effects of prepregnancy BMI on early childhood offspring BMI 脐带血DNA甲基化部分介导孕前BMI对幼儿后代BMI的影响。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-11 DOI: 10.1002/oby.24174

Alice Maguolo, Josefine Jönsson, Alexander Perfilyev, Marlena Maziarz, Allan Vaag, Emma Malchau Carlsen, Kirsten Nørgaard, Paul W. Franks, Kristina M. Renault, Charlotte Ling

Objective

We investigated whether prepregnancy BMI (prePregBMI) in women with obesity was associated with differential DNA methylation (DNAm) in cord blood (CB) and whether DNAm may mediate the association of prePregBMI and early childhood BMI z score (BMIz).

Methods

From the Treatment of Obese Pregnant Women (TOP) study, 232 mother–child pairs were included. We conducted an epigenome-wide association study on prePregBMI and CB DNAm (450k array), followed by causal mediation analyses to test whether DNAm may mediate effects of prePregBMI on BMIz at age 36 months (BMIz36).

Results

DNAm at 5345 CpG sites annotated to 2842 genes, which were overrepresented in biological processes linked to carbohydrate metabolism and plasma lipoprotein particle clearance, was associated with prePregBMI (false discovery rate < 10%). Causal mediation analyses of 168 methylation sites associated with BMIz36 (p < 0.05) and overlapping with the 5345 prePregBMI-associated sites identified two sites on SYT7 and DEAF1, partially mediating the effect of prePregBMI on BMIz36 (p ≤ 0.01). After cross-validation, a methylation risk score including these two sites could predict the highest quartile of BMIz36 and fat mass (in grams) with area under the curve = 0.72 (95% CI: 0.58–0.85) and area under the curve = 0.71 (95% CI: 0.58–0.85), respectively.

Conclusions

CB DNAm at birth may partially mediate effects of prePregBMI on early childhood BMIz36, supporting its plausible role in influencing individual future obesity risk.

目的：探讨肥胖妇女孕前BMI （prePregBMI）是否与脐带血（CB） DNA甲基化差异（DNAm）相关，以及DNAm是否介导孕前BMI与儿童早期BMIz评分（BMIz）的关联。方法：从肥胖孕妇治疗（TOP）研究中纳入232对母子。我们对prePregBMI和CB DNAm （450k阵列）进行了全表观基因组关联研究，随后进行了因果中介分析，以检验DNAm是否可能介导prePregBMI对36月龄BMIz （BMIz36）的影响。结果：5345个CpG位点的DNAm注释到2842个基因，这些基因在碳水化合物代谢和血浆脂蛋白颗粒清除相关的生物过程中被过度代表，与prePregBMI（错误发现率）相关。结论：出生时的CB DNAm可能部分介导prePregBMI对早期儿童BMIz36的影响，支持其在影响个体未来肥胖风险方面的合理作用。

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引用次数: 0

Correction to “Early changes in the gut microbiota are associated with weight outcomes over 2 years following metabolic and bariatric surgery” 更正“肠道菌群的早期变化与代谢和减肥手术后2年内的体重结果相关”。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-10 DOI: 10.1002/oby.24209

Steffen, KJ, Sorgen, AA, Fodor, AA, et al. Early changes in the gut microbiota are associated with weight outcomes over 2 years following metabolic and bariatric surgery. Obesity (Silver Spring) 2024; 32: 1985–1997.

On pages 1992 and 1995, panels from Figures 4 and 7 were inadvertently omitted. Below are the correct figures.

We apologize for this error.

引用次数: 0

Daily glucose variability is associated with intrahepatic fat content, β cell sensitivity, and biomarkers of glycolysis in youth with obesity 青少年肥胖患者每日葡萄糖变异性与肝内脂肪含量、β细胞敏感性和糖酵解生物标志物相关。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-12-10 DOI: 10.1002/oby.24175

Emiliano Barbieri, Jacopo Bonet, Delaney Fox, Rafaela Nelson, Michael B. Nelson, Loretta Nelson, Cristina Fernandez, Michelle Van Name, Stephanie Samuels, Sonia Caprio, Mohammad Sabati, Alfonso Galderisi, Jennifer Sherr, Chiara Dalla Man, Nicola Santoro

Objective

Pediatric obesity is associated with insulin resistance, which, in turn, impacts glucose and lipid metabolism. This study sought to assess how glucose variability relates to intrahepatic fat content, β cell insulin sensitivity, and glycolysis in youth with obesity.

Methods

A total of 27 youth with obesity (11 girls, BMI percentile, median [25th–75th percentiles]: 99.0 [97.9–99.0]) wore a continuous glucose monitoring device for 10 days and underwent a 3-h oral glucose tolerance test. β cell function was assessed using the oral minimal model, and liver proton density fat fraction was measured by magnetic resonance imaging.

Results

Average sensor-derived glucose and glucose standard deviation (STDEV) and coefficient of variation (CV) were associated with liver proton density fat fraction (p = 0.0130, p = 0.0005, and p = 0.0028, respectively). First-phase insulin secretion, basal insulin secretion, and insulin sensitivity were associated with STDEV (p = 0.0344, p = 0.0091, and p = 0.0031, respectively) and CV (p = 0.0128, p = 0.0012, and p = 0.0022, respectively). STDEV and CV were also associated with 2-h glucose (p = 0.0067 and p = 0.0324, respectively) and plasma lactate (p = 0.0030 and p = 0.0123, respectively).

Conclusions

Daily glucose variability is associated with the degree of intrahepatic fat content, postprandial glucose, and plasma lactate concentrations.

目的：儿童肥胖与胰岛素抵抗有关，胰岛素抵抗又影响糖脂代谢。本研究旨在评估青少年肥胖患者的葡萄糖变异性与肝内脂肪含量、β细胞胰岛素敏感性和糖酵解的关系。方法：27例肥胖青年（女生11例，BMI百分位数，中位数[25 -75百分位数]:99.0[97.9-99.0]）连续佩戴血糖监测装置10天，并进行3 h口服葡萄糖耐量试验。采用口腔最小模型评估β细胞功能，采用磁共振成像测量肝脏质子密度脂肪分数。结果：平均传感器衍生葡萄糖、葡萄糖标准差（STDEV）和变异系数（CV）与肝质子密度脂肪分数相关（p = 0.0130、p = 0.0005和p = 0.0028）。一期胰岛素分泌、基础胰岛素分泌和胰岛素敏感性与STDEV（分别为p = 0.0344、p = 0.0091和p = 0.0031）和CV（分别为p = 0.0128、p = 0.0012和p = 0.0022）相关。STDEV和CV也与2 h血糖（p = 0.0067和p = 0.0324）和血浆乳酸（p = 0.0030和p = 0.0123）相关。结论：每日葡萄糖变异性与肝内脂肪含量、餐后葡萄糖和血浆乳酸浓度有关。

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引用次数: 0