Marko Mandic, Fatemeh Safizadeh, Michael Hoffmeister, Hermann Brenner
Objective
Previous research may have underestimated the relationship between overweight/obesity and colorectal cancer (CRC) risk by overlooking important potential sources of bias.
Methods
We used data from a large, population-based case–control study encompassing 7098 CRC cases and 5757 age- and sex-matched controls with comprehensive information on risk factors, including self-reported body weight. Multivariate logistic regression was used to assess the associations of BMI with CRC risk before and after considering prediagnostic weight loss, history of lower gastrointestinal endoscopy, and potentially increased CRC risk beneath the overweight threshold (BMI 25 kg/m2). Subsequently, population attributable fractions were calculated.
Results
In the standard analysis evaluating the BMI-CRC association, in which none of the three aforementioned factors was considered, the fraction of CRC cases attributable to overweight and obesity was estimated to be 11.5%. This finding is consistent with estimates from previous studies, which mostly did not consider any of the three factors. However, when all three factors were considered in the analysis, a higher BMI was estimated to account for 23.4% of all CRC cases.
Conclusions
Careful consideration of important sources of bias suggests that a substantially larger share of the CRC burden may be attributable to excess weight than previously thought.
{"title":"Overcoming underestimation of the share of colorectal cancer cases attributable to excess weight: a population-based study","authors":"Marko Mandic, Fatemeh Safizadeh, Michael Hoffmeister, Hermann Brenner","doi":"10.1002/oby.24164","DOIUrl":"10.1002/oby.24164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Previous research may have underestimated the relationship between overweight/obesity and colorectal cancer (CRC) risk by overlooking important potential sources of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from a large, population-based case–control study encompassing 7098 CRC cases and 5757 age- and sex-matched controls with comprehensive information on risk factors, including self-reported body weight. Multivariate logistic regression was used to assess the associations of BMI with CRC risk before and after considering prediagnostic weight loss, history of lower gastrointestinal endoscopy, and potentially increased CRC risk beneath the overweight threshold (BMI 25 kg/m<sup>2</sup>). Subsequently, population attributable fractions were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the standard analysis evaluating the BMI-CRC association, in which none of the three aforementioned factors was considered, the fraction of CRC cases attributable to overweight and obesity was estimated to be 11.5%. This finding is consistent with estimates from previous studies, which mostly did not consider any of the three factors. However, when all three factors were considered in the analysis, a higher BMI was estimated to account for 23.4% of all CRC cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Careful consideration of important sources of bias suggests that a substantially larger share of the CRC burden may be attributable to excess weight than previously thought.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"156-163"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809021","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}
Rebecca F. Goldstein, Jacqueline A. Boyle, Shamil D. Cooray, Anju E. Joham, Alison L. Fitz-Gerald, Joanne Enticott, Cheryce L. Harrison, Helena J. Teede
Objective
The objective of this study was to evaluate a lifestyle intervention implemented into routine antenatal care to optimize gestational weight gain (GWG) and outcomes using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework.
Methods
This study was an embedded pragmatic behavioral intervention delivered by a health coach and supported by a physician over five sessions for women with a prepregnancy BMI between 25 and 43 kg/m2 who were <23 weeks' gestation in an Australian maternity service. Both intervention and standard care received routine antenatal care. The primary outcome was effectiveness in reducing excess GWG, and the secondary outcomes were reach, adoption, implementation, and maintenance and maternal and neonatal outcomes using the RE-AIM framework.
Results
For the “Reach” aspect, 90% of eligible women were included (N = 404; n = 202 intervention and n = 202 standard care). For the “Efficacy” aspect, there were no differences in proportion exceeding GWG recommendations or mean GWG between groups. Secondary analysis excluding women with gestational diabetes showed that a lower proportion of women in the intervention group had GWG above recommendations (β coefficient 0.51, 95% CI: 0.27 to 0.97; p = 0.04), with less GWG (β coefficient −1.93 kg, 95% CI: −3.63 to −0.24; p = 0.03). For the “Adoption” aspect, qualitative analysis of staff/participants demonstrated strong support for service. For the “Implementation” aspect, strong fidelity (implementation according to study plan) and staff/participant acceptability were observed. Finally, for the “Maintenance” aspect, the program has continued for 4 years with plans/funding for scale-up.
Conclusions
Lifestyle intervention did not alter the overall proportion with excess GWG or total GWG. Secondary analysis, excluding women with gestational diabetes mellitus, showed less GWG. This demonstrates implementation and maintenance of the intervention in routine antenatal care, generating new knowledge within the RE-AIM framework.
{"title":"Implementation effectiveness of an antenatal lifestyle intervention to optimize gestational weight gain in women with obesity","authors":"Rebecca F. Goldstein, Jacqueline A. Boyle, Shamil D. Cooray, Anju E. Joham, Alison L. Fitz-Gerald, Joanne Enticott, Cheryce L. Harrison, Helena J. Teede","doi":"10.1002/oby.24192","DOIUrl":"10.1002/oby.24192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to evaluate a lifestyle intervention implemented into routine antenatal care to optimize gestational weight gain (GWG) and outcomes using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was an embedded pragmatic behavioral intervention delivered by a health coach and supported by a physician over five sessions for women with a prepregnancy BMI between 25 and 43 kg/m<sup>2</sup> who were <23 weeks' gestation in an Australian maternity service. Both intervention and standard care received routine antenatal care. The primary outcome was effectiveness in reducing excess GWG, and the secondary outcomes were reach, adoption, implementation, and maintenance and maternal and neonatal outcomes using the RE-AIM framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the “Reach” aspect, 90% of eligible women were included (<i>N</i> = 404; <i>n</i> = 202 intervention and <i>n</i> = 202 standard care). For the “Efficacy” aspect, there were no differences in proportion exceeding GWG recommendations or mean GWG between groups. Secondary analysis excluding women with gestational diabetes showed that a lower proportion of women in the intervention group had GWG above recommendations (β coefficient 0.51, 95% CI: 0.27 to 0.97; <i>p</i> = 0.04), with less GWG (β coefficient −1.93 kg, 95% CI: −3.63 to −0.24; <i>p</i> = 0.03). For the “Adoption” aspect, qualitative analysis of staff/participants demonstrated strong support for service. For the “Implementation” aspect, strong fidelity (implementation according to study plan) and staff/participant acceptability were observed. Finally, for the “Maintenance” aspect, the program has continued for 4 years with plans/funding for scale-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lifestyle intervention did not alter the overall proportion with excess GWG or total GWG. Secondary analysis, excluding women with gestational diabetes mellitus, showed less GWG. This demonstrates implementation and maintenance of the intervention in routine antenatal care, generating new knowledge within the RE-AIM framework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"54-66"},"PeriodicalIF":4.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Rayas, Samantha Pezzica, Henri Honka, Fabrizia Carli, Richard Peterson, Ralph DeFronzo, Amalia Gastaldelli, Marzieh Salehi
Objective
The glycemic-independent actions of glucagon-like peptide-1 (GLP-1) in the prandial state in humans are unknown. We examined the contribution of GLP-1 to β-cell secretory response (primary endpoint) and glucose metabolism during protein ingestion under basal glycemia, as well as whether these responses are affected by rerouted gut after gastric bypass (GB) or sleeve gastrectomy (SG).
Methods
Insulin secretion rate (ISR) and glucose fluxes during a 50-g oral protein load were compared among 10 nondiabetic individuals with GB, 9 with SG, and 7 non-operated controls (CN), with and without intravenous infusion of exendin(9-39) (Ex-9), a GLP-1 receptor (GLP-1R) antagonist.
Results
Blocking GLP-1R increased glucose before and after protein ingestion and decreased β-cell sensitivity to glucose in the first 30 min of protein ingestion in all three groups (p < 0.05). Reduction in the premeal ISR by Ex-9 infusion was only observed in CN, whereas diminished prandial ISR3h by GLP-1R blockade was only observed in GB and SG (p < 0.05 for interaction). GLP-1R blockade enhanced post-protein insulin action in GB and SG, but not in CN, and exaggerated endogenous glucose production only GB (p < 0.05 for interaction).
Conclusions
These findings are consistent with both pancreatic and extra-pancreatic roles for GLP-1 during protein ingestion in humans that are exaggerated by bariatric surgery.
{"title":"GLP-1 enhances β-cell response to protein ingestion and bariatric surgery amplifies it","authors":"Maria Rayas, Samantha Pezzica, Henri Honka, Fabrizia Carli, Richard Peterson, Ralph DeFronzo, Amalia Gastaldelli, Marzieh Salehi","doi":"10.1002/oby.24182","DOIUrl":"10.1002/oby.24182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The glycemic-independent actions of glucagon-like peptide-1 (GLP-1) in the prandial state in humans are unknown. We examined the contribution of GLP-1 to β-cell secretory response (primary endpoint) and glucose metabolism during protein ingestion under basal glycemia, as well as whether these responses are affected by rerouted gut after gastric bypass (GB) or sleeve gastrectomy (SG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Insulin secretion rate (ISR) and glucose fluxes during a 50-g oral protein load were compared among 10 nondiabetic individuals with GB, 9 with SG, and 7 non-operated controls (CN), with and without intravenous infusion of exendin(9-39) (Ex-9), a GLP-1 receptor (GLP-1R) antagonist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blocking GLP-1R increased glucose before and after protein ingestion and decreased β-cell sensitivity to glucose in the first 30 min of protein ingestion in all three groups (<i>p</i> < 0.05). Reduction in the premeal ISR by Ex-9 infusion was only observed in CN, whereas diminished prandial ISR<sub>3h</sub> by GLP-1R blockade was only observed in GB and SG (<i>p</i> < 0.05 for interaction). GLP-1R blockade enhanced post-protein insulin action in GB and SG, but not in CN, and exaggerated endogenous glucose production only GB (<i>p</i> < 0.05 for interaction).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings are consistent with both pancreatic and extra-pancreatic roles for GLP-1 during protein ingestion in humans that are exaggerated by bariatric surgery.</p>\u0000 \u0000 <div>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"104-115"},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788274","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}
Enoch J. Abbey, Richard D. Nudotor, Banda A. A. Khalifa, Joseph K. Canner, Gregory P. Prokopowicz, Kimberly E. Steele, Jennifer S. Mammen
Objective
Obesity is an independent risk factor for chronic pain frequently treated with opioids. Our study investigated the effect of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.
Methods
Using the IBM MarketScan database (2010–2017), we analyzed adult chronic opioid users who underwent bariatric surgery. Opioid use was measured in morphine milligram equivalents (MME) for 6-month periods before and after surgery. Changes in MME for each 6-month interval were compared to preoperative exposure and across the different types of bariatric surgery.
Results
Of the 2197 patients identified, 29% discontinued opioids 6 months post surgery, further decreasing to 23.4% at 12 months. Discontinuation rates were similar for VSG and RYGB. Preoperative opioid exposure did not predict postsurgery discontinuation, but patients with multiple opioid prescription types were less likely to stop. Among those continuing opioid use, average MME increased at 6 months post surgery compared with 6 months pre surgery in both groups (mean [SD], RYGB: 49.4 [347.3]; VSG: 74.9 [533.4]).
Conclusions
Although bariatric surgery reduced the number of chronic opioid users by nearly 25%, persistent users showed increased average opioid exposure after surgery. Further research to track long-term opioid use should be conducted, and providers should inform patients of these risks and attempt opioid dose reductions before surgery.
{"title":"Users of chronic prescription opioids decrease in the first 12 months following bariatric surgery","authors":"Enoch J. Abbey, Richard D. Nudotor, Banda A. A. Khalifa, Joseph K. Canner, Gregory P. Prokopowicz, Kimberly E. Steele, Jennifer S. Mammen","doi":"10.1002/oby.24180","DOIUrl":"10.1002/oby.24180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Obesity is an independent risk factor for chronic pain frequently treated with opioids. Our study investigated the effect of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the IBM MarketScan database (2010–2017), we analyzed adult chronic opioid users who underwent bariatric surgery. Opioid use was measured in morphine milligram equivalents (MME) for 6-month periods before and after surgery. Changes in MME for each 6-month interval were compared to preoperative exposure and across the different types of bariatric surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2197 patients identified, 29% discontinued opioids 6 months post surgery, further decreasing to 23.4% at 12 months. Discontinuation rates were similar for VSG and RYGB. Preoperative opioid exposure did not predict postsurgery discontinuation, but patients with multiple opioid prescription types were less likely to stop. Among those continuing opioid use, average MME increased at 6 months post surgery compared with 6 months pre surgery in both groups (mean [SD], RYGB: 49.4 [347.3]; VSG: 74.9 [533.4]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although bariatric surgery reduced the number of chronic opioid users by nearly 25%, persistent users showed increased average opioid exposure after surgery. Further research to track long-term opioid use should be conducted, and providers should inform patients of these risks and attempt opioid dose reductions before surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"33-40"},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karri Silventoinen, José Maia, Reijo Sund, Élvio R. Gouveia, António Antunes, Gonçalo Marques, Martine Thomis, Aline Jelenkovic, Jaakko Kaprio, Duarte Freitas
Objective
We analyzed how anthropometric measures predict cardiometabolic health and how genetic and environmental factors contribute to these associations.
Methods
Data on 8 indicators of cardiometabolic health, 21 anthropometric measures, and 11 anthropometric indices were available for 216 twin pairs of individuals age 3 to 18 years living in the Autonomous Region of Madeira, Portugal (51% girls). Genetic twin modeling was used to estimate genetic and environmental correlations between the cardiometabolic and anthropometric indicators.
Results
Anthropometric indicators were positively associated with blood pressure and triglycerides and inversely associated with high-density lipoprotein cholesterol. The associations with glucose, low-density lipoprotein cholesterol, total cholesterol, and heart rate were close to zero. BMI and waist circumference showed similar or slightly higher absolute correlations with cardiometabolic health indicators compared with other anthropometric indices. Additive genetic and unique environmental correlations were at the same level as trait correlations.
Conclusions
BMI and waist circumference provide information on cardiometabolic health that is not less accurate than that provided by more comprehensive anthropometric indices. These associations reflect causal associations between obesity and cardiometabolic disorders rather than only shared genetic associations. Measuring obesity is important for monitoring cardiometabolic risks and can be accomplished using simple indicators at the population level.
{"title":"Associations of body size and morphology with cardiometabolic health in children: the contribution of genetic factors","authors":"Karri Silventoinen, José Maia, Reijo Sund, Élvio R. Gouveia, António Antunes, Gonçalo Marques, Martine Thomis, Aline Jelenkovic, Jaakko Kaprio, Duarte Freitas","doi":"10.1002/oby.24196","DOIUrl":"10.1002/oby.24196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We analyzed how anthropometric measures predict cardiometabolic health and how genetic and environmental factors contribute to these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on 8 indicators of cardiometabolic health, 21 anthropometric measures, and 11 anthropometric indices were available for 216 twin pairs of individuals age 3 to 18 years living in the Autonomous Region of Madeira, Portugal (51% girls). Genetic twin modeling was used to estimate genetic and environmental correlations between the cardiometabolic and anthropometric indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Anthropometric indicators were positively associated with blood pressure and triglycerides and inversely associated with high-density lipoprotein cholesterol. The associations with glucose, low-density lipoprotein cholesterol, total cholesterol, and heart rate were close to zero. BMI and waist circumference showed similar or slightly higher absolute correlations with cardiometabolic health indicators compared with other anthropometric indices. Additive genetic and unique environmental correlations were at the same level as trait correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BMI and waist circumference provide information on cardiometabolic health that is not less accurate than that provided by more comprehensive anthropometric indices. These associations reflect causal associations between obesity and cardiometabolic disorders rather than only shared genetic associations. Measuring obesity is important for monitoring cardiometabolic risks and can be accomplished using simple indicators at the population level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"125-133"},"PeriodicalIF":4.2,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788272","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}
Jessica Aparecida da Silva Pereira, Gerson Profeta de Souza, João V. Virgilio-da-Silva, Juliana S. Prodonoff, Gisele de Castro, Leonardo F. Pimentel, Felippe Mousovich-Neto, Gustavo G. Davanzo, Cristhiane F. Aguiar, Cristiane N. S. Breda, Marcia G. Guereschi, Ronaldo C. Araújo, Marcelo A. Mori, Niels O. S. Câmara, Diorge P. Souza, Alexandre S. Basso, Pedro M. Moraes-Vieira
Objective
Liver X receptors (LXRs) play essential roles in cholesterol homeostasis and immune response. In obesity, elevated cholesterol levels trigger proinflammatory responses; however, the specific contributions of LXRs to adipose tissue (AT) macrophage (ATM) phenotype and metabolic programming are not fully understood. In this study, we determine the role of LXR isoforms in diet-induced obesity AT inflammation and insulin resistance.
Methods
For in vivo studies, to evaluate the effects of LXR activation on AT inflammation, obese and insulin-resistant wild-type mice were treated with 10 mg/kg of the LXR modulator naringenin (NAR) for 4 weeks, and systemic insulin sensitivity and AT inflammation were assessed. To evaluate the effects of LXR deficiency on AT inflammation, we used LXRα, LXRβ, and LXRαβ knockout (KO) mice. For in vitro studies, to assess the role of LXRs specifically in macrophages, bone marrow-derived macrophages from wild-type, LXRαKO, LXRβKO, and LXRαβKO mice were treated with 0.5μM NAR 1 h prior to lipopolysaccharide (LPS) stimulation (100 ng/mL), and the effects on macrophage function and metabolism were evaluated 24 h after LPS stimulation.
Results
We found that LXR deletion intensifies AT inflammation in an LXRβ-dependent manner. LXR deficiency in immune cells exacerbates obesity-induced AT inflammation, increasing the numbers of CD11c+, TNF-α+, and IL-1β+ ATMs. We also identified NAR as a novel LXR agonist in macrophages that reduces proinflammatory cytokine secretion by mitigating glycolysis and mitochondrial dysfunction in LPS - and LPS + IFNγ-activated macrophages. Furthermore, NAR-treated obese mice display reduced AT inflammation, characterized by decreased CD11c+, IL-1β+, and TNF-α+ ATM numbers and monocyte infiltration compared with vehicle-treated obese mice.
Conclusions
Our study highlights distinct roles for each LXR isoform in AT inflammation regulation, with LXRβ being crucial for maintaining the anti- and proinflammatory balance in ATMs. Thus, LXRβ holds therapeutic potential as a target to treat AT inflammation and insulin resistance.
{"title":"LXR regulation of adipose tissue inflammation during obesity is associated with dysregulated macrophage function","authors":"Jessica Aparecida da Silva Pereira, Gerson Profeta de Souza, João V. Virgilio-da-Silva, Juliana S. Prodonoff, Gisele de Castro, Leonardo F. Pimentel, Felippe Mousovich-Neto, Gustavo G. Davanzo, Cristhiane F. Aguiar, Cristiane N. S. Breda, Marcia G. Guereschi, Ronaldo C. Araújo, Marcelo A. Mori, Niels O. S. Câmara, Diorge P. Souza, Alexandre S. Basso, Pedro M. Moraes-Vieira","doi":"10.1002/oby.24158","DOIUrl":"10.1002/oby.24158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Liver X receptors (LXRs) play essential roles in cholesterol homeostasis and immune response. In obesity, elevated cholesterol levels trigger proinflammatory responses; however, the specific contributions of LXRs to adipose tissue (AT) macrophage (ATM) phenotype and metabolic programming are not fully understood. In this study, we determine the role of LXR isoforms in diet-induced obesity AT inflammation and insulin resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For in vivo studies, to evaluate the effects of LXR activation on AT inflammation, obese and insulin-resistant wild-type mice were treated with 10 mg/kg of the LXR modulator naringenin (NAR) for 4 weeks, and systemic insulin sensitivity and AT inflammation were assessed. To evaluate the effects of LXR deficiency on AT inflammation, we used LXRα, LXRβ, and LXRαβ knockout (KO) mice. For in vitro studies, to assess the role of LXRs specifically in macrophages, bone marrow-derived macrophages from wild-type, LXRαKO, LXRβKO, and LXRαβKO mice were treated with 0.5μM NAR 1 h prior to lipopolysaccharide (LPS) stimulation (100 ng/mL), and the effects on macrophage function and metabolism were evaluated 24 h after LPS stimulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that LXR deletion intensifies AT inflammation in an LXRβ-dependent manner. LXR deficiency in immune cells exacerbates obesity-induced AT inflammation, increasing the numbers of CD11c<sup>+</sup>, TNF-α<sup>+</sup>, and IL-1β<sup>+</sup> ATMs. We also identified NAR as a novel LXR agonist in macrophages that reduces proinflammatory cytokine secretion by mitigating glycolysis and mitochondrial dysfunction in LPS - and LPS + IFNγ-activated macrophages. Furthermore, NAR-treated obese mice display reduced AT inflammation, characterized by decreased CD11c<sup>+</sup>, IL-1β<sup>+</sup>, and TNF-α<sup>+</sup> ATM numbers and monocyte infiltration compared with vehicle-treated obese mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study highlights distinct roles for each LXR isoform in AT inflammation regulation, with LXRβ being crucial for maintaining the anti- and proinflammatory balance in ATMs. Thus, LXRβ holds therapeutic potential as a target to treat AT inflammation and insulin resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"78-90"},"PeriodicalIF":4.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mackenzie K. Fitzpatrick, Alexandria Szalanczy, Angela Beeson, Anusha Vora, Christina Scott, Michael Grzybowski, Jason Klotz, Nataley Der, Rong Chen, Aron M. Geurts, Leah C. Solberg Woods
Objective
Adenylate cyclase 3 (Adcy3) has been linked to both obesity and major depressive disorder. We identified a protein-coding variant in the transmembrane (TM) helix of Adcy3 in rats; similar obesity variants have been identified in humans. This study investigates the role of a TM variant in adiposity and behavior.
Methods
We mutated the TM domain of Adcy3 (Adcy3mut/mut) and created a heterozygous knockout (Adcy3+/−) in Wistar Kyoto (WKY) rats. Wild-type, Adcy3+/−, and Adcy3mut/mut rats were fed a high-fat diet for 12 weeks. We measured body weight, fat mass, glucose tolerance, food intake, metabolism, emotion-like behaviors, memory, and downstream proteins.
Results
Adcy3+/− and Adcy3mut/mut rats weighed more than wild-type rats due to increased fat mass. There were key sex differences: adiposity was driven by increased food intake in males but by decreased energy expenditure in females. Adcy3mut/mut males displayed increased passive coping and decreased memory, whereas Adcy3mut/mut females displayed increased anxiety-like behavior. Adcy3mut/mut males had decreased hypothalamic cAMP-response element binding protein (CREB) signaling, with decreased phospho-AMP-activated protein kinase (p-AMPK) signaling in both sexes.
Conclusions
The ADCY3 TM domain plays a role in protein function via p-AMPK and CREB signaling. Adcy3 may contribute to the relationship between obesity and major depressive disorder, and sex influences the relationships between Adcy3, metabolism, and behavior.
{"title":"Protein-coding mutation in Adcy3 increases adiposity and alters emotional behaviors sex-dependently in rats","authors":"Mackenzie K. Fitzpatrick, Alexandria Szalanczy, Angela Beeson, Anusha Vora, Christina Scott, Michael Grzybowski, Jason Klotz, Nataley Der, Rong Chen, Aron M. Geurts, Leah C. Solberg Woods","doi":"10.1002/oby.24178","DOIUrl":"10.1002/oby.24178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Adenylate cyclase 3 (<i>Adcy3</i>) has been linked to both obesity and major depressive disorder. We identified a protein-coding variant in the transmembrane (TM) helix of <i>Adcy3</i> in rats; similar obesity variants have been identified in humans. This study investigates the role of a TM variant in adiposity and behavior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We mutated the TM domain of <i>Adcy3</i> (<i>Adcy3</i><sup>mut/mut</sup>) and created a heterozygous knockout (<i>Adcy3</i><sup>+/−</sup>) in Wistar Kyoto (WKY) rats. Wild-type, <i>Adcy3</i><sup>+/−</sup>, and <i>Adcy3</i><sup>mut/mut</sup> rats were fed a high-fat diet for 12 weeks. We measured body weight, fat mass, glucose tolerance, food intake, metabolism, emotion-like behaviors, memory, and downstream proteins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>Adcy3</i><sup>+/−</sup> and <i>Adcy3</i><sup>mut/mut</sup> rats weighed more than wild-type rats due to increased fat mass. There were key sex differences: adiposity was driven by increased food intake in males but by decreased energy expenditure in females. <i>Adcy3</i><sup>mut/mut</sup> males displayed increased passive coping and decreased memory, whereas <i>Adcy3</i><sup>mut/mut</sup> females displayed increased anxiety-like behavior. <i>Adcy3</i><sup>mut/mut</sup> males had decreased hypothalamic cAMP-response element binding protein (CREB) signaling, with decreased phospho-AMP-activated protein kinase (p-AMPK) signaling in both sexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ADCY3 TM domain plays a role in protein function via p-AMPK and CREB signaling. <i>Adcy3</i> may contribute to the relationship between obesity and major depressive disorder, and sex influences the relationships between <i>Adcy3</i>, metabolism, and behavior.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"91-103"},"PeriodicalIF":4.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to examine the prevalence of food insecurity among a nationally representative sample of US adults who were attempting weight loss, as well as the associations of food insecurity with weight-loss strategies.
Methods
This study included adults with BMI ≥ 25.0 kg/m2 who were intentionally trying to lose weight within the past year from the 2017 to March 2020 data cycle of the National Health and Nutrition Examination Study. Participants were categorized as either food insecure or food secure (US Food Security Survey Module), and their use of weight-loss strategies was compared using unadjusted logistic regression models and models adjusted for sociodemographics.
Results
Nearly one-quarter (22.96%, n = 582) of participants were food insecure. In unadjusted models, participants with food insecurity were more likely to use unhealthy weight-loss methods (e.g., skipping meals, taking laxatives or vomiting) and less likely to use healthy methods (e.g., exercising, joining a weight-loss program; p < 0.05). In adjusted models, participants with food insecurity were less likely to join a weight-loss program and eat less sugar, candy, and sweets.
Conclusions
Food insecurity is common among US adults with higher weight who are trying to lose weight, and individuals with food insecurity are less likely to use healthy weight-loss strategies.
{"title":"Food insecurity and weight-loss efforts among a nationally representative sample of US adults with higher weight","authors":"Kirstie M. Herb Neff","doi":"10.1002/oby.24183","DOIUrl":"10.1002/oby.24183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to examine the prevalence of food insecurity among a nationally representative sample of US adults who were attempting weight loss, as well as the associations of food insecurity with weight-loss strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included adults with BMI ≥ 25.0 kg/m<sup>2</sup> who were intentionally trying to lose weight within the past year from the 2017 to March 2020 data cycle of the National Health and Nutrition Examination Study. Participants were categorized as either food insecure or food secure (US Food Security Survey Module), and their use of weight-loss strategies was compared using unadjusted logistic regression models and models adjusted for sociodemographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nearly one-quarter (22.96%, <i>n</i> = 582) of participants were food insecure. In unadjusted models, participants with food insecurity were more likely to use unhealthy weight-loss methods (e.g., skipping meals, taking laxatives or vomiting) and less likely to use healthy methods (e.g., exercising, joining a weight-loss program; <i>p</i> < 0.05). In adjusted models, participants with food insecurity were less likely to join a weight-loss program and eat less sugar, candy, and sweets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Food insecurity is common among US adults with higher weight who are trying to lose weight, and individuals with food insecurity are less likely to use healthy weight-loss strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"190-197"},"PeriodicalIF":4.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annalie Wentzel, Sihle E. Mabhida, Musawenkosi Ndlovu, Haskly Mokoena, Bevan Esterhuizen, Machoene D. Sekgala, Phiwayinkosi V. Dludla, André P. Kengne, Zandile J. Mchiza
Objective
This study investigated the prevalence trends of metabolic syndrome (MetS) in children and adolescents with obesity by systematically analyzing global data. Additionally, it aimed to compare regional disparities and criteria used to identify at-risk subpopulations among this demographic group.
Methods
We searched three major databases, i.e., PubMed-Medline, Scopus, and Web of Science, from inception to August 31, 2023, yielding 2432 articles. We included original research papers reporting MetS prevalence among children and adolescents with obesity, irrespective of their regions and MetS diagnostic criteria used. We aggregated prevalence estimates using random-effects models to obtain the overall prevalence and conducted subgroup analyses for MetS criteria and study regions.
Results
We included 57 studies, amounting to 27,923 participants. The overall prevalence of MetS in participants with obesity varied greatly across studies, ranging from 2.1% to 74.4%, with an average prevalence of 29.4%. This high prevalence of MetS was further supported by a meta-analysis comprising 57 studies that further strengthened the observation of a high prevalence of MetS, revealing an overall prevalence of 26% (95% CI: 0.22–0.30; I2 = 98%).
Conclusions
Children and adolescents with obesity face a heightened risk of developing MetS. There is a pressing need for heightened attention to this issue, particularly in low- and middle-income countries such as those in sub-Saharan Africa.
目的：本研究通过系统分析全球数据，探讨儿童和青少年肥胖代谢综合征（MetS）的流行趋势。此外，它的目的是比较区域差异和用于确定这一人口群体中有风险的亚人群的标准。方法：检索PubMed-Medline、Scopus和Web of Science三个主要数据库，检索时间自成立至2023年8月31日，共收录论文2432篇。我们纳入了报告肥胖儿童和青少年中MetS患病率的原始研究论文，而不考虑其地区和使用的MetS诊断标准。我们使用随机效应模型汇总患病率估计，以获得总体患病率，并对MetS标准和研究区域进行亚组分析。结果：我们纳入了57项研究，共计27,923名受试者。在不同的研究中，肥胖参与者的met总体患病率差异很大，从2.1%到74.4%不等，平均患病率为29.4%。一项包含57项研究的荟萃分析进一步支持了MetS的高患病率，该分析进一步加强了MetS高患病率的观察，显示总患病率为26% (95% CI: 0.22-0.30；i2 = 98%)。结论：肥胖儿童和青少年患MetS的风险增加。迫切需要加强对这一问题的关注，特别是在撒哈拉以南非洲等低收入和中等收入国家。
{"title":"Prevalence of metabolic syndrome in children and adolescents with obesity: a systematic review and meta-analysis","authors":"Annalie Wentzel, Sihle E. Mabhida, Musawenkosi Ndlovu, Haskly Mokoena, Bevan Esterhuizen, Machoene D. Sekgala, Phiwayinkosi V. Dludla, André P. Kengne, Zandile J. Mchiza","doi":"10.1002/oby.24159","DOIUrl":"10.1002/oby.24159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the prevalence trends of metabolic syndrome (MetS) in children and adolescents with obesity by systematically analyzing global data. Additionally, it aimed to compare regional disparities and criteria used to identify at-risk subpopulations among this demographic group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched three major databases, i.e., PubMed-Medline, Scopus, and Web of Science, from inception to August 31, 2023, yielding 2432 articles. We included original research papers reporting MetS prevalence among children and adolescents with obesity, irrespective of their regions and MetS diagnostic criteria used. We aggregated prevalence estimates using random-effects models to obtain the overall prevalence and conducted subgroup analyses for MetS criteria and study regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 57 studies, amounting to 27,923 participants. The overall prevalence of MetS in participants with obesity varied greatly across studies, ranging from 2.1% to 74.4%, with an average prevalence of 29.4%. This high prevalence of MetS was further supported by a meta-analysis comprising 57 studies that further strengthened the observation of a high prevalence of MetS, revealing an overall prevalence of 26% (95% CI: 0.22–0.30; <i>I</i><sup>2</sup> = 98%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children and adolescents with obesity face a heightened risk of developing MetS. There is a pressing need for heightened attention to this issue, particularly in low- and middle-income countries such as those in sub-Saharan Africa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 1","pages":"12-32"},"PeriodicalIF":4.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xinyi Shi, Sarah Ann Duck, Elena Jansen, Bianca Borsarini, Courtney K. Blackwell, Yuchen Li, Susan Carnell
Objective
This study investigated longitudinal relationships between social media usage and binge eating (BE) in early adolescence and explored potential moderating effects of sex and BMI.
Methods
Data from the Adolescent Brain Cognitive Development (ABCD) Study, including 1940 participants aged 11 to 12 years at Wave 1, were analyzed over three annual waves. Social media addiction (SMA) scores and time spent on social media were calculated from self-report questionnaires. BE symptoms were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) through self-reports and parent reports. Modified Poisson regression was used to estimate associations, adjusting for demographic and behavioral covariates.
Results
SMA symptoms, but not time on social media, were cross-sectionally and prospectively associated with BE. Prospective associations were stronger in male adolescents and differed by baseline body weight. The consistently high SMA group showed the strongest association with follow-up BE compared with the consistently low SMA group, whereas decreased and increased SMA groups showed similarly positive associations.
Conclusions
SMA scores predict BE in early adolescence, with differentiation in the relationship by sex and weight status. Further observational and interventional research could illuminate underlying mechanisms and test the value of targeting social media-addictive behaviors to mitigate the risk of disordered eating.
目的：本研究调查了青少年早期使用社交媒体与暴饮暴食（BE）之间的纵向关系，并探讨了性别和体重指数的潜在调节作用：本研究调查了青少年早期使用社交媒体与暴饮暴食（BE）之间的纵向关系，并探讨了性别和体重指数的潜在调节作用：研究分析了青少年大脑认知发展（ABCD）研究中三个年度波次的数据，其中包括第一波次时年龄在11至12岁之间的1940名参与者。社交媒体成瘾（SMA）得分和花在社交媒体上的时间是通过自我报告问卷计算得出的。通过自我报告和家长报告，使用情感障碍和精神分裂症儿童时间表（Kiddie Schedule for Affective Disorders and Schizophrenia，KSADS-5）对BE症状进行评估。在对人口统计学和行为学协变量进行调整后，使用修正的泊松回归估计相关性：结果：SMA症状与BE有横截面和前瞻性关联，但社交媒体时间与BE无关。男性青少年的前瞻性相关性更强，且因基线体重而异。与持续低SMA组相比，持续高SMA组与随访BE的关联性最强，而持续低SMA组和持续高SMA组则表现出类似的正相关性：结论：SMA评分可预测青春期早期的BE，其关系因性别和体重状况而异。进一步的观察和干预研究可以阐明其潜在机制，并检验针对社交媒体成瘾行为以降低饮食失调风险的价值。
{"title":"Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence","authors":"Xinyi Shi, Sarah Ann Duck, Elena Jansen, Bianca Borsarini, Courtney K. Blackwell, Yuchen Li, Susan Carnell","doi":"10.1002/oby.24199","DOIUrl":"10.1002/oby.24199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated longitudinal relationships between social media usage and binge eating (BE) in early adolescence and explored potential moderating effects of sex and BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Adolescent Brain Cognitive Development (ABCD) Study, including 1940 participants aged 11 to 12 years at Wave 1, were analyzed over three annual waves. Social media addiction (SMA) scores and time spent on social media were calculated from self-report questionnaires. BE symptoms were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) through self-reports and parent reports. Modified Poisson regression was used to estimate associations, adjusting for demographic and behavioral covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SMA symptoms, but not time on social media, were cross-sectionally and prospectively associated with BE. Prospective associations were stronger in male adolescents and differed by baseline body weight. The consistently high SMA group showed the strongest association with follow-up BE compared with the consistently low SMA group, whereas decreased and increased SMA groups showed similarly positive associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SMA scores predict BE in early adolescence, with differentiation in the relationship by sex and weight status. Further observational and interventional research could illuminate underlying mechanisms and test the value of targeting social media-addictive behaviors to mitigate the risk of disordered eating.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 2","pages":"346-355"},"PeriodicalIF":4.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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