Obesity最新文献_第4页

The release of GLP-1 from gut L cells is inhibited by low extracellular pH 低细胞外 pH 会抑制肠道 L 细胞释放 GLP-1。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-09-05 DOI: 10.1002/oby.24125

Philippa Garbutt, Malgorzata Cyranka, Johanna Michl, Yuko Maejima, Natascia Vedovato, Kenju Shimomura, Pawel Swietach, Heidi de Wet

Objective

The intestinal luminal pH profile varies from stomach to rectum and becomes disrupted in diseases. However, little is known about the pH dependence of incretin hormone secretion, with most in vitro studies having failed to consider this modulatory factor or having used nonphysiological buffer systems. Here, we report the extracellular pH (pHe) dependence of glucagon-like peptide-1 (GLP-1) exocytosis from L cells.

Methods

The pHe dependence of GLP-1 release from GLUTag cells and murine ex vivo primary gut cultures was detected by ELISA. GLP-1 release was measured over a range of pHe under a physiological (CO₂/HCO₃⁻) buffering regime and in its absence (HEPES buffer). The relationship between intracellular pH (pHi) and pHe was mapped given that at least some component of pH sensitivity is likely to be intracellular.

Results

GLP-1 secretion from L cells was pHe-dependent and stimulated under alkaline conditions. In the absence of glucose or extracellular calcium, secretion remained at a pHe-insensitive baseline. pHi followed changes in pHe, but the relationship was offset to more alkaline levels in the absence of CO₂/HCO₃⁻ buffer and became shallower if [Cl⁻] changes that normally accompany [HCO₃⁻] changes were compensated iso-osmotically with gluconate.

Conclusions

GLP-1 secretion is sensitive to pHe and the buffer present. Exploiting this mechanism therapeutically may benefit patients with obesity.

目的：从胃到直肠，肠腔 pH 值各不相同，在疾病时会发生紊乱。然而，人们对增量素激素分泌的 pH 依赖性知之甚少，大多数体外研究都没有考虑这一调节因素，或者使用的是非生理缓冲系统。在此，我们报告了胰高血糖素样肽-1（GLP-1）从L细胞外排的细胞外pH值（pHe）依赖性：方法：通过 ELISA 检测 GLUTag 细胞和小鼠体外原代肠道培养物中 GLP-1 释放的 pHe 依赖性。在生理（CO2/HCO3-）缓冲体系和无生理（HEPES缓冲液）缓冲体系的情况下，在一定的pHe范围内测量了GLP-1的释放。鉴于pH敏感性中至少有一部分可能来自细胞内，因此绘制了细胞内pH（pHi）和pHe之间的关系图：结果：L 细胞的 GLP-1 分泌是 pHe 依赖性的，在碱性条件下会受到刺激。pHi随pHe的变化而变化，但在没有CO2/HCO3-缓冲液的情况下，这种关系会被偏移到更碱性的水平，如果用葡萄糖酸盐等渗补偿通常伴随[HCO3-]变化的[Cl-]变化，这种关系会变得更浅：结论：GLP-1 的分泌对 pHe 和存在的缓冲液很敏感。结论：GLP-1 的分泌对 pHe 和存在的缓冲液很敏感，利用这一机制进行治疗可能会使肥胖症患者受益。

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引用次数: 0

Comparison of race- and ethnicity-specific BMI cutoffs for categorizing obesity severity: a multicountry prospective cohort study 针对不同种族和民族的 BMI 临界值对肥胖严重程度分类的比较：一项多国前瞻性队列研究。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-09-03 DOI: 10.1002/oby.24129

Sujing Wang, Jie Shen, Woon-Puay Koh, Jian-Min Yuan, Xiang Gao, Yinshun Peng, Yaqing Xu, Shuxiao Shi, Yue Huang, Ying Dong, Victor W. Zhong

Objective

The objective of this study was to compare race- and ethnicity-specific BMI cutoffs for the three classes of obesity based on equivalent risk of type 2 diabetes (T2D).

Methods

Participants without T2D were included from the UK Biobank, the China Health and Nutrition Survey, and the Singapore Chinese Health Study. Poisson regressions with restricted cubic splines were applied to determine BMI cutoffs for each non-White race and ethnicity for equivalent incidence rates of T2D at BMI values of 30.0, 35.0, and 40.0 kg/m² in White adults.

Results

During a median follow-up of 13.8 years among 507,763 individuals, 5.2% developed T2D. In women, BMI cutoffs for an equivalent incidence rate of T2D as observed at 40.0 kg/m² in White adults were 31.6 kg/m² in Black, 29.2 kg/m² in British Chinese, 27.3 kg/m² in South Asian, 26.9 kg/m² in Native Chinese, and 25.1 kg/m² in Singapore Chinese adults. In men, the corresponding BMI cutoffs were 31.9 kg/m² in Black, 30.6 kg/m² in British Chinese, 29.0 kg/m² in South Asian, 29.6 kg/m² in Native Chinese, and 27.6 kg/m² in Singapore Chinese adults. The race and ethnicity order was consistent when equivalent BMI cutoffs were estimated for class I and II obesity.

Conclusions

Establishing a race- and ethnicity-tailored classification of the three classes of obesity is urgently needed.

研究目的本研究的目的是比较基于2型糖尿病（T2D）同等风险的三个肥胖等级的种族和民族特异性BMI临界值：方法：研究对象包括英国生物库、中国健康与营养调查和新加坡华人健康研究中未患 T2D 的参与者。采用限制性三次样条进行泊松回归，以确定每个非白人种族和族裔的 BMI 临界值，即白人成年人在 BMI 值为 30.0、35.0 和 40.0 kg/m2 时的 T2D 发生率：在对 507,763 人 13.8 年的中位随访期间，5.2% 的人患上了 T2D。在女性中，与白人成年人 40.0 kg/m2 的 T2D 发病率相当的 BMI 临界值分别为：黑人 31.6 kg/m2、英国华裔 29.2 kg/m2、南亚裔 27.3 kg/m2、本地华裔 26.9 kg/m2 和新加坡华裔 25.1 kg/m2。在男性中，黑人的相应体重指数临界值为 31.9 kg/m2，英国华裔为 30.6 kg/m2，南亚裔为 29.0 kg/m2，本土华裔为 29.6 kg/m2，新加坡华裔为 27.6 kg/m2。当为 I 级和 II 级肥胖估算等效的 BMI 临界值时，种族和族裔顺序是一致的：结论：目前亟需建立适合不同种族和族裔的三类肥胖症分类。

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引用次数: 0

Renal sinus adipose tissue: exploratory study of metabolic features and transcriptome compared with omental and subcutaneous adipose tissue 肾窦脂肪组织：与网膜和皮下脂肪组织相比的代谢特征和转录组的探索性研究。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-29 DOI: 10.1002/oby.24114

Maria J. Pereira, Argyri Mathioudaki, Alicia G. Otero, Padma Priya Duvvuri, Milica Vranic, Amir Sedigh, Jan W. Eriksson, Maria K. Svensson

Objective

The objective was to study metabolic characteristics and transcriptome of renal sinus adipose tissue (RSAT) located around renal arteries and veins.

Methods

Adipose tissue biopsies from RSAT, omental (OAT), and subcutaneous (SAT) depots were obtained from healthy kidney donors (20 female, 20 male). Adipocyte glucose uptake rate and cell size were measured, and gene expression analyses using transcriptomics were performed.

Results

RSAT adipocytes were significantly smaller, with a higher basal glucose uptake rate, than adipocytes from SAT and OAT. Transcriptomic analyses revealed 29 differentially expressed genes between RSAT and OAT (RSAT: 23 lower, 6 higher) and 1214 differentially expressed genes between RSAT and SAT (RSAT: 859 lower, 355 higher). RSAT demonstrated molecular resemblance to OAT, both exhibiting lower metabolic gene expression and higher expression of immune-related pathways, including IL-17, TNFα, and NF-κB signaling than SAT. Weighted gene coexpression network analysis associated RSAT with immune response and nucleic acid transport processes. Despite its location near the renal hilum, RSAT closely resembled OAT and there was a lack of expression in the classical brown adipose tissue genes. Gene enrichment analyses suggest an inflammatory environment in RSAT compared with SAT and, to some extent, OAT.

Conclusions

The findings suggest specific RSAT functions that could impact renal function and, possibly, the development of renal and cardiometabolic disorders.

目的目的是研究位于肾动脉和静脉周围的肾窦脂肪组织（RSAT）的代谢特征和转录组：方法：从健康的肾脏捐献者（女性 20 人，男性 20 人）身上获取 RSAT、网膜（OAT）和皮下（SAT）脂肪组织活检组织。测量了脂肪细胞的葡萄糖摄取率和细胞大小，并利用转录组学进行了基因表达分析：结果：与 SAT 和 OAT 脂肪细胞相比，RSAT 脂肪细胞明显更小，基础葡萄糖摄取率更高。转录组学分析显示，RSAT 和 OAT 有 29 个差异表达基因（RSAT：23 个较低，6 个较高），RSAT 和 SAT 有 1214 个差异表达基因（RSAT：859 个较低，355 个较高）。RSAT 在分子上与 OAT 相似，都表现出较低的代谢基因表达和较高的免疫相关通路表达，包括 IL-17、TNFα 和 NF-κB 信号转导。加权基因共表达网络分析将 RSAT 与免疫反应和核酸转运过程联系起来。尽管RSAT位于肾门附近，但它与OAT非常相似，而且缺乏经典棕色脂肪组织基因的表达。基因富集分析表明，与 SAT 相比，RSAT 存在炎症环境，在一定程度上与 OAT 也存在炎症环境：结论：研究结果表明，RSAT 的特定功能可能会影响肾功能，并有可能导致肾脏和心脏代谢疾病的发生。

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引用次数: 0

Maternal obesogenic diet during pregnancy and its impact on fetal hepatic function in baboons 狒狒孕期母体肥胖饮食及其对胎儿肝功能的影响

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-29 DOI: 10.1002/oby.24124

Ashley S. Meakin, Peter W. Nathanielsz, Cun Li, Hillary F. Huber, Vicki L. Clifton, Michael D. Wiese, Janna L. Morrison

Objective

Maternal obesity (MO) increases the risk of later-life liver disease in offspring, especially in males. This may be due to impaired cytochrome P450 (CYP) enzyme activity driven by an altered maternal-fetal hormonal milieu. MO increases fetal cortisol concentrations that may increase CYP activity; however, glucocorticoid receptor (GR)-mediated signaling can be modulated by alternative GR isoform expression. We hypothesized that MO induces sex-specific changes in GR isoform expression and localization that contribute to reduced hepatic CYP activity.

Methods

Nonpregnant, nulliparous female baboons were assigned to either an ad libitum control diet or a high-fat, high-energy diet (HF-HED) at 9 months pre pregnancy. At 165 days' gestation (term = 180 days), fetal liver samples were collected (n = 6/sex/group). CYP activity was quantified using functional assays, and GR was measured using quantitative RT-PCR and Western blot.

Results

CYP3A activity was reduced in the HF-HED group, whereas CYP2B6 activity was reduced in HF-HED males only. Total GR expression was increased in the HF-HED group. Relative nuclear expression of the antagonistic GR isoform GRβ was increased in HF-HED males only.

Conclusions

Reduced CYP activity in HF-HED males may be driven in part by dampened hepatic-specific glucocorticoid signaling via altered GR isoform expression. These findings highlight targetable mechanisms that may reduce later-life sex-specific disease risk.

目的：母体肥胖（MO）会增加后代患晚年肝病的风险，尤其是男性。这可能是由于母胎激素环境改变导致细胞色素 P450（CYP）酶活性受损。MO会增加胎儿皮质醇的浓度，从而可能增加CYP的活性；然而，糖皮质激素受体（GR）介导的信号传导可通过GR异构体的替代表达来调节。我们假设 MO 会诱导 GR 同工酶表达和定位的性别特异性变化，从而导致肝脏 CYP 活性降低：方法：在妊娠前 9 个月，将未怀孕的空腹雌性狒狒分配到自由控制饮食或高脂肪、高能量饮食（HF-HED）中。在妊娠 165 天（足月 = 180 天）时，收集胎儿肝脏样本（n = 6 个/性别/组）。采用功能测定法对 CYP 活性进行量化，并采用定量 RT-PCR 和 Western 印迹法测定 GR：结果：HF-HED 组的 CYP3A 活性降低，而仅 HF-HED 男性的 CYP2B6 活性降低。HF-HED 组的 GR 总表达量增加。仅在 HF-HED 组男性中，拮抗 GR 同工酶 GRβ 的相对核表达增加：结论：HF-HED 男性体内 CYP 活性降低的部分原因可能是肝脏特异性糖皮质激素信号通过 GR 同工酶表达的改变而受到抑制。这些发现突显了可降低晚年性别特异性疾病风险的靶向机制。

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引用次数: 0

Work-restricting musculoskeletal pain after bariatric surgery or usual obesity care in the Swedish Obese Subjects study 瑞典肥胖受试者研究》中的减肥手术后或常规肥胖护理后的工作限制性肌肉骨骼疼痛。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-29 DOI: 10.1002/oby.24128

L. Stefan Lohmander, Markku Peltonen, Johanna C. Andersson-Assarsson, Kajsa Sjöholm, Magdalena Taube, Peter Jacobson, Per-Arne Svensson, Lena M. S. Carlsson, Sofie Ahlin

Objective

The objective of this study was to study the recovery from, and incidence of, work-restricting musculoskeletal pain after bariatric surgery compared with usual obesity care.

Methods

Pain in different body regions was monitored using questionnaires in the nonrandomized, prospective, controlled Swedish Obese Subjects (SOS) study, which included 2007 participants treated with bariatric surgery and a matched control group of 2040 participants receiving usual obesity care at primary health care centers. Self-reported pain in the neck and shoulders, back, hips, knees, and ankles was captured from questionnaires administered at baseline and after 1, 2, 3, 4, 6, 8, 10, 15, and 20 years.

Results

Compared with matched controls, bariatric surgery was associated with better recovery from baseline work-restricting knee and ankle pain in both the short (1–4 years) and long term (up to 20 years), as well as from back and hip pain in the short term. In participants without pain at baseline, bariatric surgery was associated with a lower incidence of developing new pain in the knee and ankle in the short and long term.

Conclusions

Bariatric surgery was associated with better recovery from pain, primarily in weight-bearing joints, as well as with prevention of pain development in the knee and ankle compared with matched controls receiving usual obesity care.

研究目的本研究的目的是研究减肥手术后限制工作的肌肉骨骼疼痛的恢复情况和发生率，并与常规肥胖护理进行比较：在非随机、前瞻性、对照瑞典肥胖受试者（SOS）研究中，使用调查问卷对不同身体部位的疼痛进行了监测，该研究包括接受减肥手术治疗的 2007 名受试者和在初级保健中心接受常规肥胖护理的 2040 名匹配对照组受试者。研究人员在基线期和 1、2、3、4、6、8、10、15 和 20 年后进行了问卷调查，收集了他们对颈部和肩部、背部、臀部、膝盖和脚踝疼痛的自我报告：与匹配的对照组相比，减肥手术在短期（1-4 年）和长期（长达 20 年）内能更好地恢复基线工作限制性膝关节和踝关节疼痛，在短期内也能更好地恢复背部和髋关节疼痛。在基线无疼痛的参与者中，减肥手术与较低的短期和长期膝关节和踝关节新疼痛发生率相关：结论：与接受常规肥胖治疗的匹配对照组相比，减肥手术能更好地从疼痛中恢复，主要是负重关节的疼痛，并能预防膝关节和踝关节疼痛的发生。

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引用次数: 0

Identification and functional validation of rare coding variants in genes linked to monogenic obesity 单基因肥胖症相关基因中罕见编码变异的鉴定和功能验证。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-28 DOI: 10.1002/oby.24101

Çiğdem Köroğlu, Michael Traurig, Yunhua L. Muller, Samantha E. Day, Paolo Piaggi, Kim Wiedrich, Laura Vazquez, Robert L. Hanson, Cristopher V. Van Hout, Anna Alkelai, Alan R. Shuldiner, Clifton Bogardus, Leslie J. Baier

Objective

Rare cases of monogenic obesity, which may respond to specific therapeutics, can remain undetected in populations in which polygenic obesity is prevalent. This study examined rare DNA variation in established monogenic obesity genes within a community using whole-exome sequence data from 6803 longitudinally studied individuals.

Methods

Exome data across 15 monogenic obesity genes were analyzed for nonsynonymous variants observed in any child with a maximum BMI z score > 2 (N = 279) but not observed in a child with a maximum BMI z score ≤ 0 (n = 1542) or that occurred in adults in the top 5th percentile of BMI (n = 263) but not in adults below the median BMI (n = 2629). Variants were then functionally analyzed using luciferase assays.

Results

The comparisons between cases of obesity and controls identified eight missense variants in six genes: DYRK1B, KSR2, MC4R, NTRK2, PCSK1, and SIM1. Among these, MC4R p.A303P and p.R165G were previously shown to impair MC4R function. Functional analyses of the remaining six variants suggest that KSR2 p.I402F and p.T193I and NTRK2 p.S249Y alter protein function.

Conclusions

In addition to MC4R, rare missense variants in KSR2 and NTRK2 may potentially explain the severe obesity observed for the carriers.

目的：在多基因肥胖症盛行的人群中，罕见的单基因肥胖症病例可能无法被发现，而这些病例可能对特定的治疗方法有反应。本研究利用 6803 名纵向研究个体的全外显子组序列数据，研究了一个社区中已确定的单基因肥胖基因的罕见 DNA 变异：方法：分析了 15 个单基因肥胖基因的外显子组数据，以确定在最大 BMI z 得分大于 2 的儿童中观察到的非同义变异（N = 279），但在最大 BMI z 得分小于 0 的儿童中未观察到（N = 1542），或在 BMI 前 5 百分位数的成人中出现的非同义变异（N = 263），但在 BMI 中位数以下的成人中未出现（N = 2629）。然后使用荧光素酶测定法对变异进行功能分析：结果：肥胖症病例与对照组的比较发现了六个基因中的八个错义变异：结果：在肥胖病例和对照组的比较中发现了六个基因中的八个错义变异：DYRK1B、KSR2、MC4R、NTRK2、PCSK1 和 SIM1。其中，MC4R p.A303P 和 p.R165G 以前曾被证明会损害 MC4R 的功能。对其余六个变体的功能分析表明，KSR2 p.I402F和p.T193I以及NTRK2 p.S249Y会改变蛋白质的功能：结论：除 MC4R 外，KSR2 和 NTRK2 中的罕见错义变异也可能是导致携带者严重肥胖的潜在原因。

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引用次数: 0

Neural processing of sweet taste in reward regions is reduced following bariatric surgery 减肥手术后，奖赏区对甜味的神经处理会减少。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-28 DOI: 10.1002/oby.24103

Jonathan Alessi, Mario Dzemidzic, Jaroslaw Harezlak, David A. Kareken, Robert V. Considine

Objective

Bariatric surgery reduces sweet-liking, but mechanisms remain unclear. We examined related brain responses.

Methods

A total of 24 nondiabetic bariatric surgery and 21 control participants with normal weight to overweight were recruited for an observational controlled cohort study. They underwent sucrose taste testing outside the scanner followed by stimulation with 0.40M and 0.10M sucrose compared with water during functional magnetic resonance imaging. A total of 21 bariatric participants repeated these procedures after surgery.

Results

Perceived sweet intensity was not different among the control, presurgery, or postsurgery groups. Bariatric participants' preferred sweet concentration decreased after surgery (0.52M to 0.29M; p = 0.008). Brain reward system (ventral tegmental area, ventral striatum, and orbitofrontal cortex) region of interest analysis showed that 0.40M sucrose activation (but not 0.10M) decreased after surgery. Sensory region (primary somatosensory and primary taste cortex) 0.40M sucrose activation was unchanged by surgery and did not differ between control and bariatric participants. Primary taste cortex activation to 0.10M sucrose solution was greater in postsurgical bariatric participants compared with control participants.

Conclusions

Bariatric surgery reduces the reward system response to sweet taste in women with obesity without affecting activity in sensory regions, which is consistent with reduced drive to consume sweet foods.

目的：减肥手术会减少对甜食的喜好，但其机制仍不清楚。我们研究了相关的大脑反应：我们共招募了 24 名体重正常至超重的非糖尿病减肥手术参与者和 21 名对照组参与者，进行了一项观察性对照队列研究。他们在扫描仪外接受了蔗糖味觉测试，随后在功能磁共振成像中接受了 0.40M 和 0.10M 蔗糖与水的刺激。共有 21 名减肥参与者在手术后重复了这些过程：结果：对照组、术前组和术后组对甜味强度的感知没有差异。手术后，减肥参与者首选的甜味浓度降低（0.52M 降至 0.29M；p = 0.008）。大脑奖赏系统（腹侧被盖区、腹侧纹状体和眶额皮层）感兴趣区分析表明，手术后 0.40M 蔗糖激活减少（但 0.10M 没有减少）。感觉区（初级躯体感觉皮层和初级味觉皮层）0.40M蔗糖激活在手术后没有变化，对照组和减肥参与者之间也没有差异。与对照组参与者相比，手术后减肥参与者的初级味觉皮层对0.10M蔗糖溶液的激活程度更高：减肥手术降低了肥胖女性对甜味的奖赏系统反应，但没有影响感觉区域的活动，这与摄入甜味食物的驱动力降低是一致的。

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引用次数: 0

Association of epicardial adipose tissue on magnetic resonance imaging with cardiovascular outcomes: Quality over quantity? 磁共振成像中心外膜脂肪组织与心血管预后的关系：质量重于数量？

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-28 DOI: 10.1002/oby.24105

Franz Duca, Katharina Mascherbauer, Carolina Donà, Matthias Koschutnik, Christina Binder, Christian Nitsche, Kseniya Halavina, Dietrich Beitzke, Christian Loewe, Philipp Bartko, Elisabeth Waldmann, Julia Mascherbauer, Christian Hengstenberg, Andreas Kammerlander

Objective

Epicardial adipose tissue (EAT) quantity is associated with poor cardiovascular outcomes. However, the quality of EAT may be of incremental prognostic value. Cardiac magnetic resonance (CMR) is the gold standard for tissue characterization but has never been applied for EAT quality assessment. We aimed to investigate EAT quality measured on CMR T1 mapping as a predictor of poor outcomes in an all-comer cohort.

Methods

We investigated the association of EAT area and EAT T1 times (EAT-T1) with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death.

Results

A total of 966 participants were included (47.2% female; mean age: 58.4 years) in this prospective observational CMR registry. Mean EAT area and EAT-T1 were 7.3 cm² and 268 ms, respectively. On linear regression, EAT-T1 was not associated with markers of obesity, dyslipidemia, or comorbidities such as diabetes (p > 0.05 for all). During a follow-up of 57.7 months, a total of 280 (29.0%) events occurred. EAT-T1 was independently associated (adjusted hazard ratio per SD: 1.202; 95% CI: 1.022–1.413; p = 0.026) with the composite endpoint when adjusted for established clinical risk.

Conclusions

EAT quality (as assessed via CMR T1 times), but not EAT quantity, is independently associated with a composite endpoint of nonfatal myocardial infarction, heart failure hospitalization, and all-cause death.

目的：心外膜脂肪组织（EAT心外膜脂肪组织（EAT）的数量与心血管不良预后有关。然而，心外膜脂肪组织的质量可能会增加预后价值。心脏磁共振（CMR）是组织特征描述的黄金标准，但从未用于 EAT 质量评估。我们的目的是研究在 CMR T1 图谱上测量的 EAT 质量是否可以预测所有患者的不良预后：我们研究了 EAT 面积和 EAT T1 时间（EAT-T1）与非致死性心肌梗死、心力衰竭住院和全因死亡等复合终点的关系：共有 966 名参与者（47.2% 为女性；平均年龄：58.4 岁）参与了这项前瞻性 CMR 观察登记。平均 EAT 面积和 EAT-T1 分别为 7.3 平方厘米和 268 毫秒。线性回归结果显示，EAT-T1 与肥胖、血脂异常或糖尿病等合并症的指标无关（所有指标的 p > 0.05）。在57.7个月的随访期间，共发生了280起（29.0%）事件。在对已确定的临床风险进行调整后，EAT-T1与综合终点独立相关（调整后的每标度危险比：1.202；95% CI：1.022-1.413；P = 0.026）：结论：EAT质量（通过CMR T1时间评估）而非EAT数量与非致死性心肌梗死、心力衰竭住院和全因死亡的复合终点有独立关联。

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引用次数: 0

Cost-effectiveness of a primary care-based Healthy Weight Clinic compared with usual care 以初级保健为基础的健康体重诊所与常规保健的成本效益比较。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-28 DOI: 10.1002/oby.24111

Mona Sharifi, Lauren G. Fiechtner, Jessica L. Barrett, Giselle O'Connor, Meghan Perkins, Jennifer Reiner, Mandy Luo, Elsie M. Taveras, Steven L. Gortmaker

Objective

The objective of this study was to project the cost-effectiveness of implementing the Healthy Weight Clinic (HWC), a primary care-based intervention for 6- to 12-year-old children with overweight or obesity, at federally qualified health centers (FQHCs) nationally.

Methods

We estimated intervention costs from a health care sector and societal perspective and used BMI change estimates from the HWC trial. Our microsimulation of national HWC implementation among all FQHCs from 2023 to 2032 estimated cost per child and per quality-adjusted life year (QALY) gained and projected impact on obesity prevalence by race and ethnicity. Probabilistic sensitivity analyses assessed uncertainty around estimates.

Results

National implementation is projected to reach 888,000 children over 10 years, with a mean intervention cost of $456 (95% uncertainty interval [UI]: $409–$506) per child to the health care sector and $211 (95% UI: $175–$251) to families (e.g., time participating). Assuming effect maintenance, national implementation could result in 2070 (95% UI: 859–3220) QALYs gained and save $14.6 million (95% UI: $5.6–$23.5 million) in health care costs over 10 years, yielding a net cost of $278,000 (95% CI: $177,000–$679,000) per QALY gained. We project greater reductions in obesity prevalence among Hispanic/Latino and Black versus White populations.

Conclusions

The HWC is relatively low-cost per child and projected to reduce obesity disparities if implemented nationally in FQHCs.

研究目的本研究旨在预测在全国联邦合格医疗中心（FQHC）实施健康体重门诊（HWC）的成本效益：我们从医疗保健部门和社会角度估算了干预成本，并使用了 HWC 试验中的 BMI 变化估算值。我们对 2023 年至 2032 年在全国所有 FQHC 中实施 HWC 的情况进行了微观模拟，估算了每个儿童和每个质量调整生命年 (QALY) 的成本，并预测了对不同种族和族裔肥胖症患病率的影响。概率敏感性分析评估了估计值的不确定性：预计全国性实施将在 10 年内惠及 88.8 万名儿童，医疗保健部门的平均干预成本为每名儿童 456 美元（95% 不确定区间 [UI]：409-506 美元），家庭（如参与时间）的平均干预成本为 211 美元（95% 不确定区间 [UI]：175-251 美元）。假设效果保持不变，全国性实施可在 10 年内获得 2070（95% UI：859-3220）个 QALY，节省医疗成本 1460 万美元（95% UI：560-2350 万美元），每个 QALY 的净成本为 27.8 万美元（95% CI：17.7-67.9 万美元）。我们预计，西班牙裔/拉美裔和黑人与白人相比，肥胖症发病率的下降幅度更大：每个儿童的 HWC 成本相对较低，如果在全国范围内的 FQHC 中实施，预计将减少肥胖差异。

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引用次数: 0

How effective are church-based weight-loss interventions among Black adults? A systematic review 基于教堂的黑人成年人减肥干预措施效果如何？系统综述。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity

Pub Date : 2024-08-28 DOI: 10.1002/oby.24115

Lovoria B. Williams, Bassema Abu Farsakh, Erika R. Karle, Zainab S. Almogheer, Steven Coughlin, Karen H. Kim Yeary

Objective

Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research.

Methods

Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development.

Results

A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals.

Conclusions

Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.

目的：教会经常被用来帮助黑人成年人减肥。然而，据我们所知，最近还没有一篇专门针对教会环境中的黑人成年人的综述。我们试图全面研究在黑人成年人中开展的基于教堂的减肥生活方式干预的方法和减肥效果，以深入了解文献空白并为未来研究提供建议：搜索了谷歌学术、PubMed 和 CINAHL（护理和联合健康文献累积索引）中在教堂进行的、报告任何时间点体重结果的试验。系统综述和荟萃分析的首选报告项目（PRISMA）为稿件的撰写提供了指导：从 2007 年到 2023 年，共有 15 项研究（N = 2285）符合纳入标准，其中 33% 为高质量随机试验。大部分是在美国南部进行的试点研究（60%）。大多数研究报告称，干预后体重明显减轻。随访时间点从 2 个月到 12 个月不等。方法包括以下几种：文化适应（93%）；理论指导（93%）；由社区卫生工作者提供（80%）；以小组形式亲自提供（100%）。只有一项研究提供了短信/电子邮件以外的个人关注。大多数参与者是受过良好教育的女性：结论：在黑人教会环境中进行的减肥干预在统计学上具有显著的减肥效果，尽管效果很小。局限性包括试点研究和样本较小。需要进行更严格设计的研究。

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引用次数: 0