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Regular weighing of pregnant women: a relic from a bygone era 孕妇定期称重:过去时代的遗物。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-28 DOI: 10.1002/oby.24117
Jodie M. Dodd, Andrea R. Deussen, Megan Mitchell, Jennie Louise
<p>The practice of regularly weighing women during pregnancy dates to the 1940s in a strategy introduced by the government of the UK to monitor the effect of post-World War II food rationing on the maintenance of a healthy pregnancy [<span>(1)</span>]. This practice continued throughout the 1970s and into the 1990s to aid detection of both preeclampsia and infants who are born small for gestational age (SGA), although it was recognized to have a low positive predictive value [<span>(2)</span>]. There has since been a move in some countries [<span>(3)</span>] to recommend that a woman be weighed only at the time of the booking obstetric visit in the first trimester and then again at 36 weeks' gestation. However, this practice is not universal, with other countries adopting a more intensive approach with regular weighing at each antenatal appointment and adherence to the Institute of Medicine (now National Academy of Medicine) recommendations to limit gestational weight gain (GWG), with the expectation of improved pregnancy and birth outcomes [<span>(4)</span>].</p><p>In this edition, Boone-Heinonen and colleagues [<span>(5)</span>] report a cohort study using electronic health record data from 77,599 pregnancies between 2004 and 2020 from women whose body mass index (BMI) was greater than 18.5 kg/m<sup>2</sup>. GWG was measured in each trimester of pregnancy to evaluate relationships between rate of gain and the occurrence of infant size at birth, defined as large for gestational age (LGA; >90th percentile) and SGA (<10th percentile). The authors identified the risk of birth of an infant with LGA to be greatest among women with a higher prepregnancy BMI and among those whose GWG was higher. Conversely, birth of an infant with SGA was seen in women with a lower prepregnancy BMI and lower GWG. The authors suggest that first-trimester GWG may influence birth size via an effect on second- and third-trimester weight gain and that targeting first-trimester weight gain may be a strategy for intervention.</p><p>We would like to propose an alternate view that challenges some of the widely held assumptions around GWG and its relationship, often presumed to be causal, with pregnancy and birth outcomes. Recent reports [<span>(6-8)</span>] have identified the lack of evidence to suggest that the effect of maternal BMI on pregnancy outcomes is mediated via an effect on GWG. That is, GWG is not on a causal pathway between maternal BMI and adverse pregnancy outcomes [<span>(6)</span>], with limited predictive value in the identification of women who experience a range of pregnancy and birth complications [<span>(7, 8)</span>].</p><p>The validity of the purported relationships between total or trimester-specific GWG and fetal size is problematic for reasons that should be immediately apparent in considering the nature of GWG as an outcome. Although GWG is a clinically simple measure to obtain, it represents a composite of maternal fat deposition; pregnancy-r
定期为孕期妇女称重的做法可以追溯到 20 世纪 40 年代,当时英国政府为监测二战后粮食配给对维持健康妊娠的影响而引入了这一策略[(1)]。这种做法一直持续到 20 世纪 70 年代和 90 年代,以帮助检测子痫前期和出生时胎龄偏小的婴儿(SGA),尽管这种方法的阳性预测值较低[(2)]。此后,一些国家[(3)]建议仅在妊娠头三个月的产科预约就诊时为孕妇称重,然后在妊娠 36 周时再次称重。然而,这种做法并不普遍,其他一些国家则采取了更严格的方法,在每次产前检查时定期称重,并遵守美国医学研究所(现为美国国家医学研究院)关于限制妊娠体重增加(GWG)的建议,以期改善妊娠和分娩结局[(4)]。在本版中,Boone-Heinonen 及其同事[(5)]报告了一项队列研究,该研究使用了 2004 年至 2020 年期间 77,599 名孕妇的电子健康记录数据,这些孕妇的体重指数(BMI)大于 18.5 kg/m2。在妊娠的每个三个月都测量了孕妇的体重增加率(GWG),以评估增加率与婴儿出生时体型大小之间的关系,婴儿出生时体型大小被定义为胎龄偏大(LGA;第 90 百分位数)和 SGA(第 10 百分位数)。作者发现,孕前体重指数(BMI)较高的妇女和胎龄较大的妇女生出 LGA 婴儿的风险最大。相反,孕前体重指数(BMI)较低和 GWG 较低的妇女生出 SGA 婴儿的风险较高。作者认为,第一胎 GWG 可能会通过影响第二胎和第三胎的体重增加来影响胎儿的出生大小,针对第一胎的体重增加可能是一种干预策略。我们想提出另一种观点,对围绕 GWG 及其与妊娠和分娩结果的关系(通常被假定为因果关系)的一些普遍假设提出质疑。最近的报告[(6-8)]指出,缺乏证据表明孕产妇体重指数对妊娠结局的影响是通过对 GWG 的影响而介导的。也就是说,GWG 并不是孕产妇体重指数(BMI)与不良妊娠结局之间的因果关系[(6)],对识别出现一系列妊娠和分娩并发症的妇女的预测价值有限[(7, 8)]。虽然 GWG 在临床上很容易获得,但它代表了母体脂肪沉积、与妊娠相关的血浆体积膨胀、乳房和子宫组织肥大、细胞外液以及妊娠产物(包括胎盘、胎儿和羊水)的综合结果。此外,要精确测量每个妇女体内这些成分的确切贡献是非常困难的。尽管如此,GWG 与出生体重之间的任何关系都不可能是因果关系,因为胎儿体重是 GWG 的一个组成部分。这就意味着,如果两名妇女在前面概述的 GWG 各组成部分的所有其他方面都相同,但第一个胎儿的体重(包括胎龄体重)大于第二个胎儿的体重,则第一个妇女的 GWG 必然较大。此外,孕产妇体重指数(BMI)与 GWG 之间缺乏因果关系,这不仅表明 GWG 并不是改善妊娠结局的适当目标,而且也可能解释了迄今为止观察到的产前妊娠干预的临床影响非常有限的原因。相比之下,孕产妇孕前体重指数(BMI)被认为与不良妊娠结局有因果关系[(6, 8)],随着体重指数(BMI)的增加,风险也随之增加[(6)]。持续不懈地寻找 "正确的 "产前干预措施,将 GWG 作为改善临床妊娠和分娩结局的因果途径,似乎是徒劳无益的。这种做法不仅不必要地浪费了有限的医疗资源,而且还会使妇女因无法实现遥不可及的目标而陷入失败的境地。研究人员和临床医生不应继续关注 GWG,而应重新考虑这种方法的有效性以及在整个孕期积极管理 GWG 的做法。
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引用次数: 0
Modeling mechanisms driving metabolic benefits of time-restricted eating 模拟限时进食对新陈代谢有益的机制。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-28 DOI: 10.1002/oby.24093
Susan K. Fried
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引用次数: 0
MRI assessment of adipose tissue fatty acid composition in the UK Biobank and its association with diet and disease 英国生物库中脂肪组织脂肪酸组成的核磁共振成像评估及其与饮食和疾病的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-25 DOI: 10.1002/oby.24108
Marjola Thanaj, Nicolas Basty, Brandon Whitcher, Jimmy D. Bell, E. Louise Thomas

Objective

This study aimed to assess the fatty acid (FA) composition of abdominal subcutaneous and visceral adipose tissue (ASAT and VAT, respectively) in the UK Biobank imaging cohort (N = 33,823) using magnetic resonance imaging (MRI).

Methods

We measured the fractions of saturated, monounsaturated, and polyunsaturated FA (fSFA, fMUFA, and fPUFA, respectively) in ASAT and VAT from multiecho MRI scans. We selected a subcohort of participants who followed a vegan and an omnivore diet (N = 36) to validate the effect of diet on adipose tissue. In the wider imaging cohort, we examined the relationships between adipose tissue FA composition and various traits related to disease and body size.

Results

We measured adipose tissue FA composition for over 33,000 participants, revealing higher fSFA and fPUFA and lower fMUFA in VAT (p < 0.00016). fMUFA and fPUFA were higher in ASAT and lower in VAT for women (p < 0.00016). Vegan participants exhibited lower fSFA in both ASAT and VAT (p < 0.00016). VAT fSFA and fMUFA showed significant associations with disease, as well as anthropometric variables.

Conclusions

This extensive analysis revealed the relationships between adipose tissue FA composition and a range of factors in a diverse population, highlighting the importance of studying body adipose tissue beyond its quantity.

研究目的本研究旨在利用磁共振成像(MRI)评估英国生物库成像队列(N = 33,823)中腹部皮下和内脏脂肪组织(分别为 ASAT 和 VAT)的脂肪酸(FA)组成:我们通过多回波核磁共振成像扫描测量了ASAT和VAT中饱和脂肪酸、单不饱和脂肪酸和多不饱和脂肪酸的比例(分别为fSFA、fMUFA和fPUFA)。我们选择了素食者和杂食者(36 人)作为亚群,以验证饮食对脂肪组织的影响。在更广泛的成像队列中,我们研究了脂肪组织FA组成与疾病和体型相关的各种特征之间的关系:我们测量了 33,000 多名参与者的脂肪组织脂肪酸组成,结果显示,脂肪增值纤维中的 fSFA 和 fPUFA 含量较高,而 fMUFA 含量较低(p 结论:脂肪增值纤维中的 fSFA 和 fPUFA 含量较高,而 fMUFA 含量较低):这项广泛的分析揭示了不同人群中脂肪组织脂肪酸组成与一系列因素之间的关系,突出了研究人体脂肪组织数量之外的重要性。
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引用次数: 0
Association between thyroid hormone resistance and obesity: a cross-sectional study and mouse stimulation test 甲状腺激素抵抗与肥胖之间的关系:一项横断面研究和小鼠刺激试验。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-24 DOI: 10.1002/oby.24084
Zhihui Wang, Huimin Yu, Kai Wang, Junming Han, Yongfeng Song

Objective

Thyroid hormone influences key metabolic pathways, and reduced sensitivity to thyroid hormone is considered a new risk factor for adverse metabolic outcomes. However, the association between thyroid hormone resistance and obesity in euthyroid individuals is still unknown.

Methods

We enrolled 8021 euthyroid individuals, calculated thyroid hormone resistance indices, and analyzed the association between thyroid hormone resistance and obesity by regression analysis. Furthermore, we conducted the thyrotropin-releasing hormone stimulation test in both control and obese mice (n = 5) to demonstrate the association.

Results

The euthyroid adults with overweight and obesity had increased thyroid hormone resistance indices (all p < 0.05). BMI and prevalence of overweight and obesity increased (odds ratio of thyroid feedback quantile-based index [ORTFQI] = 1.164, p = 0.036; OR of free triiodothyronine/free thyroxine [ORFT3/FT4] = 1.508, p < 0.001) following the elevation of thyroid hormone resistance indices. Mediation analysis indicated a complete mediation effect (beta coefficient of indirect effect [βInd]= 6.838, p < 0.001) of metabolic disorders in the relationship. Furthermore, in the mice with obesity, the thyrotropin response to thyrotropin-releasing hormone stimulation (68.33–90.89 pg/mL) was comparatively blunted (p = 0.029).

Conclusions

Euthyroid individuals with obesity exhibit both central and peripheral thyroid hormone resistance, a phenomenon that is more pronounced in individuals with metabolic abnormalities. Thyroid hormone resistance is associated with an increased prevalence of overweight and obesity mediated by metabolic disorders.

目的:甲状腺激素影响关键的代谢途径,对甲状腺激素的敏感性降低被认为是导致不良代谢结果的新风险因素。然而,甲状腺激素抵抗与甲状腺功能正常者肥胖之间的关系仍然未知:我们招募了 8021 名甲状腺功能正常者,计算了甲状腺激素抵抗指数,并通过回归分析分析了甲状腺激素抵抗与肥胖之间的关系。此外,我们还对对照组小鼠和肥胖小鼠(5 只)进行了促甲状腺激素释放激素刺激试验,以证明两者之间的关联:结果:患有超重和肥胖症的甲状腺功能正常成人的甲状腺激素抵抗指数增加(所有 p TFQI] = 1.164,p = 0.036;游离三碘甲状腺原氨酸/游离甲状腺素 OR [ORFT3/FT4] = 1.508,p Ind]= 6.838,p 结论:甲状腺功能正常的肥胖症患者的甲状腺激素抵抗指数增加:甲状腺功能正常的肥胖症患者同时表现出中枢和外周甲状腺激素抵抗,这一现象在代谢异常的患者中更为明显。甲状腺激素抵抗与代谢紊乱导致的超重和肥胖发生率增加有关。
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引用次数: 0
Physiological response during exercise is preserved in children exposed to a suboptimal gestational environment 处于次优妊娠环境中的儿童在运动过程中的生理反应得以保持。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-24 DOI: 10.1002/oby.24049
Soraya Saidj, Stephanie-May Ruchat, Mélanie Henderson, Angelo Tremblay, Marie-Eve Mathieu

Objective

This study investigated whether exposure to suboptimal gestational factors (SGFs) alters mechanical efficiency (ME) and substrate oxidation during rest and exercise in children as a mechanism contributing to obesity.

Methods

Data from the Quebec Adiposity and Lifestyle Investigation in Youth cohort were used. Children aged 8 to 10 years performed an incremental maximal cycling test with indirect calorimetry. Their ME was measured during submaximal and maximal effort. The substrate oxidation during rest and submaximal effort was also computed. ME and substrate oxidation results between children exposed to each SGF during pregnancy (gestational diabetes mellitus: n = 68; hypertensive disorders: n = 49; maternal smoking: n = 77) and nonexposed children (n = 370) were compared.

Results

No difference was observed for ME during submaximal (F[3,540] = 0.46, p = 0.713) and maximal effort (F[3,545] = 0.86, p = 0.463) between exposed and nonexposed children. The percentage contributions of lipids and carbohydrates did not differ during rest (F[3,545] =1.68, p = 0.169) or submaximal exercise (F[3,544] = 0.31, p = 0.534) between exposed and nonexposed children.

Conclusions

Children exposed to investigated SGFs display a similar physiological response regarding ME and substrate oxidation during rest and exercise compared to nonexposed children. Future studies should confirm these novel results and continue investigating other research avenues to explain the higher risk of obesity in this population.

目的:本研究探讨了次优妊娠因素(SGFs)是否会改变儿童在休息和运动时的机械效率(ME)和底物氧化,从而导致肥胖:本研究探讨了暴露于次优妊娠因素(SGFs)是否会改变儿童在休息和运动时的机械效率(ME)和底物氧化,并将其作为导致肥胖的一种机制:方法:采用魁北克青少年肥胖和生活方式调查队列的数据。8至10岁的儿童通过间接热量计进行了增量最大骑行测试。测量了他们在次最大努力和最大努力时的 ME 值。此外,还计算了休息和次最大努力时的底物氧化。比较了孕期暴露于每种 SGF 的儿童(妊娠糖尿病:n = 68;高血压疾病:n = 49;母亲吸烟:n = 77)和未暴露于 SGF 的儿童(n = 370)的 ME 和底物氧化结果:结果表明:在亚极限(F[3,540] = 0.46,p = 0.713)和极限(F[3,545] = 0.86,p = 0.463)时,暴露和非暴露儿童的 ME 没有差异。在休息期间(F[3,545] =1.68,p =0.169)或亚极限运动期间(F[3,544] =0.31,p =0.534),暴露与非暴露儿童的脂类和碳水化合物贡献百分比没有差异:结论:与未暴露于所调查的 SGFs 的儿童相比,暴露于这些 SGFs 的儿童在休息和运动时的 ME 和底物氧化方面表现出相似的生理反应。未来的研究应确认这些新结果,并继续探索其他研究途径,以解释该人群肥胖风险较高的原因。
{"title":"Physiological response during exercise is preserved in children exposed to a suboptimal gestational environment","authors":"Soraya Saidj,&nbsp;Stephanie-May Ruchat,&nbsp;Mélanie Henderson,&nbsp;Angelo Tremblay,&nbsp;Marie-Eve Mathieu","doi":"10.1002/oby.24049","DOIUrl":"10.1002/oby.24049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated whether exposure to suboptimal gestational factors (SGFs) alters mechanical efficiency (ME) and substrate oxidation during rest and exercise in children as a mechanism contributing to obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Quebec Adiposity and Lifestyle Investigation in Youth cohort were used. Children aged 8 to 10 years performed an incremental maximal cycling test with indirect calorimetry. Their ME was measured during submaximal and maximal effort. The substrate oxidation during rest and submaximal effort was also computed. ME and substrate oxidation results between children exposed to each SGF during pregnancy (gestational diabetes mellitus: <i>n</i> = 68; hypertensive disorders: <i>n</i> = 49; maternal smoking: <i>n</i> = 77) and nonexposed children (<i>n</i> = 370) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No difference was observed for ME during submaximal (<i>F</i><sub>[3,540]</sub> = 0.46, <i>p</i> = 0.713) and maximal effort (<i>F</i><sub>[3,545]</sub> = 0.86, <i>p</i> = 0.463) between exposed and nonexposed children. The percentage contributions of lipids and carbohydrates did not differ during rest (<i>F</i><sub>[3,545]</sub> =1.68, <i>p</i> = 0.169) or submaximal exercise (<i>F</i><sub>[3,544]</sub> = 0.31, <i>p</i> = 0.534) between exposed and nonexposed children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Children exposed to investigated SGFs display a similar physiological response regarding ME and substrate oxidation during rest and exercise compared to nonexposed children. Future studies should confirm these novel results and continue investigating other research avenues to explain the higher risk of obesity in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"32 8","pages":"1551-1557"},"PeriodicalIF":4.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clarification of our response to “The importance of diversity in Obesity articles” 澄清我们对 "肥胖文章中多样性的重要性 "的答复。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-24 DOI: 10.1002/oby.24112
Michelle Cardel, Matthew M. Clark, Thomas A. Wadden, Leanne M. Redman, Michael Jensen
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引用次数: 0
Age of obesity onset affects subcutaneous adipose tissue cellularity differently in the abdominal and femoral region 肥胖发病年龄对腹部和股部皮下脂肪组织细胞的影响不同。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-24 DOI: 10.1002/oby.24059
Jessica Murphy, Abdulrahman Dera, José A. Morais, Michael A. Tsoukas, Natalie Khor, Taisiia Sazonova, Lucas Guimarães Almeida, Alexandra B. Cooke, Stella S. Daskalopoulou, Bjorn T. Tam, Sylvia Santosa

Objective

We aimed to examine the effect of age of obesity onset, sex, and their interaction on abdominal and femoral subcutaneous adipose tissue (SAT) morphology (degree of adipocyte hyperplasia or hypertrophy).

Methods

In this cross-sectional study, we isolated adipocytes via collagenase digestion from abdominal and femoral SAT biopsies taken from male and female adults with childhood-onset obesity (CO; n = 8 males, n = 16 females) or adult-onset obesity (AO; n = 8 males, n = 13 females). Regional body composition was measured with dual-energy x-ray absorptiometry and a single-slice abdominal computed tomography scan. Mean adipocyte size was measured in abdominal and femoral SAT and was used to quantify morphology in android and gynoid subcutaneous fat, respectively.

Results

Abdominal SAT morphology was more hyperplastic in females with CO than females with AO (p = 0.004) but did not differ between males with CO and males with AO (p = 0.996). Conversely, femoral SAT morphology was more hypertrophic in males and females with CO than those with AO.

Conclusions

Age of obesity onset appears to affect SAT morphology differently in the abdominal and femoral regions of male and female adults. Our findings challenge the notion that SAT is uniformly hyperplastic in CO and hypertrophic in AO.

研究目的我们旨在研究肥胖发病年龄、性别及其相互作用对腹部和股部皮下脂肪组织(SAT)形态(脂肪细胞增生或肥大程度)的影响:在这项横断面研究中,我们通过胶原酶消化从患有儿童期肥胖症(CO;男性8人,女性16人)或成年期肥胖症(AO;男性8人,女性13人)的男性和女性成人的腹部和股部SAT活检组织中分离出脂肪细胞。通过双能 X 射线吸收测量法和单片腹部计算机断层扫描测量区域身体成分。测量了腹部和股部SAT脂肪细胞的平均大小,并分别用于量化甲状腺和妇科皮下脂肪的形态:结果:患有 CO 的女性腹部 SAT 形态比患有 AO 的女性更加增生(p = 0.004),但患有 CO 的男性和患有 AO 的男性之间没有差异(p = 0.996)。相反,患有CO的男性和女性的股骨SAT形态比患有AO的男性和女性更肥大:结论:肥胖症的发病年龄似乎会对男性和女性成年人腹部和股部的SAT形态产生不同的影响。我们的研究结果对SAT在CO患者中均匀增生而在AO患者中肥大的观点提出了质疑。
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引用次数: 0
Nut consumption, gut microbiota, and body fat distribution: results of a large, community-based population study 坚果食用量、肠道微生物群和体脂分布:一项大型社区人口研究的结果。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-23 DOI: 10.1002/oby.24099
Yuwei Shi, Juntao Kan, Wenjie Wang, Yiyang Cao, Yimian Wu, Xinyu Chen, Weifang Zheng, Fei Yang, Jun Du, Wei He, Shankuan Zhu

Objective

We aimed to investigate the relationships among nut consumption, gut microbiota, and body fat distribution.

Methods

We studied 2255 Chinese adults in the Lanxi Cohort living in urban areas in Lanxi City, China. Fat distribution was assessed by dual-energy x-ray absorptiometry, and nut consumption was assessed using food frequency questionnaires. 16S ribosomal RNA (rRNA) sequencing was performed on stool samples from 1724 participants. Linear regression and Spearman correlation were used in all analyses. A validation study was performed using 1274 participants in the Lanxi Cohort living in rural areas.

Results

Nut consumption was beneficially associated with regional fat accumulation. Gut microbial analysis suggested that a high intake of nuts was associated with greater microbial α diversity. Six genera were found to be associated with nut consumption, and the abundance of genera Anaerobutyricum, Anaerotaenia, and Fusobacterium was significantly associated with fat distribution. Favorable relationships between α diversity and fat distribution were also observed. Similar relationships between gut microbiota and fat distribution were obtained in the validation analysis.

Conclusions

We have shown that nut consumption is beneficially associated with body fat distribution and gut microbiota diversity and taxonomy. Furthermore, the microbial features related to high nut intake are associated with a favorable pattern of fat distribution.

目的: 我们旨在研究坚果食用量、肠道微生物群和体脂分布之间的关系:我们旨在研究坚果食用量、肠道微生物群和体脂分布之间的关系:我们对生活在中国兰溪市城区的2255名中国成年人进行了兰溪队列研究。脂肪分布通过双能 X 射线吸收测定法进行评估,坚果食用量通过食物频率问卷进行评估。对 1724 名参与者的粪便样本进行了 16S 核糖体 RNA(rRNA)测序。所有分析均采用线性回归和斯皮尔曼相关分析。使用生活在农村地区的兰溪队列中的 1274 名参与者进行了一项验证研究:结果:坚果的摄入量与区域脂肪堆积有益处。肠道微生物分析表明,坚果摄入量高与微生物α多样性增加有关。研究发现,有六个菌属与坚果摄入量有关,其中Anaerobutyricum、Anaerotaenia和Fusobacterium菌属的丰富程度与脂肪分布有显著关系。还观察到α多样性与脂肪分布之间的有利关系。在验证分析中也发现了肠道微生物群与脂肪分布之间的类似关系:结论:我们已经证明,食用坚果与体脂分布、肠道微生物群多样性和分类有益相关。此外,与坚果高摄入量相关的微生物特征与有利的脂肪分布模式有关。
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引用次数: 0
Efficacy of an mHealth-delivered behavioral intervention on weight loss and cardiometabolic risk in African American postpartum people with overweight or obesity: the SnapBack randomized controlled trial 针对超重或肥胖的非裔美国人产后减肥和心脏代谢风险的移动医疗行为干预效果:SnapBack 随机对照试验。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-23 DOI: 10.1002/oby.24091
Sharon J. Herring, Daohai Yu, Niesha Darden, Brooke Bailer, Jane Cruice, Jessica J. Albert, Christine Santoro, Veronica Bersani, Chantelle N. Hart, Eric A. Finkelstein, Linda M. Kilby, Xiaoning Lu, Gary B. Bennett, Gary D. Foster

Objective

The objective of this study was to evaluate the efficacy of a mobile health (mHealth)-delivered behavioral intervention on changes in postpartum weight and cardiometabolic risk factors (blood pressure [BP], lipids, and hemoglobin A1c) over 12 months.

Methods

A randomized controlled trial of 300 African American postpartum people with overweight and obesity enrolled in Philadelphia Women, Infants, and Children (WIC) clinics was conducted. Participants were randomized to usual WIC care (n = 151) or a 12-month mHealth-delivered intervention (n = 149) comprising behavior change goals, interactive self-monitoring text messages, and counseling support.

Results

Intervention and usual-care participants did not significantly differ in 12-month mean postpartum weight change (1.1 vs. 1.6 kg, p = 0.5; difference −0.6 kg, 95% CI: −2.3 to 1.2). However, high intervention engagement led to weight loss compared with weight gain among those who were less engaged (−0.6 vs. 2.4 kg, p = 0.01; difference −3.0 kg, 95% CI: −5.4 to −0.6). The intervention reduced systolic BP relative to usual care (−1.6 vs. 2.4 mm Hg, p = 0.02; difference −4.0 mm Hg, 95% CI: −7.5 to −0.5), but this effect did not extend to other cardiometabolic risk factors.

Conclusions

Among African American postpartum people enrolled in WIC, an mHealth-delivered intervention reduced systolic BP but not additional cardiometabolic risk factors or weight. Intervention participants with high engagement had significantly better postpartum weight outcomes, and thus, next steps include addressing barriers to engagement.

研究目的本研究旨在评估移动医疗(mHealth)提供的行为干预在 12 个月内对产后体重和心脏代谢风险因素(血压、血脂和血红蛋白 A1c)变化的影响:对费城妇女、婴儿和儿童(WIC)诊所登记的 300 名超重和肥胖的非裔美国人产后妇女进行了随机对照试验。参与者被随机分配到 WIC 的常规护理(151 人)或为期 12 个月的移动医疗干预(149 人),其中包括行为改变目标、互动式自我监测短信和咨询支持:干预参与者和常规护理参与者在产后 12 个月的平均体重变化上没有明显差异(1.1 对 1.6 千克,P = 0.5;差异 -0.6 千克,95% CI:-2.3 对 1.2)。然而,干预参与度高的产妇体重下降,而干预参与度低的产妇体重增加(-0.6 kg vs. 2.4 kg,p = 0.01;差异-3.0 kg,95% CI:-5.4 to -0.6)。与常规护理相比,干预措施降低了收缩压(-1.6 vs. 2.4 mm Hg,p = 0.02;差异-4.0 mm Hg,95% CI:-7.5 to -0.5),但这一效果并未延伸至其他心脏代谢风险因素:在参加 WIC 的非裔美国人产后人群中,移动医疗提供的干预措施降低了收缩压,但没有降低其他心脏代谢风险因素或体重。参与度高的干预参与者的产后体重结果明显更好,因此,下一步工作包括消除参与障碍。
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引用次数: 0
Proteomic biomarkers related to obesity in heart failure with reduced ejection fraction and their associations with outcome 射血分数降低型心力衰竭患者肥胖相关的蛋白质组生物标志物及其与预后的关系。
IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-22 DOI: 10.1002/oby.24094
Teun B. Petersen, Navin Suthahar, Folkert W. Asselbergs, Marie de Bakker, K. Martijn Akkerhuis, Alina A. Constantinescu, Jan van Ramshorst, Peter D. Katsikis, Peter J. van der Spek, Victor A. Umans, Rudolf A. de Boer, Eric Boersma, Dimitris Rizopoulos, Isabella Kardys

Objective

Heart failure (HF) pathophysiology in patients with obesity may be distinct. To study these features, we identified obesity-related biomarkers from 4210 circulating proteins in patients with HF with reduced ejection fraction (HFrEF) and examined associations of these proteins with HF prognosis and biological mechanisms.

Methods

In 373 patients with trimonthly blood sampling during a median follow-up of 2.1 (25th–75th percentile: 1.1–2.6) years, we applied an aptamer-based multiplex approach measuring 4210 proteins in baseline samples and the last two samples before study end. Associations between obesity (BMI > 30 kg/m2) and baseline protein levels were analyzed. Subsequently, associations of serially measured obesity-related proteins with biological mechanisms and the primary endpoint (PEP; composite of cardiovascular mortality, HF hospitalization, left ventricular assist device implantation, and heart transplantation) were examined.

Results

Obesity was identified in 26% (96/373) of patients. A total of 30% (112/373) experienced a PEP (with obesity: 26% [25/96] vs. without obesity: 31% [87/277]). A total of 141/4210 proteins were linked to obesity, reflecting mechanisms of neuron projection development, cell adhesion, and muscle cell migration. A total of 50/141 proteins were associated with the PEP, of which 12 proteins related to atherosclerosis or hypertrophy provided prognostic information beyond clinical characteristics, N-terminal pro-B-type natriuretic peptide, and high-sensitivity troponin T.

Conclusions

Patients with HFrEF and obesity show distinct proteomic profiles compared to patients with HFrEF without obesity. Obesity-related proteins are independently associated with HF outcome. These proteins carry potential to improve management of obesity-related HF and could be leads for future research.

目的:肥胖患者的心力衰竭(HF)病理生理学可能有所不同。为了研究这些特征,我们从射血分数降低的心力衰竭(HFrEF)患者的 4210 种循环蛋白中确定了与肥胖相关的生物标记物,并研究了这些蛋白与心力衰竭预后和生物学机制的关系:在中位随访 2.1 年(第 25-75 百分位数:1.1-2.6 年)期间,我们对 373 名患者进行了三个月一次的血液采样,并采用一种基于适配体的多重方法测量了基线样本和研究结束前最后两个样本中的 4210 种蛋白质。我们分析了肥胖(体重指数大于 30 kg/m2)与基线蛋白质水平之间的关联。随后,研究人员研究了连续测量的肥胖相关蛋白质与生物机制和主要终点(PEP;心血管死亡率、高血压住院、左心室辅助装置植入和心脏移植的复合体)之间的关联:结果:26%的患者(96/373)发现肥胖。共有 30% 的患者(112/373)出现过 PEP(肥胖:26% [25/96] 与非肥胖:31% [87/277])。共有 141/4210 个蛋白质与肥胖有关,反映了神经元突起发育、细胞粘附和肌肉细胞迁移的机制。共有50/141个蛋白质与PEP相关,其中12个与动脉粥样硬化或肥厚相关的蛋白质提供了临床特征、N末端前B型钠尿肽和高敏肌钙蛋白T之外的预后信息:结论:与无肥胖症的高频低氧血症患者相比,高频低氧血症合并肥胖症的患者表现出不同的蛋白质组学特征。与肥胖相关的蛋白质与心房颤动的预后有独立关联。这些蛋白质具有改善肥胖相关性高血压管理的潜力,可作为未来研究的线索。
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引用次数: 0
期刊
Obesity
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