Obesity Reviews最新文献

Obesity is a significant health issue that poses serious risks to human well-being. Gut microbiota disorders are recognized as key factors contributing to obesity. Intestinal microbes produce lipopolysaccharides, short-chain fatty acids, and extracellular vesicles that interfere with the body's immunological and metabolic processes. In turn, the host-derived exosomes, antimicrobial peptides, and interferon systems disrupt intestinal microbial homeostasis, further affecting metabolism and immunity and promoting obesity in multiple ways. This review focuses on the mechanism of immunological metabolism by the host-microorganism interaction and elucidates the frontiers of the etiology of obesity.

Background: Although the risk of psoriatic arthritis (PsA) and obesity comorbidities is increasing, only a few systematic global prevalence studies have been conducted.

Objective: This study explored the global prevalence of obesity, abdominal obesity, and being overweight in patients with PsA.

Methods: We examined eight databases from their inception to November 20, 2024. The R language was used for the data analysis. Meta-regression and subgroup analyses were used to evaluate the heterogeneity of the pooled studies. Funnel plots and Egger's tests were used to assess publication bias in the included studies, and the trim-and-fill method was used to correct for bias.

Results: Twenty-seven studies were included. The overall prevalence of obesity in patients with PsA was 35% (95% CI, 0.30 to 0.40). The prevalence of obesity in adults with PsA was 35% (95% CI, 0.28 to 0.42), and it was 27% (95% CI, 0.11 to 0.46) in children and adolescents. Africa had the highest prevalence (57%; 95% CI, 0.43 to 0.69). In contrast, the prevalence was the lowest in Europe at 31% (95% CI, 0.25 to 0.38). In terms of countries, China had the highest prevalence (65%), followed by Egypt (57%) and Norway (55%). The lowest prevalence was observed in the United States (20%).

Conclusions: These findings confirm the association between obesity and PsA. Considering the negative impact of obesity on PsA treatment, the early detection and management of obesity should be prioritized. Further population-based prospective observational studies are required to clarify the mechanisms underlying the coexistence of obesity in patients with PsA.

Background: The pancreas is a key metabolic organ, and excessive intrapancreatic fat deposition (IPFD) has been implicated in the pathogenesis of Type 2 diabetes. Although IPFD is believed to be reversible, it remains unclear whether glucose-lowering medications can reduce it. This study aimed to perform a field-wide systematic review of randomized controlled trials (RCTs) investigating the effects of such medications on IPFD.

Methods: Three electronic databases-MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials-were searched. RCTs comparing the effects of pharmacological interventions with standard care or placebo on IPFD were meta-analyzed using a random-effects model. The mean difference in IPFD, with its corresponding 95% confidence interval, served as the primary effect estimate.

Results: Eight RCTs met the eligibility criteria, five of which were placebo-controlled. In the overall analysis, glucose-lowering medications were associated with a significant reduction in IPFD (mean difference = -1.5; 95% CI: -1.8, -1.1; p < 0.001). Constraining the analysis to placebo-controlled RCTs yielded a larger effect size (mean difference = -1.8; 95% CI: -3.1, -0.5; p = 0.01). Among the medication classes meta-analyzed, significant reductions in IPFD were observed with GLP-1 receptor agonists (mean difference = -1.6; 95% CI: -2.5, -0.7; p = 0.01) and SGLT-2 inhibitors (mean difference = -1.4; 95% CI: -1.6, -1.1; p = 0.002).

Conclusion: Glucose-lowering medications have the potential to reduce IPFD. Rigorously designed RCTs are warranted to confirm the responsiveness of IPFD to pharmacological interventions and to guide their clinical application.

Background: The association between adverse childhood experiences (ACEs) and metabolic syndrome (MetS) across life course and its components (abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia) is poorly understood.

Methods: Three databases were screened for studies published January 2000-February 2024 that examined the association between ACE and MetS. Relevant data, including authors, country, study type, participants, types, and number of ACE and MetS and its components, were extracted. Mantel-Haenszel random-effects models were used to meta-analyze the association of ACE exposure and MetS and its individual components.

Results: A total of 16 papers (14 adult, 2 adolescent samples) met inclusion criteria, and 10 were eligible for meta-analysis. There was a significant association between exposure of ≥ 1 ACE and MetS (odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.18-1.29, I² = 82.2%, p < 0.001). Those with ≥ 3 ACEs vs. none had higher odds of MetS (OR = 1.43, 95% CI 1.32-1.55, I² = 63.1%, p = 0.019). Associations with ≥ 1 ACE were shown for hyperglycemia (OR = 1.27, 95% CI 1.20-1.33, I² = 88.1%, p < 0.001) and elevated blood pressure (OR 1.16, 95% CI 1.07-1.26, I² = 28.7%, p = 0.246). There were limited studies that examined the association between ACE and dyslipidemia and abdominal obesity. Some studies showed a stronger association of ACE and MetS among race/ethnic minorities compared with non-Hispanic White individuals.

Conclusions: Results show a dose-response relationship between ACE and MetS. These findings can inform the development of targeted interventions and policies to mitigate MetS risk among individuals with ACE exposure, particularly those from race/ethnic minority populations who may be at heightened risk.

People living with obesity and obesity-related complications who are experiencing social isolation and loneliness (SIL) are at an increased risk of more disease-specific complications, the presence of comorbidities, and mortality. Interventions targeting SIL may be of benefit in this population, though research in this field is limited. This study aimed to systematically review the literature on interventions addressing SIL in people with obesity and obesity-related complications. The databases SCOPUS, PsycINFO, and EMBASE were searched for eligible articles. Studies were uploaded into Covidence for title, abstract, and full-text screening, data extraction, and quality assessment. Of 3521 studies screened, 19 were included. Studies were grouped by whether they were conducted in person or through technology, and in group or individual settings, with in-person group-based interventions more likely to report effectiveness. Interventions were also divided into four types-therapeutic, companionship, social activity, or physical type-with studies included being predominantly therapeutic interventions. Limited conclusions could be drawn from the data in relation to effectiveness due to the heterogeneity of studies. Although the limited findings align with the emerging nature of this topic, it emphasizes the need for more research in developing targeted and robust SIL interventions for individuals with obesity and obesity-related complications.

In a scenario with increasing cases of obesity and diabetes worldwide, branched-chain amino acids (BCAA) metabolism has become an important factor in the understanding of these pathologies. More recently, its chronic high plasma levels have been postulated, alongside glucose, inflammatory factors, and other molecules, as an important predictive marker for developing insulin resistance. High-fat diet protocols and models mimicking obesity and type-2 diabetes have clarified our knowledge about how these conditions, which have an important inflammatory aspect, impact the BCAA catabolism in several tissues and its systemic effects. On the other hand, BCAA supplementation has been studied in several experimental models aiming to understand its role in inflammation. Evidence reveals that a chronic low-grade inflammatory state is an important factor in several age-related pathological conditions and that its presence, characterized by augmented proinflammatory cytokines, high glucose and BCAA levels, would be a determining factor. Although, the relationship between BCAA and inflammation is complex and our current knowledge cannot identify a causative role for these amino acids, as in the majority of the cases a previous or concomitant stimulus was necessary to demonstrate their role in the modulation of inflammation.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effect of nutraceuticals containing Citrus bergamia on the management of obesity in adults by assessing measures related to obesity. We searched the following databases until October 2024: PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. The inclusion criteria were RCTs involving adults (≥ 18 years), the use of nutraceuticals containing C. bergamia, and an intervention duration of ≥ 4 weeks. Data extraction focused on weight loss, body mass index, waist circumference, waist-to-hip ratio, and body fat percentage, and the risk of bias was assessed using the Revised Cochrane Risk-of-Bias Tool. Out of 966 reports, 11 RCTs were eligible for inclusion in the meta-analysis. The pooled results, using a random-effects model, showed that C. bergamia supplementation significantly decreased body weight (SMD: -0.64; 95% CI: -1.15, -0.13; p = 0.01; I² = 90%), body mass index (SMD: -0.85; 95% CI: -1.35, -0.35; p = 0.0008; I² = 90%), and waist circumference (SMD: -0.41; 95% CI: -0.65, -0.16; p = 0.001; I² = 49%). However, no significant effect of bergamot-containing nutraceuticals was observed on the other body composition parameters analyzed. Subgroup analysis suggested that bergamot intake significantly changed anthropometric parameters for periods of ≤ 12 weeks, at dosages of ≤ 600 mg/day, and among participants with overweight and obesity. Overall, the current meta-analysis suggests that nutraceuticals containing C. bergamia show promise in the prevention and management of obesity. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO): CRD42023465541 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=465541).

Background: Pharmacotherapy offers a potential solution for individuals with overweight and obesity to decrease their body weight. However, there is limited knowledge of the effects of antiobesity agents on the distribution of body fat.

Methods: The PubMed, Embase, and Cochrane Library databases were reviewed for randomized controlled trials (RCTs) of weight-lowering drugs between inception and May 23, 2023. The main results were visceral and subcutaneous adipose tissue (VAT and SAT). Secondary outcomes were altered body weights and waist circumferences. For the statistical analysis, STATA 14.0 was utilized, and the frequentist method was used for random-effect network meta-analyses.

Results: A total of 39 articles including 41 RCTs with 2741 patients were included. GLP-1 receptor agonists and SGLT-2 inhibitors were observed to lower VAT (-0.90 [-1.32 to -0.47] and -0.66 [-1.22 to -0.10]) after a mean of 29.4 weeks, whereas only GLP-1 receptor agonists reduced SAT (-1.01 [-1.58 to -0.43]). Naltrexone-bupropion, GLP-1 receptor agonists, SGLT-2 inhibitors, and metformin were found to reduce body weight (-5.60 [-8.64 to -2.56] kg, -4.73 [-5.58 to -3.88] kg, -3.20 [-4.69 to -1.72] kg, and -1.93 [-3.01 to -0.85] kg). Lastly, waist circumference was decreased by GLP-1 receptor agonists, metformin, SGLT-2 inhibitors, and naltrexone-bupropion.

Conclusion: This analysis demonstrated that GLP-1 receptor agonists may have advantages over other antiobesity agents in reducing VAT and SAT. SGLT-2 inhibitors were more helpful to reduce VAT. The clinical significance relates to physicians being able to choose appropriate weight-loss agents in accordance with a patient's fat distribution.

This review explores the relationship between maternal obesity and alterations in the expression of microRNAs (miRNAs) in breast milk, highlighting how these changes may influence the developmental programming of the infant. Evidence suggests that maternal obesity can affect the bioactive composition of breast milk, including miRNA profiles, which are key regulators of metabolic and immune pathways in early life. Specific miRNAs, such as miR-148a and miR-30b, have been identified as modulators of metabolic processes, potentially impacting offspring growth, energy balance, and long-term health outcomes. Additionally, maternal factors such as prepregnancy BMI and dietary patterns play a crucial role in shaping milk composition. Understanding these complex interactions is essential for informing nutritional strategies aimed at supporting optimal infant development and preventing chronic diseases later in life.

Introduction: Community- and population-level and policy interventions are commonly evaluated using nonrandomized studies (NRS), rather than randomized trials (RCTs). Recent Cochrane reviews of interventions for preventing childhood obesity have been restricted to RCTs, so less is known about the effectiveness of these more upstream interventions. To address this gap, we conducted an overview of reviews of NRS interventions (NRSI), which assessed change in BMI in children and adolescents aged 5-18 years and compared NRSI findings with those from RCTs.

Methods: We searched five databases up to November 2024. Screening, data extraction, and quality assessment were performed using standardized tools.

Results: We included 28 systematic reviews and identified 136 NRSI either based in school (n = 118), community (n = 4) or combined settings (n = 14) and evaluating policy (n = 48), education (n = 11), or a combined intervention (n = 77). Twenty-six reviews included both NRSIs and RCTs; of these, 12 reported meta-analyses. Findings were largely unchanged when we excluded the RCTs and re-ran analyses. Overall, study-level results from the NRSI favored the intervention group; a quarter favored the comparison group. The meta-analysis summary effects from NRSIs were consistent with two recently published Cochrane meta-analyses of RCTs of obesity prevention interventions.

Conclusions: The results from this overview of reviews suggest researchers and policy makers can be confident in considering the results of robust nonrandomized study designs (evaluating their impact on BMI) alongside RCTs in their decision making. Although we identified a significant number of NRSIs for review, very few evaluations of upstream interventions were eligible for inclusion.