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Host-Microbiota Interactions in Obesity: Immune Metabolic Dysregulation. 肥胖中宿主-微生物群的相互作用:免疫代谢失调。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-04 DOI: 10.1111/obr.70110
Ning Zhihan, Gou Weiyu, Gan Luo, Yang Hong

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.

肥胖是一个严重的健康问题,对人类福祉构成严重威胁。肠道菌群紊乱被认为是导致肥胖的关键因素。肠道微生物产生脂多糖、短链脂肪酸和干扰机体免疫和代谢过程的细胞外囊泡。反过来,宿主衍生的外泌体、抗菌肽和干扰素系统破坏肠道微生物稳态,进一步影响代谢和免疫,并以多种方式促进肥胖。本文综述了宿主与微生物相互作用的免疫代谢机制,并阐述了肥胖病因学的最新研究进展。
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引用次数: 0
Global Prevalence of Obesity in Patients With Psoriatic Arthritis in the Past Four Decades: An Analysis of Trends From 1984 to 2024. 过去40年全球银屑病关节炎患者肥胖患病率:1984年至2024年趋势分析
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-04 DOI: 10.1111/obr.70088
Yuanting Yu, Jiao Wang, Xiaoying Sun, Liu Liu, Qingyun Wang, Pengbo Gao, Changxian Wang, Feng Li, Xin Li

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.

背景:尽管银屑病关节炎(PsA)和肥胖合并症的风险正在增加,但只有少数系统的全球患病率研究被进行。目的:本研究探讨了PsA患者中肥胖、腹部肥胖和超重的全球患病率。方法:对8个数据库从建立到2024年11月20日进行分析。使用R语言进行数据分析。meta回归和亚组分析用于评估合并研究的异质性。采用漏斗图和Egger’s检验评估纳入研究的发表偏倚,并采用修正填充法校正偏倚。结果:纳入27项研究。PsA患者中肥胖的总体患病率为35% (95% CI, 0.30 - 0.40)。患有PsA的成人肥胖患病率为35% (95% CI, 0.28 - 0.42),儿童和青少年肥胖患病率为27% (95% CI, 0.11 - 0.46)。非洲的患病率最高(57%;95% CI, 0.43至0.69)。相比之下,欧洲的患病率最低,为31% (95% CI, 0.25至0.38)。就国家而言,中国的患病率最高(65%),其次是埃及(57%)和挪威(55%)。美国的患病率最低(20%)。结论:这些发现证实了肥胖与PsA之间的关联。考虑到肥胖对PsA治疗的负面影响,应优先考虑肥胖的早期发现和管理。需要进一步以人群为基础的前瞻性观察性研究来阐明PsA患者肥胖共存的机制。
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引用次数: 0
Effects of Glucose-Lowering Medications on Intrapancreatic Fat Deposition: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 降糖药物对胰腺内脂肪沉积的影响:随机对照试验的系统回顾和荟萃分析。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 DOI: 10.1111/obr.70087
Harsen C Agon, Yan Shen, Maxim S Petrov

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.

背景:胰腺是重要的代谢器官,过量的胰腺内脂肪沉积(IPFD)与2型糖尿病的发病机制有关。虽然IPFD被认为是可逆的,但目前尚不清楚降糖药物是否能降低它。本研究旨在对调查此类药物对IPFD影响的随机对照试验(rct)进行全领域的系统评价。方法:检索三个电子数据库:medline、Embase和Cochrane Central Register of Controlled trials。比较药物干预与标准治疗或安慰剂对IPFD影响的随机对照试验使用随机效应模型进行meta分析。IPFD的平均差异及其相应的95%置信区间作为主要效果估计。结果:8项rct符合入选标准,其中5项为安慰剂对照。在整体分析中,降糖药物与IPFD的显著降低相关(平均差异= -1.5;95% CI: -1.8, -1.1; p)。结论:降糖药物具有降低IPFD的潜力。严格设计的随机对照试验是有必要的,以确认IPFD对药物干预的反应性,并指导其临床应用。
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引用次数: 0
Association of Adverse Childhood Experiences and Metabolic Syndrome: A Systematic Review and Meta-Analysis. 不良童年经历与代谢综合征的关联:系统回顾和荟萃分析。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-27 DOI: 10.1111/obr.70095
Joohan Kim, Luyu Xie, Alejandra Fernandez, Jaime P Almandoz, Sarah E Messiah

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.

背景:童年不良经历(ace)与整个生命过程中的代谢综合征(MetS)及其组成部分(腹部肥胖、血压升高、血脂异常和高血糖)之间的关系尚不清楚。方法:从2000年1月至2024年2月发表的研究中筛选三个数据库,研究ACE和MetS之间的关系。提取相关数据,包括作者、国家、研究类型、参与者、ACE和MetS及其组成部分的类型和数量。使用Mantel-Haenszel随机效应模型对ACE暴露与MetS及其各个组成部分的关系进行meta分析。结果:共有16篇论文(14篇成人样本,2篇青少年样本)符合纳入标准,10篇论文符合meta分析的条件。暴露≥1 ACE与MetS之间存在显著相关性(优势比[OR] = 1.24, 95%可信区间[CI] 1.18-1.29, I2 = 82.2%, p 2 = 63.1%, p = 0.019)。高血糖患者与≥1 ACE相关(OR = 1.27, 95% CI 1.20-1.33, I2 = 88.1%, p 2 = 28.7%, p = 0.246)。关于ACE与血脂异常和腹部肥胖之间关系的研究有限。一些研究表明,与非西班牙裔白人相比,少数种族/民族的ACE和MetS之间的关联更强。结论:结果显示ACE和MetS之间存在剂量-反应关系。这些发现可以为制定有针对性的干预措施和政策提供信息,以减轻ACE暴露个体的MetS风险,特别是那些可能处于高风险的种族/少数民族人群。
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引用次数: 0
Systematic Review of Loneliness and Social Isolation Interventions in Obesity and Obesity-Related Complications. 孤独和社会隔离干预肥胖及肥胖相关并发症的系统综述
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-26 DOI: 10.1111/obr.70099
Ghada Alsultany, Milan Piya, Kathryn Williams, Kate A McBride

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.

患有肥胖和肥胖相关并发症的人正在经历社会隔离和孤独(SIL),他们患更多疾病特异性并发症、存在合并症和死亡率的风险更高。针对SIL的干预措施可能对这一人群有益,尽管这一领域的研究有限。本研究旨在系统回顾有关肥胖及肥胖相关并发症患者SIL干预措施的文献。在SCOPUS、PsycINFO和EMBASE数据库中搜索符合条件的文章。将研究上传到covid,进行标题、摘要和全文筛选、数据提取和质量评估。在被筛选的3521项研究中,有19项被纳入。研究根据是亲自进行还是通过技术进行,以及在团体或个人环境中进行进行分组,以个人为基础的干预措施更有可能报告有效性。干预措施也分为四种类型——治疗性、陪伴性、社会活动或身体类型——研究主要包括治疗性干预措施。由于研究的异质性,从有关有效性的数据中得出的结论有限。尽管有限的研究结果与该主题的新兴性质一致,但它强调需要更多的研究来开发针对肥胖和肥胖相关并发症个体的有针对性和强大的SIL干预措施。
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引用次数: 0
The Complex Relation of Branched-Chain Amino Acids and Inflammation in the Obesity and Diabetes Context. 支链氨基酸与肥胖和糖尿病炎症的复杂关系。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-22 DOI: 10.1111/obr.70092
Bernardo Starling-Soares, Monique Macedo Coelho, Bruna Guerra Campolina, Camila Kümmel Duarte, Tatiani Uceli Maioli

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.

随着全球肥胖和糖尿病病例的增加,支链氨基酸(BCAA)代谢已成为了解这些病理的重要因素。最近,它的慢性高血浆水平与葡萄糖、炎症因子和其他分子一起被认为是胰岛素抵抗的重要预测指标。高脂肪饮食方案和模拟肥胖和2型糖尿病的模型已经阐明了我们对这些具有重要炎症方面的疾病如何影响几种组织中的BCAA分解代谢及其全身效应的认识。另一方面,已经在几个实验模型中研究了BCAA补充剂,旨在了解其在炎症中的作用。有证据表明,慢性低度炎症状态是几种与年龄相关的病理状况的重要因素,其存在以促炎细胞因子增强、高葡萄糖和BCAA水平为特征,将是一个决定性因素。虽然,BCAA和炎症之间的关系是复杂的,我们目前的知识还不能确定这些氨基酸的致病作用,因为在大多数情况下,需要先前或伴随的刺激来证明它们在炎症调节中的作用。
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引用次数: 0
Effect of Citrus bergamia Supplementation on Body Composition in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 补充佛手柑对人体成分的影响:随机对照试验的系统回顾和荟萃分析。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-22 DOI: 10.1111/obr.70094
Carmelo Pujia, Yvelise Ferro, Alberto Castagna, Elisa Mazza, Samantha Maurotti, Francesca Rita Noto, Valeria Rizzo, Tiziana Montalcini, Arturo Pujia

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).

本研究对随机对照试验(RCTs)进行了系统回顾和荟萃分析,通过评估与肥胖相关的措施,评估含有佛手柑的营养保健品对成人肥胖管理的影响。截至2024年10月,我们检索了以下数据库:PubMed、Web of Science、Scopus和Cochrane Central Register of Controlled Trials。纳入标准为成人(≥18岁)、使用含有伯格氏梭菌的营养保健品、干预时间≥4周的随机对照试验。数据提取的重点是体重减轻、体重指数、腰围、腰臀比和体脂率,并使用修订后的Cochrane风险偏倚工具评估偏倚风险。在966份报告中,11项随机对照试验符合纳入meta分析的条件。采用随机效应模型的综合结果显示,补充贝加曼菌可显著降低体重(SMD: -0.64; 95% CI: -1.15, -0.13; p = 0.01; I2 = 90%)、体重指数(SMD: -0.85; 95% CI: -1.35, -0.35; p = 0.0008; I2 = 90%)和腰围(SMD: -0.41; 95% CI: -0.65, -0.16; p = 0.001; I2 = 49%)。然而,含佛手柑的营养保健品对其他身体成分参数没有显著影响。亚组分析表明,佛手柑摄入量在≤12周的时间内显著改变了人体测量参数,剂量≤600毫克/天,超重和肥胖的参与者。总的来说,目前的荟萃分析表明,含有羊绒梭菌的营养品在预防和控制肥胖方面有希望。试验注册:国际前瞻性系统评价注册(PROSPERO): CRD42023465541 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=465541)。
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引用次数: 0
Efficacy of Weight-Lowering Agents on Fat Distribution: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. 减肥药对脂肪分布的影响:随机对照试验的系统评价和网络荟萃分析。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-19 DOI: 10.1111/obr.70100
Xiuqi Qiao, Weihao Wang, Jiaming Cao, Lixin Guo, Qi Pan

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.

背景:药物治疗为超重和肥胖个体减轻体重提供了一种潜在的解决方案。然而,关于抗肥胖药物对身体脂肪分布的影响的知识有限。方法:检索PubMed、Embase和Cochrane图书馆数据库,收集从研究开始到2023年5月23日期间有关减肥药的随机对照试验(rct)。主要结果是内脏和皮下脂肪组织(VAT和SAT)。次要结果是体重和腰围的改变。统计分析采用STATA 14.0,随机效应网络meta分析采用频率分析方法。结果:共纳入39篇文献,41篇rct, 2741例患者。GLP-1受体激动剂和SGLT-2抑制剂在平均29.4周后观察到降低VAT(-0.90[-1.32至-0.47]和-0.66[-1.22至-0.10]),而只有GLP-1受体激动剂降低SAT(-1.01[-1.58至-0.43])。纳曲酮-安非他酮、GLP-1受体激动剂、SGLT-2抑制剂和二甲双胍均可减轻体重(-5.60[-8.64至-2.56]kg, -4.73[-5.58至-3.88]kg, -3.20[-4.69至-1.72]kg, -1.93[-3.01至-0.85]kg)。最后,GLP-1受体激动剂、二甲双胍、SGLT-2抑制剂和纳曲酮-安非他酮能降低腰围。结论:GLP-1受体激动剂在降低VAT和SAT方面可能比其他抗肥胖药物有优势,SGLT-2抑制剂在降低VAT方面更有帮助。临床意义在于医生能够根据患者的脂肪分布选择合适的减肥药。
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引用次数: 0
Maternal Obesity and MicroRNAs in Breast Milk: Implications for Infant Developmental Programming. 母亲肥胖和母乳中的microrna:对婴儿发育规划的影响。
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-19 DOI: 10.1111/obr.70098
Gyslane M Santos, Fabíola Isabel Suano de Souza, Luciana P Pisani

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.

这篇综述探讨了母亲肥胖与母乳中microRNAs (miRNAs)表达变化之间的关系,强调了这些变化如何影响婴儿的发育程序。有证据表明,母亲肥胖会影响母乳的生物活性成分,包括miRNA谱,而miRNA谱是生命早期代谢和免疫途径的关键调节因子。特异性mirna,如miR-148a和miR-30b,已被确定为代谢过程的调节剂,可能影响后代的生长、能量平衡和长期健康结果。此外,母亲的因素,如孕前体重指数和饮食模式在形成牛奶成分中起着至关重要的作用。了解这些复杂的相互作用对于制定营养策略至关重要,这些营养策略旨在支持婴儿的最佳发育和预防生命后期的慢性疾病。
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引用次数: 0
Interventions for Preventing Obesity in Children and Adolescents Aged 5-18 Years: An Overview of Nonrandomized Study Evidence Reported in 28 Systematic Reviews. 预防5-18岁儿童和青少年肥胖的干预措施:28篇系统评价报告的非随机研究证据综述
IF 7.4 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-16 DOI: 10.1111/obr.70090
Francesca Spiga, Jelena Savović, Carolyn D Summerbell, Hannah Picton, Theresa H M Moore, Deborah M Caldwell, Julian P T Higgins

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.

社区和人口水平以及政策干预通常使用非随机研究(NRS)来评估,而不是随机试验(rct)。最近关于预防儿童肥胖的干预措施的Cochrane综述仅限于随机对照试验,因此对这些更上游的干预措施的有效性知之甚少。为了解决这一差距,我们对NRS干预(NRSI)进行了综述,评估了5-18岁儿童和青少年的BMI变化,并将NRSI的结果与随机对照试验的结果进行了比较。方法:检索截至2024年11月的5个数据库。使用标准化工具进行筛选、数据提取和质量评估。结果:我们纳入了28项系统评价,并确定了136项NRSI,这些NRSI基于学校(n = 118)、社区(n = 4)或联合环境(n = 14),评估政策(n = 48)、教育(n = 11)或联合干预(n = 77)。26篇综述包括NRSIs和rct;其中12篇报道了荟萃分析。当我们排除随机对照试验和重新分析时,结果基本不变。总的来说,NRSI的研究水平结果有利于干预组;四分之一的人支持对照组。这项荟萃分析总结了nrsi的效果,与最近发表的两项关于肥胖预防干预的随机对照试验的Cochrane荟萃分析一致。结论:本综述的结果表明,研究人员和政策制定者在决策时可以自信地考虑稳健的非随机研究设计(评估其对BMI的影响)和随机对照试验的结果。虽然我们确定了大量的nrsi进行审查,但很少有上游干预措施的评估符合纳入条件。
{"title":"Interventions for Preventing Obesity in Children and Adolescents Aged 5-18 Years: An Overview of Nonrandomized Study Evidence Reported in 28 Systematic Reviews.","authors":"Francesca Spiga, Jelena Savović, Carolyn D Summerbell, Hannah Picton, Theresa H M Moore, Deborah M Caldwell, Julian P T Higgins","doi":"10.1111/obr.70090","DOIUrl":"https://doi.org/10.1111/obr.70090","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>We searched five databases up to November 2024. Screening, data extraction, and quality assessment were performed using standardized tools.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70090"},"PeriodicalIF":7.4,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987428","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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Obesity Reviews
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