Obesity Reviews最新文献

Cardiovascular–kidney–metabolic (CKM) syndrome is a complex interaction of cardiovascular diseases, chronic kidney disease (CKD), and metabolic disorders, with its global prevalence rising due to increasing obesity and metabolic risk factors. The convergence of these conditions significantly worsens patient outcomes, leading to higher morbidity and mortality rates. Key pathophysiological mechanisms underpinning CKM syndrome include insulin resistance, oxidative stress, inflammation, and vascular dysfunction, all of which are exacerbated by reduced nitric oxide (NO) bioavailability and associated signaling dysfunctions. In clinical practice, organic nitrate has been used as NO donors; however, issues such as tolerance, side effects, and endothelial damage limit their effectiveness. The inorganic nitrate–nitrite–NO pathway offers a promising alternative, as emerging evidence from animal and human studies suggests that enhancing this pathway can significantly improve the progression of metabolic disorders, cardiovascular diseases, and CKD. The potential mechanisms may lie in its ability to improve the core pathophysiological processes of CKM syndrome, including inflammation, oxidative stress, insulin resistance, and vascular dysfunction. This review synthesizes current preclinical and clinical studies, highlighting the effects of inorganic nitrate and nitrite in managing CKM syndrome and suggesting avenues for future exploration.

Women with a raised body mass index are likely to take longer to conceive and have poorer outcomes from fertility treatment. Furthermore, fertility clinics commonly require women to have body mass index < 30 kg/m² prior to treatment. Consequently, many women face the challenge of needing to lose weight to improve their chances of conception or to become eligible for fertility treatment. For these women, there is an additional pressure to lose weight quickly due to the diminishment in reproductive potential with advancing age. Synthetic glucagon-like peptide-1 receptor agonists have been shown to cause rapid weight loss in individuals with obesity, as well as reversing some of the metabolic dysfunction associated with obesity and polycystic ovarian syndrome. The potential effect of preconception glucagon-like peptide-1 receptor agonist therapy to increase the chance of pregnancy in women with obesity is an emerging area of research. If this treatment proves to be safe and effective, it could provide significant benefits for many overweight women facing infertility. This article summarizes our understanding of the effect of obesity and polycystic ovarian syndrome on fertility and the success of assisted reproductive techniques. It also describes the traditional treatments for obesity, the pharmacology of glucagon-like peptide-1 receptor agonists, and the evidence for glucagon-like peptide-1 receptor agonists in improving fertility and pregnancy outcomes in overweight women, as well as the potential safety and ethical issue.

The global burden of chronic kidney disease (CKD) continues to rise, posing major public health challenges, partly driven by increasing obesity rates. Obesity has been established as an independent risk factor for renal dysfunction, with a complex pathophysiology involving renal hemodynamic changes, inflammation, lipid accumulation, and metabolic disorders. Recent research has also underscored the potential role of gastrointestinal dysbiosis and specific endothelial cell characteristics. Current evidence indicates that the impact of obesity on renal function becomes more pronounced with advancing age, partly owing to the significant structural and functional alterations in kidneys associated with aging. Furthermore, the interaction between obesity and aging exerts a synergistic effect on renal function. Sex-related differences are also observed, with males generally experiencing earlier declines in renal function, while females with obesity may face more rapid changes, although this remains a debated issue. In this review, we provide a thorough summary of what is currently known about how obesity affects renal function, focusing on age- and sex-related differences and the underlying mechanisms. Bibliometric analyses are employed to summarize and visualize the evolving trends and emerging hotspots in this field. Furthermore, we discuss methods for assessing renal function, weight management strategies, and novel treatment avenues for older individuals with obesity, offering insights for the prevention or mitigation of renal dysfunction.

As “obesogenic environments” grow increasingly prevalent, obesity has become a pressing global health challenge. It has been somewhat overlooked that individual responses to this obesogenic condition tend to be varied, and the mechanism behind this variability remains poorly understood. In the current study, we seek to summarize recent studies of human subjects and rodents that aim to identify the predictive factors of the heterogeneity of obesity. These factors include baseline fat mass (FM), fat-free mass (FFM), muscle oxidative capacity, VO₂max, androgen level, plasma leptin level, physical activity (PA), energy intake (EI), and genes such as SFRP5, MEST, and BMP3. Influenced by both genetic and environmental conditions, these factors provide a comprehensive framework for understanding the causes why individuals, even under the same obesogenic environment, exhibit differing weight gain responses. Our review synthesizes the existing literature to highlight these predictive factors, such as FM and FFM, as strong potential indicators of future weight gain and obesity risk. Integrating these factors into a unified framework not only enhances our understanding of obesity susceptibility but also provides a foundation for developing personalized obesity prevention and treatment strategies.