Obesity Reviews最新文献

Polycystic ovary syndrome (PCOS) is a common endocrine disorder with a complex pathogenesis that includes disordered follicle development, hypothalamic–pituitary–ovarian (HPO) axis dysfunction, hyperandrogenemia, and insulin resistance. The risk of complications during pregnancy, such as gestational diabetes mellitus (GDM) and preeclampsia (PE), among PCOS patients is higher than that in the general population. Kisspeptin (KP) is a peptide hormone widely expressed in the hypothalamus, limbic system, gonads, pancreas, and liver; it is highly expressed in the placenta and is considered to play an important role in pregnancy. Therefore, the aim of this review is to summarize the complex relationships among KP levels and pregnancy complications in PCOS and to provide a comprehensive understanding of the role of KP throughout pregnancy in PCOS patients. In our summary of the existing research, we provide information regarding the direct impact of high prepregnancy KP levels in PCOS patients on early embryo implantation and placental development, leading to abnormal KP levels during pregnancy and ultimately increasing the risk of complications such as gestational GDM and PE.

Obesity, particularly pediatric obesity, has dramatically increased over the last three decades, with a wide range of detrimental health outcomes, including negative consequences for brain neurodevelopment. The present article reviewed magnetic resonance imaging studies between January 2011 and March 2024 examining the brain's role in pediatric obesity, including parental influences and diverse interventions. A literature search identified 97 eligible MRI studies in the pediatric population. Findings suggest that altered brain structures and functions in pediatric obesity are strongly dependent on the developmental stage of children and adolescents. The function and structure of limbic regions, such as the hippocampus, amygdala, and striatum, as well as the prefrontal cortex, seem to be particularly affected by higher body mass index during development. In response to palatable foods, children and adolescents with excess weight have increased activation in reward-related regions and decreased activation in regions involved in interoceptive signal processing, especially during decision processes. In addition, children of mothers with obesity and gestational diabetes mellitus show alterations in brain structure and function independent of their current obesity. Behavioral, exercise, and weight-loss intervention studies showed promising effects on the brain, with increased structural integrity, decreased brain responses to reward, and strengthened inhibitory brain responses in children and adolescents with excess weight after the intervention.

Adolescence (10–19 years) is a pivotal life stage, presenting both risks and opportunities for optimizing nutrition. There are global calls advocating for adolescents to play a central role in transforming food environments. The extent to which adolescents have participated in research to improve food environments is unknown. A scoping review was conducted to investigate the extent, impact, and processes of adolescent participation in food environment research. Included studies were mapped through the Healthy Food Environment Policy Index. Extent, impact (individual/community/national/international-level), and processes (barriers/enablers) were analyzed. Adolescent co-researchers informed each stage. Eighty-nine articles (70 unique studies with 20,697 participants across 31 countries) were identified. Most (81%) were conducted in high-income countries. Food retail (56%) and provision (54%) were most reported, improving the availability of healthy food in their local community and school. Most were adolescent-led (41%); however, only 16% included adolescents throughout each research stage. Impact included improved professional skills and implemented policy. Using engaging participatory methods helped reduce power imbalances. There is substantial evidence of adolescents participating in various modes, methods, and levels of research to transform healthy food environments through policy, demonstrating adolescents can be central actors for change. Ensuring diverse representation from priority population groups and lower-income countries is necessary to reduce the global noncommunicable disease burden.

Obesity is a chronic metabolic disease characterized by disturbances in energy homeostasis, leading to excessive fat accumulation. The pathogenesis of the disease is shaped by a complex interplay of genetic, epigenetic, biological, psychological, and environmental factors. These contributors affect regulatory mechanisms in the hypothalamus, hormonal signaling, and the gut-brain axis, all of which control energy intake, expenditure, and energy utilization in body tissues. In this context, particular attention is given to the role of genetic factors, which have a major impact on an individual's susceptibility to disease and support the development of personalized preventive and therapeutic approaches. Modern obesity treatment goes beyond weight reduction and focuses on optimizing body composition by reducing fat mass and increasing lean mass. This review includes a detailed overview of the mechanisms and clinical effects of current pharmacological approaches to obesity treatment, alongside other established strategies such as lifestyle modifications and bariatric surgery. It specifically discusses lipase inhibitors, opioid antagonists, sympathomimetics, and GLP-1 receptor agonists. Looking ahead, emerging therapies—such as microbiota modulation, dual and triple drug combinations, PYY agonists, and monoclonal antibodies—are expected to play a crucial role in the management of obesity. Furthermore, this review explores the potential of CRISPR-based technology for monogenic obesity, opening new avenues for targeted obesity treatments and identifying promising research directions. In the time to come, personalized medicine might have a fundamental place in the management of obesity, providing tailored and more effective therapeutic approaches that prioritize the long-term improvement of body composition and health outcomes in patients.