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Causality of visceral adipose tissue on chronic kidney disease and renal function measure indicators, and mediation role of hypertension: Mendelian randomization study. 内脏脂肪组织对慢性肾脏病和肾功能测量指标的因果关系及高血压的中介作用:孟德尔随机研究
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-10 DOI: 10.1111/obr.13845
Teng-Yu Gao, Jun-Chi Wang, Qi-Jian Zhao, Xiang-Ning Zhou, Yu-Ting Jiang, Lian Ren, Chao Zhang

Although chronic kidney disease (CKD) is associated with obesity, few studies have used visceral adipose tissue (VAT) as an indicator to investigate its causal effect on CKD. Therefore, Mendelian randomization (MR) was employed to study the causal effects of VAT on CKD and its potential mediation by hypertension. Genome-wide association study (GWAS) statistics on VAT exposure were obtained from the UK Biobank, while GWAS datasets of CKD outcomes were obtained from CKDGen and FinnGen (validation study). Furthermore, VAT was considered the exposure, with the estimated glomerular filtration rate based on creatinine (eGFR (crea)), estimated glomerular filtration rate based on cystatin C (eGFR(cys)), and blood urea nitrogen (BUN) employed to assess the causal effect of VAT on kidney test indicators. Lastly, a two-step MR method was used to study the mediating role of hypertension in the pathogenesis of VAT among patients with CKD. VAT exhibited a positive causal association with CKD, irrespective of whether the GWAS datasets from CKDGen (odds ratio [OR] = 1.18, 95% CI: 1.08 to 1.29, P = 1.433140e-04) or FinnGen (1.47, 1.30 to 1.67, p = 2.500000e-09). VAT was not causally associated with eGFR (crea) (1.00, 0.99 to 1.00, p = 0.53), was negatively associated with eGFR (cys) (0.95, 0.93 to 0.97, P = 5.070000e-10), and was positively associated with BUN (1.02,1.01 to 1.02, P = 7.824860e-04). The mediating effect of VAT on CKD via hypertension was 45.8% (95% CI: 26.4 65.1). VAT has a positive causal effect on CKD, with hypertension playing a significant role. However, the effects of VAT on renal function indicators require further investigation.

虽然慢性肾脏病(CKD)与肥胖有关,但很少有研究使用内脏脂肪组织(VAT)作为指标来研究其对慢性肾脏病的因果效应。因此,研究人员采用孟德尔随机法(MR)研究了内脏脂肪组织对 CKD 的因果效应及其与高血压的潜在中介作用。有关增值税暴露的全基因组关联研究(GWAS)统计数据来自英国生物库,而有关 CKD 结果的 GWAS 数据集来自 CKDGen 和 FinnGen(验证研究)。此外,将增值税视为暴露,并采用基于肌酐的估计肾小球滤过率(eGFR (crea))、基于胱抑素 C 的估计肾小球滤过率(eGFR(cys))和血尿素氮(BUN)来评估增值税对肾脏检测指标的因果效应。最后,采用两步磁共振法研究了高血压在 CKD 患者 VAT 发病机制中的中介作用。无论 GWAS 数据集是来自 CKDGen(几率比 [OR] = 1.18,95% CI:1.08 至 1.29,P = 1.433140e-04)还是 FinnGen(1.47,1.30 至 1.67,P = 2.500000e-09),VAT 都与 CKD 呈正因果关系。VAT 与 eGFR(crea)(1.00,0.99 至 1.00,P = 0.53)无因果关系,与 eGFR(cys)呈负相关(0.95,0.93 至 0.97,P = 5.070000e-10),与 BUN 呈正相关(1.02,1.01 至 1.02,P = 7.824860e-04)。VAT 通过高血压对 CKD 的中介效应为 45.8%(95% CI:26.4 65.1)。VAT 对 CKD 具有积极的因果效应,高血压在其中发挥了重要作用。然而,增值税对肾功能指标的影响还需要进一步研究。
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引用次数: 0
Weight/height2: Mathematical overview of the world's most widely used adiposity index. 体重/身高2:世界上最广泛使用的脂肪指数的数学概述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-10 DOI: 10.1111/obr.13842
Steven B Heymsfield, John D Sorkin, Diana M Thomas, Shengping Yang, Moonseong Heo, Cassidy McCarthy, Jasmine Brown, Angelo Pietrobelli

A footnote in Adolphe Quetelet's classic 1835 Treatise on Man described his algebraic analysis of how body weight ( W $$ W $$ ) varies with height ( H $$ H $$ ) in adult males and females. Using data on 12 short and 12 tall subjects of each sex, Quetelet established the rule that W $$ W $$ is approximately proportional ( $$ propto $$ ) to H2 in adults; that is, W H 2 $$ Wpropto {H}^2 $$ when W α H 2 $$ Wapprox alpha {H}^2 $$ for some constant α $$ alpha $$ . Quetelet's Rule ( W H 2 $$ Wpropto {H}^2 $$ ), transformed and renamed in the twentieth century to body mass index ( BMI = W / H 2 $$ mathrm{BMI}=W/{H}^2 $$ ), is now a globally applied phenotypic descriptor of adiposity at the individual and population level. The journey from footnote to ubiquitous adiposity measure traveled through hundreds of scientific reports and many more lay publications. The recent introduction of highly effective pharmacologic weight loss treatments has heightened scrutiny of BMI's origins and appropriateness as a gateway marker for diagnosing and monitoring people with obesity. This contemporary context prompted the current report that delves into the biological and mathematical paradigms that underlie the simple index BMI = W / H 2 $$ mathrm{BMI}=W/{H}^2 $$ . Students and practitioners can improve or gain new insights into their understanding of BMI's historical origins and quantitative underpinning from the provided overview, facilitating informed use of BMI and related indices in research and clinical settings.

阿道夫-奎特莱(Adolphe Quetelet)在 1835 年的经典著作《人论》中的一个脚注描述了他对成年男性和女性体重(W $$ W $$)随身高(H $$ H $$)变化的代数分析。奎特莱利用男女各12名矮个子和12名高个子受试者的数据,建立了成人W $$ W $$与H2近似成正比(∝ $$ propto $$)的规则;也就是说,当W ≈ α H 2 $$ Wapprox alpha {H}^2$为某个常数α $$ alpha $$时,W ∝ H 2 $$ Wpropto {H}^2$。Quetelet's Rule ( W ∝ H 2 $$ Wpropto {H}^2 $$),在二十世纪被转换并更名为身体质量指数(BMI = W / H 2 $$ mathrm{BMI}=W/{H}^2$$),现在已成为全球应用的个体和人群脂肪含量的表型描述符。从脚注到无处不在的脂肪测量方法,其间经历了数百份科学报告和更多的非专业出版物。最近推出的高效药物减肥疗法,使人们更加关注 BMI 作为诊断和监测肥胖症患者的入口标志的起源和适宜性。在这一时代背景下,本报告深入探讨了简单指数 BMI = W / H 2 $$ mathrm{BMI}=W/{H}^2 $$ 的生物学和数学范式。学生和从业人员可以从所提供的概述中提高对 BMI 的历史渊源和定量基础的理解或获得新的见解,从而有助于在研究和临床环境中明智地使用 BMI 和相关指数。
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引用次数: 0
A review on drug repurposing applicable to obesity. 回顾适用于肥胖症的药物再利用。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1111/obr.13848
Feng Chen, Kai Jing, Zhen Zhang, Xia Liu

Obesity is a major public health concern and burden on individuals and healthcare systems. Due to the challenges and limitations of lifestyle adjustments, it is advisable to consider pharmacological treatment for people affected by obesity. However, the side effects and limited efficacy of available drugs make the obesity drug market far from sufficient. Drug repurposing involves identifying new applications for existing drugs and offers some advantages over traditional drug development approaches including lower costs and shorter development timelines. This review aims to provide an overview of drug repurposing for anti-obesity medications, including the rationale for repurposing, the challenges and approaches, and the potential drugs that are being investigated for repurposing. Through advanced computational techniques, researchers can unlock the potential of repurposed drugs to tackle the global obesity epidemic. Further research, clinical trials, and collaborative efforts are essential to fully explore and leverage the potential of drug repurposing in the fight against obesity.

肥胖症是一个重大的公共卫生问题,也是个人和医疗系统的负担。由于调整生活方式所面临的挑战和局限性,建议考虑对肥胖症患者进行药物治疗。然而,现有药物的副作用和有限疗效使得肥胖症药物市场远远不够。药物再利用包括为现有药物寻找新的应用领域,与传统的药物开发方法相比,它具有成本低、开发时间短等优势。本综述旨在概述抗肥胖药物的再利用,包括再利用的理由、挑战和方法,以及正在进行再利用研究的潜在药物。通过先进的计算技术,研究人员可以发掘再利用药物的潜力,解决全球肥胖症流行的问题。进一步的研究、临床试验和合作努力对于充分探索和利用药物再利用在对抗肥胖症方面的潜力至关重要。
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引用次数: 0
Correction to "Role of telemedicine in the management of obesity: State of the art review". 更正 "远程医疗在肥胖症管理中的作用:最新进展回顾"。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-09 DOI: 10.1111/obr.13846
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引用次数: 0
Efficacy of interventions aimed at reducing explicit and implicit weight bias in healthcare students: A systematic review and meta-analysis. 旨在减少医学生显性和隐性体重偏差的干预措施的效果:系统回顾和荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13847
Ravisha S Jayawickrama, Briony Hill, Moira O'Connor, Stuart W Flint, Erik Hemmingsson, Lucy R Ellis, Yaxing Du, Blake J Lawrence

We conducted a systematic review and meta-analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random-effects meta-analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta-analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = -0.31 (95% CI = -0.43 to -0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = -0.12 (95% CI = -0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I2 = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta-analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies.

我们进行了一项系统综述和荟萃分析,以确定旨在减少医学生体重偏差的干预措施的效果,并探讨可能影响干预成功的因素。我们通过系统综述和随机效应荟萃分析,收录了针对医学生的减轻体重偏差干预效果的研究。在筛选出的 3463 篇期刊论文和学位论文中,有 67 项研究(64 条记录内)符合纳入标准,其中 35 项研究被纳入荟萃分析(显性 = 35,隐性[和显性] = 10),32 项研究被纳入叙述性综合(显性 = 34,隐性[和显性] = 3)。体重偏差干预的影响较小,但具有积极意义,g = -0.31 (95% CI = -0.43 to -0.19, p 2 = 74.28, Q = 132.21, df = 34, p 0.05),无法解释观察到的异质性。叙述性综述支持荟萃分析结果。显性体重偏差的减少幅度虽小,但意义重大,这鼓励人们继续对干预措施进行测试,而不管干预措施的各个组成部分是否存在差异。与此相反,内隐体重偏差的减少只有在社会对体重较大者的负面信念和态度发生巨大转变时才有可能实现。
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引用次数: 0
Bariatric surgeries and cardiac structure and function: Systematic review and network meta-analysis. 减肥手术与心脏结构和功能:系统回顾和网络荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13843
Xiao-Qian Zhang, Ke-Ning Chen, Zu-Xuan Zhang, Nian-Rong Zhang, Fang-Jie-Yi Zheng, Biao Zhou, Hua Meng, Zhi-Xin Zhang, Wen-Quan Niu

Background: Obesity, a global health problem, is causally implicated in the development of cardiovascular disease. Bariatric surgeries are effective treatment options for obesity; however, the effectiveness of different bariatric surgeries on cardiac structure and function is not fully understood. We undertook a systematic review and network meta-analysis to comprehensively assess this effectiveness.

Data source: PubMed, Web of Science, and EMBASE were searched from their inception until November 11, 2023. Studies that compared bariatric surgeries vis-à-vis non-surgical treatment, placebo, and other bariatric surgeries, as well as reported changes in left ventricular mass or its index (LVM or LVMI) or left ventricular ejection fraction (LVEF), were summarized.

Results: Total 19 studies (17 cohort studies and 2 randomized controlled trials) and 2012 adults were meta-analyzed. Patients receiving gastric bypass had appreciably lowered LVM (weighted mean difference [WMD]: -43.86 g, 95% confidence interval [CI] -61.09 to -26.63, p < 0.01) and LVMI (standardized mean difference: -0.67, 95% CI -1.03 to -0.32, p < 0.01) compared with other bariatric surgeries. No significant improvement in LVEF was noted across all surgeries. The drop in body mass index was most pronounced for biliopancreatic diversion with duodenal switch (WMD -16.33 kg/m2, 95% CI -21.60 to -11.05, p < 0.01).

Conclusions: Our findings of this network meta-analysis indicated that gastric bypass proved best for the improvement in cardiac structure, and there was no obvious improvement in cardiac function for all bariatric surgeries. Further studies are required to better understand the differing effectiveness of bariatric surgeries on cardiac structure and function and the underlying molecular mechanisms.

背景:肥胖症是一个全球性的健康问题,与心血管疾病的发生有着因果关系。减肥手术是治疗肥胖症的有效方法;然而,不同减肥手术对心脏结构和功能的效果尚不完全清楚。我们进行了一项系统综述和网络荟萃分析,以全面评估这种有效性:我们对 PubMed、Web of Science 和 EMBASE 进行了检索,检索时间从开始到 2023 年 11 月 11 日。对减肥手术与非手术治疗、安慰剂和其他减肥手术进行比较的研究,以及报告左心室质量或其指数(LVM 或 LVMI)或左心室射血分数(LVEF)变化的研究进行了汇总:共对 19 项研究(17 项队列研究和 2 项随机对照试验)和 2012 名成人进行了荟萃分析。接受胃旁路手术的患者LVM明显降低(加权平均差[WMD]:-43.86 g,95%置信区间[CI]-61.09至-26.63,P 2,95%CI-21.60至-11.05,P 结论:我们的这项网络荟萃分析结果表明,接受胃旁路手术的患者LVM明显降低:我们的网络荟萃分析结果表明,胃旁路手术对心脏结构的改善效果最好,而所有减肥手术对心脏功能的改善效果都不明显。要更好地了解减肥手术对心脏结构和功能的不同效果及其潜在的分子机制,还需要进一步的研究。
{"title":"Bariatric surgeries and cardiac structure and function: Systematic review and network meta-analysis.","authors":"Xiao-Qian Zhang, Ke-Ning Chen, Zu-Xuan Zhang, Nian-Rong Zhang, Fang-Jie-Yi Zheng, Biao Zhou, Hua Meng, Zhi-Xin Zhang, Wen-Quan Niu","doi":"10.1111/obr.13843","DOIUrl":"https://doi.org/10.1111/obr.13843","url":null,"abstract":"<p><strong>Background: </strong>Obesity, a global health problem, is causally implicated in the development of cardiovascular disease. Bariatric surgeries are effective treatment options for obesity; however, the effectiveness of different bariatric surgeries on cardiac structure and function is not fully understood. We undertook a systematic review and network meta-analysis to comprehensively assess this effectiveness.</p><p><strong>Data source: </strong>PubMed, Web of Science, and EMBASE were searched from their inception until November 11, 2023. Studies that compared bariatric surgeries vis-à-vis non-surgical treatment, placebo, and other bariatric surgeries, as well as reported changes in left ventricular mass or its index (LVM or LVMI) or left ventricular ejection fraction (LVEF), were summarized.</p><p><strong>Results: </strong>Total 19 studies (17 cohort studies and 2 randomized controlled trials) and 2012 adults were meta-analyzed. Patients receiving gastric bypass had appreciably lowered LVM (weighted mean difference [WMD]: -43.86 g, 95% confidence interval [CI] -61.09 to -26.63, p < 0.01) and LVMI (standardized mean difference: -0.67, 95% CI -1.03 to -0.32, p < 0.01) compared with other bariatric surgeries. No significant improvement in LVEF was noted across all surgeries. The drop in body mass index was most pronounced for biliopancreatic diversion with duodenal switch (WMD -16.33 kg/m<sup>2</sup>, 95% CI -21.60 to -11.05, p < 0.01).</p><p><strong>Conclusions: </strong>Our findings of this network meta-analysis indicated that gastric bypass proved best for the improvement in cardiac structure, and there was no obvious improvement in cardiac function for all bariatric surgeries. Further studies are required to better understand the differing effectiveness of bariatric surgeries on cardiac structure and function and the underlying molecular mechanisms.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142386795","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}
引用次数: 0
Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose-response meta-analysis of epidemiological studies with GRADE assessment. 膳食钙摄入量与成人代谢综合征的关系:通过 GRADE 评估对流行病学研究进行系统回顾和剂量反应荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-08 DOI: 10.1111/obr.13850
Roxana Nematbakhsh, Parisa Rouhani, Parvane Saneei

Numerous studies have examined the relationship of calcium intake and metabolic syndrome (MetS) in adults in previous decades; but the results were inconsistent across different societies. This systematic review and dose-response meta-analysis assessed the relation between calcium consumption and MetS in adults. We did a systematic search of all articles published up to July 2023 in Scopus, PubMed/Medline, ISI Web of Science electronic databases, and Google Scholar. Observational studies investigated the association between dietary calcium (Ca) intake and MetS in adults were eligible to be included. For computing the estimates, a random effects model was applied. Combining 24 effect size from 17 investigations (15 cross-sectional and two cohort studies) with 74,720 participants and 18,200 cases showed that highest versus lowest level of dietary Ca intake was related to 23% significant decreased odds of MetS (OR = 0.77; 95% CI: 0.66, 0.89). Linear dose-response analysis of estimates from 12 investigations showed that each 100 mg/day increment in dietary Ca intake was associated with 3% marginally significant decreased odds in MetS (OR = 0.97; 95%CI: 0.93, 1.01). In nonlinear dose-response analysis of 12 studies with 67,896 participants, a significant association between dietary calcium intake and MetS was found (Pnonlinearity <0.001); such that 500 mg/day dietary calcium intake was related to maximum decrease in odds of MetS. According to this meta-analysis, the likelihood of MetS was significantly lower in adults with higher level of dietary calcium intake. Further large-scale prospective cohort investigations are needed to obtain stronger and more accurate results.

在过去的几十年中,有许多研究探讨了成人钙摄入量与代谢综合征(MetS)之间的关系;但不同社会的研究结果并不一致。本系统综述和剂量反应荟萃分析评估了成人钙摄入量与代谢综合征之间的关系。我们对 Scopus、PubMed/Medline、ISI Web of Science 电子数据库和 Google Scholar 中截至 2023 年 7 月发表的所有文章进行了系统检索。研究成人膳食钙(Ca)摄入量与 MetS 之间关系的观察性研究均符合纳入条件。在计算估计值时,采用了随机效应模型。将来自 17 项调查(15 项横断面研究和 2 项队列研究)、74,720 名参与者和 18,200 个病例的 24 个效应大小合并显示,膳食钙摄入量最高与最低水平相比,MetS 发生几率显著降低 23% (OR = 0.77; 95% CI: 0.66, 0.89)。对 12 项调查的估计值进行的线性剂量反应分析表明,膳食中钙的摄入量每增加 100 毫克/天,MetS 的几率就会略微降低 3%(OR = 0.97;95%CI:0.93, 1.01)。在对 12 项研究的 67,896 名参与者进行的非线性剂量反应分析中,发现膳食钙摄入量与 MetS 之间存在显著关联(Pnonlinearity)。
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引用次数: 0
Metabolomics: Implication in cardiovascular research and diseases. 代谢组学:对心血管研究和疾病的影响。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-06 DOI: 10.1111/obr.13825
Amir Ajoolabady, Domenico Pratico, Warwick B Dunn, Gregory Y H Lip, Jun Ren

Cellular metabolism influences all aspects of cellular function and is crucial for overall organismal health. Metabolic disorders related to cardiovascular health can lead to cardiovascular diseases (CVDs). Moreover, associated comorbidities may also damage cardiovascular metabolism, exacerbating CVD and perpetuating a vicious cycle. Given the prominent role of metabolic alterations in CVD, metabolomics has emerged as an imperative technique enabling a comprehensive assessment of metabolites and metabolic architecture within the body. Metabolite profile and metabolic pathways help to deepen and broaden our understanding of complex genomic landscape and pathophysiology of CVD. Here in this review, we aim to overview the experimental and clinical applications of metabolomics in pathogenesis, diagnosis, prognosis, and management of various CVD plus future perspectives and limitations.

细胞代谢影响着细胞功能的方方面面,对整个机体的健康至关重要。与心血管健康有关的代谢紊乱可导致心血管疾病(CVD)。此外,相关的并发症也会损害心血管代谢,加剧心血管疾病,使恶性循环持续下去。鉴于代谢改变在心血管疾病中的突出作用,代谢组学已成为一项必要的技术,可对体内代谢物和代谢结构进行全面评估。代谢物图谱和代谢途径有助于加深和拓宽我们对心血管疾病复杂基因组图谱和病理生理学的理解。在这篇综述中,我们旨在概述代谢组学在各种心血管疾病的发病机制、诊断、预后和管理方面的实验和临床应用,以及未来的前景和局限性。
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引用次数: 0
Potential pathways to the onset and development of eating disorders in people with overweight and obesity: A scoping review. 超重和肥胖症患者饮食失调症发病和发展的潜在途径:范围综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-04 DOI: 10.1111/obr.13840
Rabia Khalid, Natalie B Lister, Susan J Paxton, Sarah Maguire, Sol Libesman, Anna L Seidler, Kelly Cooper, Fiona Quigley, Jacqlyn Yourell, Louise A Baur, Hiba Jebeile

Objective: To describe pathways to eating disorder (ED) development that have been evaluated in people with overweight and obesity.

Methods: Four databases were searched to identify studies testing ED development models in adolescents (10-19 years) or adults (>19 years) with overweight and obesity. Explanatory variables were thematically grouped into constructs to describe pathways to each ED outcome.

Results: Of 2226 studies screened, 46 (10 adolescent; 36 adult) were included. Study samples were predominantly female, ranging from 22 to 2236 participants and mean age 12.3 to 56.0 years. In total, 207 explanatory variables were grouped into 18 constructs to summarize 107 pathways that were identified. The most common ED outcome was binge eating (n = 24 studies), followed by global ED psychopathology (n = 10 studies). Across pathways to ED development, negative affect was the most proposed construct, followed by preoccupation with weight/shape and weight stigma.

Conclusion: Pathways to ED development in people with overweight and obesity are complex and may include more than 18 different explanatory factors of which negative affect, preoccupation with weight/shape, and weight stigma are the most common. More research on adolescents, males, and the spectrum of ED in diverse populations is required for early identification and intervention.

目的描述对超重和肥胖症患者饮食失调(ED)发展途径的评估:对四个数据库进行了检索,以确定对超重和肥胖青少年(10-19 岁)或成年人(19 岁以上)饮食失调发展模式进行测试的研究。对解释性变量进行了主题分组,以描述每种 ED 结果的形成途径:在筛选出的 2226 项研究中,有 46 项(10 项青少年研究;36 项成人研究)被纳入其中。研究样本以女性为主,参与者人数从 22 人到 2236 人不等,平均年龄为 12.3 岁到 56.0 岁。共有 207 个解释性变量被归类为 18 个结构,总结出 107 条路径。最常见的 ED 结果是暴饮暴食(24 项研究),其次是整体 ED 精神病理学(10 项研究)。在所有导致 ED 的发展途径中,消极情绪是提出最多的结构,其次是对体重/体形的关注和体重耻辱感:结论:超重和肥胖症患者发生肥胖症的途径非常复杂,可能包括超过 18 种不同的解释因素,其中负性情绪、对体重/体形的关注和体重耻辱感是最常见的因素。需要对青少年、男性和不同人群的 ED 范围进行更多研究,以便及早识别和干预。
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引用次数: 0
Investigating discrepancies in findings between rigorous randomized trials and meta-analyses evaluating pregnancy interventions to limit gestational weight gain. 调查评估限制妊娠体重增加的孕期干预措施的严格随机试验和荟萃分析结果之间的差异。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-03 DOI: 10.1111/obr.13826
Jodie M Dodd, Andrea R Deussen, Amanda J Poprzeczny, Laura J Slade, Megan Mitchell, Jennie Louise

Introduction: Robust randomized trials consistently demonstrate little impact from diet and physical activity interventions on gestational weight gain (GWG) and clinical outcomes, although meta-analyses report some benefit. Our aim was to evaluate the effect of trial quality on treatment effect estimates and review conclusions.

Methods: We conducted a systematic review of dietary and/or physical activity interventions for pregnant women with a body mass index ≥18.5 kg/m2. We assessed studies for risk of bias and methodological features impacting reliability. Outcomes included GWG; gestational diabetes mellitus (GDM); pre-eclampsia; caesarean birth; and birth weight measures. For each outcome, a sequence of meta-analyses was performed based on intervention group and level of potential bias in the effect estimate.

Results: We identified 128 eligible studies. The most robust estimate from a combined diet and physical activity behavioral intervention, with only studies at negligible risk of bias, was a difference in GWG of 1.10 kg (95% CI -1.62 to -0.58; 17,755 women). There was no evidence of an effect on any clinical outcomes.

Conclusions: Our findings highlight discrepancies produced by the indiscriminate inclusion of studies with methodological flaws in previous systematic reviews. Regular weighing of pregnant women is futile in the absence of clinical benefit.

导言:尽管荟萃分析表明饮食和体育锻炼干预对妊娠体重增加(GWG)和临床结果的影响很小,但可靠的随机试验始终证明了这一点。我们的目的是评估试验质量对治疗效果估计值和综述结论的影响:我们对体重指数≥18.5 kg/m2的孕妇的饮食和/或体力活动干预进行了系统性回顾。我们评估了研究的偏倚风险和影响可靠性的方法特征。结果包括妊娠体重指数(GWG)、妊娠糖尿病(GDM)、先兆子痫、剖腹产和出生体重测量。对于每项结果,我们都根据干预组和效应估计的潜在偏倚程度进行了一系列荟萃分析:我们确定了 128 项符合条件的研究。在只有偏倚风险可忽略不计的研究中,综合饮食和体育锻炼行为干预得出的最可靠的估计值是,GWG 的差异为 1.10 千克(95% CI -1.62 至 -0.58;17755 名女性)。没有证据表明对任何临床结果产生了影响:我们的研究结果凸显了以往系统性综述中不加区分地纳入有方法缺陷的研究而产生的差异。在没有临床益处的情况下,对孕妇进行定期称重是徒劳的。
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引用次数: 0
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Obesity Reviews
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