Obesity Reviews最新文献

Introduction: Neighborhood determinants of health have been documented in several populations, yet less is known about their role in pediatric obesity treatment. A systematic review of longitudinal studies examining associations between neighborhood environment features and changes in obesity and in lifestyle behaviors among children participating in obesity management interventions was conducted.

Methods: Searches were conducted in Medline, Embase, CINAHL, and Web of Science for peer-reviewed articles published in English from database inception until April 2025. We included studies of children with overweight/obesity at baseline, participating in multicomponent obesity management interventions, and with at least one pre- and one post-intervention measurement of obesity or lifestyle behaviors.

Results: Of the 27,310 records screened, six met inclusion criteria. Studies were conducted in the United States (n = 5) and United Kingdom (n = 1), with participants' age ranging from 6 to 18 years, and a total of 13,364 participants. Studies examined availability of parks (n = 3), supermarkets (n = 2), greenspaces (n = 1), walkability (n = 1), recreational facilities (n = 1), and neighborhood deprivation (n = 1). Residing in neighborhoods with more parks was associated with greater reductions in post-intervention body mass index in two studies. Inconsistent findings relating availability of supermarkets to changes in fruit and vegetable intake were reported. Residing in neighborhoods with more recreational facilities was associated with increases in objectively measured physical activity but not with self-reported screen time.

Conclusion: Findings among the few studies that examined neighborhood determinants of obesity management outcomes among children were inconsistent. Neighborhood resources that support physical activity (parks, recreational facilities) may be associated with better outcomes.

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.

Smartphone application (app)-based interventions to prevent Type 2 diabetes (T2D) are becoming increasingly available. A thorough summary of their effectiveness is lacking. We synthesized evidence on the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes. For this systematic review and meta-analysis, we searched Web of Science, Embase, Scopus, PubMed Central, and Medline between January 1, 2013, and January 31, 2024, to identify randomized controlled trials (RCTs) that assessed the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes, published in English, without restrictions regarding the effectiveness outcome. We synthesized all outcomes graphically via effect directions and conducted meta-analyses for clinical outcomes, including the Risk of Bias 2 Tool. This study was prospectively registered with PROSPERO (CRD42023491693) and OSF (DOI 10.17605/OSF.IO/B89QP). Of 9703 articles, 18 RCTs were included in the systematic review, and 15 RCTs in the meta-analysis. We found statistically significant reductions in body weight (-1.35 kg, 95% CI: [-2.48; -0.23], N = 13 RCTs), body mass index (-0.53 kg/m², 95% CI: [-0.97; -0.09], N = 11 RCTs), and glycated hemoglobin (-0.08%, 95% CI: [-0.10; -0.05], N = 11 RCTs) and point estimates and/or effect directions predominantly suggesting improvements for additional outcomes. Stratified meta-analyses showed no statistically significant between-group differences and missing evidence for long-term effectiveness and equity-relevant subgroups. Our study shows that app-based interventions can improve outcomes (i.e., motivation, behavior, and clinical parameters) in individuals with prediabetes. The effect on clinical outcomes is small. Evidence on equity impacts, long-term effectiveness, and diabetes incidence is missing and remains to be investigated.

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.

Background: Brain-derived neurotrophic factor (BDNF), a neurotrophin, plays a crucial role in neuronal survival and maintenance. Growing evidence suggests its potential involvement in the pathogenesis of coronary artery disease (CAD) and obesity. This study aims to investigate the effects of the BDNF nonsynonymous variant (rs6265) on cardiometabolic profiles, CAD risk, and obesity susceptibility.

Methods: PubMed, Cochrane Library, Central, CINAHL, and ClinicalTrials.gov were searched until March 12, 2024.

Results: The analysis included 35,505 individuals. Carriers of the rs6265 A allele (which encodes Met at the 66th position) exhibited a reduced risk of overweight, obesity, and CAD, along with lower fasting plasma glucose (FPG) and diastolic blood pressure (DBP). However, these individuals showed an increased risk of depression among patients with CAD. The effects of rs6265 on obesity and overweight were particularly significant in Asian and Caucasian. Notably, the rs6265 A allele's influence on obesity was more pronounced than its effect on overweight. Additionally, the impact of the rs6265 A allele on obesity and overweight was stronger in adults compared with children.

Conclusions: The rs6265 variant exerts a modest yet statistically significant influence on cardiometabolic profiles, overweight, obesity, CAD, and depression. Specifically, the rs6265 A allele serves as a protective factor against cardiovascular disease and obesity but appears to be a risk factor for depression in patients with CAD.

The aim of this systematic review with pairwise and network meta-analyses was to examine the effects of different exercise types on visceral adipose tissue (VAT) in patients with prediabetes and type 2 diabetes mellitus (T2DM). A comprehensive search was conducted in PubMed, Web of Science, and Scopus using four main keywords including "exercise training," "visceral fat," "diabetes," and "randomization" from inception to April 2025. Thirty-three randomized controlled trials or clinical trials with parallel groups were included (1740 patients), in which exercise training was compared with either nonexercise or other types of exercise training. Combined training (n = 5) (-0.63 [95% CI -0.95 to -0.30], p = 0.001), high-intensity interval training (n = 11) (-0.53 [95% CI -0.86 to -0.19], p = 0.001), and aerobic training (n = 24) (-0.38 [95% CI -0.59 to -0.18], p = 0.001), but not resistance training (n = 8) (-0.25 [95% CI -0.54 to 0.03], p = 0.08) were more effective for reducing VAT as compared with controls. Subgroup analyses based on age, health status, body mass index, or intervention duration confirmed that combined training, high-intensity interval training, aerobic training, but not resistance training, induced advantageous alterations in VAT compared to the control group. The main findings show that the P-score-based ranking of interventions reported the highest probability ranking for CT (0.89), followed by HIIT (0.76), AT (0.52), and RT (0.32). These findings provide compelling evidence to support the use of exercise training as a noninvasive and cost-effective nonpharmacological intervention for the reduction of VAT in patients with prediabetes and T2DM. PROSPERO REGISTRATION NUMBER: CRD42024598045.

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.

Adipose tissue thermogenesis, both uncoupling protein 1 (UCP1)-dependent and independent thermogenesis, plays a critical role in the homeostasis of whole-body metabolism. Emerging evidence demonstrates that key nodes in adipose tissue thermogenesis can be regulated by dynamic and reversible N⁶-methyladenosine (m⁶A) modification, which is one of the most prevalent and extensively studied RNA modifications. Furthermore, its dysregulation drives the pathogenesis of obesity and related metabolic disorders. In this review, we elucidate the role and molecular mechanisms of m⁶A modification in adipose tissue thermogenesis, highlight potential therapeutic strategies for promoting thermogenic remodeling of adipose tissue through targeting m⁶A modification, and discuss future research directions in this field. The insights provide clues for translational research aimed at developing m⁶A-based therapies for metabolic diseases.