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A systematic review and qualitative synthesis of weight management interventions for people with spinal cord injury 对脊髓损伤患者体重管理干预措施的系统回顾和定性综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-09 DOI: 10.1111/obr.13785
Claire D. Madigan, James A. King, Carolyn Taylor, Sven P. Hoekstra, Heneritta E. Graham, Natasha Kirk, Jordan M. Fenton, Vicky L. Goosey-Tolfrey

People with spinal cord injury (SCI) are at greater risk of developing obesity and related co-morbidities than those without SCI. The objectives of this systematic review were to examine the effectiveness of weight management interventions for people with SCI and to synthesize the experiences of people involved with SCI weight management (e.g., SCI healthcare professionals and caregivers). Five databases were searched (up to July 31, 2023) and 5,491 potentially eligible articles were identified. Following screening, 22 articles were included, comprising 562 adults. There was considerable heterogeneity in study design and weight loss interventions included behavioral nutritional and exercise education sessions, recalling food diaries, exercise interventions, and pharmaceuticals. The mean percentage change of the pooled body mass data equated to −4.0 ± 2.3%, with a range from −0.5 to −7.6%. In addition, 38% of the individuals with SCI who completed a weight loss intervention (N = 262) had a ≥5% reduction in body weight. Collectively, although on average the included interventions led to moderate weight loss, the finding that just over a third of individuals achieved clinically meaningful 5% weight loss suggests that available interventions for this population may need to be improved.

脊髓损伤(SCI)患者患肥胖症及相关并发症的风险高于非 SCI 患者。本系统性综述的目的是研究针对 SCI 患者的体重管理干预措施的有效性,并总结参与 SCI 体重管理的人员(如 SCI 医护人员和护理人员)的经验。我们检索了五个数据库(截至 2023 年 7 月 31 日),发现了 5,491 篇可能符合条件的文章。经过筛选,共纳入 22 篇文章,包括 562 名成人。研究设计存在相当大的异质性,减肥干预措施包括行为营养和运动教育课程、回忆食物日记、运动干预和药物。汇总体重数据的平均百分比变化为-4.0 ± 2.3%,范围在-0.5%至-7.6%之间。此外,在完成减肥干预的 SCI 患者(N = 262)中,有 38% 的人体重下降了 ≥5%。总的来说,虽然所纳入的干预措施平均能使体重适度减轻,但发现仅有超过三分之一的人实现了有临床意义的 5% 的体重减轻,这表明针对这一人群的现有干预措施可能需要改进。
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引用次数: 0
Adult obesity treatment and prevention: A trans-agency commentary on the research landscape, gaps, and future opportunities 成人肥胖症的治疗和预防:关于研究现状、差距和未来机遇的跨机构评论。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-03 DOI: 10.1111/obr.13769
Rebecca K. Hoffman, Laurie Friedman Donze, Tanya Agurs-Collins, Brook Belay, David Berrigan, Heidi M. Blanck, Andrea Brandau, Amanda Chue, Susan Czajkowski, Glenn Dillon, Lyudmyla Kompaniyets, Bramaramba Kowtha, Rui Li, Priscah Mujuru, Lanay Mudd, Linda Nebeling, Naomi Tomoyasu, Deborah Young-Hyman, Xincheng (Ted) Zheng, Charlotte Pratt

Given the high and growing prevalence of obesity among adults in the United States, obesity treatment and prevention are important topics in biomedical and public health research. Although researchers recognize the significance of this problem, much remains unknown about safe and effective prevention and treatment of obesity in adults. In response to the worsening obesity epidemic and the many unknowns regarding the disease, a group of key scientific and program staff members of the National Institutes of Health (NIH) and other federal and non-government agencies gathered virtually in September 2021 to discuss the current state of obesity research, research gaps, and opportunities for future research in adult obesity prevention and treatment. The current article synthesizes presentations given by attendees and shares their organizations' current initiatives and identified gaps and opportunities. By integrating the information discussed in the meeting and current initiatives, we identify potential targets and overlapping priorities for future research, including health equity and disparities in obesity, the heterogeneity of obesity, and the use of technological and innovative approaches in interventions.

鉴于美国成年人肥胖症发病率高且不断增长,肥胖症的治疗和预防成为生物医学和公共卫生研究的重要课题。尽管研究人员认识到这一问题的重要性,但对于成人肥胖症的安全有效预防和治疗,仍有许多未知数。为了应对日益恶化的肥胖症疫情和有关该疾病的许多未知因素,美国国立卫生研究院(NIH)及其他联邦和非政府机构的一批重要科学和项目人员于 2021 年 9 月通过虚拟方式聚集在一起,讨论肥胖症研究的现状、研究差距以及未来成人肥胖症预防和治疗研究的机会。本文综述了与会者的发言,并分享了他们所在机构的当前举措以及发现的差距和机遇。通过整合会议讨论的信息和当前的倡议,我们确定了未来研究的潜在目标和重叠的优先事项,包括肥胖症的健康公平和差异、肥胖症的异质性以及在干预中使用技术和创新方法。
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引用次数: 0
Bibliometric analysis of research on sarcopenic obesity: a review of scientific literature 有关肌肉疏松性肥胖症研究的文献计量分析:科学文献综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-28 DOI: 10.1111/obr.13784
Fanny Petermann-Rocha, Felipe Diaz-Toro, Desirée Valera-Gran, Eva-María Navarrete-Muñoz

Considering the current prevalence in obesity and sarcopenia globally, this study aimed to summarize the development of sarcopenic obesity research to establish the topic's past, present, and future research direction using a bibliometric analysis. A comprehensive search for publications on sarcopenia and obesity was conducted in the Web of Science (WoS) database until the 31st of December 2023. We performed a detailed descriptive analysis, considering metrics like sources, authors, and documents, along with analyzing conceptual and social structures to map sarcopenic obesity research. Between 1993 and 2023, there were 4978 publications on sarcopenic obesity, representing 22.6% of the whole sarcopenia research (22070). Most published articles were originals (74.6%), and one of the highest increments in the fields was seen after 2010. The most significant contribution in this research area falls under the categories of Nutrition & Dietetics, Gerontology, and Geriatrics & Gerontology. Among regions, scientific production was located in 93 different countries. The United States, China, and South Korea had the highest contributions. The most relevant keywords were sarcopenia, obesity, and body composition. Research on sarcopenic obesity primarily focuses on epidemiology and identifying risk factors and outcome predictors. Yet, there is a shortage of research addressing prevention, early detection, and treatments to enhance the health of individuals with sarcopenia.

考虑到目前肥胖症和肌肉疏松症在全球的流行情况,本研究旨在通过文献计量分析,总结肌肉疏松性肥胖症研究的发展情况,以确定该课题过去、现在和未来的研究方向。我们在 Web of Science(WoS)数据库中全面检索了截至 2023 年 12 月 31 日有关肌肉疏松症和肥胖症的出版物。我们进行了详细的描述性分析,考虑了来源、作者和文献等指标,并分析了概念和社会结构,以绘制肌肉疏松性肥胖症研究的地图。从1993年到2023年,共有4978篇关于肌肉疏松性肥胖症的论文发表,占整个肌肉疏松症研究(22070篇)的22.6%。大多数发表的文章都是原创文章(74.6%),2010 年以后,该领域的文章数量增长最快。营养与饮食学、老年学、老年医学与老年学在这一研究领域的贡献最大。在各地区中,科研成果分布在 93 个不同的国家。美国、中国和韩国的贡献最大。最相关的关键词是肌肉疏松症、肥胖症和身体成分。有关肌肉疏松性肥胖症的研究主要集中在流行病学以及确定风险因素和结果预测因素方面。然而,有关预防、早期检测和治疗以提高肌肉疏松症患者健康水平的研究却十分匮乏。
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引用次数: 0
A systematic review and meta-analysis combining adolescent and adult data to evaluate weight loss and the effect of age following the laparoscopic sleeve gastrectomy 结合青少年和成年人的数据进行系统回顾和荟萃分析,以评估腹腔镜袖带胃切除术后体重减轻情况和年龄的影响。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-28 DOI: 10.1111/obr.13770
Danielle Karasko

Obesity is a grave concern within the United States, resulting in lost productivity, increased medical costs, and comorbidities with lifelong repercussions. The laparoscopic sleeve gastrectomy is a treatment option for obesity. The following meta-analysis sought to combine adolescent and adult literature to determine the overall effect of the sleeve gastrectomy on weight loss, to evaluate the effect of age at the time of surgery on weight loss, and to describe and explore variation in weight loss by sample characteristics. Overall weight loss was assessed at proximal and distal points, a dichotomous moderator variable analysis was conducted with subjects ≤21 years of age and >21 years of age, and a meta-regression assessing % male, % female, and baseline BMI was conducted to assess moderator variables. The laparoscopic sleeve gastrectomy was effective at facilitating weight loss with effect sizes varying from 0.916 to2.816. Age, biological sex, and baseline BMI were not found to have an impact on weight loss. The clinical consequences of prolonged obesity are evident and earlier intervention may be justified to counter the long-term effects caused by obesity related comorbidities. Standardized reporting of comorbidities and the effect of bariatric surgery on comorbid conditions is essential to allow further analysis.

肥胖症是美国的一个严重问题,它导致生产力损失、医疗费用增加以及影响终生的并发症。腹腔镜袖带胃切除术是治疗肥胖症的一种方法。以下荟萃分析试图结合青少年和成人的文献,确定袖带胃切除术对体重减轻的总体效果,评估手术时年龄对体重减轻的影响,并根据样本特征描述和探讨体重减轻的差异。在近端和远端点对总体体重减轻情况进行评估,对年龄≤21岁和大于21岁的受试者进行二分调节变量分析,并对男性比例、女性比例和基线体重指数进行元回归以评估调节变量。腹腔镜袖带胃切除术能有效减轻体重,其效应大小从0.916到2.816不等。未发现年龄、生理性别和基线体重指数对体重减轻有影响。长期肥胖的临床后果显而易见,因此有必要尽早采取干预措施,以消除肥胖相关合并症造成的长期影响。对合并症以及减肥手术对合并症的影响进行标准化报告对于进一步分析至关重要。
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引用次数: 0
Exploring factors of adherence to weight loss interventions in population with overweight/obesity: an umbrella review 探索超重/肥胖人群坚持减肥干预的因素:综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-28 DOI: 10.1111/obr.13783
Deng Wang, Pedro J. Benito, Jacobo Á. Rubio-Arias, Domingo J. Ramos-Campo, Miguel A. Rojo-Tirado

Adherence is key for achieving the optimal benefits from a weight loss intervention. Despite the number of studies on factors that promote adherence, their findings suggest inconsistent and fragmented evidence. The aim of this study was to review the existing factors of adherence to weight loss interventions and to find factors that facilitate the design of effective intervention programs. Six databases were searched for this umbrella review; after the screening process, 21 studies were included. A total of 47 factors were identified in six groups as relevant for adherence: (i) sociodemographic (n = 7), (ii) physical activity (n = 2), (iii) dietary (n = 8), (iv) behavioral (n = 4), (v) pharmacological (n = 3), and (vi) multi-intervention (n = 23). In addition, a map of adherence factors was created. The main findings are that with respect to demographic factors, the development of personalized intervention strategies based on the characteristics of specific populations is encouraged. Moreover, self-monitoring has been shown to be effective in behavioral, dietary, and multi-interventions, while technology has shown potential in dietary, behavioral, and multi-interventions. In addition, multi-interventions are adherence-promoting strategies, although more evidence is required on adherence to pharmacological interventions. Overall, the factor map can be controlled and modified by researchers and practitioners to improve adherence to weight loss interventions.

坚持是减肥干预取得最佳效果的关键。尽管对促进坚持的因素进行了大量研究,但研究结果表明,这些因素并不一致,证据也很零散。本研究的目的是回顾现有的减肥干预措施的坚持因素,并找出有助于设计有效干预计划的因素。本综述检索了六个数据库;经过筛选,共纳入 21 项研究。共确定了六组与坚持干预相关的 47 个因素:(i) 社会人口因素(n = 7),(ii) 体力活动因素(n = 2),(iii) 饮食因素(n = 8),(iv) 行为因素(n = 4),(v) 药物因素(n = 3),以及 (vi) 多重干预因素(n = 23)。此外,还绘制了坚持治疗因素图。主要研究结果表明,在人口统计学因素方面,鼓励根据特定人群的特点制定个性化干预策略。此外,在行为、饮食和多种干预措施中,自我监测被证明是有效的,而在饮食、行为和多种干预措施中,技术被证明是有潜力的。此外,多种干预措施也是促进坚持治疗的策略,但在坚持药物干预方面还需要更多的证据。总之,研究人员和从业人员可以控制和修改因子图,以提高减肥干预措施的依从性。
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引用次数: 0
Validity of dietary assessment methods compared with doubly labeled water in children: A systematic review and meta-analysis 儿童膳食评估方法与双标水的有效性比较:系统回顾和荟萃分析。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-24 DOI: 10.1111/obr.13768
Sanaz Mehranfar, Yahya Jalilpiran, Alireza Jafari, Ahmad Jayedi, Sakineh Shab-bidar, John R. Speakman, Kurosh Djafarian

Objectives

We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI).

Methods

PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1–18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24-h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random-effects meta-analysis models.

Results

Thirty-three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta-analysis of 22 studies identified underestimation of TEI (mean difference [MD] = −262.9 kcal/day [95% CI: −380.0, −145.8]; I2 = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (n = 9) (MD = 54.2 kcal/day [95% CI: −19.8, 128.1]; I2 = 49.62%), FFQ (n = 7) (MD = 44.5 kcal/day [95% CI: −317.8, 406.8]; I2 = 94.94%), and diet history (n = 3) (MD = −130.8 kcal/day [95% CI: −455.8, 194.1]; I2 = 77.48%), showed no significant differences in TEI compared with DLW-estimated TEE. All studies were of high quality.

Conclusion

Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.

目的我们旨在对照黄金标准--双标记水(DLW)--验证膳食评估方法,以估算总能量摄入量(TEI):方法:检索了 PubMed、Scopus、Web of Science 和 Google Scholar 数据库,检索期至 2023 年 5 月。纳入标准包括涉及 1-18 岁参与者的研究,这些研究采用食物记录、膳食史、食物频率问卷(FFQ)或 24 小时回忆等膳食评估方法估算总能量摄入量(TEI),同时使用 DLW 测量总能量消耗(TEE)。采用随机效应荟萃分析模型对数据进行了汇总:共发现 33 项研究,样本量从 9 到 118 人不等。对 22 项研究进行的荟萃分析发现,与 DLW 估算的 TEE 相比,食物记录的 TEI 被低估(平均差 [MD] = -262.9 千卡/天 [95% CI: -380.0, -145.8];I2 = 93.55%)。其他膳食评估方法,包括食物回忆(n = 9)(MD = 54.2 千卡/天 [95% CI: -19.8, 128.1];I2 = 49.62%)、FFQ(n = 7)(MD = 44.5 千卡/天 [95% CI: -317.8, 406.8]; I2 = 94.94%)和饮食史(n = 3)(MD = -130.8 kcal/day [95% CI: -455.8, 194.1]; I2 = 77.48%)显示,与 DLW 估算的 TEE 相比,TEI 没有显著差异。所有研究的质量都很高:结论:食物记录可能会低估 TEI,但仍需开展更多研究,以确定评估儿童膳食摄入量的最准确方法。
{"title":"Validity of dietary assessment methods compared with doubly labeled water in children: A systematic review and meta-analysis","authors":"Sanaz Mehranfar,&nbsp;Yahya Jalilpiran,&nbsp;Alireza Jafari,&nbsp;Ahmad Jayedi,&nbsp;Sakineh Shab-bidar,&nbsp;John R. Speakman,&nbsp;Kurosh Djafarian","doi":"10.1111/obr.13768","DOIUrl":"10.1111/obr.13768","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1–18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24-h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random-effects meta-analysis models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta-analysis of 22 studies identified underestimation of TEI (mean difference [MD] = −262.9 kcal/day [95% CI: −380.0, −145.8]; <i>I</i><sup>2</sup> = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (<i>n</i> = 9) (MD = 54.2 kcal/day [95% CI: −19.8, 128.1]; <i>I</i><sup>2</sup> = 49.62%), FFQ (<i>n</i> = 7) (MD = 44.5 kcal/day [95% CI: −317.8, 406.8]; <i>I</i><sup>2</sup> = 94.94%), and diet history (<i>n</i> = 3) (MD = −130.8 kcal/day [95% CI: −455.8, 194.1]; <i>I</i><sup>2</sup> = 77.48%), showed no significant differences in TEI compared with DLW-estimated TEE. All studies were of high quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 9","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086300","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
Sequencing methods, functional characterization, prevalence, and penetrance of rare coding mutations in panels of monogenic obesity genes from the leptin-melanocortin pathway: A systematic review 瘦素-黑皮素通路单基因肥胖症基因组中罕见编码突变的测序方法、功能特征、患病率和渗透率:系统综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-23 DOI: 10.1111/obr.13754
Sonia Dosda, Emeline Renard, David Meyre

The recent development of next-generation sequencing (NGS) technologies has led to an increase of mutation screening reports of monogenic obesity genes in diverse experimental designs. However, no study to date has summarized their findings. Two reviewers independently conducted a systematic review of MEDLINE, Embase, and Web of Science Core Collection databases from inception to September 2022 to identify monogenic non-syndromic obesity gene screening studies. Of 1051 identified references, 31 were eligible after title and abstract screening and 28 after full-text reading and risk of bias and quality assessment. Most studies (82%) used NGS methods. The number of genes screened varied from 2 to 12 genes from the leptin-melanocortin pathway. While all the included studies used in silico tools to assess the functional status of mutations, only 2 performed in vitro tests. The prevalence of carriers of pathogenic/likely pathogenic monogenic mutations is 13.24% on average (heterozygous: 12.31%; homozygous/heterozygous composite: 0.93%). As no study reported the penetrance of pathogenic mutations on obesity, we estimated that homozygous carriers exhibited a complete penetrance (100%) and heterozygous carriers a variable penetrance (3–100%). The review provides an exhaustive description of sequencing methods, functional characterization, prevalence, and penetrance of rare coding mutations in monogenic non-syndromic obesity genes.

近年来,随着下一代测序(NGS)技术的发展,在各种实验设计中对单基因肥胖症基因进行突变筛查的报告越来越多。然而,迄今为止还没有研究对这些研究结果进行总结。两位审稿人独立对 MEDLINE、Embase 和 Web of Science Core Collection 数据库(从开始到 2022 年 9 月)进行了系统性回顾,以确定单基因非综合征肥胖基因筛选研究。在确定的 1051 篇参考文献中,31 篇经标题和摘要筛选后符合条件,28 篇经全文阅读、偏倚风险和质量评估后符合条件。大多数研究(82%)采用 NGS 方法。筛选的基因数量从瘦素-黑皮素通路的 2 个基因到 12 个基因不等。虽然所有纳入的研究都使用了硅学工具来评估突变的功能状态,但只有 2 项研究进行了体外测试。致病性/可能致病性单基因突变携带者的患病率平均为 13.24%(杂合子:12.31%;同种/异种杂合子:0.93%)。由于没有研究报告肥胖症致病基因突变的渗透率,我们估计同卵携带者表现出完全渗透率(100%),而杂合携带者表现出可变渗透率(3-100%)。这篇综述详尽描述了单基因非综合征肥胖基因中罕见编码突变的测序方法、功能特征、患病率和渗透率。
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引用次数: 0
A systematic review on the applicability of cell-free DNA level as an obesity biomarker 无细胞 DNA 水平作为肥胖生物标志物的适用性系统综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-21 DOI: 10.1111/obr.13765
Keith T. S. Tung, Hing Wai Tsang, Ulrike Ngo, Rosa S. Wong, Clare H. Y. Chow, Winnie H. Y. Tso, Jason C. S. Yam, Godfrey C. F. Chan, Patrick Ip

Obesity has become a global health concern in recent decades. Utilizing biomarkers presents a promising approach to comprehensively monitor the progress of obesity and its associated health conditions. This review aims to synthesize the available evidence on the correlation between cfDNA level and obesity and to provide insights into the applicability of using cfDNA level as a tool for monitoring progression of obesity. Searches were performed in PubMed and Embase on April 1, 2022. Data and other relevant information were extracted and compiled into a structured table for further analysis. Among 1170 articles screened, 11 articles were included in this review and assessed qualitatively. The results demonstrated that existing evidence mainly focused on three populations, including healthy individuals, cancer patients and pregnant women. Majority of the studies on healthy individuals identified a significant association between cfDNA level and body weight status but not among cancer patients. Varying results were observed among pregnant women at different gestational trimesters. Our review summarized some preliminary evidence on the association between cfDNA level and obesity. More cohort studies in larger scale with comprehensive assessment have to be conducted to examine the applicability of cfDNA as a biomarker for severity and disease progression of obesity.

近几十年来,肥胖症已成为全球关注的健康问题。利用生物标记物来全面监测肥胖及其相关健康问题的进展是一种很有前景的方法。本综述旨在综合现有的关于 cfDNA 水平与肥胖之间相关性的证据,并深入探讨使用 cfDNA 水平作为监测肥胖进展的工具的适用性。本文于 2022 年 4 月 1 日在 PubMed 和 Embase 中进行了检索。提取数据和其他相关信息,并将其编制成结构化表格,以便进一步分析。在筛选出的 1170 篇文章中,有 11 篇被纳入本综述并进行了定性评估。结果表明,现有证据主要集中在三个人群,包括健康人、癌症患者和孕妇。大多数针对健康人的研究发现,cfDNA 水平与体重状况有显著关联,但在癌症患者中却没有发现。在不同孕期的孕妇中观察到了不同的结果。我们的综述总结了 cfDNA 水平与肥胖之间关系的一些初步证据。要研究 cfDNA 作为肥胖严重程度和疾病进展的生物标志物的适用性,还需要进行更大规模的队列研究和综合评估。
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引用次数: 0
Evaluation of visceral adipose tissue thresholds for elevated metabolic syndrome risk across diverse populations: A systematic review 评估不同人群代谢综合征风险升高的内脏脂肪组织阈值:系统综述。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-18 DOI: 10.1111/obr.13767
Jonathan P. Bennett, Carla M. Prado, Steven B. Heymsfield, John A. Shepherd

Beyond obesity, excess levels of visceral adipose tissue (VAT) significantly contribute to the risk of developing metabolic syndrome (MetS), although thresholds for increased risk vary based on population, regions of interest, and units of measure employed. We sought to determine whether a common threshold exists that is indicative of heightened MetS risk across all populations, accounting for sex, age, BMI, and race/ethnicity. A systematic literature review was conducted in September 2023, presenting threshold values for elevated MetS risk. Standardization equations harmonized the results from DXA, CT, and MRI systems to facilitate a comparison of threshold variations across studies. A total of 52 papers were identified. No single threshold could accurately indicate elevated risk for both males and females across varying BMI, race/ethnicity, and age groups. Thresholds fluctuated from 70 to 165.9 cm2, with reported values consistently lower in females. Generally, premenopausal females and younger adults manifested elevated risks at lower VAT compared to their older counterparts. Notably, Asian populations exhibited elevated risks at lower VAT areas (70–136 cm2) compared to Caucasian populations (85.6–165.9 cm2). All considered studies reported associations of VAT without accommodating covariates. No single VAT area threshold for elevated MetS risk was discernible post-harmonization by technology, units of measure, and region of interest. This review summarizes available evidence for MetS risk assessment in clinical practice. Further exploration of demographic-specific interactions between VAT area and other risk factors is imperative to comprehensively delineate overarching MetS risk.

除肥胖外,内脏脂肪组织(VAT)超标也会大大增加患代谢综合征(MetS)的风险,但风险增加的阈值因人群、相关地区和使用的测量单位而异。我们试图确定,在考虑性别、年龄、体重指数和种族/人种的情况下,是否存在一个共同的阈值,表明所有人群的 MetS 风险都会增加。2023 年 9 月,我们进行了一次系统的文献综述,提出了 MetS 风险升高的阈值。标准化方程统一了 DXA、CT 和 MRI 系统的结果,以便于比较不同研究的阈值差异。共鉴定出 52 篇论文。在不同的体重指数、种族/人种和年龄组中,没有一个阈值能准确显示男性和女性的风险升高。阈值在 70 到 165.9 平方厘米之间波动,女性的报告值一直较低。一般来说,绝经前女性和年轻成年人在 VAT 值较低时的风险高于年长者。值得注意的是,与白种人(85.6-165.9 平方厘米)相比,亚洲人在较低的 VAT 面积(70-136 平方厘米)上表现出更高的风险。所有的研究都报告了 VAT 的相关性,但没有考虑协变量。根据技术、测量单位和感兴趣的地区进行协调后,没有发现单一的 VAT 面积阈值可导致 MetS 风险升高。本综述总结了临床实践中 MetS 风险评估的现有证据。为了全面界定 MetS 风险,必须进一步探讨 VAT 面积与其他风险因素之间的人口特异性相互作用。
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引用次数: 0
Deciphering the complex interplay of obesity, epithelial barrier dysfunction, and tight junction remodeling: Unraveling potential therapeutic avenues 解读肥胖、上皮屏障功能障碍和紧密连接重塑之间复杂的相互作用:揭示潜在的治疗途径。
IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-14 DOI: 10.1111/obr.13766
Sara K. AlMarzooqi, Fajr Almarzooqi, Hana Q. Sadida, Jayakumar Jerobin, Ikhlak Ahmed, Abdul-Badi Abou-Samra, Khalid A. Fakhro, Punita Dhawan, Ajaz A. Bhat, Ammira S. Al-Shabeeb Akil

Obesity stands as a formidable global health challenge, predisposing individuals to a plethora of chronic illnesses such as cardiovascular disease, diabetes, and cancer. A confluence of genetic polymorphisms, suboptimal dietary choices, and sedentary lifestyles significantly contribute to the elevated incidence of obesity. This multifaceted health issue profoundly disrupts homeostatic equilibrium at both organismal and cellular levels, with marked alterations in gut permeability as a salient consequence. The intricate mechanisms underlying these alterations have yet to be fully elucidated. Still, evidence suggests that heightened inflammatory cytokine levels and the remodeling of tight junction (TJ) proteins, particularly claudins, play a pivotal role in the manifestation of epithelial barrier dysfunction in obesity. Strategic targeting of proteins implicated in these pathways and metabolites such as short-chain fatty acids presents a promising intervention for restoring barrier functionality among individuals with obesity. Nonetheless, recognizing the heterogeneity among affected individuals is paramount; personalized medical interventions or dietary regimens tailored to specific genetic backgrounds and allergy profiles may prove indispensable. This comprehensive review delves into the nexus of obesity, tight junction remodeling, and barrier dysfunction, offering a critical appraisal of potential therapeutic interventions.

肥胖症是一项严峻的全球健康挑战,易导致心血管疾病、糖尿病和癌症等多种慢性疾病。遗传多态性、次优饮食选择和久坐不动的生活方式共同导致了肥胖症发病率的上升。这一多方面的健康问题严重破坏了机体和细胞层面的平衡,肠道通透性的明显改变是其突出后果。这些变化背后的复杂机制尚未完全阐明。不过,有证据表明,炎症细胞因子水平的升高和紧密连接(TJ)蛋白,尤其是克劳丁蛋白的重塑,在肥胖症上皮屏障功能障碍的表现中起着关键作用。针对与这些途径有关的蛋白质和代谢物(如短链脂肪酸)进行策略性干预,是恢复肥胖症患者屏障功能的有效方法。然而,认识到受影响个体之间的异质性是至关重要的;针对特定遗传背景和过敏特征的个性化医疗干预或饮食方案可能证明是不可或缺的。本综述深入探讨了肥胖、紧密连接重塑和屏障功能障碍之间的关系,并对潜在的治疗干预措施进行了批判性评估。
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Obesity Reviews
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