Pub Date : 2025-03-01Epub Date: 2025-02-18DOI: 10.1016/j.obmed.2025.100592
David Sánchez-García, Eloísa Saavedra-Castillo, Mariela Rivas-Hernández, Luis Diego Maximiliano Ramos-Anthony, Graciela Gómez-Martínez, Marcelo Diaz-Sallas, Dania Lizet Quintanilla-Flores
Aims
To analyze the correlation between estimated glucose disposal rate (eGDR), Carotid intima-media thickness (CIMT) and cardiovascular risk prediction scales in young adults with diabetes type 1 (T1D).
Methods
A cross-sectional, analytical, and retrospective study was conducted. Patients with T1D > 15 years were included, insulin resistance (IR) was defined by eGDR <8 mg/kg/min, and preclinical atherosclerosis as ≥0.54 mm of CIMT, STENO and ESC cardiovascular risk was calculated. Pearson's correlation test was used to measure the strength of association between them.
Results
102 patients with a median age of 19 years, HbA1c of 8.2%, diabetes duration of 8 years were included. IR was found in 50.9% of the patients and preclinical atherosclerosis in 46.1%, with a median CIMT of 0.52 mm. An inverse correlation was obtained between the eGDR and CIMT r = −0.23, p = 0.021, and STENO r = 0.33, p=<0.001, CIMT was higher in the IR group 0.54 vs 0.50 mm, p = 0.047, also was associated with more microvascular complications 36.5% vs 18%, p = 0.03, and proinflammatory markers, p=<0.001.
Conclusions
Carotid intima-media thickening is inversely associated with insulin sensitivity, the eGDR value could be used as a cardiovascular and as a enhance risk factor and could help to decide treatment in patients whit T1D.
目的分析1型糖尿病（T1D）青年患者估计葡萄糖处置率（eGDR）、颈动脉内膜-中膜厚度（CIMT）与心血管风险预测量表的相关性。方法采用横断面、分析和回顾性研究。T1D >患者；纳入15年，胰岛素抵抗（IR）定义为eGDR <；8 mg/kg/min，临床前动脉粥样硬化≥0.54 mm的CIMT，计算STENO和ESC心血管风险。使用Pearson相关检验来衡量两者之间的关联强度。结果纳入102例患者，中位年龄19岁，HbA1c为8.2%，糖尿病病程8年。50.9%的患者发现IR， 46.1%的患者发现临床前动脉粥样硬化，中位CIMT为0.52 mm。eGDR与CIMT r = - 0.23, p= 0.021, STENO r = 0.33, p=<；0.001呈负相关，IR组CIMT较高（0.54 vs 0.50 mm, p= 0.047），微血管并发症发生率较高（36.5% vs 18%, p= 0.03），促炎标志物发生率较高（p=<0.001）。结论颈动脉内膜-中膜增厚与胰岛素敏感性呈负相关，eGDR值可作为T1D患者的心血管和增强危险因素，有助于决定治疗方案。
{"title":"Correlation between estimated glucose disposal rate, carotid intima-media thickness and cardiovascular risk prediction scales in adolescents and young adults with type 1 diabetes","authors":"David Sánchez-García, Eloísa Saavedra-Castillo, Mariela Rivas-Hernández, Luis Diego Maximiliano Ramos-Anthony, Graciela Gómez-Martínez, Marcelo Diaz-Sallas, Dania Lizet Quintanilla-Flores","doi":"10.1016/j.obmed.2025.100592","DOIUrl":"10.1016/j.obmed.2025.100592","url":null,"abstract":"<div><h3>Aims</h3><div>To analyze the correlation between estimated glucose disposal rate (eGDR), Carotid intima-media thickness (CIMT) and cardiovascular risk prediction scales in young adults with diabetes type 1 (T1D).</div></div><div><h3>Methods</h3><div>A cross-sectional, analytical, and retrospective study was conducted. Patients with T1D > 15 years were included, insulin resistance (IR) was defined by eGDR <8 mg/kg/min, and preclinical atherosclerosis as ≥0.54 mm of CIMT, STENO and ESC cardiovascular risk was calculated. Pearson's correlation test was used to measure the strength of association between them.</div></div><div><h3>Results</h3><div>102 patients with a median age of 19 years, HbA1c of 8.2%, diabetes duration of 8 years were included. IR was found in 50.9% of the patients and preclinical atherosclerosis in 46.1%, with a median CIMT of 0.52 mm. An inverse correlation was obtained between the eGDR and CIMT r = −0.23, p = 0.021, and STENO r = 0.33, p=<0.001, CIMT was higher in the IR group 0.54 vs 0.50 mm, p = 0.047, also was associated with more microvascular complications 36.5% vs 18%, p = 0.03, and proinflammatory markers, p=<0.001.</div></div><div><h3>Conclusions</h3><div>Carotid intima-media thickening is inversely associated with insulin sensitivity, the eGDR value could be used as a cardiovascular and as a enhance risk factor and could help to decide treatment in patients whit T1D.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100592"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We investigated the effect of 52-week liraglutide treatment on the incidence of type 2 diabetes (T2D) compared with placebo treatment in women with obesity and previous gestational diabetes (pGDM) requiring medical treatment. As secondary outcomes, the prevalence of prediabetes and glycaemic control were investigated.
Methods
Women were randomized to once daily subcutaneous liraglutide 1.8 mg or placebo for 52 weeks. Oral glucose tolerance test, C-peptide, insulin, HbA1c and lipids were determined at baseline, 26 weeks, and 52 weeks.
Results
In total, 75 women [mean age of 34.5 years, median BMI of 38.0 kg/m2] were assigned to liraglutide (n = 37) or placebo (n = 38). At 52 weeks, T2D was diagnosed in 3% (n = 1) of the liraglutide group and 8% (n = 2) of the placebo group (p = 0.58), and prediabetes in 27% (n = 9) and 58% (n = 15), respectively (p = 0.032). In intention-to-treat analysis, 52-week liraglutide treatment reduced fasting glucose [group × time interaction p = 0.0047; estimated treatment difference (ETD) at 52 weeks −0.5 mmol/L, p = 0.0020], HbA1c [p = 0.020; ETD -0.2% (−2.1 mmol/mol), p = 0.056], weight (p = 0.0087; ETD -6.2 kg, p = 0.20) and waist circumference (p = 0.022; ETD -3.9 cm, p = 0.25), and improved Matsuda index (p = 0.049; ETD 0.7, p = 0.011) compared with placebo.
Conclusions
Liraglutide reduces the prevalence of prediabetes and improves glycaemic control in women with obesity and pGDM. Due to few T2D cases, the effect of liraglutide on diabetes risk could not be reliably assessed.
{"title":"Effect of 52-week liraglutide treatment on diabetes risk and glycaemic control in women with obesity and prior gestational diabetes. A randomized, double-blind, placebo-controlled study","authors":"Roosa Perämäki , Meri-Maija Ollila , Janne Hukkanen , Marja Vääräsmäki , Jukka Uotila , Saara Metso , Heidi Hakkarainen , Reeta Rintamäki , Eliisa Löyttyniemi , Heidi Immonen , Risto Kaaja","doi":"10.1016/j.obmed.2025.100596","DOIUrl":"10.1016/j.obmed.2025.100596","url":null,"abstract":"<div><h3>Aims</h3><div>We investigated the effect of 52-week liraglutide treatment on the incidence of type 2 diabetes (T2D) compared with placebo treatment in women with obesity and previous gestational diabetes (pGDM) requiring medical treatment. As secondary outcomes, the prevalence of prediabetes and glycaemic control were investigated.</div></div><div><h3>Methods</h3><div>Women were randomized to once daily subcutaneous liraglutide 1.8 mg or placebo for 52 weeks. Oral glucose tolerance test, C-peptide, insulin, HbA1c and lipids were determined at baseline, 26 weeks, and 52 weeks.</div></div><div><h3>Results</h3><div>In total, 75 women [mean age of 34.5 years, median BMI of 38.0 kg/m<sup>2</sup>] were assigned to liraglutide (n = 37) or placebo (n = 38). At 52 weeks, T2D was diagnosed in 3% (n = 1) of the liraglutide group and 8% (n = 2) of the placebo group (p = 0.58), and prediabetes in 27% (n = 9) and 58% (n = 15), respectively (p = 0.032). In intention-to-treat analysis, 52-week liraglutide treatment reduced fasting glucose [group × time interaction p = 0.0047; estimated treatment difference (ETD) at 52 weeks −0.5 mmol/L, p = 0.0020], HbA1c [p = 0.020; ETD -0.2% (−2.1 mmol/mol), p = 0.056], weight (p = 0.0087; ETD -6.2 kg, p = 0.20) and waist circumference (p = 0.022; ETD -3.9 cm, p = 0.25), and improved Matsuda index (p = 0.049; ETD 0.7, p = 0.011) compared with placebo.</div></div><div><h3>Conclusions</h3><div>Liraglutide reduces the prevalence of prediabetes and improves glycaemic control in women with obesity and pGDM. Due to few T2D cases, the effect of liraglutide on diabetes risk could not be reliably assessed.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100596"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gestational diabetes mellitus (GDM) is a prevalent metabolic condition affecting pregnant women, impairing glucose tolerance, and causing short- and long-term effects on mother, fetus, and neonate. The goal of management therapy during pregnancy is to obtain optimal glycemic control by preventing hyperglycemia and maintaining safety. The increasing prevalence of GDM worldwide is a rising concern, underscoring the need for dietary adjustments and improved detection, diagnostic and treatment strategies to overcome adverse consequences. International guidelines recommend pharmaceutical interventions for GDM when lifestyle adjustments do not attain glycemic control. Insulin is first-line treatment, but oral anti-hyperglycemic medications serve as often-used alternatives. Metformin and glyburide effectively regulate increased blood glucose in pregnancy. Metformin is preferred due to its ease of administration, reduced risk of hypoglycemia, and potential for improved long-term outcomes. Whereas glyburide is administered cautiously due to potential feto-maternal risk. In this review, the pharmaceutical alternatives for GDM have been discussed in detail, along with pharmacology and pharmacokinetics. The effects of metabolic and glycemic control on feto-maternal morbidity have also been elaborated, along with efficacy as well as side effects and long-term outcomes. However, their long-term safety profiles and fetal exposure remain unclear. By focusing on this research gap, we can explore effective management therapy by evaluating feto-maternal long-term outcomes through follow-up studies, comparing efficacy of pharmacological interventions, pharmacogenomics, digital health technologies, emerging pharmaceutical alternatives (GLP-1-Ra & SGLT-2 inhibitors), and personalized medicine. By incorporating these advancements into clinical practice by healthcare professionals, the risk of adverse effects may decrease to improve health and well-being.
{"title":"Pharmacological therapy for Gestational Diabetes Mellitus: A comprehensive overview","authors":"Tanu Gautam , Amreen Shamsad , Renu Singh , S. Shabihe Raza Baqri , Monisha Banerjee","doi":"10.1016/j.obmed.2025.100587","DOIUrl":"10.1016/j.obmed.2025.100587","url":null,"abstract":"<div><div>Gestational diabetes mellitus (GDM) is a prevalent metabolic condition affecting pregnant women, impairing glucose tolerance, and causing short- and long-term effects on mother, fetus, and neonate. The goal of management therapy during pregnancy is to obtain optimal glycemic control by preventing hyperglycemia and maintaining safety. The increasing prevalence of GDM worldwide is a rising concern, underscoring the need for dietary adjustments and improved detection, diagnostic and treatment strategies to overcome adverse consequences. International guidelines recommend pharmaceutical interventions for GDM when lifestyle adjustments do not attain glycemic control. Insulin is first-line treatment, but oral anti-hyperglycemic medications serve as often-used alternatives. Metformin and glyburide effectively regulate increased blood glucose in pregnancy. Metformin is preferred due to its ease of administration, reduced risk of hypoglycemia, and potential for improved long-term outcomes. Whereas glyburide is administered cautiously due to potential feto-maternal risk. In this review, the pharmaceutical alternatives for GDM have been discussed in detail, along with pharmacology and pharmacokinetics. The effects of metabolic and glycemic control on feto-maternal morbidity have also been elaborated, along with efficacy as well as side effects and long-term outcomes. However, their long-term safety profiles and fetal exposure remain unclear. By focusing on this research gap, we can explore effective management therapy by evaluating feto-maternal long-term outcomes through follow-up studies, comparing efficacy of pharmacological interventions, pharmacogenomics, digital health technologies, emerging pharmaceutical alternatives (GLP-1-Ra & SGLT-2 inhibitors), and personalized medicine. By incorporating these advancements into clinical practice by healthcare professionals, the risk of adverse effects may decrease to improve health and well-being.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-17DOI: 10.1016/j.obmed.2025.100593
Randhir Singh , Shah Asma Farooq , Ashi Mannan , Nikhil Garg , Sushma Devi , Kamal Dua , Thakur Gurjeet Singh
Introduction
The present research aims to examine the efficacy of Murraya koenigii (L.) extracts in the management of diabetic peripheral neuropathy (DPN).
Methods
A dose of 65 mg/kg of streptozotocin (STZ) was administered intraperitoneally (i.p.) in fresh citrate buffer with a pH of 4.5 to induce diabetes 15 min after nicotinamide (230 mg/kg, ip) was administered and on 60th day development of DPN was evaluated by measuring behavioural parameters like tactile allodynia and hyperalgesia. In-vitro and in-vivo techniques were employed for estimation of oxidative stress.
Results
Oral administration of extracts at various doses as well as standard drug was continued up to 90th day after 60th day of STZ-NAD administration. In diabetic animals, antioxidants like as SOD and GSH levels was reduced while the level of TBARS, nitrites, TNF-α, and AGE production were significantly increased. These extracts were discovered to positively impact fasting blood sugar levels, food intake, and body weight loss management. Furthermore, research demonstrated that the extracts had positive impact on pain perception as measured by thermal and mechanical hyperalgesia in experimental rats. Studies of these extracts, both in-vivo and in-vitro, indicated their potential to reduce oxidative stress as well as hyperglycemia, which are crucial in the progression of diabetes complications.
Conclusion
It can be concluded that Murraya koenigii (L.) leaf extracts, ameliorates diabetes and diabetic peripheral neuropathy by regulating hyperglycemia and oxidative stress.
{"title":"Murraya koenigii Linn. Modulate diabetic neuropathy via attenuation of mechanical hyperalgesia and allodynia in STZ-induced diabetic rats","authors":"Randhir Singh , Shah Asma Farooq , Ashi Mannan , Nikhil Garg , Sushma Devi , Kamal Dua , Thakur Gurjeet Singh","doi":"10.1016/j.obmed.2025.100593","DOIUrl":"10.1016/j.obmed.2025.100593","url":null,"abstract":"<div><h3>Introduction</h3><div>The present research aims to examine the efficacy of <em>Murraya koenigii</em> (L.) extracts in the management of diabetic peripheral neuropathy (DPN).</div></div><div><h3>Methods</h3><div>A dose of 65 mg/kg of streptozotocin (STZ) was administered intraperitoneally (i.p.) in fresh citrate buffer with a pH of 4.5 to induce diabetes 15 min after nicotinamide (230 mg/kg, ip) was administered and on 60th day development of DPN was evaluated by measuring behavioural parameters like tactile allodynia and hyperalgesia. <em>In-vitro</em> and <em>in-vivo</em> techniques were employed for estimation of oxidative stress.</div></div><div><h3>Results</h3><div>Oral administration of extracts at various doses as well as standard drug was continued up to 90th day after 60th day of STZ-NAD administration. In diabetic animals, antioxidants like as SOD and GSH levels was reduced while the level of TBARS, nitrites, TNF-α, and AGE production were significantly increased. These extracts were discovered to positively impact fasting blood sugar levels, food intake, and body weight loss management. Furthermore, research demonstrated that the extracts had positive impact on pain perception as measured by thermal and mechanical hyperalgesia in experimental rats. Studies of these extracts, both <em>in-vivo</em> and <em>in-vitro,</em> indicated their potential to reduce oxidative stress as well as hyperglycemia, which are crucial in the progression of diabetes complications.</div></div><div><h3>Conclusion</h3><div>It can be concluded that <em>Murraya koenigii</em> (L.) leaf extracts, ameliorates diabetes and diabetic peripheral neuropathy by regulating hyperglycemia and oxidative stress.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100593"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-27DOI: 10.1016/j.obmed.2025.100598
Duong Thi Huong Nguyen, Huy Khanh Tang, An Thi Hoai Nguyen, Luu Bao Le
Objectives
Today, obesity is a significant public health concern. Traditional medicine, known for its minimal side effects and positive outcomes, is increasingly being utilized as an alternative intervention in clinical practice. This study seeks to examine Vietnamese literature to identify herbs that can aid in reducing obesity and to interpret the association rules among these herbs.
Methods
Four hundred thirty-six formulas were collected from 43 documents suited to inclusion criteria. Using Microsoft Excel 2016, we continuously interpreted the characteristics of 320 herbs extracted from 436 anti-obesity formulas. The Apriori algorithm, operated by R Studio version 4.3.3, investigated the association rules among core materials.
Results
Shan Zha (Fructus crataegi) is the most popular herb mentioned in 436 compounded medications. The predominant property and flavor were warm (33,02%) and sweet (52,7%), respectively. Eventually, we also found 18 association rules and screened out 7 potential anti-obesity herbs. Each rule consists of two or three components. Especially, the greatest prevalent associated law is a triple combination among Fu Ling (Poria cocos), Ban Xia (Rhizoma pinelliae), and Chen Pi (Pericarpium citri reticulatae).
Conclusions
This study documents traditional Vietnamese medicinal knowledge on herbs with anti-obesity properties. According to the traditional function, all of herbs can be divided into these classifications: Tonify Spleen-Qi, Move Qi and invigorate Blood, Resolve retention of food, Resolve Dampness and Promoting diuresis. Besides, the pharmacological functions of them are suppressing appetite, inhibition of fat absorption and elevation of fat metabolism rate.
今天，肥胖是一个重要的公共健康问题。传统医学以其最小的副作用和积极的结果而闻名，越来越多地被用作临床实践中的替代干预措施。本研究旨在研究越南文献，以确定可以帮助减少肥胖的草药，并解释这些草药之间的关联规则。方法从43篇符合纳入标准的文献中抽取436个方剂。我们使用Microsoft Excel 2016对436种抗肥胖配方中提取的320种草药的特性进行了连续解析。使用R Studio 4.3.3版本运行的Apriori算法，研究核心材料之间的关联规则。结果山楂在436种复方药物中被提及最多。其主要特性和风味分别为温（33.02%）和甜（52.7%）。最终，我们还发现了18条关联规则，筛选出了7种潜在的抗肥胖草药。每个规则由两个或三个部分组成。尤以茯苓（茯苓）、半夏（半夏）、陈皮（柑桔皮）的三联系最为普遍。结论本研究记录了越南传统医药知识中具有抗肥胖作用的草药。根据传统的功能，所有的草药都可以分为以下几类：健脾、气血、解食、化湿、利尿。此外，其药理作用还包括抑制食欲、抑制脂肪吸收、提高脂肪代谢率等。
{"title":"Survey on the herbal combinations in traditional Vietnamese medicine formulas for obesity treatment based on literature","authors":"Duong Thi Huong Nguyen, Huy Khanh Tang, An Thi Hoai Nguyen, Luu Bao Le","doi":"10.1016/j.obmed.2025.100598","DOIUrl":"10.1016/j.obmed.2025.100598","url":null,"abstract":"<div><h3>Objectives</h3><div>Today, obesity is a significant public health concern. Traditional medicine, known for its minimal side effects and positive outcomes, is increasingly being utilized as an alternative intervention in clinical practice. This study seeks to examine Vietnamese literature to identify herbs that can aid in reducing obesity and to interpret the association rules among these herbs.</div></div><div><h3>Methods</h3><div>Four hundred thirty-six formulas were collected from 43 documents suited to inclusion criteria. Using Microsoft Excel 2016, we continuously interpreted the characteristics of 320 herbs extracted from 436 anti-obesity formulas. The Apriori algorithm, operated by R Studio version 4.3.3, investigated the association rules among core materials.</div></div><div><h3>Results</h3><div>Shan Zha (<em>Fructus crataegi</em>) is the most popular herb mentioned in 436 compounded medications. The predominant property and flavor were warm (33,02%) and sweet (52,7%), respectively. Eventually, we also found 18 association rules and screened out 7 potential anti-obesity herbs. Each rule consists of two or three components. Especially, the greatest prevalent associated law is a triple combination among Fu Ling (<em>Poria cocos</em>)<em>,</em> Ban Xia (<em>Rhizoma pinelliae</em>)<em>,</em> and Chen Pi (<em>Pericarpium citri reticulatae</em>).</div></div><div><h3>Conclusions</h3><div>This study documents traditional Vietnamese medicinal knowledge on herbs with anti-obesity properties. According to the traditional function, all of herbs can be divided into these classifications: Tonify Spleen-Qi, Move Qi and invigorate Blood, Resolve retention of food, Resolve Dampness and Promoting diuresis. Besides, the pharmacological functions of them are suppressing appetite, inhibition of fat absorption and elevation of fat metabolism rate.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100598"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-02-11DOI: 10.1016/j.obmed.2025.100591
Panadeekarn Panjawatanan, Richard J. Comi
Objective
Insulin therapy in Type 1 diabetes is associated with weight gain. Glucagon-like peptide 1 (GLP-1) agonists, which lower blood glucose and promote weight loss, may help reverse this trend and reduce hemoglobin A1C (A1C) levels.
Methods
Patients with Type 1 diabetes with concomitant GLP-1 agonists used for at least one year were included. Observed outcomes were the change in A1C, weight, and basal insulin use compared at baseline and 12 months using mixed models repeated measures.
Results
Forty-nine patients with weight gain were included. Prior to treatment, patients gained an average of 2.0 kg annually over three years. After 12 months of GLP-1 agonist therapy, weight significantly decreased from 97.6 kg (95% CI: 92.7–102.5) to 90.0 kg (95% CI: 84.9–95.1) (p < 0.001). A1C levels also improved significantly, from 8.2% (95% CI: 7.9–8.6) to 7.6% (95% CI: 7.2–7.9) (p < 0.001). Basal insulin requirements were significantly reduced.
Conclusion
We conclude that GLP-1 agonists effectively reverse the trend of weight gain and improve A1C levels in patients with Type 1 diabetes.
{"title":"GLP-1 agonists in Type 1 diabetes – Indications and use","authors":"Panadeekarn Panjawatanan, Richard J. Comi","doi":"10.1016/j.obmed.2025.100591","DOIUrl":"10.1016/j.obmed.2025.100591","url":null,"abstract":"<div><h3>Objective</h3><div>Insulin therapy in Type 1 diabetes is associated with weight gain. Glucagon-like peptide 1 (GLP-1) agonists, which lower blood glucose and promote weight loss, may help reverse this trend and reduce hemoglobin A1C (A1C) levels.</div></div><div><h3>Methods</h3><div>Patients with Type 1 diabetes with concomitant GLP-1 agonists used for at least one year were included. Observed outcomes were the change in A1C, weight, and basal insulin use compared at baseline and 12 months using mixed models repeated measures.</div></div><div><h3>Results</h3><div>Forty-nine patients with weight gain were included. Prior to treatment, patients gained an average of 2.0 kg annually over three years. After 12 months of GLP-1 agonist therapy, weight significantly decreased from 97.6 kg (95% CI: 92.7–102.5) to 90.0 kg (95% CI: 84.9–95.1) (p < 0.001). A1C levels also improved significantly, from 8.2% (95% CI: 7.9–8.6) to 7.6% (95% CI: 7.2–7.9) (p < 0.001). Basal insulin requirements were significantly reduced.</div></div><div><h3>Conclusion</h3><div>We conclude that GLP-1 agonists effectively reverse the trend of weight gain and improve A1C levels in patients with Type 1 diabetes.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100591"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-22DOI: 10.1016/j.obmed.2025.100586
Ammar Abdulrahman Jairoun
Obesity is a complex health issue that affects every nation worldwide. It is associated with various economic and societal difficulties, substantial comorbidities, and complex disease mechanisms. Conventional approaches to treating obesity often do not result in tailored, sustainable health outcomes. However, new approaches to its treatment may be found in biohacking, an approach defined by the combined use of technology, advances in science, and self-experimentation. This Editorial explores biohacking's potential role in managing obesity, particularly in addressing its behavioral factors, socioeconomic effects, and disease mechanisms. Biohacking aims to manipulate core biological processes such as gene expression, systemic inflammation, and cellular health to reduce the risks associated with obesity and enhance metabolic health. These techniques include nutrigenomics, microbiome manipulation, and intermittent fasting with wearable technologies and ongoing glucose monitors, allowing people to access their health data in real time and personalize their approach to managing their weight. With the support of habit-establishing strategies and mindfulness tools, behavioral interventions underpinned by biohacking principles can deliver long-term changes to people's lifestyles. Biohacking offers potential benefits not only for the individual but also for society, where it may lessen healthcare inequalities by providing low-cost, accessible tools. Nonetheless, ethical concerns about self-experimentation and biohacking's equitability and safety remain. However, integrating biohacking into conventional medicine could transform obesity management and tackle its many associated factors by delivering tailored, preventative treatment options.
{"title":"The application of biohacking in obesity medicine: New perspectives on obesity's socioeconomic effects and disease mechanisms","authors":"Ammar Abdulrahman Jairoun","doi":"10.1016/j.obmed.2025.100586","DOIUrl":"10.1016/j.obmed.2025.100586","url":null,"abstract":"<div><div>Obesity is a complex health issue that affects every nation worldwide. It is associated with various economic and societal difficulties, substantial comorbidities, and complex disease mechanisms. Conventional approaches to treating obesity often do not result in tailored, sustainable health outcomes. However, new approaches to its treatment may be found in biohacking, an approach defined by the combined use of technology, advances in science, and self-experimentation. This Editorial explores biohacking's potential role in managing obesity, particularly in addressing its behavioral factors, socioeconomic effects, and disease mechanisms. Biohacking aims to manipulate core biological processes such as gene expression, systemic inflammation, and cellular health to reduce the risks associated with obesity and enhance metabolic health. These techniques include nutrigenomics, microbiome manipulation, and intermittent fasting with wearable technologies and ongoing glucose monitors, allowing people to access their health data in real time and personalize their approach to managing their weight. With the support of habit-establishing strategies and mindfulness tools, behavioral interventions underpinned by biohacking principles can deliver long-term changes to people's lifestyles. Biohacking offers potential benefits not only for the individual but also for society, where it may lessen healthcare inequalities by providing low-cost, accessible tools. Nonetheless, ethical concerns about self-experimentation and biohacking's equitability and safety remain. However, integrating biohacking into conventional medicine could transform obesity management and tackle its many associated factors by delivering tailored, preventative treatment options.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity is a complex metabolic disorder driven by an imbalance between energy intake and expenditure. A critical pathogenetic component of obesity is dysregulated hunger and satiety mechanisms, driven by both central and peripheral factors. This review explores the pathophysiology of obesity-induced hunger, focusing on key mechanisms involving neurohormonal signals, gut-brain communication, and the dysregulation of appetite-related pathways. It discusses the roles of hormones such as ghrelin, leptin, and insulin, as well as the influence of inflammatory processes on hunger regulation. Additionally, environmental and psychological factors contributing to food cravings and reward-driven eating are considered. The article also examines current and emerging therapeutic interventions targeting hunger and appetite control, including pharmacologic treatments, such as glucagon-like peptide-1 (GLP-1) receptor agonists, lifestyle modifications, and bariatric surgery. Novel strategies under investigation, including appetite-regulating peptides, are highlighted. Bridging the understanding of the intricate mechanisms driving obesity-related hunger with therapeutic advances provides a comprehensive framework for more effective treatment strategies to combat obesity and its associated comorbidities which will ultimately improve patient outcomes.
{"title":"Obesity-driven hunger: From pathophysiology to intervention","authors":"Ahmad Khusairi Azemi , Yahkub Babatunde Mutalub , Monsurat Abdulwahab , Aida Hanum Ghulam Rasool , Sagir Mustapha , Siti Qusyasyiah Ahmad Suhaimi , Siti Safiah Mokhtar","doi":"10.1016/j.obmed.2025.100588","DOIUrl":"10.1016/j.obmed.2025.100588","url":null,"abstract":"<div><div>Obesity is a complex metabolic disorder driven by an imbalance between energy intake and expenditure. A critical pathogenetic component of obesity is dysregulated hunger and satiety mechanisms, driven by both central and peripheral factors. This review explores the pathophysiology of obesity-induced hunger, focusing on key mechanisms involving neurohormonal signals, gut-brain communication, and the dysregulation of appetite-related pathways. It discusses the roles of hormones such as ghrelin, leptin, and insulin, as well as the influence of inflammatory processes on hunger regulation. Additionally, environmental and psychological factors contributing to food cravings and reward-driven eating are considered. The article also examines current and emerging therapeutic interventions targeting hunger and appetite control, including pharmacologic treatments, such as glucagon-like peptide-1 (GLP-1) receptor agonists, lifestyle modifications, and bariatric surgery. Novel strategies under investigation, including appetite-regulating peptides, are highlighted. Bridging the understanding of the intricate mechanisms driving obesity-related hunger with therapeutic advances provides a comprehensive framework for more effective treatment strategies to combat obesity and its associated comorbidities which will ultimately improve patient outcomes.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2025-01-25DOI: 10.1016/j.obmed.2025.100582
Marjan Mokhtare , Shahin Sharafeh , Mohammadjavad Sotoudeheian , Amir M. Sadeghian , Said A. Al-Busafi
Objectives
Metabolic-associated fatty liver disease (MAFLD) is a universal health concern. Detecting advanced fibrosis significantly impacts prognosis. This study designated to assess the accuracy of FIB-4, FIB-6, Agile3+, Agile4, and NAFLD fibrosis score (NFS) in predicting disease severity.
Design and Methods
Clinical, laboratory, and FibroScan findings of adult MAFLD patients were recorded. A fibrosis (F) score over 10 kPa indicates advanced fibrosis. We assessed the area under the receiver operating characteristic curve (AUROCC), along with the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy with various cutoff values. Reliability was analyzed with the intra-class correlation coefficient (ICC).
Results
Advanced fibrosis was found in 5 of 103 patients (4.85%). AUROCC values were as follows: 0.967 for Agile3+, 0.951 for FIB-6, 0.932 for NFS, 0.909 for Agile4, and 0.869 for FIB-4. The PPVs ranged from 18.18% (FIB-4) to 57.09% (NFS), followed by 75.02% (FIB-6), and 18.18% (Agile4) to 100% (Agile3+). All tools achieved acceptable NPVs above 96%. The ICC between the fibrosis score and other tools was 0.772 (95% CI: 0.696-0.834). Significant differences were noted in gamma-glutamyl transferase (p=0.039), diabetes mellitus (P=0.011), platelet count, hemoglobin A1C, alkaline phosphatase, triglycerides, fasting blood glucose, and Vitamin D levels
{"title":"The role of simple and specialized non-invasive tools in predicting of metabolic dysfunction-associated fatty liver disease severity and prognosis","authors":"Marjan Mokhtare , Shahin Sharafeh , Mohammadjavad Sotoudeheian , Amir M. Sadeghian , Said A. Al-Busafi","doi":"10.1016/j.obmed.2025.100582","DOIUrl":"10.1016/j.obmed.2025.100582","url":null,"abstract":"<div><h3>Objectives</h3><div>Metabolic-associated fatty liver disease (MAFLD) is a universal health concern. Detecting advanced fibrosis significantly impacts prognosis. This study designated to assess the accuracy of FIB-4, FIB-6, Agile3+, Agile4, and NAFLD fibrosis score (NFS) in predicting disease severity.</div></div><div><h3>Design and Methods</h3><div>Clinical, laboratory, and FibroScan findings of adult MAFLD patients were recorded. A fibrosis (F) score over 10 kPa indicates advanced fibrosis. We assessed the area under the receiver operating characteristic curve (AUROCC), along with the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy with various cutoff values. Reliability was analyzed with the intra-class correlation coefficient (ICC).</div></div><div><h3>Results</h3><div>Advanced fibrosis was found in 5 of 103 patients (4.85%). AUROCC values were as follows: 0.967 for Agile3+, 0.951 for FIB-6, 0.932 for NFS, 0.909 for Agile4, and 0.869 for FIB-4. The PPVs ranged from 18.18% (FIB-4) to 57.09% (NFS), followed by 75.02% (FIB-6), and 18.18% (Agile4) to 100% (Agile3+). All tools achieved acceptable NPVs above 96%. The ICC between the fibrosis score and other tools was 0.772 (95% CI: 0.696-0.834). Significant differences were noted in gamma-glutamyl transferase (p=0.039), diabetes mellitus (P=0.011), platelet count, hemoglobin A1C, alkaline phosphatase, triglycerides, fasting blood glucose, and Vitamin D levels</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyperlipidemia characterized by elevated cholesterol levels and formation of Reactive Oxygen Species (ROS) is a critical risk factor for coronary heart diseases. In traditional Indian Ayurveda and herbal medicine, various parts of Betula alnoides are reputed for their therapeutic uses. The main aim of this study is to explore the hypolipidemic and antioxidant effects of Betula alnoides bark extracts (petroleum ether and ethyl acetate) in rats with induced hypercholesterolemia.
Methods
Soxhlet extraction method was used to extract Betula alnoides bark powder, utilizing petroleum ether and ethyl acetate as solvents and both the extracts underwent phytochemical screening to identify a range of phytoconstituents. The acute oral toxicity was evaluated on male albino rats, adhering to OECD guideline No. 420. DPPH and nitric oxide scavenging assay was used to determine antioxidant capacity of bark extracts. Hypolipidemic activity was evaluated by inducing hyperlipidemia through a high-fat diet and measuring serum biochemical markers like total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.
Results
The extraction yields were found to be 1.4% ± 0.65% for the petroleum ether extract and 3.2% ± 0.80% for the ethyl acetate extract. In the acute toxicity study, it was found that the bark extracts showed no signs of toxicity. The findings indicated that the DPPH/Nitric oxide free radical scavenging capacity of Betula alnoides bark extracts increased with higher concentrations. When compared to the petroleum ether bark extract, the ethyl acetate bark extract showed a noticeably better antioxidant capacity. Both petroleum ether and ethyl acetate extracts (50 mg/kg and 100 mg/kg) and fenofibrate (65 mg/kg), exhibited significant hypolipidemic effects.
Conclusion
The ethyl acetate extract demonstrated superior hypolipidemic activity compared to the petroleum ether extract. Lupeol binds strongly to SOD, SGLT2, and APOE proteins, showing significant docking scores and engaging multiple amino acids through various stabilizing interactions. These findings suggest that Betula alnoides bark extracts possess promising antioxidant and anti-hyperlipidemic properties.
{"title":"Exploring Betula alnoides bark: Insilico and preclinical insights into its antioxidant and lipid-lowering effects in hypercholesterolemia","authors":"Shahbaz Khan , Alka Lohani , Prashant Tiwari , Sunil Kumar Kadiri","doi":"10.1016/j.obmed.2025.100583","DOIUrl":"10.1016/j.obmed.2025.100583","url":null,"abstract":"<div><h3>Aim</h3><div>Hyperlipidemia characterized by elevated cholesterol levels and formation of Reactive Oxygen Species (ROS) is a critical risk factor for coronary heart diseases. In traditional Indian Ayurveda and herbal medicine, various parts of <em>Betula alnoides</em> are reputed for their therapeutic uses. The main aim of this study is to explore the hypolipidemic and antioxidant effects of <em>Betula alnoides</em> bark extracts (petroleum ether and ethyl acetate) in rats with induced hypercholesterolemia.</div></div><div><h3>Methods</h3><div>Soxhlet extraction method was used to extract <em>Betula alnoides</em> bark powder, utilizing petroleum ether and ethyl acetate as solvents and both the extracts underwent phytochemical screening to identify a range of phytoconstituents. The acute oral toxicity was evaluated on male albino rats, adhering to OECD guideline No. 420. DPPH and nitric oxide scavenging assay was used to determine antioxidant capacity of bark extracts. Hypolipidemic activity was evaluated by inducing hyperlipidemia through a high-fat diet and measuring serum biochemical markers like total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides.</div></div><div><h3>Results</h3><div>The extraction yields were found to be 1.4% ± 0.65% for the petroleum ether extract and 3.2% ± 0.80% for the ethyl acetate extract. In the acute toxicity study, it was found that the bark extracts showed no signs of toxicity. The findings indicated that the DPPH/Nitric oxide free radical scavenging capacity of <em>Betula alnoides</em> bark extracts increased with higher concentrations. When compared to the petroleum ether bark extract, the ethyl acetate bark extract showed a noticeably better antioxidant capacity. Both petroleum ether and ethyl acetate extracts (50 mg/kg and 100 mg/kg) and fenofibrate (65 mg/kg), exhibited significant hypolipidemic effects.</div></div><div><h3>Conclusion</h3><div>The ethyl acetate extract demonstrated superior hypolipidemic activity compared to the petroleum ether extract. Lupeol binds strongly to SOD, SGLT2, and APOE proteins, showing significant docking scores and engaging multiple amino acids through various stabilizing interactions. These findings suggest that <em>Betula alnoides</em> bark extracts possess promising antioxidant and anti-hyperlipidemic properties.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"54 ","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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