Obesity Medicine最新文献_第4页

Association between sleep and weight loss in a 12-month digital lifestyle intervention 一项为期12个月的数字生活方式干预中睡眠和体重减轻之间的关系

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-22 DOI: 10.1016/j.obmed.2025.100653

Aila J. Ahola , Anu Joki , Mikko S. Venäläinen , Sakris K.E. Kupila , Laura-Unnukka Suojanen , E. Juulia Paavonen , Kirsi H. Pietiläinen

Objectives

We studied how sleep quality and chronotype relate to weight loss in a 12-month real-world digital lifestyle intervention, the Healthy Weight Coaching.

Methods

Patients self-reported weight and waist circumference and completed a set of customized sleep-related online questionnaires at baseline, 3-, 6-, 9-, and 12-months. Primary outcomes were percent changes in weight and waist circumference, calculated from baseline to each follow-up time point. Using generalized linear regression for repeated measures, we explored associations between sleep variables (individual variables and factor analysis-derived clusters) and changes in measures of obesity across the program. Additionally, we investigated how changes in reported sleep are associated with weight loss outcomes.

Results

Baseline data included 1883 individuals (82.6 % women, median age 52 years, median BMI 39.1 kg/m²). Reporting sleep apnoea was associated with less successful weight loss across the program [weight, B = 0.760 (95 % CI = 0.446–1.073), p < 0.001; waist, B = 1.275 (95 % CI = 0.780–1.771), p < 0.001]. Eveningness and Tiredness factors were associated with poorer weight [B = 0.206 (95 % CI = 0.027–0.385), p = 0.024 and B = 0.613 (95 % CI = 0.371–0.855), p < 0.001, respectively] and waist circumference [B = 0.434 (95 % CI = 0.155–0.713), p = 0.002 and B = 0.720 (95 % CI = 0.337–1.102), p < 0.001, respectively] reduction over the 12-month program. Increase in reported daytime alertness, over the program, was beneficial for weight loss outcomes.

Conclusions

Addressing evening chronotype and reasons for reduced daytime alertness may be associated with enhanced weight loss; however this study does not establish causality. Additional research is needed to adapt interventions for those with sleep apnoea.

Trial registration

The trial is registered at clinicaltrials.cov (Clinical Trials Identifier NCT04019249).

目的：我们在一项为期12个月的现实世界数字生活方式干预——健康体重指导——中研究睡眠质量和时间类型与减肥之间的关系。方法患者在基线、3个月、6个月、9个月和12个月时自我报告体重和腰围，并完成一套定制的与睡眠相关的在线问卷。主要结局是体重和腰围变化的百分比，从基线到每个随访时间点计算。通过对重复测量的广义线性回归，我们探索了睡眠变量（个体变量和因子分析衍生的聚类）与整个项目中肥胖测量变化之间的关系。此外，我们还调查了报告的睡眠变化与减肥结果之间的关系。结果基线数据包括1883例个体（82.6%为女性，中位年龄52岁，中位BMI 39.1 kg/m2）。报告睡眠呼吸暂停与整个项目中减肥成功率较低相关[weight， B = 0.760 (95% CI = 0.446-1.073), p < 0.001；腰,B = 1.275 (95% CI = 0.780 - -1.771), p & lt; 0.001]。在为期12个月的项目中，夜间和疲劳因素与较差的体重[B = 0.206 (95% CI = 0.027-0.385), p = 0.024和B = 0.613 (95% CI = 0.371-0.855), p <； 0.001]和腰围[B = 0.434 (95% CI = 0.155-0.713), p = 0.002和B = 0.720 (95% CI = 0.337-1.102), p <； 0.001]减少有关。在这个项目中，白天警觉性的增加对减肥结果是有益的。结论解决夜间睡眠类型和白天警觉性降低的原因可能与体重减轻有关；然而，这项研究并没有建立因果关系。需要进一步的研究来适应睡眠呼吸暂停患者的干预措施。试验注册该试验在临床试验中注册。cov（临床试验标识符NCT04019249）。

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引用次数: 0

Assessment of quality of life among type 2 diabetes mellitus and hypertensive patients in Punjab region: A WHOQoL-BREF based hospital study 旁遮普地区2型糖尿病和高血压患者生活质量评价：基于WHOQoL-BREF的医院研究

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-16 DOI: 10.1016/j.obmed.2025.100651

Priyanka Garg, Palakurthi Yanadaiah

Aim

According to recent WHO report, type 2 diabetes mellitus along with associated conditions like hypertension are the most prevalent and alarming disorders especially in low-income settings. The prognosis rates of type 2 diabetes mellitus with hypertension depends on the quality of life of the patients. It arises concern to perform research on this group of patients to reduce the poor outcomes and to improve the prognosis of the disease. This study merely focuses on evaluating the quality of life of patients with type 2 diabetes mellitus and hypertension.

Methods

A cross-sectional study was conducted at Christian Medical College & Hospital in Ludhiana, Punjab, India, using a WHOQoL-BREF questionnaire. The research was conducted among 126 hypertensive and type 2 diabetes mellitus patients, aged between 18 and 70 years. Each patient received informed consent before filling the questionnaire. The data was analyzed using SPSS 16, ANOVA, and an independent student t-test.

Results

The study determined 59.5 % as female and 40.5 % being male. Further, the findings reported that environmental health domain exhibited the highest mean score of 29.3 while the social relationship domain exhibited the lowest quality of life. The variables like BMI, and duration of diseases showed a strong statistical significance with quality of life.

Conclusion

The study concluded that increase in BMI and duration of disease will significantly reduce the quality of life in patients suffering with type 2 diabetes with hypertension.

目的根据世卫组织最近的报告，2型糖尿病以及高血压等相关疾病是最普遍和最令人担忧的疾病，特别是在低收入环境中。2型糖尿病合并高血压的预后取决于患者的生活质量。对这组患者进行研究以减少不良后果和改善疾病预后引起关注。本研究仅对2型糖尿病合并高血压患者的生活质量进行评价。方法在印度旁遮普卢迪亚纳基督教医学院医院采用WHOQoL-BREF问卷进行横断面研究。研究对象为126名高血压和2型糖尿病患者，年龄在18岁至70岁之间。每位患者在填写问卷前均获得知情同意。数据分析采用SPSS 16、方差分析和独立学生t检验。结果女性占59.5%，男性占40.5%。此外，环境健康领域的平均得分最高，为29.3分，而社会关系领域的平均得分最低。BMI、疾病持续时间等变量与生活质量有较强的统计学意义。结论2型糖尿病合并高血压患者BMI升高和病程延长会显著降低患者的生活质量。

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引用次数: 0

Evaluating the waist circumference and waist–to–height ratio as most reliable indicators to determine abdominal obesity among adolescents: Findings from a cross-sectional study in Kazakhstan 评估腰围和腰高比是确定青少年腹部肥胖的最可靠指标：来自哈萨克斯坦横断面研究的结果

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-15 DOI: 10.1016/j.obmed.2025.100650

Ainur S. Ospanova , Aiman S. Kerimkulova , Vijay Kumar Chattu , Ainur O. Samigatova , Akbayan Markabaeva , Riza Nurpeissova , Meruyert O. Zhakupbekova

Background

Childhood obesity is a significant public health issue in Kazakhstan and worldwide. The prevalence of teenager obesity has increased almost three times over the past 20 years among adolescents from 12 to 19 years old. This study aimed to evaluate the waist–to–height ratio (WHtR) as the most informative method for identifying abdominal obesity among young people of 12–13 years old.

Methods

In this cross–sectional study of 1519 adolescents aged 12–13years (mean age: 12.3 ± 0.46years), data were obtained from the from all the seven secondary schools in Semey city (Kazakhstan) science during 2015–2016. Statistical analyses were performed using SPSS (version 22).

Results

The prevalence of overweight and obesity in terms of body mass index (BMI) among adolescents was 24.6 %. Excess weight is significantly higher among girls, but obesity is less pronounced in comparison with boys. According to body BMI by ethnicity overweight is more prevalent among Russian teenagers. The prevalence of abdominal obesity (WC˃90^Th percentile) was 1.2 % among boys (n = 9) and 5.3 % among girls (n = 41). According to the WHtR, the obesity among boys (n = 57) was 7.7 % and 7.5 % among girls (n = 58) respectively.

Conclusions

The prevalence of overweight and obesity was found to be 24.6 % in adolescents. Underweight or overweight were significantly higher among girls, but obesity was less pronounced compared with boys (р˃0,001). Our study recommends to use both WC and WHtR in determining abdominal obesity among adolescents.

儿童肥胖在哈萨克斯坦和全世界都是一个重大的公共卫生问题。在过去的20年里，12岁至19岁的青少年中，青少年肥胖的患病率几乎增加了三倍。本研究旨在评估腰高比（WHtR）作为识别12-13岁青少年腹部肥胖的最具信息量的方法。方法对2015-2016年哈萨克斯坦Semey市7所中学的1519名12 - 13岁青少年（平均年龄：12.3±0.46岁）进行横断面研究。采用SPSS （version 22）进行统计分析。结果青少年体重指数（BMI）超重和肥胖患病率为24.6%。女孩超重的比例明显高于男孩，但与男孩相比，肥胖的比例不那么明显。根据种族的身体体重指数，超重在俄罗斯青少年中更为普遍。腹部肥胖的患病率（WC - 90百分位数）在男孩中为1.2% (n = 9)，在女孩中为5.3% （n = 41）。根据WHtR，男孩（n = 57）的肥胖率为7.7%，女孩（n = 58）的肥胖率为7.5%。结论青少年超重和肥胖患病率为24.6%。女孩体重过轻或超重的比例明显高于男孩，但与男孩相比，肥胖的比例不那么明显。我们的研究建议同时使用腰围和腰围来确定青少年腹部肥胖。

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引用次数: 0

A randomized controlled trial comparing a very low-calorie low-fat ketogenic diet with a standard hypocaloric diet in adults with class I obesity 一项比较极低热量低脂生酮饮食与标准低热量饮食的I级肥胖成人的随机对照试验

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-12 DOI: 10.1016/j.obmed.2025.100642

Francisco J. Nachon Garcia , Gabriela E. Saldaña-Davila , Magdalena Valencia , Cesar Ochoa-Martínez

Background

The global rise in obesity, driven by hypercaloric diets and sedentary lifestyles, has intensified interest in novel dietary interventions. Very low-calorie ketogenic diets (VLCKDs) induce rapid weight loss but are typically high in fat. This study assessed the efficacy and safety of a very low-calorie, low-fat, ketogenic diet (VLCLFKD), also known as the Zélé method, versus a standard low-calorie diet (LCD) in adults with class I obesity.

Methods

In this 12-week, randomized, double-blind controlled trial (NCT06275347), 88 participants were allocated to VLCLFKD (n = 56) or LCD (n = 32), with 77 completing the protocol. The primary endpoint was weight change; secondary outcomes included body composition, fasting glucose, lipid profile, blood pressure, hepatic and renal function, and acid–base balance. All participants received weekly clinical and dietary support.

Results

VLCLFKD led to significantly greater weight loss (−12.4 ± 2.8 kg) than LCD (−7.0 ± 1.9 kg; p < 0.001). Fat mass reduction accounted for 82.1 % of total weight loss in the VLCLFKD group, compared to 38.4 % in the LCD group (p < 0.001), with markedly lower lean mass loss (11.9 % vs. 51.0 %). Significant improvements were observed in fasting glucose (−12.8 mg/dL), total cholesterol (−37.4 mg/dL), triglycerides (−67.4 mg/dL), and blood pressure normalization (88.1 % vs. 71.4 %). Renal and hepatic function and acid–base balance remained stable. No serious adverse events occurred.

Conclusion

The VLCLFKD (Zélé method) is a safe, fat-targeted, and metabolically advantageous strategy for class I obesity, delivering superior weight and metabolic outcomes compared with a conventional LCD while preserving lean mass.

高热量饮食和久坐不动的生活方式导致全球肥胖人数上升，这引起了人们对新型饮食干预措施的兴趣。极低热量生酮饮食（VLCKDs）可以快速减轻体重，但通常含有高脂肪。这项研究评估了极低热量、低脂肪、生酮饮食（VLCLFKD）（也称为z 法）与标准低热量饮食（LCD）在成人I级肥胖患者中的疗效和安全性。方法在这项为期12周的随机双盲对照试验（NCT06275347）中，88名参与者被分配到VLCLFKD组（n = 56）或LCD组（n = 32），其中77人完成了治疗方案。主要终点为体重变化；次要结局包括身体组成、空腹血糖、血脂、血压、肝肾功能和酸碱平衡。所有参与者每周接受临床和饮食支持。结果vlclfkd组体重减轻（- 12.4±2.8 kg）显著高于LCD组（- 7.0±1.9 kg; p < 0.001）。VLCLFKD组脂肪质量减少占总体重减轻的82.1%，而LCD组为38.4% (p < 0.001)，瘦体重减少明显更低（11.9%比51.0%）。空腹血糖（- 12.8 mg/dL）、总胆固醇（- 37.4 mg/dL）、甘油三酯（- 67.4 mg/dL）和血压正常化（88.1% vs. 71.4%）均有显著改善。肝肾功能及酸碱平衡保持稳定。未发生严重不良事件。结论VLCLFKD （z方法）是一种安全的、以脂肪为目标的、代谢优势的I级肥胖策略，与传统的LCD相比，在保持瘦质量的同时，提供了更好的体重和代谢结果。

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引用次数: 0

Overweight/obesity and sedentary Behavior: Dual modifiable factors associated with Hypertension–diabetes comorbidity among adults in Haiphong, Vietnam 超重/肥胖和久坐行为：越南海防成年人高血压-糖尿病合并症的双重可改变因素

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-12 DOI: 10.1016/j.obmed.2025.100649

Thuc Huy Phan , Kien Trung Dong , Diem Thi Hong Nguyen , Hong Thi Nguyen , Khoa Xuan Tang , Anh Hai Cao , Linh Thuy Nguyen , Tuyet Thi Hong Nguyen , Duc Minh Cap

Aims

Hypertension and diabetes are major global public health challenges. This study aimed to assess the prevalence of comorbid hypertension and diabetes and to identify associated factors among adults in Haiphong, Vietnam.

Materials and methods

A large-scale cross-sectional screening study involving 2100 adults was conducted. Participants were selected using multistage sampling from November to December 2023. Data were collected through face-to-face interviews, blood pressure measurements, and anthropometric assessments. Fasting plasma glucose levels were determined using venous blood samples. Univariable and multivariable logistic regression analyses were performed to identify factors associated with comorbid hypertension and diabetes.

Results

The prevalence of hypertension, diabetes, and their comorbidity was 21.8 %, 10.6 %, and 4.3 %, respectively. In the overall population, comorbidity was significantly associated with age 50–60 years (adjusted odds ratio [aOR], 5.03; 95 % confidence interval [CI], 1.53–16.60), male sex (aOR, 1.84; 95 % CI, 1.06–3.21), overweight/obesity (aOR, 1.98; 95 % CI, 1.17–3.36), and sedentary behavior ≥8 h/day (aOR, 2.37; 95 % CI, 1.26–4.46). Among males, significant factors included age 50–60, sedentary behavior, and high-risk alcohol use. Among females, comorbidity was associated with overweight/obesity and a family history of diabetes.

Conclusion

These findings underscore the need for gender-sensitive interventions to reduce the burden of hypertension–diabetes comorbidity in adults. For males, strategies should address sedentary lifestyles, alcohol-related risks, and age-related screening, while in females, efforts should focus on weight management and early identification of individuals with a family history of diabetes.

高血压和糖尿病是全球主要的公共卫生挑战。本研究旨在评估越南海防市成人高血压和糖尿病的患病率，并确定相关因素。材料与方法对2100名成人进行了大规模横断面筛查研究。研究对象于2023年11月至12月采用多阶段抽样方法进行选择。通过面对面访谈、血压测量和人体测量评估收集数据。使用静脉血样本测定空腹血糖水平。进行单变量和多变量logistic回归分析，以确定与高血压和糖尿病合并症相关的因素。结果高血压、糖尿病及其合并症患病率分别为21.8%、10.6%和4.3%。在总体人群中，共病与年龄50-60岁（校正优势比[aOR]， 5.03； 95%可信区间[CI]， 1.53-16.60）、男性（aOR, 1.84; 95% CI, 1.06-3.21）、超重/肥胖（aOR, 1.98; 95% CI, 1.17-3.36）和久坐行为≥8小时/天（aOR, 2.37; 95% CI, 1.26-4.46）显著相关。在男性中，重要因素包括年龄50-60岁、久坐行为和高风险饮酒。在女性中，合并症与超重/肥胖和糖尿病家族史有关。结论这些发现强调了采取性别敏感的干预措施以减轻成人高血压-糖尿病合并症的负担的必要性。对于男性，策略应该解决久坐不动的生活方式、酒精相关的风险和年龄相关的筛查，而对于女性，努力应该集中在体重管理和早期识别有糖尿病家族史的个体。

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引用次数: 0

Association between 8 a.m. cortisol levels and insulin resistance in healthy individuals from Algiers 阿尔及尔健康人早上8点皮质醇水平与胰岛素抵抗之间的关系

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-12 DOI: 10.1016/j.obmed.2025.100648

Nadia Ould Bessi , Yousra Touahria Miliani , Rayane Damou , Meriem Achraf EL Mehdaoui , Amine Kemache , Belaid Ait Abdelkader

Background

Cortisol is a counterregulatory hormone that antagonizes insulin. Its chronic supraphysiological elevation induces insulin resistance, a risk factor for cardiovascular and metabolic diseases. However, the relationship between insulin resistance and normal cortisol concentrations remains controversial. This study evaluates the association between 8:00 a.m. cortisol levels and insulin resistance, as estimated by the HOMA-IR index, and compares the HOMA-IR index with other insulin resistance indices: QUICKI, TyG, and the TG/HDL ratio.

Methods

Healthy adult volunteers were recruited. Exclusion criteria included smoking, pregnancy, and use of lipid-lowering medications, steroids, antidiabetic agents, or antihypertensive agents. Fasting measurements included blood glucose, insulin, cortisol, C-peptide, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol, and AST. Blood pressure was measured, and a questionnaire on clinical, anthropometric, dietary, and lifestyle data was completed.

Results

Of 77 participants, 6 were excluded due to impaired biochemical status. A significant association was found between the HOMA-IR index and cortisol levels in the upper normative range (≥95.5 μg/L, p < 0.001). This association was also found with BMI, waist circumference, insomnia, sedentary lifestyle, unbalanced diet, and fruit intake, but not for sweets and vegetable intake (p > 0.05). A correlation was confirmed between insulin resistance (assessed by the HOMA-IR index) and other indices such as QUICKI, the TG/HDL ratio and the TyG index.

Conclusion

The QUICKI, TyG and TG/HDL indices are good alternative indicators of insulin resistance, which is more severe in people with cortisol levels in the upper normative range. In addition, a sedentary lifestyle and unbalanced diet also contribute to insulin resistance.

皮质醇是一种对抗胰岛素的反调节激素。它的慢性生理上升高导致胰岛素抵抗，这是心血管和代谢疾病的危险因素。然而，胰岛素抵抗和正常皮质醇浓度之间的关系仍然存在争议。本研究通过HOMA-IR指数评估上午8:00皮质醇水平与胰岛素抵抗之间的关系，并将HOMA-IR指数与其他胰岛素抵抗指数（QUICKI、TyG和TG/HDL比值）进行比较。方法招募健康成人志愿者。排除标准包括吸烟、怀孕、使用降脂药物、类固醇、抗糖尿病药物或抗高血压药物。空腹测量包括血糖、胰岛素、皮质醇、c肽、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和谷草转氨酶，测量血压，完成临床、人体测量、饮食和生活方式数据的问卷调查。结果77例受试者中，6例因生化状态受损而被排除。HOMA-IR指数与皮质醇水平在规范上限（≥95.5 μg/L, p < 0.001）之间存在显著相关性。体重指数、腰围、失眠、久坐不动的生活方式、不平衡的饮食和水果摄入量也存在这种关联，但与甜食和蔬菜摄入量无关（p > 0.05）。胰岛素抵抗（由HOMA-IR指数评估）与其他指标如QUICKI、TG/HDL比值和TyG指数之间存在相关性。结论QUICKI、TyG和TG/HDL指标是胰岛素抵抗的较好替代指标，皮质醇水平在正常值较高的人群胰岛素抵抗更为严重。此外，久坐不动的生活方式和不平衡的饮食也会导致胰岛素抵抗。

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引用次数: 0

Antidiabetic impact of bariatric surgery: A meta-analysis of long-term outcome data 减肥手术对糖尿病的影响：长期结果数据的荟萃分析

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-01 DOI: 10.1016/j.obmed.2025.100645

Grace C. Bloomfield , Marcus H. Cunningham , Mike Y. Chen , Dan E. Azagury , Yewande R. Alimi , Nicholas J. Prindeze

Background

Bariatric surgery is a proven method for weight loss and reducing obesity-related comorbidities. While the link between obesity and type 2 diabetes is well established, the long-term impact of bariatric surgery on diabetic patients remains unclear.

Methods

A meta-analysis was conducted between 2000 and 2024 on studies reporting outcomes of Roux-en-Y gastric bypass, gastric sleeve, or medical weight loss controls. Data on BMI, type 2 diabetes, and hypertension were collected and analyzed.

Results

A total of 20 studies with 4092 patients were included. At 1-year weight loss was similar between the diabetic and general populations at 35–40 % total weight loss (TWL), however by 10–12 years1 year, weight loss was similar between the diabetic and general populations at 35–40 % total weight loss (TWL); however, by 10–12 years, while the general population dropped to 23–28 % TWL, the diabetic group maintained an improved 35–39 % TWL. Short-term diabetes resolution was 83–85 % in the diabetic group and 63–85 % in the general population. However, the long-term diabetes rebound was greater in diabetics, with a rate of 26–51 % resolution vs. 26–60 %. Hypertension resolution at 1-year was lower in diabetics at 44–55 % vs. 63–73 %, with insufficient long-term data. At all times, control groups showed persistent worsening of diabetes and hypertension rates.

Conclusions

Bariatric surgery is highly effective for diabetic patients; however long-term outcomes differ from those of the general population. While both groups experienced significant initial weight loss, diabetics maintained better weight control but had higher diabetes recurrence. Roux-en-Y gastric bypass outperformed the gastric sleeve in all measured outcomes.

背景：减肥手术是一种行之有效的减肥和减少肥胖相关合并症的方法。虽然肥胖和2型糖尿病之间的联系已经确立，但减肥手术对糖尿病患者的长期影响尚不清楚。方法对2000年至2024年间报告Roux-en-Y胃旁路、胃套管或药物减肥控制结果的研究进行荟萃分析。收集并分析BMI、2型糖尿病和高血压的数据。结果共纳入20项研究，4092例患者。1年时，糖尿病患者与普通人群的总体重减轻35 - 40% （TWL）相似，但到10-12年时，糖尿病患者与普通人群的总体重减轻35 - 40% （TWL）相似；然而，在10-12年，当普通人群下降到23 - 28%的TWL时，糖尿病组保持了35 - 39%的TWL。糖尿病组的短期糖尿病治愈率为83 - 85%，普通人群为63 - 85%。然而，糖尿病患者的长期糖尿病反弹率更高，前者为26 - 51%，后者为26 - 60%。糖尿病患者1年高血压治愈率为44 - 55%，低于63 - 73%，长期数据不足。在任何时候，对照组的糖尿病和高血压发病率都持续恶化。结论减肥手术治疗糖尿病疗效显著；然而，长期结果与一般人群不同。虽然两组患者的初始体重都有显著下降，但糖尿病患者的体重控制较好，但糖尿病复发率较高。Roux-en-Y胃旁路术在所有测量结果中都优于胃套管术。

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引用次数: 0

Gut microbiome alterations in type 2 diabetes following COVID-19: A comprehensive review 2019冠状病毒病后2型糖尿病患者肠道微生物组的改变：一项综合综述

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-01 DOI: 10.1016/j.obmed.2025.100643

Nilanjana Bose , Deepa Bisht , M. Vinod Kumar , Kazi Anika Nawar , Benjo Chalissery , D. Neha , Nikita Dung Dung , Shivani Rawat , Deepika Ahuja , Ranjay Kumar Choudhary , Alak Kumar Syamal

The COVID-19 pandemic has raised growing concern over its long-term effects, particularly in individuals with pre-existing metabolic conditions such as type 2 diabetes. Beyond its well-known impact on the respiratory and immune systems, emerging research highlights the virus's influence on gut microbiota, a key player in metabolic regulation. This review explores how COVID-19-induced inflammation, immune dysregulation, and direct gastrointestinal effects contribute to disruptions in gut microbial composition and function. Such imbalances may worsen insulin resistance, impair glucose metabolism, and aggravate glycemic control in diabetic patients. We discuss current evidence linking gut dysbiosis to metabolic deterioration in post-COVID type 2 diabetes, emphasizing the role of the gut-lung axis and cytokine storm in this interaction. Recognizing the gut microbiome as a modifiable factor opens new possibilities for targeted interventions, such as probiotics, dietary modulation, and microbiota-based therapies. Understanding these mechanisms is essential not only for managing diabetes in the post-COVID context but also for developing integrative strategies that address the gut microbiome's role in metabolic health. This review underscores the need for further research to elucidate causal relationships and optimize gut-targeted therapeutic approaches in diabetes care following COVID-19 infection.

COVID-19大流行引起了人们对其长期影响的日益关注，特别是对已经患有2型糖尿病等代谢疾病的个体。除了众所周知的对呼吸系统和免疫系统的影响，新兴研究强调了该病毒对肠道微生物群的影响，肠道微生物群是代谢调节的关键角色。这篇综述探讨了covid -19诱导的炎症、免疫失调和直接胃肠道效应如何导致肠道微生物组成和功能的破坏。这种失衡可能加重胰岛素抵抗，损害葡萄糖代谢，加重糖尿病患者的血糖控制。我们讨论了目前将肠道生态失调与covid - 2型糖尿病后代谢恶化联系起来的证据，强调了肠-肺轴和细胞因子风暴在这种相互作用中的作用。认识到肠道微生物群是一个可改变的因素，为有针对性的干预开辟了新的可能性，如益生菌、饮食调节和基于微生物群的治疗。了解这些机制不仅对于在covid后背景下管理糖尿病至关重要，而且对于制定解决肠道微生物组在代谢健康中的作用的综合策略也至关重要。这篇综述强调需要进一步研究阐明COVID-19感染后糖尿病护理的因果关系并优化肠道靶向治疗方法。

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引用次数: 0

Global trends and focuses of GLP-1RA in obesity: A bibliometric analysis and visualization from 2014 to 2024 肥胖症中GLP-1RA的全球趋势和焦点：2014年至2024年的文献计量分析和可视化

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-01 DOI: 10.1016/j.obmed.2025.100640

Riad Mohammed Abdelrahman , Suleiman I. Sharif , Taha Hussein Musa , Hassan Hussein Musa , Ismail Adam Arbab , Mohsen Hussein Suleiman , Khalid Ahmed Mohammed , Sahar Ibrahim Gismallah , Chiamaka Linda Mgbechidinma , Mohammed Jalal , Eltieb Omer Ahmed

Purpose

Obesity is a multifaceted disease with complex causes, distinct pathophysiology, numerous comorbidities, and significant health impacts. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have become leading pharmacological options for its management. Our objective was to conduct a comprehensive analysis of the literature on GLP-1RAs in obesity within the Scopus database and identify relevant articles published between 2014 and 2024.

Methods

We perform a systematic bibliometric analysis to identify key trends, major sources, and emerging topics in GLP-1RA obesity research. The data were analyzed using VOS viewer (Var1.6.20) and the Biblioshiny tool.

Results

A total of 1702 documents were analyzed. Research output remained steady from 2014 to 2020 (approximately 50 documents per year), followed by exponential growth starting in 2020, peaking in 2024 (566 documents). The average number of citations per article peaked at 92 in 2018 before it dropped to 7 in 2024. Among the 130 contributing countries, the United States led with 25.9 % of publications. HOLST J.J. (University of Copenhagen) was the most prolific author (45 publications, 1901 citations, h-index 22). “Diabetes, obesity and metabolism” was the most active journal, publishing 105 articles. (h_index: 39, impact factor: 5.4 (2023)).

Keywords and thematic analyses revealed increasing research interest in specific agents (e.g., Semaglutide, Tirzepatide, and Dulaglutide) and in themes such as body weight loss, heart failure, cohort analysis, and long-term follow-up. Liraglutide and Semaglutide are the most studied. Keyword analysis did not highlight safety concerns related to cancer risk, as previously speculated.

Conclusion

This bibliometric analysis shows rapid growth in GLP-1RA obesity research, underscoring the need to expand focus beyond efficacy to long-term safety, real-world outcomes, and equitable access through international collaboration.

肥胖是一种病因复杂、病理生理独特、合并症众多、影响健康的多面性疾病。胰高血糖素样肽-1受体激动剂（GLP-1RAs）已成为其管理的主要药理选择。我们的目标是对Scopus数据库中关于肥胖中GLP-1RAs的文献进行全面分析，并确定2014年至2024年间发表的相关文章。方法我们进行了系统的文献计量分析，以确定GLP-1RA肥胖研究的关键趋势、主要来源和新兴主题。使用VOS viewer （Var1.6.20）和Biblioshiny工具对数据进行分析。结果共分析文献1702份。从2014年到2020年，研究产出保持稳定（每年约50篇论文），随后从2020年开始呈指数增长，2024年达到峰值（566篇论文）。2018年，每篇文章的平均引用次数达到了92次的峰值，2024年降至7次。在130个贡献国家中，美国以25.9%的出版物领先。HOLST J.J.（哥本哈根大学）是最多产的作者（45篇出版物，1901次引用，h指数22）。《糖尿病、肥胖和新陈代谢》是最活跃的期刊，发表了105篇文章。（h_index: 39，影响因子：5.4(2023)）。关键词和专题分析显示，对特定药物（如Semaglutide、tizepatide和Dulaglutide）以及体重减轻、心力衰竭、队列分析和长期随访等主题的研究兴趣日益增加。利拉鲁肽和西马鲁肽是研究最多的。关键词分析并没有像之前推测的那样强调与癌症风险相关的安全问题。这项文献计量学分析显示，GLP-1RA肥胖研究的快速增长，强调需要通过国际合作将重点从疗效扩展到长期安全性、现实结果和公平获取。

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引用次数: 0

Targeting gut microbial signatures to personalize obesity treatment: Integrating microbiome-based stratification into precision medicine 针对肠道微生物特征个性化肥胖治疗：将基于微生物组的分层整合到精准医学中

Q2 Medicine

Obesity Medicine

Pub Date : 2025-09-01 DOI: 10.1016/j.obmed.2025.100639

Okechukwu Paul-Chima Ugwu , Melvin Nnaemeka Ugwu , Mariam Basajja , Chinyere Nkemjika Anyanwu

Obesity is a chronic heterogenous metabolic disease that is on the rise in low- and middle-income countries like sub-Saharan Africa, where they are experiencing an urbanisation and westernisation of the diet, transforming the nutrition environment. Although microbiome-based stratification of obesity treatment has been suggested as a global solution, there are no African-specific structures. The current communication introduces the first Africa-adapted, conceptual and evidence-informed, enterotype-based model, combining recent African microbiome data. Unique microbial signatures of the gut e.g., a greater occurrence of Succinivibria, Treponema, and Methanobrevibacter are likely to affect nutritional response patterns and responses to interventions among Africans. The four-step conceptual model includes (1) gut profiling, (2) enterotype-matched diets, (3) metabolite tracking and (4) digital feedback loops, which are enabled by culturally adapted, low-cost diagnostics (e.g., portable quantitative polymerase chain reaction (qPCR) kits, lateral-flow short-chain fatty acid (SCFA)/lipopolysaccharide (LPS) assays), and mobile health platforms. We clarified that this is a hypothesis-driven framework, conceptually informed by existing evidence but not empirically validated. A randomised controlled trial (RCT) design proposal to use permutational multivariate analysis of variance (PERMANOVA) to test microbiome composition and multivariate regression to test the diet-microbiome body mass index (BMI) association. This methodology provides solutions to some of the main translational gaps in precision obesity care by incorporating African-specific microbial data, culturally specific diets, and scalable technology.

肥胖是一种慢性异质性代谢性疾病，在撒哈拉以南非洲等低收入和中等收入国家呈上升趋势，这些国家正在经历城市化和饮食西方化，改变着营养环境。尽管以微生物组为基础的肥胖治疗分层已被认为是一种全球性的解决方案，但没有非洲特有的结构。当前的信息通报结合了最近的非洲微生物组数据，介绍了第一个适合非洲的、概念性的和基于证据的、基于肠道型的模型。肠道独特的微生物特征，如琥珀弧菌、密螺旋体和甲烷菌的大量出现，可能会影响非洲人的营养反应模式和对干预措施的反应。四步概念模型包括(1)肠道分析，(2)肠道型匹配饮食，(3)代谢物跟踪和(4)数字反馈循环，这是通过适应文化的低成本诊断(例如，便携式定量聚合酶链反应（qPCR）试剂盒，横向流动短链脂肪酸（SCFA)/脂多糖（LPS）测定）和移动健康平台实现的。我们澄清说，这是一个假设驱动的框架，由现有证据在概念上提供信息，但未经经验验证。一项随机对照试验（RCT）设计建议使用排列多变量方差分析（PERMANOVA）来测试微生物组组成，并使用多变量回归来测试饮食-微生物组体重指数（BMI）的相关性。该方法通过结合非洲特有的微生物数据、文化特有的饮食和可扩展的技术，解决了精确肥胖护理方面的一些主要转化差距。

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引用次数: 0