Obesity Medicine最新文献_第6页

Cardiovascular complications in Diabetes: The role of NLRP3 inflammasome and targeted interventions 糖尿病心血管并发症：NLRP3炎性体的作用和针对性干预

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100629

Gnanaprakash Jeyaraj

Diabetes mellitus (DM) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD), driven by complex metabolic and inflammatory pathways. Among these, the NLRP3 inflammasome has emerged as a crucial mediator linking hyperglycemia, oxidative stress, and chronic inflammation to vascular dysfunction. Dyslipidemia, endothelial dysfunction, and excessive reactive oxygen species (ROS) production further exacerbate plaque formation and cardiovascular complications. Recent cardiovascular outcome trials (CVOTs) highlight the cardioprotective benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), while novel anti-inflammatory strategies, including IL-1β inhibition and NLRP3-targeting agents, offer promising therapeutic avenues. This review explores the molecular mechanisms underlying diabetic atherosclerosis, with a unique emphasis on the role of the NLRP3 inflammasome in disease progression and how targeted interventions including SGLT2 inhibitors, GLP-1 receptor agonists, and emerging NLRP3-modulating agents can be integrated with precision medicine strategies. Unlike existing reviews, we highlight how genomic, epigenetic, and phenotypic stratification can guide combination therapies to optimize cardiovascular protection. Integrating individualized anti-inflammatory and metabolic interventions may provide tailored cardiovascular care, reducing morbidity and mortality in diabetic patients. Future research should focus on refining these personalized approaches to mitigate diabetes-associated cardiovascular complications.

糖尿病（DM）是动脉粥样硬化性心血管疾病（ASCVD）的主要危险因素，由复杂的代谢和炎症途径驱动。其中，NLRP3炎性小体已成为连接高血糖、氧化应激和慢性炎症与血管功能障碍的关键介质。血脂异常、内皮功能障碍和过多的活性氧（ROS）产生进一步加剧斑块形成和心血管并发症。最近的心血管结局试验（CVOTs）强调了钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP-1 RAs）的心脏保护作用，而新的抗炎策略，包括IL-1β抑制和nlrp3靶向药物，提供了有希望的治疗途径。这篇综述探讨了糖尿病动脉粥样硬化的分子机制，特别强调了NLRP3炎症体在疾病进展中的作用，以及包括SGLT2抑制剂、GLP-1受体激动剂和新兴的NLRP3调节剂在内的靶向干预如何与精准医学策略相结合。与现有的综述不同，我们强调基因组、表观遗传和表型分层如何指导联合治疗以优化心血管保护。整合个体化抗炎和代谢干预可以提供量身定制的心血管护理，降低糖尿病患者的发病率和死亡率。未来的研究应侧重于改进这些个性化的方法，以减轻糖尿病相关的心血管并发症。

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引用次数: 0

Future projections of elderly obesity in the United States using time series models 使用时间序列模型预测美国老年人肥胖的未来

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100627

Halil Çolak

This study aims to forecast the prevalence of obesity among the elderly population (aged 65 and over) in the United States through 2035 using time series forecasting techniques. Obesity data from 2013 to 2022 were analysed using six models: Autoregressive Integrated Moving Average (ARIMA), Long-Short Term Memory (LSTM), Gated Recurrent Units GRU, Random Forest (RF), Vector autoregression model (VAR), and eXtreme Gradient Boosting (XGBoost). The primary goal is to inform future public health strategies and optimize healthcare resource allocation for the aging population. The results indicate a consistent rise in obesity rates. ARIMA predicted an increase from 30.6 % in 2022 to 35.0 % in 2035, while VAR estimated 37.9 %. Machine learning models forecasted sharper growth: RF projected 40.6 %, LSTM 41.3 %, and GRU 39.8 %. XGBoost anticipated the highest rate, reaching 44.3 % in 2035. Model performances were evaluated using coefficient of determination (R²), mean square error, root mean square error, and sum of squares error. VAR and XGBoost achieved the best results (R² = 0.9995 and 0.9993, respectively), while LSTM (R² = 0.9004) and GRU (R² = 0.8648) showed moderate predictive power. ARIMA also performed well with R² = 0.9420. The findings reveal that ensemble and multivariate models, particularly XGBoost and VAR, offer higher forecasting accuracy. This study fills a gap in the literature by focusing on elderly obesity projections and offers valuable insights for developing targeted intervention policies and health programme.

本研究旨在利用时间序列预测技术预测到2035年美国老年人（65岁及以上）肥胖的流行程度。采用自回归综合移动平均（ARIMA）、长短期记忆（LSTM）、门控循环单元（GRU）、随机森林（RF）、向量自回归模型（VAR）和极端梯度增强（XGBoost） 6种模型分析了2013年至2022年的肥胖数据。主要目标是为未来的公共卫生战略提供信息，并优化老龄化人口的医疗资源分配。结果表明肥胖率持续上升。ARIMA预测从2022年的30.6%增长到2035年的35.0%，而VAR估计为37.9%。机器学习模型预测的增长幅度更大：RF预测为40.6%，LSTM预测为41.3%，GRU预测为39.8%。XGBoost预计这一比例最高，到2035年将达到44.3%。采用决定系数（R2）、均方误差、均方根误差和平方和误差评价模型的性能。VAR和XGBoost的预测效果最好（R2分别为0.9995和0.9993），而LSTM （R2 = 0.9004）和GRU （R2 = 0.8648）的预测能力中等。ARIMA也表现良好，R2 = 0.9420。结果表明，集合模型和多元模型，特别是XGBoost和VAR，具有较高的预测精度。本研究通过关注老年人肥胖预测填补了文献空白，为制定有针对性的干预政策和健康规划提供了有价值的见解。

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引用次数: 0

Direct medical costs of childhood obesity during 2015–2024: A systematic review 2015-2024年儿童肥胖直接医疗费用的系统回顾

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100628

Nadia J. Sweis , Manal Said Qarain , Sanjay Marasini

Background

Child obesity is a serious public health concern and is known to cause a significant burden on health care costs across the world. This systematic review aimed to determine the cost of care for child obesity during 2015–2024.

Method

MEDLINE, Embase, Scopus and Cochrane CENTRAL were searched on November 15, 2024 to identify original articles conducted in children and adolescents (aged 0–20 years) which reported the costs of care of children with obesity and without obesity. The outcome measures included relative and direct costs of care attributed to child obesity.

Results

In total, 745 studies that reported obesity were identified, of which eight studies were included in the qualitative synthesis. The included studies had either used the real-world data collected from different data sources (database studies, n = 5) or epidemiological and economic sources (modeling studies, n = 3) to estimate medical care expenditure. The relative costs of care were 35 % higher and direct of care were between 0.4 % and 88 % higher in children with obesity than normal weight children. In absolute terms, the excess costs (USD, 2024) for treating overweight and children with obesity ranged from $32.44 to $1225.35. The annual per capita health care costs (USD) differed across countries, which was attributed to methodological differences in cost estimation and durations of the studies.

Conclusion

Childhood obesity incurs country specific higher direct costs of care.

儿童肥胖是一个严重的公共卫生问题，在世界范围内造成了巨大的卫生保健费用负担。本系统综述旨在确定2015-2024年期间儿童肥胖的护理成本。方法于2024年11月15日检索medline、Embase、Scopus和Cochrane CENTRAL，以确定在儿童和青少年（0-20岁）中报道肥胖和非肥胖儿童护理成本的原创文章。结果测量包括归因于儿童肥胖的相对和直接护理成本。结果共确定了745项报告肥胖的研究，其中8项研究被纳入定性综合。纳入的研究要么使用从不同数据源（数据库研究，n = 5）收集的真实数据，要么使用流行病学和经济来源（建模研究，n = 3）来估计医疗保健支出。肥胖儿童的相对护理费用比正常体重儿童高35%，直接护理费用比正常体重儿童高0.4%至88%。按绝对值计算，治疗超重和肥胖儿童的额外费用（2024美元）从32.44美元到1225.35美元不等。各国的年度人均医疗保健费用（美元）有所不同，这是由于成本估算方法和研究持续时间的差异。结论儿童肥胖导致国家特有的较高的直接护理成本。

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引用次数: 0

Association between diabetes markers, physical fitness, and balance among people with type 2 diabetes mellitus 2型糖尿病患者的糖尿病标志物、身体健康和平衡之间的关系

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100631

Sobia Hasan , Basit Ansari , Tehreem Anis , Fahad Alanazi , Mehrunnisha Ahmed , Ahmad Alanazi , Faizan Zaffar Kashoo

Background and purpose

Diabetes mellitus, a common disorder of glucose metabolism, affects multiple organ systems and often leads to complications such as diabetic peripheral neuropathy (DPN), which impairs balance and mobility. To manage DPN effectively, understanding the relationships between key markers, such as fasting blood sugar (FBS), glycated hemoglobin (HbA1c), and aerobic capacity (VO₂max), and balance-related outcomes is crucial but remains underexplored. This study aimed to investigate the associations between diabetes markers (FBS, HbA1c), physical fitness (VO₂max), body mass index (BMI), and balance measures such as One-Leg Stance test (OLS), Berg Balance Scale (BBS), and Timed Up and Go test (TUGT) in adults with type 2 diabetes mellitus (T2DM).

Methods

A cross-sectional correlation analysis was performed using baseline data from a randomized controlled study (n = 90, 67.8 % female, mean age = 55.96 ± 4.61 years). Pearson's correlation and mediation analyses were used to assess relationships between diabetes markers, fitness indicators, and balance measures.

Results

Higher FBS and HbA1c correlated negatively with balance (OLS: r = −0.43 to −0.45, p < 0.01; BBS: r = −0.37 to −0.40, p < 0.05) and positively with mobility impairment (HbA1c-TUG: r = 0.28, p = 0.04). A higher VO₂max was correlated with better balance (OLS: r = 0.50, p < 0.01) and faster mobility (TUGT: r = −0.39, p < 0.05). A high BMI negatively impacts balance and slows mobility. Neuropathy severity (Michigan Neuropathy Screening Instrument-MNSI) significantly predicted higher HbA1c (β = 0.106, p < 0.001) and reduced VO₂max, OLS, and BBS scores.

Discussion

Poor glycemic control (higher FBS and HbA1c) is linked to poorer balance, whereas higher VO₂max and lower BMI are correlated with improved balance in T2DM patients. Exercise and metabolic control strategies are essential for optimizing functional outcomes in diabetes management.

背景和目的糖尿病是一种常见的糖代谢紊乱，可影响多器官系统，并经常导致糖尿病周围神经病变（DPN）等并发症，损害平衡和活动能力。为了有效地管理DPN，了解关键指标(如空腹血糖（FBS）、糖化血红蛋白（HbA1c）和有氧能力（VO2max）与平衡相关结果之间的关系至关重要，但仍未得到充分研究。本研究旨在探讨成人2型糖尿病（T2DM）患者的糖尿病标志物（FBS、HbA1c）、体能（VO2max）、体重指数（BMI）和平衡测量（如单腿站立测试（OLS）、Berg平衡量表（BBS）和定时起床测试（TUGT））之间的关系。方法采用随机对照研究（n = 90，女性67.8%，平均年龄55.96±4.61岁）的基线资料进行横断面相关分析。使用Pearson相关分析和中介分析来评估糖尿病标志物、健康指标和平衡测量之间的关系。结果较高的FBS和HbA1c与平衡呈负相关(OLS: r = - 0.43 ~ - 0.45, p <；0.01;BBS: r = - 0.37至- 0.40,p <；活动能力障碍呈阳性（HbA1c-TUG: r = 0.28, p = 0.04）。较高的VO2max与较好的平衡性相关(OLS: r = 0.50, p <；0.01)和更快的迁移速度(TUGT: r = - 0.39, p <；0.05)。高BMI会对平衡产生负面影响，并减缓行动能力。神经病变严重程度（密歇根神经病变筛查仪器- mnsi）显著预测HbA1c升高(β = 0.106, p <；0.001)， VO2max、OLS和BBS评分降低。血糖控制不良（较高的FBS和HbA1c）与较差的平衡有关，而较高的VO2max和较低的BMI与T2DM患者的平衡改善有关。运动和代谢控制策略对于优化糖尿病管理的功能结果至关重要。

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引用次数: 0

The impact of epigenetic factors in type 2 diabetes: Insights into development and pathogenesis 表观遗传因素对2型糖尿病的影响：对发展和发病机制的见解

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100635

Thammanna Gowda SS, Shobith Rangappa, Parimala Hanumesh

Background

Insights into Development and Pathogenesis investigates the critical role of epigenetic modifications, such as DNA methylation, histone alterations, and non-coding RNA, in the onset and progression of Type 2 diabetes (T2D). It highlights how environmental factors, lifestyle choices, and genetic predispositions influence these epigenetic changes, contributing to insulin resistance, beta-cell dysfunction, and other key mechanisms of T2D. The review provides a comprehensive understanding of the complex interplay between genetic and epigenetic factors in diabetes pathogenesis.

Aim

The aim of this review is to explore the role of epigenetic modifications in the development and pathogenesis of Type 2 diabetes (T2D). It examines how environmental factors, lifestyle, and genetic predisposition influence epigenetic changes, contributing to key mechanisms such as insulin resistance and beta-cell dysfunction. By providing insights into these interactions, the review aims to enhance understanding of T2D etiology and inform potential therapeutic strategies.

Result

The review reveals that epigenetic modifications, including DNA methylation, histone alterations, and non-coding RNA regulation, significantly contribute to the development and progression of Type 2 diabetes (T2D). It highlights how environmental factors, lifestyle choices, and genetic predisposition lead to changes in these epigenetic marks, driving insulin resistance, impaired beta-cell function, and other aspects of T2D. The findings underscore the potential of targeting epigenetic pathways for novel therapeutic approaches in managing T2D.

Conclusion

The review concludes that epigenetic factors play a crucial role in Type 2 diabetes development, offering promising targets for therapeutic intervention. Understanding these mechanisms may lead to more effective prevention and treatment strategies.

《发展和发病机制》研究了表观遗传修饰，如DNA甲基化、组蛋白改变和非编码RNA，在2型糖尿病（T2D）的发生和进展中的关键作用。它强调了环境因素、生活方式选择和遗传倾向如何影响这些表观遗传变化，促进胰岛素抵抗、β细胞功能障碍和其他T2D的关键机制。这篇综述提供了对糖尿病发病中遗传和表观遗传因素之间复杂相互作用的全面理解。目的探讨表观遗传修饰在2型糖尿病（T2D）发生和发病中的作用。它研究了环境因素、生活方式和遗传易感性如何影响表观遗传变化，促进胰岛素抵抗和β细胞功能障碍等关键机制。通过提供这些相互作用的见解，该综述旨在加强对T2D病因的理解，并为潜在的治疗策略提供信息。结果研究表明，表观遗传修饰，包括DNA甲基化、组蛋白改变和非编码RNA调控，在2型糖尿病（T2D）的发生和进展中起着重要作用。它强调了环境因素、生活方式选择和遗传易感性如何导致这些表观遗传标记的变化，从而驱动胰岛素抵抗、β细胞功能受损和T2D的其他方面。这些发现强调了针对表观遗传途径的治疗T2D的新方法的潜力。结论表观遗传因素在2型糖尿病的发生发展中起着至关重要的作用，为治疗干预提供了有希望的靶点。了解这些机制可能会导致更有效的预防和治疗策略。

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引用次数: 0

Evaluate the Gln223Arg LEPR genotype variation in T2DM patients with chronic kidney disease 评估Gln223Arg LEPR基因型在T2DM合并慢性肾病患者中的变异

Q2 Medicine

Obesity Medicine

Pub Date : 2025-07-01 DOI: 10.1016/j.obmed.2025.100630

Shahab Ahmed Salıh Gezh , Figen Guzelgul , Nihan Bozkurt , Hakan Sivgin , Koksal Deveci

Background

Obesity significantly contributes to the development of type 2 diabetes mellitus (T2DM). Genetic variations in leptin receptor (LEPR) genes are thought to be influential in the onset of T2DM in patients with kidney malfunction and obesity. This study focused on examining the link between the Gln223Arg polymorphism in the LEPR gene and T2DM in the mid-Black Sea region of the Anatolian Turkish population.

Methodology

In this study, we examined a group of 174 patients with T2DM and compared them to a control group of 30 healthy individuals to explore the relationship involving the leptin receptor gene (Gln223Arg). The T2DM group was divided into 91 patients with macroproteinuria and 46 patients with normoproteinuria subgroups. The genetic analysis was conducted using the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) technique.

Results

Our data revealed a significant increase in the frequency of gene polymorphism with HbA1c levels.

Conclusion

The Gln223Arg leptin receptor gene mutation may cause an elevation of HbA1c in T2DM patients with chronic kidney disease (CKD) in the mid-Black Sea region of the Anatolian Turkish population.

背景：肥胖与2型糖尿病（T2DM）的发生有显著关系。瘦素受体（LEPR）基因的遗传变异被认为对肾功能障碍和肥胖患者的T2DM发病有影响。本研究的重点是研究黑海中部地区安纳托利亚土耳其人LEPR基因Gln223Arg多态性与T2DM之间的联系。在这项研究中，我们检查了一组174例T2DM患者，并将其与30名健康个体的对照组进行比较，以探讨瘦素受体基因（Gln223Arg）的关系。T2DM组分为大蛋白尿组91例和正常蛋白尿组46例。采用基于聚合酶链反应的限制性片段长度多态性（PCR-RFLP）技术进行遗传分析。结果我们的数据显示，基因多态性的频率随着HbA1c水平的升高而显著增加。结论Gln223Arg瘦素受体基因突变可能导致安纳托利亚土耳其人口中黑海地区T2DM合并慢性肾脏疾病（CKD）患者HbA1c升高。

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引用次数: 0

Microbial dysbiosis, obesity, and insulin Resistance: Understanding gut-ovary association in polycystic ovary syndrome 微生物生态失调、肥胖和胰岛素抵抗：了解多囊卵巢综合征的肠-卵巢关联

Q2 Medicine

Obesity Medicine

Pub Date : 2025-06-18 DOI: 10.1016/j.obmed.2025.100626

Suparna Parua , Anukona Hazra , Krishnendu Adhikary , Krishnendu Ganguly , Deepika Ahuja , Rajkumar Maiti , Lipika Das Mukhopadhyay , Sulagna Dutta , Pragati Panda , Koushik Bhattacharya , Pallav Sengupta , Alak Kumar Syamal

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder, affecting 5–10 % of women of reproductive age, and is characterized by complex etiology involving reproductive and metabolic disturbances. The core clinical features include anovulation, irregular ovulation, polycystic ovarian morphology, and hyperandrogenism (HA), with frequent accompaniments of metabolic dysfunctions such as dyslipidemia, insulin resistance (IR), abdominal obesity, and impaired glucose metabolism. The available evidence shows significant involvement of gut microbiota in the pathogenesis and progression of PCOS. Alterations in gut, PCOS axis-including changes in gut microbiota composition as contributed by such alterations in the pathogenesis of PCOS and its complications like obesity, IR, and type 2 diabetes mellitus (T2DM), will be discussed in this review. This review covers such aspects that gut dysbiosis, HA, chronic inflammation, and non-alcoholic fatty liver disease are related to the pathology of PCOS, thereby amplifying it. Lifestyle-related interventions include physical activity, yoga, therapeutic strategies in terms of gut microbiota including fecal microbiota transplantation (FMT), prebiotics, probiotics, synbiotics, and psychobiotics, which are reviewed for improving metabolic as well as reproductive outcomes in PCOS. Rather, this review focuses on the pressing need for further research into understanding the roles of gut microbiota in PCOS as well as optimizing gut-targeted therapies aimed at better managing this complex condition.

多囊卵巢综合征（PCOS）是一种常见的内分泌疾病，影响5 - 10%的育龄妇女，其特点是病因复杂，涉及生殖和代谢紊乱。核心临床特征包括无排卵、不规则排卵、多囊卵巢形态和高雄激素（HA），并常伴有代谢功能障碍，如血脂异常、胰岛素抵抗（IR）、腹部肥胖和糖代谢受损。现有的证据表明，肠道微生物群在多囊卵巢综合征的发病和进展中有重要的参与。肠道、多囊卵巢综合征轴的改变——包括肠道菌群组成的变化，这些变化是由多囊卵巢综合征及其并发症如肥胖、IR和2型糖尿病（T2DM）的发病机制的改变所引起的。本文综述了肠道生态失调、透明质酸、慢性炎症和非酒精性脂肪性肝病与PCOS的病理相关，从而放大了PCOS。与生活方式相关的干预措施包括体育锻炼、瑜伽、肠道微生物群的治疗策略，包括粪便微生物群移植（FMT）、益生元、益生菌、合成菌和精神微生物，这些都是改善多囊卵巢综合征代谢和生殖结果的方法。相反，本综述的重点是迫切需要进一步研究肠道微生物群在多囊卵巢综合征中的作用，以及优化肠道靶向治疗，以更好地管理这一复杂疾病。

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引用次数: 0

Rethinking obesity metrics in Southeast Asia: Evidence from Haiphong highlights urgent gaps 重新思考东南亚的肥胖指标：来自海防的证据凸显了紧迫的差距

Q2 Medicine

Obesity Medicine

Pub Date : 2025-06-18 DOI: 10.1016/j.obmed.2025.100625

Riza Amalia , Henny Indreswari , Fatimah Setiani

引用次数: 0

Intertwined pathways of SARS-CoV-2 infection and its clinical repercussions on glucose homeostasis: Exploring the rise of new-onset diabetes SARS-CoV-2感染的相互交织的途径及其对葡萄糖稳态的临床影响：探讨新发糖尿病的上升

Q2 Medicine

Obesity Medicine

Pub Date : 2025-06-12 DOI: 10.1016/j.obmed.2025.100624

Vertika Awasthi , Rupinder Kaur , Chirag Pasricha, Pratima Kumari, Suruchi Chaubey, Sarita Jangra, Sanjana Mehta, Ravinder Singh

Coronavirus disease 2019 (COVID-19) and diabetes seem to have a bidirectional relationship. People suffering from diabetes mellitus (DM) are at higher risk than non-diabetics to contract SARS-CoV-2 infections and acquire COVID-19-related health issues. Diabetes is consistently linked to higher disease risk and death among COVID-19 patients. Data also suggest that multiple phenotypic expression alterations caused by SARS-CoV-2 could complicate the pathogenesis of pre-existing diabetes or result in additional pathological conditions. Clinical research data shows that SARS-CoV-2 infection promotes metabolic abnormalities in humans. Furthermore, recent studies concerning new-onset diabetes (NOD) in COVID-19 affected population, who had previously been infected with the virus, reinforce the notion that SARS-CoV-2 has a direct influence on glucose metabolism. Data from various sources indicated that SARS-CoV-2 infected individuals had a greater prevalence of Diabetic Ketoacidosis (DKA), which might be related to a blatant assault on the beta (β)cells of the pancreas. This virus has also been attributed to binding with the ACE 2 receptors found in critical body tissues as well as organs such as β islet cells of the pancreas, small intestine, kidneys and adipose tissues, causing Ketosis-prone diabetes (KPD), which is a very prevalent form of diabetes in Asia, especially India. It has been observed that despite the lack of autoantibodies, the people so affected experience short, transitory insulin deficit that produces DKA at first, but they recover from this β-cell secretory failure over time. This paper highlights the complex interplay between SARS-CoV-2 and its clinical implications on diabetic pathobiology, emphasizing how the cause-effect relationship operates bidirectionally between the two.

2019冠状病毒病（COVID-19）和糖尿病似乎存在双向关系。糖尿病患者比非糖尿病患者更容易感染SARS-CoV-2并出现与covid -19相关的健康问题。在COVID-19患者中，糖尿病一直与更高的疾病风险和死亡有关。数据还表明，由SARS-CoV-2引起的多种表型表达改变可能使原有糖尿病的发病机制复杂化，或导致额外的病理状况。临床研究数据显示，SARS-CoV-2感染会促进人类代谢异常。此外，最近关于COVID-19感染人群中曾感染该病毒的新发糖尿病（NOD）的研究强化了SARS-CoV-2对葡萄糖代谢有直接影响的观点。来自各种来源的数据表明，SARS-CoV-2感染个体的糖尿病酮症酸中毒（DKA）患病率更高，这可能与对胰腺β (β)细胞的公然攻击有关。这种病毒还被认为与关键身体组织和器官（如胰腺、小肠、肾脏和脂肪组织的β胰岛细胞）中的ACE 2受体结合，导致酮症易感性糖尿病（KPD），这是亚洲，特别是印度非常普遍的糖尿病形式。据观察，尽管缺乏自身抗体，但受影响的人最初会经历短暂的胰岛素缺乏，产生DKA，但随着时间的推移，他们会从这种β细胞分泌失败中恢复过来。本文重点介绍了SARS-CoV-2及其对糖尿病病理生物学的临床意义之间的复杂相互作用，强调了两者之间的因果关系是如何双向运作的。

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引用次数: 0

Obesity and Climate Change: A Two-way Street with Global Health Implications 肥胖和气候变化：具有全球健康影响的双行道

Q2 Medicine

Obesity Medicine

Pub Date : 2025-06-11 DOI: 10.1016/j.obmed.2025.100623

Esther Ugo Alum , Regina Idu Ejemot-Nwadiaro , Peter A. Betiang , Mariam Basajja , Daniel Ejim Uti

Obesity and climate change are critical global challenges of the 21st century, with shared drivers and far-reaching impacts on public health, environmental sustainability, and socioeconomic equity. Both crises are fueled by factors such as unsustainable food systems, urbanization, and systemic inequities. Industrialized food production contributes to greenhouse gas emissions, deforestation, and resource depletion while promoting calorie-dense, nutrient-poor diets that exacerbate obesity rates. Climate-induced food insecurity further intensifies the malnutrition paradox, where undernutrition and obesity coexist, disproportionately affecting vulnerable populations. This short communication explores the complex connections between obesity and climate change, examining their mutual drivers, public health implications, and role in food systems. The novelty of this communication lies in its amalgamation of emerging, underexplored bidirectional mechanisms, including thermoregulatory effects and differential emissions contributions, supported by recent evidence. Rather than serving as a comprehensive review, this paper aims to offer a concise yet policy-relevant perspective that emphasizes overlooked linkages and actionable solutions. By clearly framing the scope and contribution of this short communication, we aim to distinguish our work from broader literature reviews and highlight its relevance for integrated health-environment policy development. Recommendations include leveraging technology, fostering global collaboration, and advancing interdisciplinary research to address these intersecting crises holistically. Aligning with public health and environmental goals is essential for creating a resilient and equitable future for both human and planetary well-being. This short communication was developed through an extensive review of scholarly articles, policy reports, and case studies addressing the intersections of obesity and climate change. Sources were identified via databases such as PubMed, Scopus, and Google Scholar, with keywords including “obesity,” “climate change,” “food systems,” and “public health policies.” The analysis focused on identifying shared drivers, mutual impacts, and actionable strategies. Emphasis was placed on evidence-based insights and multidisciplinary approaches to propose integrated solutions that address both crises.

肥胖和气候变化是21世纪的重大全球挑战，它们对公共卫生、环境可持续性和社会经济公平具有共同的驱动因素和深远的影响。不可持续的粮食体系、城市化和系统性不平等等因素加剧了这两场危机。工业化粮食生产助长了温室气体排放、森林砍伐和资源枯竭，同时促进了高热量、营养不良的饮食，从而加剧了肥胖率。气候导致的粮食不安全进一步加剧了营养不良悖论，营养不足和肥胖并存，对弱势群体造成了不成比例的影响。这篇简短的文章探讨了肥胖与气候变化之间的复杂联系，考察了它们的相互驱动因素、公共卫生影响以及在粮食系统中的作用。这种交流的新颖之处在于它融合了新兴的、未被充分探索的双向机制，包括温度调节效应和不同的排放贡献，并得到了最近证据的支持。本文旨在提供一个简洁但与政策相关的观点，强调被忽视的联系和可行的解决方案，而不是作为一份全面的综述。通过明确构建这篇简短信息的范围和贡献，我们的目标是将我们的工作与更广泛的文献综述区分开来，并强调其与综合卫生-环境政策制定的相关性。建议包括利用技术、促进全球合作和推进跨学科研究，以全面解决这些交叉的危机。与公共卫生和环境目标保持一致，对于为人类和地球的福祉创造一个有复原力和公平的未来至关重要。这个简短的交流是通过对学术文章、政策报告和案例研究的广泛审查而形成的，这些研究涉及肥胖和气候变化的交叉点。通过PubMed、Scopus和谷歌Scholar等数据库确定来源，关键词包括“肥胖”、“气候变化”、“食品系统”和“公共卫生政策”。分析的重点是确定共同的驱动因素、相互影响和可操作的策略。会议强调了基于证据的见解和多学科方法，以提出解决这两个危机的综合解决方案。

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