Obesity Medicine最新文献

Aim

The rising prevalence of obesity has elevated it to a significant public health concern. Bariatric surgery (BS) has emerged as a promising solution for severe obesity and associated complications, surpassing traditional approaches. Nonetheless, the escalating utilization of BS has given rise to novel challenges, namely weight regain (WR) and insufficient weight loss (IWL). Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have surfaced as a promising therapeutic avenue. Recognizing the potential of GLP-1 RAs in addressing relapse among individuals who have undergone BS is imperative for enhancing patient outcomes.

Materials and methods

A comprehensive systematic review was undertaken by searching through databases including PUBMED, EBSCO, ProQuest, and manual exploration, following the PRISMA 2020 guideline. Included were studies that examined the application of GLP-1RAs in individuals who had undergone BS and encountered WR and IWL.

Results

This review encompassed 10 studies, all of which demonstrated consistent findings. Irrespective of the diversity in surgical methods, a range of total weight loss (TWL) outcomes were observed. Both primary and revisional surgeries exhibited reductions in body mass index (BMI); emphasizing the overall efficacy of GLP-1 RAs. The collective evidence consistently highlighted the effectiveness and safety of GLP-1RAs in managing post-bariatric weight concerns.

Conclusions

Based on current evidence, GLP-1 RA is a safe and effective treatment for post-BS WR and IWL. However, comparison studies using cohort or randomized controlled trials are needed to confirm its effect.

Background

Obesity has devastating impacts on both physical and mental health and has emerged as a major global health concern. This cross-sectional study aimed to assess the impact of obesity on various health outcomes and to measure the health-related quality of life (HRQoL) of obese population.

Methods

For the study, 207 adult individuals who had a body mass index (BMI) of 30 kg/m2 or greater were chosen from a tertiary care hospital. The Weight-Related Symptom Measure (WRSM), the Depression, Anxiety, and Stress Scale 21 (DASS21), and the Obesity Weight Loss-Quality of Life (OWL-QOL) questionnaires were given to the study participants. The correlation between obesity and the relevant factors was evaluated using Pearson correlation coefficients.

Results

The findings showed a strong correlation between obesity and weight-related symptoms such fatigue, joint pain, back pain, shortness of breath, overeating behaviours, and irritability. Furthermore, obesity and HRQoL showed a strong inverse connection, suggesting individuals with higher BMI experienced a lower level of quality of life. The assessment of psychological factors revealed a strong correlation between obesity and a higher prevalence of stress, anxiety, and depressive symptoms.

Conclusion

The study emphasises the intricate interactions between obesity, weight related symptoms, HRQoL, and mental health. The physical and psychological effects of obesity should be addressed by healthcare professionals using a comprehensive strategy. Tailored interventions, early prevention, and targeted management strategies for vulnerable subgroups are essential to enhance the overall well-being and mental health of obese individuals.

Due to its significant impact on public health, obesity has been studied from a variety of perspectives. All surgical procedures of bariatric and metabolic surgeries (BMS) carry their risks and benefits and have specific characteristics. Considering that weight regain (WR) is considered a surgical failure. This systematic review, registered on PROSPERO under code CRD42023421203, aims to identify physical and behavioral predictors associated with WR post-BMS. Primary outcomes included WR prevalence after BMS (>10% recovery from maximum weight loss or points of BMI >4 or 5 kg/m²), while secondary outcomes assessed factors associated with WR. This systematic review with meta-analysis demonstrated that 49% of patients WR after BMS and this prevalence is higher in those who underwent Roux-en-Y Gastric Bypass (RYGB) surgery (42%) and in Europe (64%). Protective factors for WR only included prior BMI and younger age with statistical significance, however other analyzes did not demonstrate statistical significance. Therefore, it is important to note that the use of BMS does not guarantee long-term sustainable weight loss without continuous lifestyle modifications and treatment dietetic. Efforts to maintain weight loss should include ongoing lifestyle modifications to ensure the effectiveness and efficacy of the surgery.

Aims

This study sought to evaluate anti-obesity effects, improved metabolic function, and spermatogenesis of Licorice root extract at doses of 343 mg/kg and 686 mg/kg.

Methods

This was a controlled experimental, descriptive cross-sectional, longitudinal study follow-up over 10 weeks of nourishment. We generated an obesity model in white mice (Swiss albino) in 6 weeks with a high-fat diet (52–53% lipid, 610 Kcal/100g). Besides, the hydroethanolic extract of Radix Glycyrrhizae (RG) was prepared. Then, we divided mice into 4 groups (NFD, HFD, RG343, RG686) with 12 mice/group. We followed morphological indices, metabolic function, and spermatogenesis after 4 weeks of taking this extract.

Results

Following the intervention, mice exhibited reduced weight, weight gain, BMI, and waist circumference. However, there was no difference between the 2 doses. Moreover, blood glucose, visceral fat mass, total cholesterol, and LDL-c levels of mice after the intervention were lower. Furthermore, there was a clear difference between the two doses. After the intervention, mice had larger penis, testes, epididymis, and seminal vesicle diameters and improved semen parameters, noting the difference between the two doses.

Conclusion

Licorice root extract helps to reduce weight, BMI, and visceral fat and improve metabolic function and spermatogenesis of obese mice. Significantly, the dose of 686 mg/kg was more effective than the dose of 343 mg/kg.

With a 25–30% prevalence worldwide, the burden of nonalcoholic fatty liver disease (NAFLD) continues to increase. Southeast Asia has the greatest prevalence of NAFLD in Asia, estimated to be 29% overall. This paper aims to determine the characteristics and trends of published NAFLD studies in SEA countries. We systematically reviewed the literature using the Scopus database and obtained pertinent bibliographic and citation information. Visualization of collaboration networks of countries and keywords related to NAFLD was conducted using VOSviewer software. This bibliometric analysis shows that research on NAFLD is increasing in SEA but varies among countries. Singapore is the most productive country in NAFLD research, followed by Malaysia and Thailand. The majority of papers were published in journals based outside Asia. The study's emergent themes include probiotics, epigenetics, cardiovascular disease, diagnostics, treatment, genetics-related risk factors, and comorbidities. Research productivity in NAFLD and collaborations vary within and outside the region among different countries and is influenced by socioeconomic factors.

The rate of childhood obesity is a public health problem and has increased dramatically in recent decades in most Latin American countries, mainly in Mexico. The different causal factors of the disease are an unhealthy diet based on ultra-processed and easily consumed foods, the environment, socioeconomic status, culture, eating patterns, sedentary lifestyles, insufficient sleep, social prejudice, environmental chemical pollutants, reduced physical activity and the media. The latter exert great pressure to consume more and more industrial foods, which is contributing to aggravate the childhood obesity epidemic existing today in our society. This review presents an analysis of the effect of the different factors related to childhood obesity and shows an acceleration in its prevalence, which could reflect the result of the neglect of prevention programs and methodological deficiencies not yet identified by government authorities. This is important from the point of view of the challenges that Mexican health systems will face in the next generations. In conclusion, Mexico presents alarming obesity rates in children.

Aims

To examine if the Time elapsed between Dinner and the Midpoint of sleep (TDM) is associated with BMI and obesity.

Methods

Participants (n = 1303) were part of a virtual exploratory, population-based survey. To evaluate differences in BMI associated with TDM we performed linear and quantile regression analyses. Logistic regression models were fitted to assess ORs (95%CI) of obesity associated with TDM. Restricted cubic splines were also used to study the shape of the association.

Results

We found a dose-response association between TDM and BMI, which decreased by 0.22 kg/m² for each additional hour of TDM, with stronger and higher effects in the highest percentile of BMI. By increasing TDM, the odds of obesity decreased [OR (95%CI):0.87 (0.78,0.97); P = 0.01]. These associations were independent of age, gender, marital status, weekly duration of physical activity, and the largest meal of the day.

Conclusions

Because we found that having dinner farther from the midpoint of sleep was significantly associated with BMI, our data reflect the pertinence of assessing the circadian meal timing, along with the energy intake and the quality of meals, in nutritional recommendations and obesity prevention and treatment.

COVID-19 is the disease caused by SARS-CoV-2 coronavirus infection, with patients exhibiting asymptomatic or mild clinical manifestations to severe life-threatening respiratory disease. Obesity was early identified as one of the risk factors for the worsening COVID-19 related clinical manifestations. Considering that around a fifth of the Portuguese adult population has obesity, it is pivotal to explore the impact of obesity on COVID-19 clinical outcomes also in this population. To assess the association between obesity and the outcomes of patients hospitalized with COVID-19 in a University Hospital in southern Portugal (Algarve), clinical and biochemical data from a continuous sample of patients was collected and analyzed. Comparisons between patients with and without obesity were performed with appropriate statistical tests. From the 215 patients hospitalized with COVID-19, 24.7% were classified with obesity. Logistic regression showed that patients with obesity were more likely to need intensive care (OR = 2.66; p = 0.009) and higher oxygen requirement (OR = 5.04; p = 0.033), even after adjusting for hypertension (which was more prevalent in the obesity group). Obesity in patients with COVID-19 was not associated with increased mortality, as there were no differences in inflammation or sepsis biomarkers, or the use of corticosteroids/antibiotics, compared to patients without obesity. This work highlights the risk associated with obesity in COVID-19 patients in terms of the course of clinical outcomes. This is the first study analyzing the relationship between obesity and COVID-19 when it comes to clinical outcomes in a Portuguese population from the southern Portugal.