Obesity Medicine最新文献

The intestinal microbiota has been shown to be a potential determining factor in the development of obesity. The aim of this systematic review was to identify the effect of probiotic supplementation in children with obesity. Randomized Clinical Trials (RCTs) of interventions with the oral use of probiotics for children with obesity were considered eligible. The PubMed, Scopus, Science Direct, Web of Science, VHL, and Embase databases were used as a source of information. The risk of bias was assessed using the Cochrane Risk of bias criteria. Most of the articles included were carried out in developed countries and showed the benefits of probiotic intervention in reducing anthropometric indices in children with obesity. Future RCTs are needed to assess the effect of probiotics in the absence of weight loss strategies, in order to truly ascertain the specific benefits of probiotic strains on adiposity.

Background and aims

Obesity is a health problem that is linked to complicated metabolic disorders, increasing the risk of developing cardiovascular diseases, insulin resistance, and cancer. The aim of this study was to investigate the preoperative impact of morbid obesity on lipids and micronutrient status.

Methods

This was a retrospective study conducted at King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. A total of 142 obese individuals who were candidates for operation were recruited. Data were obtained from participants’ records, including lipids, HbA1c, RBCs, hemoglobin, iron, ferritin, vitamin B12, and vitamin D.

Results

The study population comprised 57% women; the mean age was 35.9 ± 9.40 years and BMI was 45.1 ± 6.35 kg/m². Abnormal lipid profiles were found in 34% for TG, 34.5% for TC, 83.3% for HDL-C, and 73.9% for LDL-C. The degree of dyslipidemia was significantly higher in patients with increased HbA1c. The study found a prevalence of MCV (38.4%), hemoglobin (20.4%), iron (9%), and ferritin (35%) deficiency, accompanied by RBC elevation in 34% of cases. Vitamins D and B12 were correlated with BMI, and a higher prevalence (82.6%) of vitamin D deficiency was observed.

Conclusion

The study cohort had significant dyslipidemia, especially those with elevated HbA1c. Micronutrient deficiency was seen prior to bariatric surgery. Determining preoperative micronutrient status could aid in supplementing patients prior to operation and optimizing nutritional treatment afterward.

Purpose

Polycystic ovarian syndrome (PCOS) has an impact on numerous women's health issues worldwide. Since the specific aetiology is unknown, the diagnostic criteria are currently insufficient, which contributes to the under diagnosis and under treatment of PCOS in many women.

Basic procedure

Eighteen mature Parkes strain mice (4–5 weeks old) weighing 18–21 g were at random separated to three groups with six mice each: Group I served as the control; Group II was given Letrozole (LET) dissolved in normal saline water (0.9%) orally by using oral gavage at the dose of (6 mg/kg bw) for twenty one days to induce PCOS followed by 60 days without treatment; Group III was given LET (6 mg/kg) for the twenty one days, followed by the oral gavage treatment of ginger (350 mg/kg bw orally daily) for 60 days.

Main findings

In our study we observed that mice with PCOS had increased body weight, ovary mass, blood glucose, insulin, Homa insulin resistance (IR), cholesterol, low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and interleukin-6 (IL-6) as well as increase in testosterone, and luteinizing hormone (LH). We observed decline in estrogen, follicle stimulating hormone (FSH) and decreased antioxidant capacity in the ovary. These alterations were linked to decreased adiponectin in mice. However after ginger administration these changes were reversed.

Conclusion

The findings from our research suggested that adiponectin has direct impact on metabolic and endocrine facets of PCOS, & its drop can cause women infertility. Therefore, boosting the circulation of adiponectin may be employed as a remedy to metabolic, and perhaps endocrine, conditions in polycystic ovarian syndrome-affected individuals.

Objective

To assess the association between the percentage of excess body mass index loss (%EBMIL) and cardiometabolic risk reduction in Peruvian adults undergoing laparoscopic sleeve gastrectomy (LSG).

Methods

Retrospective cohort study conducted with adult patients who underwent LSG in a bariatric clinic during 2016–2020. The outcome variable was cardiometabolic risk change (expressed in Δ) 1 year after LSG. To that effect, the variables total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein (LDL) cholesterol, very LDL (VLDL) cholesterol, triglycerides, glucose, insulin, and HOMA-IR at baseline and after 12 months were considered. The exposure variable was %EBMIL. Crude and adjusted β coefficients were estimated with linear regression models.

Results

Of the 110 patients analyzed, 68.2% were women, and the median patient age was 34.5 years. In the model adjusted for sex, age, and baseline BMI, we noted that each 25% increase in %EBMIL resulted in a decrease in the values for total cholesterol, LDL, triglycerides, and insulin by 10.36 mg/dL (p < 0.001), 7.98 mg/dL (p = 0.001), 13.35 mg/dL (p = 0.033), and 3.63 uU/mL (p = 0.040), respectively.

Conclusion

%EBMIL was associated with a decrease in total cholesterol, LDL, triglycerides, and insulin levels, which could suggest a favorable cardiometabolic evolution during the first 12 months following LSG.

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy that often occurs in reproductive-age women and causes anovulatory infertility problems. Current management guidelines, including fertility medications, hormonal therapy, and glycemic control, have drawbacks due to their limited efficacy and undesirable outcomes. Therefore, this review intended to scrutinise the mechanism and potential benefits of a candidate herbal therapy for PCOS, quercetin, as an adjunctive medication to alleviate disease manifestations. Articles were searched in PubMed, EBSCOHost, ProQuest, and Scopus databases and screened based on their titles and abstracts. A critical appraisal was done using an Evidence-Based Medicine worksheet. Fourteen eligible articles were obtained, including one systematic review, four randomized clinical trials; eight experimental studies; and one systematic pharmacological strategy-based research. It was shown that quercetin alleviated insulin resistance via activating phosphatidylinositol 3-kinase (PI3–K) signalling, reduced testosterone, controlled luteinising hormone, and had anti-inflammatory effects on the ovaries. This antioxidant also altered catabolism and steroidogenesis, regulated AMP-activated protein kinase (AMPK), and decreased oocyte nucleation failure. Furthermore, the lipid profile was reduced by quercetin through the modulation of adiponectin receptors. Ultimately, quercetin successfully improved the pregnancy rate. Due to its potential to modulate several pathways involved in metabolic disease and infertility, quercetin is a promising candidate in clinical practice as adjunctive therapy for PCOS.

Aims

In this study, we aimed to determine the PA and dietary habits of patients with asthma and whether asthma control had a role in these habits.

Methods

Adult patients with asthma were included. Three questionnaires were administered to the patients. and daily step counts were recorded for one week. Asthma control level and severe asthma attacks in the previous year were assessed.

Results

A total of 277 patients were included. One hundred eighty-two (65.3%) of the patients were overweight/obese. According to FFQ, none of the food groups were comsumed in recommended levels. According to the IPAQ scores, 82.7% of the patients had mild physical activity. The daily step counts and the PA domain of the HLBS-II in obese patients were lower than the nonobese patients (p = 0.001 and p = 0.034,respectively). The rate of obese patients (n = 9; 50%) was higher in the uncontrolled patients.

Conclusion

In our study, the majority of patients were physically inactive. Few patients consumed the recommended amount of foods. Being overweight seems to be a significant barrier to the healthy life behaviors. Although these behaviours do not seem to have an effect on asthma controlling this study, further prospective placebo-controlled studies are needed.

Background

The primary aim of this study is to report on changes in obese patients’ comorbidities before and after gastric sleeve surgery. We also want to assess the safety outcomes of performing bariatric surgery at an ambulatory surgical facility by recording the number of complications after surgery.

Methods

This is a retrospective observational study which quantifies the impact of laparoscopic gastric sleeve surgery on the treatment of obesity and its comorbidities among adults 18 and over (n = 219) with a minimum BMI of 30. Pre-operatively, obesity related comorbidities were reported using an in-person medical assessment. Post-operatively, patients were contacted for reassessment through a survey-based questionnaire. The changes in patients’ comorbidities were recorded and quantified.

Results

A total of 219 patients, 177 women (80.8%) and 42 men (19.2%), with a mean age of 41.6 years and an average BMI of 37.3 underwent gastric sleeve surgery. There were three reported complications post-op, and no deaths were reported as a result of the surgery. Moreover, an exact McNemar's test determined a statistically significant difference between the number of self-reported comorbidities in pre-operation (M = 0.8) vs post-operation (M = 0.2); t (218) = 10.61, p = .05. Improvements were seen in the incidence of diabetes, sleep apnea, hypertension, Gastroesophageal reflux disease (GERD), and chronic pain.

Conclusion

The findings suggest significant improvement in weight loss and obesity-related comorbidities such as diabetes, sleep apnea, hypertension, and GERD, among patients who underwent the gastric sleeve surgery. Moreover, the low number of complications suggest that successful surgery can be safely performed in an outpatient setting.

Aims

We aimed to evaluate the relationship between the period of obesity onset in the life cycle of obese adults with their cardiometabolic profile and response to clinical treatment.

Methods

A cross-sectional study carried out in 124 individuals, ≥18 years old, who received clinical treatment for obesity based on the same protocol of care and were stratified according to the period of obesity onset in childhood/adolescence (early) or adulthood (adult). Cardiometabolic profiles (e.g., hypertension, dyslipidemia and diabetes) and weight loss during clinical treatment (mean follow-up of 2 years) were compared among the groups. A ≥10% weight loss of the baseline weight was considered a successful response to clinical treatment.

Results

Early-onset obesity group (n = 40) was younger at the beginning of follow-up [35.8(10.3) vs. 47.9(10.5) years, p < 0.001] and presented a higher frequency of BMI≥40kg/m² [29(72.5) vs. 42(50.0) %, p = 0.018)] than the adult-onset obesity group (n = 84). Duration of obesity and of follow-up was similar in both groups as well as mean weight loss during the treatment and frequencies of hypertension, diabetes, pre-diabetes or dyslipidemia.

Conclusions

Weight loss response to clinical treatment of obesity as well as prevalence of cardiometabolic risk factors were similar in early- and adult-onset obesity.

Background

Childhood weight abnormalities are often considered a global health issue with several consequences. This study was conducted to determine the prevalence of underweight, overweight and obesity, and also identify associated factors in elementary school children.

Materials and methods

A total of 1579 elementary school students out of 70000 in the academic year 2014–2015 were selected to participate in this cross-sectional study, using two-stage cluster random sampling. Students' height and weight were measured and their body mass index (BMI) was calculated. Weight status was determined by age and sex according to BMI percentiles of the Center for Disease Control (CDC) standards and based on the percentiles calculated by SPSS in the studied population. Percentiles of more than 95, between 85 and 95, and less than 5 were considered as obese, overweight, and under-weight, respectively. Age, gender, level of parent's education, parent's occupation, place of residence, type of school, monthly income, nutritional status and time of starting complementary feeding, were collected by an information form. Data were analyzed by SPSS software.

Results

According to BMI percentile of CDC, the prevalence of obesity, overweight and underweight among students was 9%, 10% and 17%, respectively. A significant correlation was observed between age, type of school, place of residence, and students' nutrition with weight abnormalities. Also, parents’ education, birth weight, time of starting complementary feeding, hours of watching television and playing computer games, and physical activity rate had no significant relationship with weight abnormalities of students.

Conclusion

Weight abnormalities are one of the most common health problems among elementary school students living in Kerman city, Iran. Overall, more than 35% of children participated in this study had some form of weight abnormalities. Underweight is considered a health issue in our society, the same as obesity and overweight.