Obesity (Silver Spring, Md.)最新文献

Objective: Cholecystectomy (GBX) may alter energy metabolism, but human evidence is limited. We examined whether GBX alters energy expenditure (EE), respiratory exchange ratio (RER), and substrate oxidation.

Methods: A total of 384 healthy Southwestern Indigenous American adults (222 males, age 28 ± 6 years) were studied, including individuals with a history of gallbladder surgery [GBX(+), n = 39] and without surgery [GBX(-), n = 345]. In addition, 24-h energy metabolism was measured in a respiratory chamber. General linear models were adjusted for age, sex, body composition, and glucose regulation. RER and macronutrient oxidation rates were further adjusted for energy balance.

Results: GBX(+) participants were older (31 ± 7 vs. 27 ± 6 years, p = 0.0002) and mostly female (95% vs. 36%, p < 0.0001), and they had higher body fat (40% ± 5% vs. 32% ± 8%, p < 0.0001), although body composition differences were sex related. Adjusted models showed lower RER (β = -0.01, p = 0.01), higher lipid oxidation (β = 79 kcal/day, p = 0.03), and higher sleep EE (β = 78 kcal/day, p = 0.006) in the GBX(+) group. Other EE variables and macronutrient oxidation rates were not significantly associated with GBX history (all p's > 0.1).

Conclusions: Independent of obesity, an absent gallbladder is associated with decreased RER and increased lipid oxidation and sleep EE rates, indicating that the gallbladder may have a role in metabolic fuel selection that has implications for metabolic health.

Trial registration: ClinicalTrials.gov identifiers: NCT00339482, NCT00340132.

Objective: Obesity prevalence in the United States has surged dramatically, yet comprehensive analysis of cardiovascular mortality patterns among adults with obesity remains lacking.

Methods: We analyzed CDC WONDER Multiple Cause of Death data for adults aged ≥ 25 years in the United States (1999-2023), identifying deaths where cardiovascular disease was the underlying cause and obesity was a contributing cause. Age-adjusted mortality rates (AAMR) per 100,000 population were calculated. Joinpoint regression analysis identified temporal trends stratified by sex, age, race/ethnicity, and geographic region.

Results: Among 363,203 cardiovascular deaths, AAMR tripled from 3.40 to 10.34 per 100,000 (average annual percent change [AAPC]: +4.88%). Three distinct phases emerged: steady increase (1999-2018), pandemic acceleration (2018-2021, 12.22% annual increase), and recent decline (2021-2023). Men had higher mortality than women (12.69 vs. 8.06 per 100,000 in 2023). The 75-84 years group showed the steepest increase (AAPC: +5.66%). Non-Hispanic Black adults maintained the highest AAMR (18.30 per 100,000 in 2023). The South transformed from lowest to highest regional burden (AAPC: +5.52%). The disease spectrum shifted toward atherosclerotic and hypertensive conditions.

Conclusions: Cardiovascular mortality among US adults with obesity tripled over 25 years, with widening disparities across demographic and geographic groups, necessitating equitable public health interventions targeting high-risk populations.

Objective: The distribution of excess white adipose tissue (WAT) in obesity correlates with risk for comorbidities. Thus, understanding depot-specific WAT developmental mechanisms is translationally relevant. SNPs near the gene CEBPA associate with waist to hip ratio, and while C/EBPα is a recognized regulator of adipogenesis, there is no previously known role for C/EBPα in regulating adipose distribution.

Methods: We crossed Cebpa floxed mice to the AdipoQ-Cre transgenic mouse strain, generating mice with adipocyte-specific knockout of Cebpa (Cebpa_ASKO). Mice were phenotyped on a chow diet and after prolonged high-fat diet (HFD) feeding.

Results: Cebpa_ASKO mice almost entirely lack gonadal WAT (gWAT), while inguinal WAT (iWAT) is present in near normal amounts. Despite developing, Cebpa_ASKO iWAT contains fewer and larger adipocytes, fails to expand under HFD challenge, and is dysfunctional as evidenced by transcriptomics and functional studies. Finally, Cebpa_ASKO mice have lipid-laden brown adipose tissue (BAT), increased hepatic triglycerides, and increased plasma cholesterol, all of which worsen with prolonged HFD feeding.

Conclusions: These results highlight a previously unrecognized difference in the essentiality of C/EBPα for gWAT and iWAT development and highlight novel interorgan relationships between WAT and other metabolic tissues. Further studies of these specific mechanisms could have clinical relevance for targeting visceral adiposity in humans.

Objective: This study aimed to describe near real-time, county-level prevalence of overweight and obesity among individuals aged 18 years and older using electronic health records (EHRs) from Epic Cosmos and kiosks in retail locations.

Methods: Using cross-sectional data (January 2024-July 2025) from 85 million patients from EHRs and 1.2 million users of Pursuant Health kiosks, we estimated the prevalence of overweight (BMI: 25 to < 30 kg/m²) or obesity (BMI ≥ 30 kg/m²) using height (EHRs: measured, kiosks: self-reported) and measured weight. Prevalence was estimated directly for EHRs and using multilevel regression and post stratification based on sociodemographic variables for kiosks, then compared with direct and modeled estimates from the Centers for Disease Control and Prevention (CDC) surveys: National Health and Nutrition Examination Survey and Behavioral Risk Factor Surveillance System.

Results: Nationally, the prevalence of overweight was 39.1% and 33.6% (95% CI: 32.8%-34.4%), and obesity was 43.7% and 43.3% (95% CI: 42.3%-44.4%) from EHRs and kiosks, respectively, which was similar to national surveys. Higher prevalence was observed among Non-Hispanic Black adults, those aged 45-64 years, and rural residents. County hot spots were observed across Southern and Midwestern states and were correlated with modeled CDC estimates (EHRs: 0.64, kiosks: 0.34).

Conclusions: Recent EHR and kiosk samples of US adults show a high prevalence of overweight and obesity and identify local hot spots that are masked in surveys.

Objective: While prior work has related pregravid or childhood excess weight to brain outcomes in children, their combined associations remain unclear. We examined these relationships in 6-year-old children.

Methods: Ninety-nine mother-child pairs (60% girls) were classified into four groups based on pregravid BMI (< 25 vs. ≥ 25 kg/m²) and child BMI (< 85th and ≥ 85th percentile). T1-weighted MRI assessed cortical thickness, sulcal depth, gyrification, and subcortical volumes in children. ANCOVA revealed group differences controlling age, sex, parental education, and birth weight (and total intracranial volume in non-thickness models). Bonferroni-adjusted post hoc tests followed omnibus tests.

Results: High pregravid BMI was associated with a thicker right superior temporal gyrus, while high child BMI was linked to greater gyrification in temporo-cingulate cortices. Both maternal and child higher BMI were related to a thinner right cuneus and a smaller right accumbens and pallidum. Children with higher BMI born to mothers with higher BMI showed deeper sulci in the left caudal middle frontal gyrus and reduced gyrification in the left entorhinal cortex.

Conclusions: Higher BMI in both children and mothers, separately and jointly, was associated with gray matter differences in obesity-related regions. Longitudinal studies are needed to establish temporal relationships, mechanisms, biomarkers, and functional implications.

Objective: Obesity, or excessive body fat, is a significant health risk factor. Western diets (WD) contribute to metabolic dysfunction and obesity, while Mediterranean diets (MD) improve metabolic health. This study examined the contrasting effects of WD versus MD on visceral and subcutaneous adipose tissues (VAT, SAT) using a randomized preclinical trial in 38 female cynomolgus macaques assigned to consume either WD (n = 21) or MD (n = 17) for 31 months.

Methods: Body composition, metabolic parameters, and adipose transcriptomics were evaluated.

Results: WD significantly induced VAT and SAT accumulation, which was directly associated with insulin resistance, hepatosteatosis, and time spent alone and inversely related to cortisol suppression response to dexamethasone indicating hypothalamic-pituitary glucocorticoid insensitivity. Diet significantly influenced the VAT transcriptome, with MD upregulating pathways linked to RNA processing and protein folding while downregulating those involved in fatty acid oxidation and aerobic respiration.

Conclusions: These findings highlight the protective role of MD against fat accumulation and metabolic dysfunction and provide novel insights into the molecular mechanisms underlying diet-induced obesity. Promoting this dietary pattern may help reduce obesity and chronic disease risk. Further research integrating proteomics and metabolomics is required to better understand diet-induced molecular changes.

Objective: This meta-analysis evaluates the safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1 RA) for the treatment of older adults with obesity compared to younger individuals.

Methods: A systematic review was conducted following PRISMA guidelines (PROSPERO CRD420251074381). PubMed, Embase, and Scopus were searched until May 17, 2025, for randomized controlled trials and observational studies assessing GLP-1 RA in adults ≥ 65 years with obesity with or without type 2 diabetes. Random effects meta-analyses calculated the log odds ratios (LOR) for dichotomous outcomes and the mean differences (MD) for continuous outcomes, with equivalence testing via two one-sided tests (TOST) and meta-regression for baseline adjustments.

Results: Five studies involving 1229 participants were included. No significant difference in serious adverse events was found between older and younger adults (pooled LOR: 0.06, p = 0.9). Older adults had a trend toward lower frequency of nausea (LOR: -0.44, p = 0.06) but higher incidence of constipation (LOR: 0.72, p = 0.02) and hypoglycemia (LOR: 0.97, p < 0.001). Efficacy in metabolic and weight control was comparable. Additionally, one study suggested that liraglutide could reduce fat mass without worsening sarcopenia.

Conclusions: GLP-1 RA therapy seems to be safe and effective in older adults with obesity, achieving similar effects on weight loss and glycemic control as in younger individuals.