Obesity (Silver Spring, Md.)最新文献

Objective: The study objective was to determine whether associations between a genetic risk score (GRS) for insulin resistance (IR) and measures of insulin sensitivity differ by race and/or BMI status in African American (AA) and European American (EA) adults without diabetes.

Methods: Fifty-three AA and 54 EA participants were classified into "high" or "low" BMI groups using the sample median (25.9 kg/m²) as the cut point. The GRS was derived from 52 previously identified genetic variants. Skeletal muscle insulin sensitivity was measured with the hyperinsulinemic-euglycemic clamp. The homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda index of insulin sensitivity were calculated from oral glucose tolerance test values to determine hepatic and whole-body insulin sensitivity, respectively. Linear regression models, stratified by race, assessed interactions between BMI status and GRS on measures of insulin sensitivity.

Results: In EA participants, associations of GRS with HOMA-IR and the Matsuda index differed by BMI status, where the GRS was associated with IR in the high-BMI group only. In AA participants, associations from the clamp differed by BMI status, but an association was observed only in the low-BMI group.

Conclusions: These results highlight the heterogeneity of IR and support the hypothesis that the relationship between genetic predisposition for IR and obesity is race- and tissue-specific.

Objective: The aim of this study was to investigate the effects of zoledronic acid for the prevention of bone loss after bariatric surgery.

Methods: In this randomized, double-blinded study, 59 patients undergoing Roux-en-Y gastric bypass or sleeve gastrectomy (mean [SD], age: 48.9 [6.3] years, BMI: 42.3 [5.3], 73% female) were randomly assigned (1:1) to receive either zoledronic acid (5 mg; intervention [INT]) or placebo (control [CON]) preoperatively. The primary endpoint was the change in spine volumetric bone mineral density (vBMD) at 12 months after surgery. Secondary outcomes included changes in hip and femoral neck vBMD and areal BMD.

Results: The estimated mean treatment effects of zoledronic acid on the spine and total hip were 6.8 mg/cm³ (95% CI 1.9-11.7; p = 0.003) and 5.0 mg/cm³ (95% CI: 1.4-8.5; p = 0.006), respectively. Bone mass in the spine increased by 2.6% in INT, whereas no changes were observed in CON. Additionally, bone loss in the total hip was prevented in INT compared with CON (vBMD: -0.6% vs. -3.6%; p = 0.006).

Conclusions: Zoledronic acid increases bone mass in the spine and prevents bone loss in the hip region after bariatric surgery compared with placebo.

Objective: The objective of this study was to investigate whether long-term weight change in children with obesity is affected after deciding not to participate in a lifestyle intervention.

Methods: This observational study included 713 children (aged 5-8 years) with obesity living in Aarhus, Denmark, of whom 157 decided not to participate in a community-based lifestyle intervention between 2010 and 2020, and 556 were never invited to participate (i.e., no-intervention group). Height and weight measurements were combined with socioeconomic information from national registers. A mixed-effects model with splines was used to model changes in BMI z score and stratification to investigate effect modifications.

Results: We observed a median follow-up of 3.6 years (quartile [Q]₁;Q₃: 0.4;5.1) for the decided-not-to-participate group. No difference was observed in annual change in BMI z score between the decided-not-to-participate and no-intervention groups (0.00 per year, 95% CI: -0.03 to 0.03; p = 0.90). No effect modifications were observed between the two groups concerning highest completed household education (p = 0.59), household income (p = 0.72), or immigration status (p = 0.17).

Conclusions: Children deciding not to participate in an intervention did not increase their weight compared with children who were never invited, indicating that treatment could be briefly postponed until families are able to participate. Additionally, socioeconomic status or immigration background did not modify the weight change.

Objective: Metabolic improvements may precede weight loss. We compared the effects of self-selected 8-h time-restricted eating (TRE), 15% caloric restriction (CR), and unrestricted eating (UE) on weight, body composition, caloric intake, glycemic measures, and metabolic flexibility.

Methods: In this 12-week randomized-controlled trial, we measured weight (primary outcome), body composition (dual-energy x-ray absorptiometry/magnetic resonance imaging), caloric intake (24-h recall), metabolic flexibility (indirect calorimetry during hyperinsulinemic-euglycemic clamp), and glycemic measures (hemoglobin A1c, hyperinsulinemic-euglycemic clamp, continuous glucose monitoring).

Results: Of the 88 enrolled participants, 81 (92%) completed the trial (mean [SD], age, 43.2 [10.5] years, BMI, 36.2 [5.1] kg/m²; 54.5% female, 84.1% White). Final eating windows were 9.8 h (95% CI: 9.0 to 10.6) for TRE, 12.9 h (95% CI: 11.9 to 13.9) for CR, and 11.8 h (95% CI: 11.0 to 12.7) for UE. Compared with UE (n = 29), weight changes were -1.4 kg (95% CI: -4.5 to 1.7; p = 0.53) with TRE (n = 30) and -2.5 kg (95% CI: -5.8 to 0.8; p = 0.18) with CR (n = 29). TRE showed lower metabolic flexibility than CR (-0.041 [95% CI: -0.080 to -0.002]). Weight, body composition, caloric intake, and glycemic measures were similar among groups. Eating window reduction correlated with decreased caloric intake and visceral fat.

Conclusions: In a 12-week intervention, TRE did not lead to significant improvements in weight, average body composition, or glycemic or metabolic measures compared with CR or UE.

Objective: The objective of this study was to examine weight reduction and adverse events associated with use of antiobesity medications (AOMs) in older adults ages ≥65 years.

Methods: Seven databases were searched for studies evaluating weight reduction of Food and Drug Administration (FDA)-approved AOMs. Studies had to include adults ages ≥65 years with obesity (BMI ≥ 30 kg/m² or ≥27 kg/m² with one weight-related condition), with independent analysis of weight reduction for adults ages ≥65 years. Two coauthors extracted and evaluated studies for risk of bias using standardized forms.

Results: Six experimental studies (five secondary analyses of randomized clinical trial data and one single-arm trial) and two observational studies met inclusion criteria. Seven medications were studied. Sample size of older adults ranged from 13 to 6728. Experimental studies predominantly included patients with concurrent prediabetes or cardiovascular disease. All studies found statistically significant weight reduction between intervention and placebo groups or compared with baseline weight. Few studies reported on adverse events.

Conclusions: Limited evidence suggests weight reduction of AOMs in older adults, with the best current evidence for the use of semaglutide in older adults with obesity and cardiovascular disease. Larger, more inclusive studies of older adults are needed to guide clinical care and determine the tolerability of AOMs for older adults.