BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic...BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic characteristics including abnormal drug distribution and clearance.Rocuronium exhibits markedly different distribution patterns in obese patients,with conventional weight correction methods inadequately addressing individual muscle mass variations that critically influence drug distribution.AIM To investigate the quantitative relationship between skeletal muscle index(SMI)and rocuronium distribution volume in obese colorectal cancer patients,establish a population pharmacokinetic model,and develop individualized dosing strategies based on muscle mass.METHODS A retrospective cohort study was conducted,including 100 obese patients(body mass index≥30 kg/m^(2))who underwent elective radical colorectal cancer surgery at our hospital from June 2023 to January 2025.Skeletal muscle mass was measured using InBody 260 body composition analyzer and SMI was calculated to assess muscle mass,with male SMI<7.0 kg/m^(2) and female SMI<5.7 kg/m^(2)as diagnostic criteria for sarcopenia.Plasma rocuronium concentrations were detected by liquid chromatography-tandem mass spectrometry/mass spectrometry,and nonlinear mixed-effect modeling was used to establish population pharmacokinetic modeling.Stepwise regression was used to screen covariates,and dosing regimens were optimized through Monte Carlo simulation.The primary endpoint was targeted plasma concentration achievement rate,and the secondary endpoint was postoperative residual muscle relaxation incidence.RESULTS Among 100 patients,35(35.0%)had sarcopenia and 65(65.0%)did not.Patients in the sarcopenia group were older(64.1±9.8 years vs 54.2±10.9 years,P<0.001)and had significantly lower SMI(6.2±0.8 kg/m^(2)vs 8.4±1.2 kg/m^(2),P<0.001).SMI showed strong positive correlation with rocuronium steady-state distribution volume(r=0.718,P<0.001)and moderate negative correlation with clearance(r=-0.502,P<0.001).A two-compartment population pharmacokinetic model was successfully established,with SMI being the most important covariate affecting central compartment distribution volume(△OFV=-41.2,P<0.001).Model validation showed bootstrap successful convergence rate of 92.3%,and 92.1%of observed values fell within prediction intervals in predicted concentration versus predicted concentration.The SMI-based individualized dosing regimen improved target exposure achievement rate from 82.0%in traditional regimen to 93.5%(P=0.009),and reduced postoperative residual muscle relaxation incidence from 13.0%to 3.5%(P=0.018).The sarcopenia group showed the most significant improvement in achievement rate,from 71.4%to 93.8%(P=0.017).CONCLUSION SMI shows strong correlation with rocuronium distribution volume in obese colorectal cancer patients and is a key factor affecting drug distribution.SMI-based individualized dosing strategies can significantly improve target exposure achievement rate and reduce postoperative residual muscle relaxation incidence,providing scientific evidence for precision anesthesia management in obese patients.展开更多
Objective To explore the sequential effects of hypoxic exercising on miR-27/PPARγand lipid metabolism targetgene and protein expression levels in the obesity rats’liver.Methods 13-week-old male diet-induced obesity ...Objective To explore the sequential effects of hypoxic exercising on miR-27/PPARγand lipid metabolism targetgene and protein expression levels in the obesity rats’liver.Methods 13-week-old male diet-induced obesity rats were randomlydivided into three groups(n=10):normal oxygen concentration quiet group(N),hypoxia quiet group(H),hypoxic exercise group(HE).Exercise training on the horizontal animal treadmill for 1 h/d,5 d/week for a total of 4 week,and the intensity of horizontaltreadmill training was 20 m/min(hypoxic concentration was 13.6%).Comparison of the weights of perirenal fat and epididymal fat in rats across different groups and calculation of Lee’s index based on body weight and body length of rats in each group were done.And the serum concentrations of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high-densitylipoprotein cholesterol(HDL-C)levels were detected.RT-PCR and Western Blot were used to detect the levels of miR-27,PPARγ,CYP7A1 and CD36.Results Hypoxic exercise decreased the expression levels of miR-27 in the obese rats’liver,however,theexpression level of PPARγwas gradually increased.The expression levels of miR-27 in HE group were significantly lower than Ngroup(P<0.05).The expression levels of PPARγmRNA in N group were significantly lower than H group(P<0.05),especially lowerthan HE group(P<0.01).The protein expression of PPARγprotein in N group was significantly lower than that other groups(P<0.01).The expression of lipid metabolism-related genes and proteins increased in the obese rats’liver.The expression of CYP7A1mRNA in N group was significantly lower than H group(P<0.05),especially lower than HE group(P<0.01).The expression ofCYP7A1 protein in the obese rats’liver in N group was extremely lower than H group and HE group(P<0.01).The proteinexpression of CD36 in N group was significantly lower than that in HE group(P<0.05).Hypoxia exercise improved the relatedphysiological and biochemical indexes of lipid metabolism disorder.The perirenal fat weight of obese rats in HE group wasextremely lower than N group and H group(P<0.01),and the perirenal fat weight in N group was significantly higher than H group(P<0.05).The epididymal fat weight in N group was significantly higher than H group(P<0.05),and extremely higher than HEgroup(P<0.01).The Lee’s index in HE group was extremely lower than N group and H group(P<0.01).The serum concentration ofTC in obese rats in HE group was extremely lower than N group and H group(P<0.01).The serum concentration of TG in HE groupwas extremely lower than N group and H group(P<0.01).The serum concentration of LDL-C in N group was extremely higher thanHE group(P<0.01).The serum concentration of HDL-C in N group was extremely lower than H group(P<0.01).Conclusion Hypoxiaand hypoxia exercise may negatively regulate the levels of PPARγby inhibiting miR-27 in the obese rats’liver,thereby affecting theexpression of downstream target genes CYP7A1 and CD36,and promoting cholesterol,fatty acid oxidation and HDL-C transport inthe liver,and ultimately the lipid levels in obese rats were improved.The effect of hypoxia exercise on improving blood lipid isbetter than simple hypoxia intervention.展开更多
In recent years,the incidence of type 2 diabetes mellitus(T2DM)caused by obesity in China has been increasing continuously,which has become a risk factor for the onset of T2DM and seriously affects the quality of life...In recent years,the incidence of type 2 diabetes mellitus(T2DM)caused by obesity in China has been increasing continuously,which has become a risk factor for the onset of T2DM and seriously affects the quality of life of patients.The conventional treatment methods include weight loss and regulating the body’s metabolism.Semaglutide,as a glucagon-like peptide-1 receptor agonist(GLP-1RA),mainly reduces patients’appetite,decreases their craving for high-fat and high-sugar foods,regulates hypothalamic feeding behavior,inhibits gastric emptying and gastrointestinal motility,and ultimately leads to weight loss.Metformin mainly acts on extra-islet tissues,increasing glucose utilization,reducing glucose production,and ultimately lowering blood glucose levels.Based on this,this article reviews relevant literature on authoritative websites such as CNKI and Wanfang,organizes the data,and analyzes the research progress of semaglutide combined with metformin in the treatment of obese T2DM.The aim is to bring more treatment options for obese T2DM and promote better prognosis for patients.展开更多
Arabinoxylan(AX)has been found to improve an imbalanced gut microbiota.Lactobacillus gasseri is a beneficial endogenous bacterium that has been shown to have several health benefits in the human gut,particularly its l...Arabinoxylan(AX)has been found to improve an imbalanced gut microbiota.Lactobacillus gasseri is a beneficial endogenous bacterium that has been shown to have several health benefits in the human gut,particularly its lipid-lowering activity.However,it is not known whether AX can promote the action of L.gasseri.The results of in vitro experiments showed that AX promoted biofilm formation in L.gasseri,its acid and bile salt resistance could be enhanced,and enabled better colonization of L.gasseri in the intestinal tract of mice.In vivo experiments showed that the AX+L.gasseri group could effectively ameliorate weight gain and fat accumulation in high-fat diet-induced obese mice,and the L.gasseri group or AX+L.gasseri alleviated liver injury in mice.16S rRNA sequencing showed that L.gasseri can colonize the mice intestine and AX+L.gasseri can ameliorate gut microbiota dysbiosis in obese mice by increasing Lactobacillus spp.and Coriobacteriaceae_UCG-002,and decreasing Peptococcaceae.In addition,metabolomics results indicated that the L.gasseri group and the AX+L.gasseri group could alleviate metabolic disorders by decreasing the levels of L-phenylalanine,L-tyrosine,kynurenine acid,and arachidonic acid in obese mice.The effect of AX+L.gasseri group was better than that of the L.gasseri group,suggesting that AX promotes the lipid-lowering activity of L.gasseri,and the mechanism may be due to the activation of retrograde endocannabinoid signaling.AX can be used as a functional food ingredient to potentially alleviate obesity and metabolic syndrome.展开更多
Iron overload has been evidenced to contribute to obesity-associated metabolic disorders,including insulin resistance.Strategies to reduce iron levels might help manage the metabolic complications associated with obes...Iron overload has been evidenced to contribute to obesity-associated metabolic disorders,including insulin resistance.Strategies to reduce iron levels might help manage the metabolic complications associated with obesity.Here,it is demonstrated that the specific accumulation of oleic acid-modified polyoxovanadates(OPOVs)in adipose tissue leads to the reduction of iron concentrations in adipocytes in mice fed with a high-fat diet(HFD).Conjugation of oleic acids to polyoxovanadates enables tissue-specific depletion of iron from white adipose tissue(WAT)by OPOVs,protecting mice from HFD-induced obesity and obesity-associated metabolic deteriorations.Glucose tolerance and insulin sensitivity are improved in OPOV-treated mice,which demonstrates that the OPOV-induced iron depletion can reverse the metabolic degeneration caused by HFD-induced obesity.Furthermore,a decrease in expression of the marker genes of iron overload suggests the participation of OPOVs in maintaining iron homeostasis and a potential medical application of vanadium clusters in targeting the iron overload caused by obesity.These findings underscore the potential of vanadate-based clusters tailored to address the complex interplay between iron metabolism and metabolic health.展开更多
Apples are popular fruits worldwide and rich in phenolic compounds that can alleviate obesity and related metabolic diseases.However,the mechanisms underlying the anti-obesity actions of apple polyphenols(AP)like phlo...Apples are popular fruits worldwide and rich in phenolic compounds that can alleviate obesity and related metabolic diseases.However,the mechanisms underlying the anti-obesity actions of apple polyphenols(AP)like phlorizin(PZ)and procyanidin B2(PB2)on transplanted obese patient fecal microbiota(TOPFM)-induced obesity and related syndromes have not yet been fully examined in vivo.Herein,a commercial AP product,PZ compound or PB2 compound was used to ameliorate TOPFM-induced obesity in mice.The results indicated that the AP,PZ or PB2 supplementation markedly alleviate TOPFM-induced obesity in mice through effectively suppressing body weight gain and fat accumulation,alleviating insulin resistance and liver inflammation,regulating gut microecology and lipid synthesis/metabolism,and improving gut barrier function and antioxidant capacity.The gut barrier function and integrity were improved through regulating the expression of intestinal pro-inflammatory cytokines,tumor necrosis factor-alpha(TNF-α),interleukin-1beta(IL-1β)and interleukin-6(IL-6),and gut barrier function-related genes,zonula occludens-1(ZO-1)and Occludin,and raising the glucagon-like peptide 2(GLP-2)level via increasing the contents of short-chain fatty acids(SCFAs).Interestingly,the AP,PZ or PB2 supplementation could significantly improve the production of SCFAs and restore the microbial community structure and diversity in mice with TOPFM-induced obesity,in particular,increased the abundance of Lachnospiraceae and Bifidobacteriaceae possibly by inhibiting Blautia and Bifidobacterium phages.The influences of AP,PZ or PB2 on gut microorganisms and phases of the mice upon TOPFM were species-specific.This study was the first report on the ability of an AP,PZ or PB2 supplementation to promote the production of SCFAs by modulating gut microbiota possibly via regulating gut phages.展开更多
Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,bu...Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,but severe obesity combined with refractory hypertension is very rare in clinical practice.The optimal anesthetic management strategy for obese pregnant women with a difficult airway and poorly controlled hypertension remains debatable.This report presents a 32-year-old woman with severe obesity and refractory hypertension at 36 weeks and 6 days of pregnancy.Owing to fetal heart rate abnormalities,she was scheduled for emergency cesarean section.Given the urgency of the fetal condition and the challenges posed by the patient's obesity for epidural puncture,the anesthesiologist opted for rapid sequence induction and tracheal intubation instead of intervertebral anesthesia.Short-acting antihypertensive medications were adminstrated preoperatively to control elevated blood pressure,and vasopressor agents were continuously infused during surgery to prevent severe hypotension induced by anesthetic drugs.The entire anesthesia and surgical procedure proceeded uneventfully,with no major adverse events observed.Both the patient and fetus achieved favorable outcomes.This case indicates that early anesthetic risk assessment and meticulous pre-delivery planning are paramount,necessitating personalized management of airway and hemodynamics to optimize outcomes in obese parturients.展开更多
Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adi...Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adipocytes and high-fat diet(HFD)-induced obese zebrafish larvae.Methods:GCSW210 was fractionated through solvent partitioning,ion-exchange chromatography,and silica gel medium-pressure liquid chromatography,followed by preparative high performance liquid chromatography.At each step,bioactivities were assessed in 3T3-L1 adipocytes by Oil Red O staining and 2-NBDG uptake assays.The most active fractions were further purified,and isolated compounds were tested in HFD-induced obese zebrafish larvae.Results:Liquid chromatography-hyphenated analysis with reference standards identified two major compounds in GCSW210:5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether.Both compounds significantly inhibited lipid accumulation in 3T3-L1 adipocytes and modulated gene expression associated with adipogenesis,glucose metabolism,and inflammation in zebrafish.They also enhanced glucose uptake,reduced circulating glucose levels,and improved insulin sensitivity.Notably,the effects were comparable to those of the crude GCSW210 extract.In silico docking studies confirmed stable interactions of both compounds with key metabolic and inflammatory targets,with bis(5-formylfurfuryl)ether showing stronger binding affinities.Conclusions:These findings suggest that 5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether are key contributors to the therapeutic activity of Gracilaria chorda,highlighting its potential as a functional food ingredient for the prevention or management of metabolic disorders.展开更多
Laparoscopic sleeve gastrectomy(LSG),as an effective treatment for morbid obesity and its metabolic complications,exerts its therapeutic effects by significantly reducing body weight and improving metabolic disorders....Laparoscopic sleeve gastrectomy(LSG),as an effective treatment for morbid obesity and its metabolic complications,exerts its therapeutic effects by significantly reducing body weight and improving metabolic disorders.Its core mechanisms involve multi-level regulation of free fatty acid(FFA)metabolism and chronic low-grade inflammatory states(represented by tumor necrosis factor-alpha,TNF-α).This paper systematically reviews the direct impact of LSG on FFA dynamics including lipolysis,tissue uptake,and oxidation,as well as the molecular pathways through which it indirectly regulates TNF-αby reducing adipose tissue inflammation,improving intestinal barrier function,and modulating epigenetic modifications such as SCD gene methylation.Postoperatively,FFA and TNF-αform a bidirectional promoting feedback loop.LSG effectively breaks this vicious cycle of mutual promotion between the two under obese conditions by reducing FFA levels and inhibiting TNF-αexpression.Lower FFA levels alleviate inflammatory signal activation,while reduced TNF-αinhibits lipolysis,collectively promoting the restoration of insulin sensitivity.A thorough understanding of these mechanisms provides a theoretical basis for optimizing surgical strategies and developing targeted therapies.展开更多
Background:Obesity remains a major global health challenge,closely linked to individuals'health beliefs and lifestyle behaviors.Descriptive and relational research methods were used to ascertain the correlation be...Background:Obesity remains a major global health challenge,closely linked to individuals'health beliefs and lifestyle behaviors.Descriptive and relational research methods were used to ascertain the correlation between health beliefs and healthy lifestyle behaviors in obese individuals based on the Health Belief Model.Methods:The population of the research are obese individuals who are treated in the internal medicine clinic in a state hospital in Diyarbakır and applied to a dietitian.Based on power analysis,the study’s sample consisted of 192 obese people.The health belief model scale in obese individuals(HBMSO),the Healthy Lifestyle Behaviors Scale-II(HLBS-II),and the Personal Information Form were used to gather the data.The data was evaluated using the following methods:mean,standard deviation,linear regression analysis,Mann-Whitney U test,Kruskal-Wallis test,Shapiro Wilk and Kolmogorov Smirnov tests,post-hoc Dunn-Benferronni tests,Pearson and Spearman correlation,and others.Results:It was determined that 26.0%of obese individuals were in the 46–55 age range,63.5%were female,64.6%were married,60.4%had a BMI in the range of 30–34.9 kg/m^(2),and 42.7%partially exercised.All sub-dimensions and HBMSO sub-dimensions had statistically significant correlation with the HLBS-II total score.The linear regression analysis results used to identify the predictors of the HLBS-II total score showed that the increase in the level of education and the HBMSO“Importance of Health”sub-dimension score increased the HLBS-II total score,while not exercising and an increase in the HBMSO“Obstacle Perception”sub-dimension score decreased the HLBS-II total score.Conclusion:Individuals’health attitudes have a major impact on leading a healthy lifestyle,which is consistent with the research results.展开更多
The increasing prevalence of pediatric obesity has raised numerous questions about its health implications,particularly regarding renal transplant outcomes.These complications often hinder medical interventions in the...The increasing prevalence of pediatric obesity has raised numerous questions about its health implications,particularly regarding renal transplant outcomes.These complications often hinder medical interventions in these children.While kidney transplants are often viewed from an organocentric perspective,the overall health of the patient is critical to the success of the procedure.Current discussions make it clear that childhood obesity poses significant problems not only for graft survival,but also for long-term overall health.Childhood obesity can lead to many metabolic disorders such as diabetes and hypertension.These conditions can significantly affect a child's suitability for a transplant or make the process more difficult.A child's weight can affect the pharmacokinetics of drugs used to prevent organ rejection.Obesity impacts the individual and sets in motion a cascade of effects that can jeopardize transplant success and recovery,so understanding is needed.Research on graft survival rates is both optimistic and concerning.Clinical studies show that obese children often have an increased risk of post-transplant complications,which affects transplant longevity.The likelihood of rejection may increase due to the metabolic status of an obese child.Due to the allocation of healthcare resources for the treatment of obesity-related diseases,availability for the transplant itself may be limited.Many children maintain an adequate quality of life after a kidney transplant,but excessive weight can significantly affect their health and chances of survival.The main target is looking for highly successful strategies to give all children who need a transplant a better future,regardless of their weight.展开更多
BACKGROUND Obese patients(body mass index≥30 kg/m^(2))undergoing isolated aortic valve replacement(AVR)face increased surgical risks due to comorbidities.Partial upper sternotomy(PUS),a minimally invasive approach,ma...BACKGROUND Obese patients(body mass index≥30 kg/m^(2))undergoing isolated aortic valve replacement(AVR)face increased surgical risks due to comorbidities.Partial upper sternotomy(PUS),a minimally invasive approach,may reduce complications compared to full median sternotomy(FMS).We hypothesize that PUS improves outcomes over FMS in obese patients undergoing AVR.AIM To compare the efficacy and safety of PUS vs FMS in obese patients undergoing isolated AVR.METHODS This systematic review and meta-analysis followed PRISMA guidelines,searching PubMed,EMBASE,and Cochrane databases for observational studies comparing PUS vs FMS in obese patients undergoing AVR.Outcomes were analyzed using odds ratios(OR),mean differences(MD),95%confidence intervals(CI),I^(2)statistic,and Newcastle-Ottawa Scale was used for quality assessment.RESULTS Four observational studies involving 677 patients were analyzed.PUS reduced intensive care unit stay(MD-2.67 days,95%CI:-4.43 to-0.90,P=0.003,I^(2)=78%)but increased cardiopulmonary bypass time(MD 5.62 minutes,95%CI:-0.36 to 11.59,I^(2)=55%).No differences were observed in renal failure(OR 1.13,95%CI:0.63-2.94,I^(2)=0%),atrial fibrillation(OR 0.81,95%CI:0.43-1.54,I^(2)=30%),reexploration(OR 1.09,95%CI:0.48-2.47,I^(2)=0%),postoperative bleeding(OR 1.48,95%CI:0.53-4.15,I^(2)=60%),wound infection(OR 1.23,95%CI:0.70-2.14,I^(2)=0%),hospital stay(MD 0.51 days,95%CI:-4.13 to 5.15,I^(2)=90%),or cross-clamp time(MD 4.03 minutes,95%CI:-0.75 to 8.80,I^(2)=50%).CONCLUSION PUS is safe and effective for obese patients undergoing AVR,reducing intensive care unit stay and enhancing recovery,provided surgical expertise is available.展开更多
<div style="text-align:justify;"> <strong>Background:</strong> By the dawn of this modern era of science, the prime challenge of physician is cardiovascular disease (CVD).<span "=&q...<div style="text-align:justify;"> <strong>Background:</strong> By the dawn of this modern era of science, the prime challenge of physician is cardiovascular disease (CVD).<span "=""> </span><span "="">The most important modifiable risk factors of CVDs are unhealthy diet, physical inactivity and tobacco use. The effects of unhealthy diet and physical inactivity include abnormal blood lipid, obesity and hypertension. We tried to evaluate and correlate the pattern of lipid profile in obese and non-obese hypertensive patients. <b>Objectives:</b> This study was conducted at medicine department of Cumilla Medical College Hospital. The principal aim was to evaluate the lipid profile in obese and non-obese adult hypertensive patients. <b>Methodology:</b> During this cross sectional analytical study, </span>a total of<span "=""> </span>100 adult hypertensive patients were taken by purposive sampling. Among them 50<span "=""> </span>(group 1) patients were taken those were obese and 50<span "=""> </span>(group 2) patients taken those were non-obese according to BMI measurement on operational definition. Diagnosis of hypertension would be established with the help of ambulatory BP measurements two occasions few minutes apart. The staging of hypertension was done according to JNC7 Criteria. Morning blood samples were taken after 8<span "=""> </span>-<span "=""> </span>12 hours of fasting and lipid profiles were done on authentic laboratories. The laboratory values were interpreted according to the operational definition of dyslipidaemia. The ethical research and review committee approved the study protocol and signed informed consent was obtained from the participants. The statistics was analyzed using the IBM SPSS software of version 19.0.<span "=""> </span><span "="">Statistical significance was set at p < 0.05. <b>Results:</b> Among the two groups, there were 56 (56%) male</span>s and 44 (44%) females. The mean age of group 1 (46.10 ± 11.09) was compared to that of group 2 (45.5 ± 10.6). Lipid profile abnormalities were significantly higher in the stage 2 hypertension<span "=""> </span>(59.62%) and stage 3 hypertension<span "=""> </span>(66.66%), higher in class 2 obese<span "=""> </span>(100%) and class 3 obese subjects<span "=""> </span>(100%),<span "=""> </span>female hypertensive patients had significantly higher BMI than their male counterparts<span "=""> </span>(27.24 ± 3.63<span "=""> </span><span "="">kg/m<sup>2</sup> versus 29.29 ± 3.99</span><span "=""> </span><span "="">kg/m<sup>2</sup>),</span><span "=""> </span>lipid profiles were higher in the female than male hypertensive patients (63.33% vs 55.35%) but only TC was statistically significant (4.45 ± 1.19<span "=""> </span>mmol/l versus 4.86 ± 1.29<span "=""> </span>mmol/l, p < 0.05). Those who were obese had significant high TG (p < 0.001), high TC (p < 0.001) and high LDL-C (p < 0.001). 38<span "=""> </span>(76%) of the obese hypertensive patients had dyslipidaemia whereas 21<span "=""> </span>(42%) of non-obese hypertensive patients had dyslipidaemia. In multivariate regression, TG was significantly and directly associated with BMI of subjects. Dyslipidaemia was more prevalent in the age group 30<span "=""> </span>-<span "=""> </span>59 of adult hypertensive patients. It showed that obese hypertensive patients had significantly higher SBP<span "=""> </span>(p < 0.001), DBP<span "=""> </span>(p < 0.001) than non-obese subjects. The mean TC (4.83 ± 0.95<span "=""> </span>mmol/l versus 4.15 ± 0.57<span "=""> </span>mmol/l, t = -9.70, p < 0.001), TG (2.64 ± 0.67<span "=""> </span>mmol/l versus 2.10 ± 0.45<span "=""> </span>mmol/l, t = -5.37, p < 0.001) and LDL-C (3.00 ± 0.82<span "=""> </span>mmol/l versus 2.44 ± 0.53<span "=""> </span>mmol/l, t = -9.11, p < 0.001) were also significantly higher among the hypertensive obese subjects. The mean HDL-C was however comparable in the two groups (1.25 ± 0.27<span "=""> </span>mmol/l versus 1.24 ± 0.57<span "=""> </span>mmol/l, t = -0.25, p = 0.08)... </div>展开更多
Objective To compare the efficacy of treating obese patients with abnormity of lipids and serum leptin by dilatational wave or continuous wave of electroacupuncture combined with thunder-fire moxibustion in order to p...Objective To compare the efficacy of treating obese patients with abnormity of lipids and serum leptin by dilatational wave or continuous wave of electroacupuncture combined with thunder-fire moxibustion in order to provide a clinical basis for selecting wave types of electroacupuncture for different patterns of obesity. Methods Sixty obese patients with abnormal lipids and serum leptin were randomly divided into a dilatational wave group and a continuous wave group via random number table, with 30 cases in each group. They were divided by TCM differentiation into three types： stomachintestine excessive heat, weakness of the spleen-stomach and spleen-kidney yang deficiency, treated by electroacupuncture on Tianshu （天枢 ST 25）, Daheng （大横 SP 15）, Zusanli （足三里ST 36）, Shangjuxu （上巨虚 ST 37）, Fanglong （丰隆 ST 40）, Yinlingquan （阴陵泉 SP 9）, Quchi （曲池 LI 11）, Zhigou （支沟 TE 6） and Hegu （合谷 LI 4） along with thunder-fire moxibustion. The frequency of electro-acupuncture in the dilatational wave group and the continuous wave group was 2 Hz/100 Hz and 2 Hz, respectively. Patients in the two groups were treated once a day, six times a week. The treatment lasted for 4 weeks with 3-month follow-up. Body mass and body fat percentage before and after the treatment, as well as during the follow-up, were compared. The effectiveness rates in the two groups were compared, and the efficacy statistics of patients with different TCM patterns in the dilatational wave group were also analyzed. Lipid levels of the patients in two groups before and after the treatment were measured with an automatic biochemical analyzer, and serum leptin levels were detected with flow cytometry system. Results After the treatment, the patients＇ blood lipids, serum leptin levels, body mass and body fat percentage were effectively reduced in the two groups; three months＇ follow-up witnessed continuous decline of obesity indicators （P〈0.01 or P〈0.05）, and patients in the dilatat-ional wave group improved more significantly than those in continuous wave group （P〈0.05 or P〈0.01）. The efficacy in the dilatational wave group was superior to that in the continuous wave group （P〈0.01）. The best efficacy could be found among patients with weakness of the spleen and the stomach in the dilatational wave group. Conclusion Efficacy of treating obese patients with abnormity of lipids and serum leptin by electro-acupuncture combined with thunder-fire moxibustion in the dilatational wave group was significantly better than that of the continuous wave group, and efficacy for obese patients with weakness of the spleen and the stomach was superior to that of those with stomach-intestine excessive heat and spleen-kidney yang deficiency.展开更多
AIM: To investigate the effect of lifestyle intervention on non-alcoholic fatty liver disease (NAFLD) in Chinese obese children. METHODS: Seventy-six obese children aged from 10 to 17 years with NAFLD were enrolled fo...AIM: To investigate the effect of lifestyle intervention on non-alcoholic fatty liver disease (NAFLD) in Chinese obese children. METHODS: Seventy-six obese children aged from 10 to 17 years with NAFLD were enrolled for a one-month intervention and divided randomly into three groups. Group1, consisting of 38 obese children, was an untreated control group without any intervention. Group 2, consisting of 19 obese children in summer camp, was strictly controlled only by life style intervention. Group 3, consisting of 19 obese children, received oral vitamin E therapy at a dose of 100 mg/d. The height, weight, fasting blood glucose (FBG), fasting serum insulin (FINS), plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TCHO) and homeostasis model assent- insulin resistance (HOMA-IR) were measured at baseline and after one month. All patients were underwent to an ultrasonographic study of the liver performed by one operator who was blinded to the groups. RESULTS: The monitor indices of BMI, ALT, AST, TG, TCHO and HOMA-IR were successfully improved except in group 1. BMI and ALT in group 2 were reduced more significantly than in group 3 (2.44 ± 0.82 vs 1.45 ± 0.80, P = 0.001; 88.58 ± 39.99 vs 63.69 ± 27.05, P = 0.040, respectively).CONCLUSION: Both a short-term lifestyle intervention and vitamin E therapy have an effect on NAFLD in obese children. Compared with vitamin E, lifestyle intervention is more effective. Therefore, lifestyle intervention should represent the first step in the management of children with NAFLD.展开更多
To investigate the effects of hypoxic exercise training on microRNA （miRNA） expression and the role of miRNA expression in regulating lipid metabolism, 20 dietary-induced obese SD rats were divided into a normoxic s...To investigate the effects of hypoxic exercise training on microRNA （miRNA） expression and the role of miRNA expression in regulating lipid metabolism, 20 dietary-induced obese SD rats were divided into a normoxic sedentary group （N, n=10） and a hypoxic exercise training group （H, n=10）. After four weeks, measurements were taken of body weight, body length, fat mass, serum lipid concentration, miRNAs differentially expressed in rat liver, and gene and protein expression levels of perexisome proliferator activated receptor a （PPARα）, fatty acid synthetase （FAS）, and carnitine palmitoyl transferase 1A （CPTIA） in rat liver. Body weight, Lee＇s index, fat mass, fat/weight ratio, and serum levels of total cholesterol （TC） and high density lipoprotein cholesterol （HDL-C） were all significantly lower in the H group than in the N group （P〈0.01）. Six miRNAs expressed significantly differently in the liver （P〈0.05）. Specifically, expression levels of miR-378b were significantly lower in the H group than in the N group （P〈0.05）. Compared with the normoxic sedentary group, hypoxic exercise training resulted in a lower ratio of FAS mRNA to CPTIA mRNA （P〈0.05）, as well as lower CPT1A protein levels （P〈0.01）, while a higher ratio of FAS to CPT1A protein levels （P〈0.01） was observed. In conclusion, hypoxic training may elevate the resistance of high fat diet induced obesity in rats by reducing the expression of miR-378b, and decrease the fatty acid mitochondrial oxidation in obese rat livers by decreasing the protein expression of CPTIA and increasing the protein expression ratio of FAS/CPTIA.展开更多
Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-o...Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese population.Methods: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver(normal or NAFLD), and body mass index(BMI) levels(non-obese if BMI < 25 kg/m~2 or obese if BMI ≥ 25 kg/m~2).Results: There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver(group A), non-obese NAFLD(group B), obese normal liver(group C) and obese NAFLD(group D),respectively. The highest ratio of metabolic syndrome existed in the group B(26.9%), followed by group A(11.7%), group D(10.9%) and finally the group C(5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02) and glucose(OR = 1.02; 95% CI:1.01–1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02). The positive association was most significant in all cases(adjusted OR = 2.41; 95% CI: 1.78–3.24), especially in non-obese individuals(OR = 2.81; 95% CI: 1.92–4.12).Conclusions: Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.展开更多
AIM： To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indi- ces, and non-alcoholic fatty liver disease severity we...AIM： To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indi- ces, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver （FL） and 41 with nonalcoholic steatohepatitis （NASH）. METHODS： Circulating levels of Bcl-2 were detected in 84 patients with ultrasonographic findings of ＂bright liver＂ and/or hyper-transaminasemia of unknown origin and/or increase in T-glutamyl-transpeptidase （T-GT） strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups （43 with FL and 41 with NASH）. Twenty lean subjects, apparently healthy and young, were chosen as controls.RESULTS： Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein （CRP） concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index （BMI） values （P ~ 0.0001） but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males （P = 0.0008）. γ-GT activity was associated with homeostatic metabolic assessment （HOMA） （P = 0.0003） and with serum ferritin （P = 0.02）. Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients pre- sented a weak negative correlation between Iobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metabolically unhealthy overweight/obese patients （MUOs） was evidenced. HOMA, BMI and uric acid, in that sequence, best predicted serum Bcl-2 concentrations. CONCLUSION： IvlUOs could be detected by Bcl-2 levels. By favoring the life span of hepatocytes, and enhancing triglyceride formation, the anti-apoptotic process inhibits free fatty acids toxicity in FL.展开更多
Objective:To explore the anti-obesity effects and the mechanism of action of Monascus pilosus(M.pilosus)-fermented black soybean(MFBS)extracts(MFBSE)and MFBS powders(MFBSP)in adipocytes and high-fat diet(HFD)-induced ...Objective:To explore the anti-obesity effects and the mechanism of action of Monascus pilosus(M.pilosus)-fermented black soybean(MFBS)extracts(MFBSE)and MFBS powders(MFBSP)in adipocytes and high-fat diet(HFD)-induced obese mice,respectively.Methods:Black soybean was fermented with M.pilosus,and the main constituents in MFBS were analyzed by HPLC analysis.In vitro,MFBSE were examined for anti-adipogenic effects using Oil-Red O staining.In vivo,mice were fed a normal-fat diet(NFD)control,HFD control or HFD containing 1 g/kg MFBSP for 12 weeks,and then body weight gain and tissues weight measured.Real-time PCR and western blot assay were used to determine the mechanism of anti-adipogenic effects.Results:MFBSE inhibited lipid accumulation in 3T3-L1 adipocytes without exerting cell cytotoxicity.MFBSP treatment in HFD-fed mice significantly decreased the body weight gain compared with the HFD control mice.MFBSE and MFBSP treatment resulted in significantly lower mRNA levels of adipogenesis-related genes,such as peroxisome proliferator-activated receptorγ(PPARγ),fatty acid-binding protein 4(FABP4),and fatty acid synthase(FAS),in adipocytes and in white adipose tissue(WAT)of HFD-induced obese mice.Conclusions:These results suggest that the anti-obesity effects of MFBS are elicited by regulating the expression of adipogenesis-related genes in adipocytes and WAT of HFDinduced obese mice.展开更多
文摘BACKGROUND Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic characteristics including abnormal drug distribution and clearance.Rocuronium exhibits markedly different distribution patterns in obese patients,with conventional weight correction methods inadequately addressing individual muscle mass variations that critically influence drug distribution.AIM To investigate the quantitative relationship between skeletal muscle index(SMI)and rocuronium distribution volume in obese colorectal cancer patients,establish a population pharmacokinetic model,and develop individualized dosing strategies based on muscle mass.METHODS A retrospective cohort study was conducted,including 100 obese patients(body mass index≥30 kg/m^(2))who underwent elective radical colorectal cancer surgery at our hospital from June 2023 to January 2025.Skeletal muscle mass was measured using InBody 260 body composition analyzer and SMI was calculated to assess muscle mass,with male SMI<7.0 kg/m^(2) and female SMI<5.7 kg/m^(2)as diagnostic criteria for sarcopenia.Plasma rocuronium concentrations were detected by liquid chromatography-tandem mass spectrometry/mass spectrometry,and nonlinear mixed-effect modeling was used to establish population pharmacokinetic modeling.Stepwise regression was used to screen covariates,and dosing regimens were optimized through Monte Carlo simulation.The primary endpoint was targeted plasma concentration achievement rate,and the secondary endpoint was postoperative residual muscle relaxation incidence.RESULTS Among 100 patients,35(35.0%)had sarcopenia and 65(65.0%)did not.Patients in the sarcopenia group were older(64.1±9.8 years vs 54.2±10.9 years,P<0.001)and had significantly lower SMI(6.2±0.8 kg/m^(2)vs 8.4±1.2 kg/m^(2),P<0.001).SMI showed strong positive correlation with rocuronium steady-state distribution volume(r=0.718,P<0.001)and moderate negative correlation with clearance(r=-0.502,P<0.001).A two-compartment population pharmacokinetic model was successfully established,with SMI being the most important covariate affecting central compartment distribution volume(△OFV=-41.2,P<0.001).Model validation showed bootstrap successful convergence rate of 92.3%,and 92.1%of observed values fell within prediction intervals in predicted concentration versus predicted concentration.The SMI-based individualized dosing regimen improved target exposure achievement rate from 82.0%in traditional regimen to 93.5%(P=0.009),and reduced postoperative residual muscle relaxation incidence from 13.0%to 3.5%(P=0.018).The sarcopenia group showed the most significant improvement in achievement rate,from 71.4%to 93.8%(P=0.017).CONCLUSION SMI shows strong correlation with rocuronium distribution volume in obese colorectal cancer patients and is a key factor affecting drug distribution.SMI-based individualized dosing strategies can significantly improve target exposure achievement rate and reduce postoperative residual muscle relaxation incidence,providing scientific evidence for precision anesthesia management in obese patients.
文摘Objective To explore the sequential effects of hypoxic exercising on miR-27/PPARγand lipid metabolism targetgene and protein expression levels in the obesity rats’liver.Methods 13-week-old male diet-induced obesity rats were randomlydivided into three groups(n=10):normal oxygen concentration quiet group(N),hypoxia quiet group(H),hypoxic exercise group(HE).Exercise training on the horizontal animal treadmill for 1 h/d,5 d/week for a total of 4 week,and the intensity of horizontaltreadmill training was 20 m/min(hypoxic concentration was 13.6%).Comparison of the weights of perirenal fat and epididymal fat in rats across different groups and calculation of Lee’s index based on body weight and body length of rats in each group were done.And the serum concentrations of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high-densitylipoprotein cholesterol(HDL-C)levels were detected.RT-PCR and Western Blot were used to detect the levels of miR-27,PPARγ,CYP7A1 and CD36.Results Hypoxic exercise decreased the expression levels of miR-27 in the obese rats’liver,however,theexpression level of PPARγwas gradually increased.The expression levels of miR-27 in HE group were significantly lower than Ngroup(P<0.05).The expression levels of PPARγmRNA in N group were significantly lower than H group(P<0.05),especially lowerthan HE group(P<0.01).The protein expression of PPARγprotein in N group was significantly lower than that other groups(P<0.01).The expression of lipid metabolism-related genes and proteins increased in the obese rats’liver.The expression of CYP7A1mRNA in N group was significantly lower than H group(P<0.05),especially lower than HE group(P<0.01).The expression ofCYP7A1 protein in the obese rats’liver in N group was extremely lower than H group and HE group(P<0.01).The proteinexpression of CD36 in N group was significantly lower than that in HE group(P<0.05).Hypoxia exercise improved the relatedphysiological and biochemical indexes of lipid metabolism disorder.The perirenal fat weight of obese rats in HE group wasextremely lower than N group and H group(P<0.01),and the perirenal fat weight in N group was significantly higher than H group(P<0.05).The epididymal fat weight in N group was significantly higher than H group(P<0.05),and extremely higher than HEgroup(P<0.01).The Lee’s index in HE group was extremely lower than N group and H group(P<0.01).The serum concentration ofTC in obese rats in HE group was extremely lower than N group and H group(P<0.01).The serum concentration of TG in HE groupwas extremely lower than N group and H group(P<0.01).The serum concentration of LDL-C in N group was extremely higher thanHE group(P<0.01).The serum concentration of HDL-C in N group was extremely lower than H group(P<0.01).Conclusion Hypoxiaand hypoxia exercise may negatively regulate the levels of PPARγby inhibiting miR-27 in the obese rats’liver,thereby affecting theexpression of downstream target genes CYP7A1 and CD36,and promoting cholesterol,fatty acid oxidation and HDL-C transport inthe liver,and ultimately the lipid levels in obese rats were improved.The effect of hypoxia exercise on improving blood lipid isbetter than simple hypoxia intervention.
文摘In recent years,the incidence of type 2 diabetes mellitus(T2DM)caused by obesity in China has been increasing continuously,which has become a risk factor for the onset of T2DM and seriously affects the quality of life of patients.The conventional treatment methods include weight loss and regulating the body’s metabolism.Semaglutide,as a glucagon-like peptide-1 receptor agonist(GLP-1RA),mainly reduces patients’appetite,decreases their craving for high-fat and high-sugar foods,regulates hypothalamic feeding behavior,inhibits gastric emptying and gastrointestinal motility,and ultimately leads to weight loss.Metformin mainly acts on extra-islet tissues,increasing glucose utilization,reducing glucose production,and ultimately lowering blood glucose levels.Based on this,this article reviews relevant literature on authoritative websites such as CNKI and Wanfang,organizes the data,and analyzes the research progress of semaglutide combined with metformin in the treatment of obese T2DM.The aim is to bring more treatment options for obese T2DM and promote better prognosis for patients.
基金The following funding sources are gratefully acknowledged:National Key Research and Development Program Project of China(2022YFF1100102)the Cross-Innovation Open Project of Food Flavor and Health,Beijing Technology&Business University(FFHCI-2025071).
文摘Arabinoxylan(AX)has been found to improve an imbalanced gut microbiota.Lactobacillus gasseri is a beneficial endogenous bacterium that has been shown to have several health benefits in the human gut,particularly its lipid-lowering activity.However,it is not known whether AX can promote the action of L.gasseri.The results of in vitro experiments showed that AX promoted biofilm formation in L.gasseri,its acid and bile salt resistance could be enhanced,and enabled better colonization of L.gasseri in the intestinal tract of mice.In vivo experiments showed that the AX+L.gasseri group could effectively ameliorate weight gain and fat accumulation in high-fat diet-induced obese mice,and the L.gasseri group or AX+L.gasseri alleviated liver injury in mice.16S rRNA sequencing showed that L.gasseri can colonize the mice intestine and AX+L.gasseri can ameliorate gut microbiota dysbiosis in obese mice by increasing Lactobacillus spp.and Coriobacteriaceae_UCG-002,and decreasing Peptococcaceae.In addition,metabolomics results indicated that the L.gasseri group and the AX+L.gasseri group could alleviate metabolic disorders by decreasing the levels of L-phenylalanine,L-tyrosine,kynurenine acid,and arachidonic acid in obese mice.The effect of AX+L.gasseri group was better than that of the L.gasseri group,suggesting that AX promotes the lipid-lowering activity of L.gasseri,and the mechanism may be due to the activation of retrograde endocannabinoid signaling.AX can be used as a functional food ingredient to potentially alleviate obesity and metabolic syndrome.
基金supported by the National Natural Science Foundation of China(No.22101086)Guangzhou Basic and Applied Basic Research Project(No.202201010052)Guangdong Basic and Applied Basic Research Foundation(No.2023A1515140030).
文摘Iron overload has been evidenced to contribute to obesity-associated metabolic disorders,including insulin resistance.Strategies to reduce iron levels might help manage the metabolic complications associated with obesity.Here,it is demonstrated that the specific accumulation of oleic acid-modified polyoxovanadates(OPOVs)in adipose tissue leads to the reduction of iron concentrations in adipocytes in mice fed with a high-fat diet(HFD).Conjugation of oleic acids to polyoxovanadates enables tissue-specific depletion of iron from white adipose tissue(WAT)by OPOVs,protecting mice from HFD-induced obesity and obesity-associated metabolic deteriorations.Glucose tolerance and insulin sensitivity are improved in OPOV-treated mice,which demonstrates that the OPOV-induced iron depletion can reverse the metabolic degeneration caused by HFD-induced obesity.Furthermore,a decrease in expression of the marker genes of iron overload suggests the participation of OPOVs in maintaining iron homeostasis and a potential medical application of vanadium clusters in targeting the iron overload caused by obesity.These findings underscore the potential of vanadate-based clusters tailored to address the complex interplay between iron metabolism and metabolic health.
基金funded by Natural Science Foundation of Shandong Province(ZR2024QC147)Key Research&Development Project of Shandong Province(2021TZXD007,2019GNCI06048)+2 种基金Major Agricultural Application Technology Innovation Projects in Shandong Province(SD2019ZZ023)Youth Innovation Science and Technology Program of Shandong College and Universities Plan(2020KJE007)Shandong Double Tops Program(SYT2017XTTD04).
文摘Apples are popular fruits worldwide and rich in phenolic compounds that can alleviate obesity and related metabolic diseases.However,the mechanisms underlying the anti-obesity actions of apple polyphenols(AP)like phlorizin(PZ)and procyanidin B2(PB2)on transplanted obese patient fecal microbiota(TOPFM)-induced obesity and related syndromes have not yet been fully examined in vivo.Herein,a commercial AP product,PZ compound or PB2 compound was used to ameliorate TOPFM-induced obesity in mice.The results indicated that the AP,PZ or PB2 supplementation markedly alleviate TOPFM-induced obesity in mice through effectively suppressing body weight gain and fat accumulation,alleviating insulin resistance and liver inflammation,regulating gut microecology and lipid synthesis/metabolism,and improving gut barrier function and antioxidant capacity.The gut barrier function and integrity were improved through regulating the expression of intestinal pro-inflammatory cytokines,tumor necrosis factor-alpha(TNF-α),interleukin-1beta(IL-1β)and interleukin-6(IL-6),and gut barrier function-related genes,zonula occludens-1(ZO-1)and Occludin,and raising the glucagon-like peptide 2(GLP-2)level via increasing the contents of short-chain fatty acids(SCFAs).Interestingly,the AP,PZ or PB2 supplementation could significantly improve the production of SCFAs and restore the microbial community structure and diversity in mice with TOPFM-induced obesity,in particular,increased the abundance of Lachnospiraceae and Bifidobacteriaceae possibly by inhibiting Blautia and Bifidobacterium phages.The influences of AP,PZ or PB2 on gut microorganisms and phases of the mice upon TOPFM were species-specific.This study was the first report on the ability of an AP,PZ or PB2 supplementation to promote the production of SCFAs by modulating gut microbiota possibly via regulating gut phages.
文摘Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,but severe obesity combined with refractory hypertension is very rare in clinical practice.The optimal anesthetic management strategy for obese pregnant women with a difficult airway and poorly controlled hypertension remains debatable.This report presents a 32-year-old woman with severe obesity and refractory hypertension at 36 weeks and 6 days of pregnancy.Owing to fetal heart rate abnormalities,she was scheduled for emergency cesarean section.Given the urgency of the fetal condition and the challenges posed by the patient's obesity for epidural puncture,the anesthesiologist opted for rapid sequence induction and tracheal intubation instead of intervertebral anesthesia.Short-acting antihypertensive medications were adminstrated preoperatively to control elevated blood pressure,and vasopressor agents were continuously infused during surgery to prevent severe hypotension induced by anesthetic drugs.The entire anesthesia and surgical procedure proceeded uneventfully,with no major adverse events observed.Both the patient and fetus achieved favorable outcomes.This case indicates that early anesthetic risk assessment and meticulous pre-delivery planning are paramount,necessitating personalized management of airway and hemodynamics to optimize outcomes in obese parturients.
文摘Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adipocytes and high-fat diet(HFD)-induced obese zebrafish larvae.Methods:GCSW210 was fractionated through solvent partitioning,ion-exchange chromatography,and silica gel medium-pressure liquid chromatography,followed by preparative high performance liquid chromatography.At each step,bioactivities were assessed in 3T3-L1 adipocytes by Oil Red O staining and 2-NBDG uptake assays.The most active fractions were further purified,and isolated compounds were tested in HFD-induced obese zebrafish larvae.Results:Liquid chromatography-hyphenated analysis with reference standards identified two major compounds in GCSW210:5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether.Both compounds significantly inhibited lipid accumulation in 3T3-L1 adipocytes and modulated gene expression associated with adipogenesis,glucose metabolism,and inflammation in zebrafish.They also enhanced glucose uptake,reduced circulating glucose levels,and improved insulin sensitivity.Notably,the effects were comparable to those of the crude GCSW210 extract.In silico docking studies confirmed stable interactions of both compounds with key metabolic and inflammatory targets,with bis(5-formylfurfuryl)ether showing stronger binding affinities.Conclusions:These findings suggest that 5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether are key contributors to the therapeutic activity of Gracilaria chorda,highlighting its potential as a functional food ingredient for the prevention or management of metabolic disorders.
基金Medical Science and Technology Disciplinary Reserve Talent Program under the Kunming Municipal Health Science and Technology Talent Cultivation Project(Project No.:2024-SW(Reserve)-45)Health Research Project of the Kunming Municipal Health Commission(Project No.:2023-03-06-012)。
文摘Laparoscopic sleeve gastrectomy(LSG),as an effective treatment for morbid obesity and its metabolic complications,exerts its therapeutic effects by significantly reducing body weight and improving metabolic disorders.Its core mechanisms involve multi-level regulation of free fatty acid(FFA)metabolism and chronic low-grade inflammatory states(represented by tumor necrosis factor-alpha,TNF-α).This paper systematically reviews the direct impact of LSG on FFA dynamics including lipolysis,tissue uptake,and oxidation,as well as the molecular pathways through which it indirectly regulates TNF-αby reducing adipose tissue inflammation,improving intestinal barrier function,and modulating epigenetic modifications such as SCD gene methylation.Postoperatively,FFA and TNF-αform a bidirectional promoting feedback loop.LSG effectively breaks this vicious cycle of mutual promotion between the two under obese conditions by reducing FFA levels and inhibiting TNF-αexpression.Lower FFA levels alleviate inflammatory signal activation,while reduced TNF-αinhibits lipolysis,collectively promoting the restoration of insulin sensitivity.A thorough understanding of these mechanisms provides a theoretical basis for optimizing surgical strategies and developing targeted therapies.
文摘Background:Obesity remains a major global health challenge,closely linked to individuals'health beliefs and lifestyle behaviors.Descriptive and relational research methods were used to ascertain the correlation between health beliefs and healthy lifestyle behaviors in obese individuals based on the Health Belief Model.Methods:The population of the research are obese individuals who are treated in the internal medicine clinic in a state hospital in Diyarbakır and applied to a dietitian.Based on power analysis,the study’s sample consisted of 192 obese people.The health belief model scale in obese individuals(HBMSO),the Healthy Lifestyle Behaviors Scale-II(HLBS-II),and the Personal Information Form were used to gather the data.The data was evaluated using the following methods:mean,standard deviation,linear regression analysis,Mann-Whitney U test,Kruskal-Wallis test,Shapiro Wilk and Kolmogorov Smirnov tests,post-hoc Dunn-Benferronni tests,Pearson and Spearman correlation,and others.Results:It was determined that 26.0%of obese individuals were in the 46–55 age range,63.5%were female,64.6%were married,60.4%had a BMI in the range of 30–34.9 kg/m^(2),and 42.7%partially exercised.All sub-dimensions and HBMSO sub-dimensions had statistically significant correlation with the HLBS-II total score.The linear regression analysis results used to identify the predictors of the HLBS-II total score showed that the increase in the level of education and the HBMSO“Importance of Health”sub-dimension score increased the HLBS-II total score,while not exercising and an increase in the HBMSO“Obstacle Perception”sub-dimension score decreased the HLBS-II total score.Conclusion:Individuals’health attitudes have a major impact on leading a healthy lifestyle,which is consistent with the research results.
文摘The increasing prevalence of pediatric obesity has raised numerous questions about its health implications,particularly regarding renal transplant outcomes.These complications often hinder medical interventions in these children.While kidney transplants are often viewed from an organocentric perspective,the overall health of the patient is critical to the success of the procedure.Current discussions make it clear that childhood obesity poses significant problems not only for graft survival,but also for long-term overall health.Childhood obesity can lead to many metabolic disorders such as diabetes and hypertension.These conditions can significantly affect a child's suitability for a transplant or make the process more difficult.A child's weight can affect the pharmacokinetics of drugs used to prevent organ rejection.Obesity impacts the individual and sets in motion a cascade of effects that can jeopardize transplant success and recovery,so understanding is needed.Research on graft survival rates is both optimistic and concerning.Clinical studies show that obese children often have an increased risk of post-transplant complications,which affects transplant longevity.The likelihood of rejection may increase due to the metabolic status of an obese child.Due to the allocation of healthcare resources for the treatment of obesity-related diseases,availability for the transplant itself may be limited.Many children maintain an adequate quality of life after a kidney transplant,but excessive weight can significantly affect their health and chances of survival.The main target is looking for highly successful strategies to give all children who need a transplant a better future,regardless of their weight.
文摘BACKGROUND Obese patients(body mass index≥30 kg/m^(2))undergoing isolated aortic valve replacement(AVR)face increased surgical risks due to comorbidities.Partial upper sternotomy(PUS),a minimally invasive approach,may reduce complications compared to full median sternotomy(FMS).We hypothesize that PUS improves outcomes over FMS in obese patients undergoing AVR.AIM To compare the efficacy and safety of PUS vs FMS in obese patients undergoing isolated AVR.METHODS This systematic review and meta-analysis followed PRISMA guidelines,searching PubMed,EMBASE,and Cochrane databases for observational studies comparing PUS vs FMS in obese patients undergoing AVR.Outcomes were analyzed using odds ratios(OR),mean differences(MD),95%confidence intervals(CI),I^(2)statistic,and Newcastle-Ottawa Scale was used for quality assessment.RESULTS Four observational studies involving 677 patients were analyzed.PUS reduced intensive care unit stay(MD-2.67 days,95%CI:-4.43 to-0.90,P=0.003,I^(2)=78%)but increased cardiopulmonary bypass time(MD 5.62 minutes,95%CI:-0.36 to 11.59,I^(2)=55%).No differences were observed in renal failure(OR 1.13,95%CI:0.63-2.94,I^(2)=0%),atrial fibrillation(OR 0.81,95%CI:0.43-1.54,I^(2)=30%),reexploration(OR 1.09,95%CI:0.48-2.47,I^(2)=0%),postoperative bleeding(OR 1.48,95%CI:0.53-4.15,I^(2)=60%),wound infection(OR 1.23,95%CI:0.70-2.14,I^(2)=0%),hospital stay(MD 0.51 days,95%CI:-4.13 to 5.15,I^(2)=90%),or cross-clamp time(MD 4.03 minutes,95%CI:-0.75 to 8.80,I^(2)=50%).CONCLUSION PUS is safe and effective for obese patients undergoing AVR,reducing intensive care unit stay and enhancing recovery,provided surgical expertise is available.
文摘<div style="text-align:justify;"> <strong>Background:</strong> By the dawn of this modern era of science, the prime challenge of physician is cardiovascular disease (CVD).<span "=""> </span><span "="">The most important modifiable risk factors of CVDs are unhealthy diet, physical inactivity and tobacco use. The effects of unhealthy diet and physical inactivity include abnormal blood lipid, obesity and hypertension. We tried to evaluate and correlate the pattern of lipid profile in obese and non-obese hypertensive patients. <b>Objectives:</b> This study was conducted at medicine department of Cumilla Medical College Hospital. The principal aim was to evaluate the lipid profile in obese and non-obese adult hypertensive patients. <b>Methodology:</b> During this cross sectional analytical study, </span>a total of<span "=""> </span>100 adult hypertensive patients were taken by purposive sampling. Among them 50<span "=""> </span>(group 1) patients were taken those were obese and 50<span "=""> </span>(group 2) patients taken those were non-obese according to BMI measurement on operational definition. Diagnosis of hypertension would be established with the help of ambulatory BP measurements two occasions few minutes apart. The staging of hypertension was done according to JNC7 Criteria. Morning blood samples were taken after 8<span "=""> </span>-<span "=""> </span>12 hours of fasting and lipid profiles were done on authentic laboratories. The laboratory values were interpreted according to the operational definition of dyslipidaemia. The ethical research and review committee approved the study protocol and signed informed consent was obtained from the participants. The statistics was analyzed using the IBM SPSS software of version 19.0.<span "=""> </span><span "="">Statistical significance was set at p < 0.05. <b>Results:</b> Among the two groups, there were 56 (56%) male</span>s and 44 (44%) females. The mean age of group 1 (46.10 ± 11.09) was compared to that of group 2 (45.5 ± 10.6). Lipid profile abnormalities were significantly higher in the stage 2 hypertension<span "=""> </span>(59.62%) and stage 3 hypertension<span "=""> </span>(66.66%), higher in class 2 obese<span "=""> </span>(100%) and class 3 obese subjects<span "=""> </span>(100%),<span "=""> </span>female hypertensive patients had significantly higher BMI than their male counterparts<span "=""> </span>(27.24 ± 3.63<span "=""> </span><span "="">kg/m<sup>2</sup> versus 29.29 ± 3.99</span><span "=""> </span><span "="">kg/m<sup>2</sup>),</span><span "=""> </span>lipid profiles were higher in the female than male hypertensive patients (63.33% vs 55.35%) but only TC was statistically significant (4.45 ± 1.19<span "=""> </span>mmol/l versus 4.86 ± 1.29<span "=""> </span>mmol/l, p < 0.05). Those who were obese had significant high TG (p < 0.001), high TC (p < 0.001) and high LDL-C (p < 0.001). 38<span "=""> </span>(76%) of the obese hypertensive patients had dyslipidaemia whereas 21<span "=""> </span>(42%) of non-obese hypertensive patients had dyslipidaemia. In multivariate regression, TG was significantly and directly associated with BMI of subjects. Dyslipidaemia was more prevalent in the age group 30<span "=""> </span>-<span "=""> </span>59 of adult hypertensive patients. It showed that obese hypertensive patients had significantly higher SBP<span "=""> </span>(p < 0.001), DBP<span "=""> </span>(p < 0.001) than non-obese subjects. The mean TC (4.83 ± 0.95<span "=""> </span>mmol/l versus 4.15 ± 0.57<span "=""> </span>mmol/l, t = -9.70, p < 0.001), TG (2.64 ± 0.67<span "=""> </span>mmol/l versus 2.10 ± 0.45<span "=""> </span>mmol/l, t = -5.37, p < 0.001) and LDL-C (3.00 ± 0.82<span "=""> </span>mmol/l versus 2.44 ± 0.53<span "=""> </span>mmol/l, t = -9.11, p < 0.001) were also significantly higher among the hypertensive obese subjects. The mean HDL-C was however comparable in the two groups (1.25 ± 0.27<span "=""> </span>mmol/l versus 1.24 ± 0.57<span "=""> </span>mmol/l, t = -0.25, p = 0.08)... </div>
基金Supported by Guangxi Natural Science Foundation Project:2010 GXNSFA 013210
文摘Objective To compare the efficacy of treating obese patients with abnormity of lipids and serum leptin by dilatational wave or continuous wave of electroacupuncture combined with thunder-fire moxibustion in order to provide a clinical basis for selecting wave types of electroacupuncture for different patterns of obesity. Methods Sixty obese patients with abnormal lipids and serum leptin were randomly divided into a dilatational wave group and a continuous wave group via random number table, with 30 cases in each group. They were divided by TCM differentiation into three types： stomachintestine excessive heat, weakness of the spleen-stomach and spleen-kidney yang deficiency, treated by electroacupuncture on Tianshu （天枢 ST 25）, Daheng （大横 SP 15）, Zusanli （足三里ST 36）, Shangjuxu （上巨虚 ST 37）, Fanglong （丰隆 ST 40）, Yinlingquan （阴陵泉 SP 9）, Quchi （曲池 LI 11）, Zhigou （支沟 TE 6） and Hegu （合谷 LI 4） along with thunder-fire moxibustion. The frequency of electro-acupuncture in the dilatational wave group and the continuous wave group was 2 Hz/100 Hz and 2 Hz, respectively. Patients in the two groups were treated once a day, six times a week. The treatment lasted for 4 weeks with 3-month follow-up. Body mass and body fat percentage before and after the treatment, as well as during the follow-up, were compared. The effectiveness rates in the two groups were compared, and the efficacy statistics of patients with different TCM patterns in the dilatational wave group were also analyzed. Lipid levels of the patients in two groups before and after the treatment were measured with an automatic biochemical analyzer, and serum leptin levels were detected with flow cytometry system. Results After the treatment, the patients＇ blood lipids, serum leptin levels, body mass and body fat percentage were effectively reduced in the two groups; three months＇ follow-up witnessed continuous decline of obesity indicators （P〈0.01 or P〈0.05）, and patients in the dilatat-ional wave group improved more significantly than those in continuous wave group （P〈0.05 or P〈0.01）. The efficacy in the dilatational wave group was superior to that in the continuous wave group （P〈0.01）. The best efficacy could be found among patients with weakness of the spleen and the stomach in the dilatational wave group. Conclusion Efficacy of treating obese patients with abnormity of lipids and serum leptin by electro-acupuncture combined with thunder-fire moxibustion in the dilatational wave group was significantly better than that of the continuous wave group, and efficacy for obese patients with weakness of the spleen and the stomach was superior to that of those with stomach-intestine excessive heat and spleen-kidney yang deficiency.
基金Science and Technology Department of Zhejiang Province of China, No. 2005C24001, No. 2004C30064
文摘AIM: To investigate the effect of lifestyle intervention on non-alcoholic fatty liver disease (NAFLD) in Chinese obese children. METHODS: Seventy-six obese children aged from 10 to 17 years with NAFLD were enrolled for a one-month intervention and divided randomly into three groups. Group1, consisting of 38 obese children, was an untreated control group without any intervention. Group 2, consisting of 19 obese children in summer camp, was strictly controlled only by life style intervention. Group 3, consisting of 19 obese children, received oral vitamin E therapy at a dose of 100 mg/d. The height, weight, fasting blood glucose (FBG), fasting serum insulin (FINS), plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TCHO) and homeostasis model assent- insulin resistance (HOMA-IR) were measured at baseline and after one month. All patients were underwent to an ultrasonographic study of the liver performed by one operator who was blinded to the groups. RESULTS: The monitor indices of BMI, ALT, AST, TG, TCHO and HOMA-IR were successfully improved except in group 1. BMI and ALT in group 2 were reduced more significantly than in group 3 (2.44 ± 0.82 vs 1.45 ± 0.80, P = 0.001; 88.58 ± 39.99 vs 63.69 ± 27.05, P = 0.040, respectively).CONCLUSION: Both a short-term lifestyle intervention and vitamin E therapy have an effect on NAFLD in obese children. Compared with vitamin E, lifestyle intervention is more effective. Therefore, lifestyle intervention should represent the first step in the management of children with NAFLD.
基金Project supported by the Science Foundation for the Youth of China Institute of Sport Science （CISS） （No. 13-19）
文摘To investigate the effects of hypoxic exercise training on microRNA （miRNA） expression and the role of miRNA expression in regulating lipid metabolism, 20 dietary-induced obese SD rats were divided into a normoxic sedentary group （N, n=10） and a hypoxic exercise training group （H, n=10）. After four weeks, measurements were taken of body weight, body length, fat mass, serum lipid concentration, miRNAs differentially expressed in rat liver, and gene and protein expression levels of perexisome proliferator activated receptor a （PPARα）, fatty acid synthetase （FAS）, and carnitine palmitoyl transferase 1A （CPTIA） in rat liver. Body weight, Lee＇s index, fat mass, fat/weight ratio, and serum levels of total cholesterol （TC） and high density lipoprotein cholesterol （HDL-C） were all significantly lower in the H group than in the N group （P〈0.01）. Six miRNAs expressed significantly differently in the liver （P〈0.05）. Specifically, expression levels of miR-378b were significantly lower in the H group than in the N group （P〈0.05）. Compared with the normoxic sedentary group, hypoxic exercise training resulted in a lower ratio of FAS mRNA to CPTIA mRNA （P〈0.05）, as well as lower CPT1A protein levels （P〈0.01）, while a higher ratio of FAS to CPT1A protein levels （P〈0.01） was observed. In conclusion, hypoxic training may elevate the resistance of high fat diet induced obesity in rats by reducing the expression of miR-378b, and decrease the fatty acid mitochondrial oxidation in obese rat livers by decreasing the protein expression of CPTIA and increasing the protein expression ratio of FAS/CPTIA.
文摘Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese population.Methods: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver(normal or NAFLD), and body mass index(BMI) levels(non-obese if BMI < 25 kg/m~2 or obese if BMI ≥ 25 kg/m~2).Results: There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver(group A), non-obese NAFLD(group B), obese normal liver(group C) and obese NAFLD(group D),respectively. The highest ratio of metabolic syndrome existed in the group B(26.9%), followed by group A(11.7%), group D(10.9%) and finally the group C(5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02) and glucose(OR = 1.02; 95% CI:1.01–1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02). The positive association was most significant in all cases(adjusted OR = 2.41; 95% CI: 1.78–3.24), especially in non-obese individuals(OR = 2.81; 95% CI: 1.92–4.12).Conclusions: Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.
文摘AIM： To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indi- ces, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver （FL） and 41 with nonalcoholic steatohepatitis （NASH）. METHODS： Circulating levels of Bcl-2 were detected in 84 patients with ultrasonographic findings of ＂bright liver＂ and/or hyper-transaminasemia of unknown origin and/or increase in T-glutamyl-transpeptidase （T-GT） strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups （43 with FL and 41 with NASH）. Twenty lean subjects, apparently healthy and young, were chosen as controls.RESULTS： Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein （CRP） concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index （BMI） values （P ~ 0.0001） but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males （P = 0.0008）. γ-GT activity was associated with homeostatic metabolic assessment （HOMA） （P = 0.0003） and with serum ferritin （P = 0.02）. Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients pre- sented a weak negative correlation between Iobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metabolically unhealthy overweight/obese patients （MUOs） was evidenced. HOMA, BMI and uric acid, in that sequence, best predicted serum Bcl-2 concentrations. CONCLUSION： IvlUOs could be detected by Bcl-2 levels. By favoring the life span of hepatocytes, and enhancing triglyceride formation, the anti-apoptotic process inhibits free fatty acids toxicity in FL.
基金the support of the "Cooperative Research Program for Agriculture Science & Technology Development (Project No.PJ009582)" of the Rural Development Administration.Republic of Korea
文摘Objective:To explore the anti-obesity effects and the mechanism of action of Monascus pilosus(M.pilosus)-fermented black soybean(MFBS)extracts(MFBSE)and MFBS powders(MFBSP)in adipocytes and high-fat diet(HFD)-induced obese mice,respectively.Methods:Black soybean was fermented with M.pilosus,and the main constituents in MFBS were analyzed by HPLC analysis.In vitro,MFBSE were examined for anti-adipogenic effects using Oil-Red O staining.In vivo,mice were fed a normal-fat diet(NFD)control,HFD control or HFD containing 1 g/kg MFBSP for 12 weeks,and then body weight gain and tissues weight measured.Real-time PCR and western blot assay were used to determine the mechanism of anti-adipogenic effects.Results:MFBSE inhibited lipid accumulation in 3T3-L1 adipocytes without exerting cell cytotoxicity.MFBSP treatment in HFD-fed mice significantly decreased the body weight gain compared with the HFD control mice.MFBSE and MFBSP treatment resulted in significantly lower mRNA levels of adipogenesis-related genes,such as peroxisome proliferator-activated receptorγ(PPARγ),fatty acid-binding protein 4(FABP4),and fatty acid synthase(FAS),in adipocytes and in white adipose tissue(WAT)of HFD-induced obese mice.Conclusions:These results suggest that the anti-obesity effects of MFBS are elicited by regulating the expression of adipogenesis-related genes in adipocytes and WAT of HFDinduced obese mice.
