Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on healt...Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.展开更多
BACKGROUND The global rise in overweight and obesity has reached alarming levels,substantially increasing the risk of metabolic disorders such as dyslipidemia.We outlined the evolving trends in baseline blood lipid le...BACKGROUND The global rise in overweight and obesity has reached alarming levels,substantially increasing the risk of metabolic disorders such as dyslipidemia.We outlined the evolving trends in baseline blood lipid levels among patients experiencing overweight or obesity,as observed in placebo-controlled randomized trials,to address the unmet clinical requirements.AIM To assess long-term trends in lipid profiles in overweight or obese populations and their association with clinical and treatment factors.METHODS EMBASE,PubMed,Cochrane Library,and Web of Science databases were searched up to October 9,2024.Randomized placebo-controlled trials of participants with overweight or obesity,with reports of baseline lipid levels,were included.The main outcome was a correlation between pooled baseline levels of triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)with study year.Subgroup analysis was conducted based on characteristics of the populations and intervention types.RESULTS A comprehensive meta-analysis encompassing 866 studies across nearly 60 countries and regions worldwide,involving 3300 participants,revealed significant temporal trends in baseline lipid profiles.The analysis revealed a significant decline in TG(Rs=-0.704,P<0.001,I^(2)=98.6%),TC(Rs=-0.884,P<0.001,I^(2)=99.6%),and LDL-C(Rs=-0.808,P<0.001,I^(2)=96.8%)levels.In contrast,HDL-C(Rs=0.336,P=0.041,I^(2)=99.2%)levels exhibited a progressive increase over the study period.Subgroup analyses revealed that sex,body mass index,blood pressure,diabetes status,and type of intervention influenced the observed trends,especially with patients receiving pharmacological therapies demonstrating more pronounced improvements(TG:Rs=-0.449,P_(adj)=0.011;I^(2)=98.9%;TC:Rs=-0.650,P_(adj)=0.001;I^(2)=99.4%;HDL-C:Rs=0.650,P_(adj)=0.002;I^(2)=98.6%;LDL-C:Rs=-0.417,P_(adj)=0.031;I²=98.0%).CONCLUSION Despite rising obesity rates,lipid control has improved over three decades among individuals with overweight or obesity,reflecting the positive impact of public health efforts and effective dyslipidemia treatment strategies.展开更多
This letter critically examines a recent study by Zhang et al investigating the mediating role of overweight in the association between depression and new-onset diabetes among middle-aged and older adults.The study pr...This letter critically examines a recent study by Zhang et al investigating the mediating role of overweight in the association between depression and new-onset diabetes among middle-aged and older adults.The study provides com-pelling evidence that overweight mediates approximately 61%of this relationship,suggesting that depression may contribute to diabetes by influencing behaviors that lead to weight gain.This aligns with the understanding that depression can impact appetite regulation and physical activity.While the study employs a longitudinal design and robust statistical methods,limitations such as reliance on self-reported data and body mass index measurements warrant consideration.This analysis emphasizes the need for integrated interventions that address both mental and metabolic health for effective diabetes prevention.Future research should further explore the interplay of lifestyle factors,biological pathways,and social determinants in the development of this complex relationship.Ultimately,an integrated approach targeting both behavioral and biological components is crucial for the prevention and management of new-onset diabetes.展开更多
Objective To investigate the association between long-term exposure to ambient fine particulate matter(PM_(2.5))and its constituents and the risk of incident type 2 diabetes mellitus(T2DM),and to examine the modificat...Objective To investigate the association between long-term exposure to ambient fine particulate matter(PM_(2.5))and its constituents and the risk of incident type 2 diabetes mellitus(T2DM),and to examine the modification roles of overweight status.Methods This prospective study included 27,507 adults living in rural China.The annual mean residential exposure to PM_(2.5)and its constituents was estimated using a satellite-based statistical model.Cox models were used to estimate the risk of T2DM associated with PM_(2.5)and its constituents.Stratified analysis quantified the role of overweight status in the association between PM_(2.5)constituents and T2DM.Results Over a median follow-up of 9.4 years,3,001 new T2DM cases were identified.The hazard ratio(HR)for a 10μg/m^(3)increase in ambient PM_(2.5)was 1.30(95%confidence interval[CI]:1.17,1.45).Among the constituents,the strongest association was observed with black carbon.Being overweight significantly modified the association between certain constituents and the risk of T2DM.Participants who were overweight and exposed to the highest quartile of PM_(2.5)constituents had the highest risk of T2DM(HR:2.46,95%CI:2.04,2.97).Conclusions Our findings indicate that PM_(2.5)was associated with an increased risk of T2DM,with black carbon potentially being the primary contributor.Being overweight appeared to enhance the association between PM_(2.5)and T2DM.This suggests that controlling both PM_(2.5)exposure and overweight status may reduce the burden of T2DM.展开更多
BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood...BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood.AIM To investigate the role of overweight in mediating the association between depression and new-onset diabetes in middle-aged and older populations.METHODS Data of 9426 individuals aged≥50 years from the 1998-2016 Health and Retirement Study database were analyzed.Weighted logistic regression was employed to obtain odds ratios(ORs)and 95%confidence intervals(95%CIs)for depression and new-onset diabetes in the middle-aged and older populations.Mediation analysis and the Sobel test were used to test the mediating effects of overweight between depression and the risk of new-onset diabetes.RESULTS New-onset diabetes was identified in 23.6%of the study population.Depression was significantly associated with new-onset diabetes(OR:1.18,95%CI:1.03-1.35,P value:0.014).Further adjustment for overweight attenuated the effect of depression on new-onset diabetes to 1.14(95%CI:1.00-1.30,P=0.053),with a significant mediating effect(P of Sobel test=0.003).The mediation analysis demonstrated that overweight accounted for 61%in depression for the risk of new-onset diabetes,with overweight having a partially mediating role in the depression-to-diabetes pathway.CONCLUSION New-onset diabetes was not necessarily a direct complication of depression;rather,depression led to behaviors that increase the risk of overweight and,consequently,new-onset diabetes.展开更多
Dear Editor,Bronchial asthma (BA) is a common chronic inflammatory disease of the airways,characterized by variable obstruction and airway hyperreactivity.It is a heterogeneous lung disease characterized by variabilit...Dear Editor,Bronchial asthma (BA) is a common chronic inflammatory disease of the airways,characterized by variable obstruction and airway hyperreactivity.It is a heterogeneous lung disease characterized by variability in both clinical symptoms and the underlying cellular and molecular mechanisms[1].展开更多
We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.K...We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.Key measures included selection of a patient newly diagnosed with type 2 diabetes mellitus,use of CGM,analysis of glucose trends and contributing factors,and patient guidance in maintaining a health diary and developing personalized self‐management strategies(e.g.,dietary modification and exercise regimens).Following 6‐month CGM‐guided self‐management,the patient's glycated hemoglobin level decreased from 7.3%at baseline to 6.0%and his body weight decreased from 83 to 77 kg,a 7%reduction;thus,the patient met the criteria for diabetes remission.展开更多
Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the...Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.展开更多
Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Stude...Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.展开更多
Objective To evaluate trends of overweight and obesity prevalence between 1996 and 2007 in Yi farmers and Yi migrants.Methods An Yi migrant study was conducted in Liangshan Yi Autonomous Prefecture,Sichuan Province,Ch...Objective To evaluate trends of overweight and obesity prevalence between 1996 and 2007 in Yi farmers and Yi migrants.Methods An Yi migrant study was conducted in Liangshan Yi Autonomous Prefecture,Sichuan Province,China from 1996 to 2007.Data were collected with identical methods,including standardized questionnaire and body measurements.Results Age‐ and sex‐specific body mass index （BMI） significantly increased from 20.02 in 1996 to 22.36 in 2007,among Yi farmers,which was significantly different from those among Yi migrants （23.67 in 2007 and 20.90 in 1996） （P0.05）.Prevalence of obesity rose from 1.21 % in 1996 to 4.55 % in 2007 （OR=1.15,P0.001） in Yi migrants,while that in Yi farmers from none in 1996 to 0.12 % in 2007 （P0.05）.Prevalence of overweight rose significantly to 26.24 %in 2007 from 17.24 % in 1996 （OR=1.06,P0.001） in Yi migrants,while that in Yi farmers from 1.29 % in 1996 to 4.45 % in 2007 （OR=1.14,P0.001）.Yi migrants appeared to have a 5.52‐fold higher risk ondeveloping overweight and obesity than Yi farmers have.Conclusion The Yi migrants had a steeper increase of overweight with year and consequently caused more obesity.Change in lifestyle may contribute most likely to higher prevalence of overweight and obesity in Yi migrants.展开更多
Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness a...Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness and health survey in Jiangsu province. A total of 255,581 subjects （50.03% males and 49.97% females） enrolled in 82 school and 10 universities in Jiangsu. Weights and heights were obtained for each subject and its body mass index （BMI） was calculated using the Chinese Working Group on Obesity in China （CWGO）. Results Anthropometric measurement including bodyweight, height, BMI and bust were significantly different between males in urban compared to females living rural areas （P〈0.001）. The total prevalence of overweight and obesity was 12.4% and 5.7%. Males had a significantly higher rate than in female＇s student. The prevalence of overweight and obesity by age groups was （14.5%, 10.3%） at age 7-11 years, （11.2%, 6.8%） at age 12-14 years, （11.7%, 3.1%） at age 15-17 years, and （11.4%, 2.3%） at age 18-22 years. By regions; the highest prevalence of overweight obesity reported in Taizhou （10.0%, 14.2%）, Xuzhou （9.4%, 12.5%）, and Nanjing （9.2%, 15.6%）, respectively. Conclusion The finding declares that overweight and obesity are important health problems among students in Jiangsu Province. Early intervention programme are needed to address this problems.展开更多
AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: ...AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD.Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.展开更多
We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group ...We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group （n=397, BMI〈24 kg/m2） and the overweight group （n=400, BMI〉24 kg/m2）. Our results showed that the overweight group had higher blood pressure [（130.15±19.01） mmHg vs （123.66±18.70） mmHg] and higher levels of blood sugar [（7.09±2.89） mmol/L vs （6.21±2.59） mmol/L], triglyceride [（1.93±1.19） mmol/L vs （1.44 ±0.85） mmol/L], total cholesterol [（4.26±1.06） mmol/L vs （4.09±0.99） mmol/L], low-density lipoprotein cholesterol （LDL-C） [（2.56±0.75） mmol/L vs （2.39±0.72） mmol/L], and apoB [（0.83±0.27） mg/L vs （0.78±0.23） mg/L], and a higher apoB/apoA1 ratio （0.83 ±0.27 vs 0.75±0.25） and lower levels high-density lipoprotein cholesterol [（1.10±0.26） mmol/L vs （1.21±0.31） mmol/L] and apoA1 [（1.04±0.20） mg/L vs （1.08±0.22） mg/L] than those of the normal weight group （all P 〈 0.05）. The prevalence of CHD in the over-weight group in the lowest LDL quartile was almost twice greater than that of the highest apoB/apoA1 quartile, compared with the subjects in the lowest apoB/apoA1 quartile. The higher apoB/apoA1 quartile was in agreement with the higher prevalence of CHD. In the overweight and obesity group, the area under ROC curve （AUC） was the highest for apoB/apoA1 （0.655）. The cut-off point of apoB/apoA1 for optimal sensitivity and specificity was at 0.80, with a sensitivity of 57.19% and a specificity of 71.72%. In conclusion, apoB and apoA1 were simple clinical indicators, and the apoB/apoA1 ratio was closely related with CHD in overweight and obese patients. The apoB/apoA1 ratio may provide some useful information in the differential diagnosis.展开更多
AIM: To evaluate whether the prevalence of overweight and obese conditions is increased in gastro-esophageal reflux disease (GERD) patients (with 24-h pathological pH recordings) in comparison to general population. M...AIM: To evaluate whether the prevalence of overweight and obese conditions is increased in gastro-esophageal reflux disease (GERD) patients (with 24-h pathological pH recordings) in comparison to general population. METHODS: A total of 196 consecutive patients (103 females, age range 18-83 years) with symptoms of gastro-esophageal reflux (GER) and 24-h pathological esophageal pH-metry. Body mass index (BMI) of the patients was calculated and its distribution (%) was compared with that of the Italian general population as assessed by National Bureau of Census (ISTAT). To evaluate the association of GERD with weight categories, the binomial test was employed. P < 0.05 was considered statistically significant. RESULTS: In males, overweightedness (BMI 25-25.9) was present in 43% of GERD patients vs 41.8% of Italian population (IP) (ns), obesity (BMI ≥ 30) in 10.9% vs 9.1% (ns). In females overweight was present in 34.9% of GERD patients vs 25.7% of IP (P < 0.01), obesity in 13.6% of GERD patients vs 9.1% of IP (P < 0.01). No statistically significant differences were noted in different age classes. CONCLUSION: In comparison to the Italian general population, the prevalence of overweightedness and obesity is increased in female but not in male patients with ascertained gastro-esophageal reflux disease.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
AIM: To investigate the effect of being overweight on the surgical results of patients with gastric cancer. METHODS: Comprehensive electronic searches of the PubMed, Web of Science, and Cochrane Library databases were...AIM: To investigate the effect of being overweight on the surgical results of patients with gastric cancer. METHODS: Comprehensive electronic searches of the PubMed, Web of Science, and Cochrane Library databases were conducted. Studies were identified that included patients with surgical complications from gastric cancer who were classified as normal weight [body mass index (BMI) < 25 kg/m 2 ] or overweight (BMI ≥ 25 kg/m 2 ). The operative time, retrieved lymph nodes, blood loss, and long-term survival were analyzed. A subgroup analysis was conducted based on whether patients received laparoscopic or open gastrectomy procedures. All statistical tests were performed using ReviewerManager 5.1.2 software. RESULTS: This meta-analysis included 23 studies with 20678 patients (15781 with BMI < 25 kg/m 2 ; 4897 with BMI ≥ 25 kg/m 2 ). Overweight patients had significantly increased operation times [MD: -29.14; 95%CI: -38.14-(-20.21); P < 0.00001], blood loss [MD: -194.58; 95%CI: -314.21-(-74.95); P = 0.001], complications (RR: 0.75; 95%CI: 0.66-0.85; P < 0.00001), anastomosis leakages (RR: 0.59; 95%CI: 0.42-0.82; P = 0.002), and pancreatic fistulas (RR: 0.486; 95%CI: 0.34-0.63; P < 0.00001), whereas lymph node retrieval was decreased significantly in the overweight group (MD: 1.69; 95%CI: 0.75-2.62; P < 0.0001). In addition, overweight patients had poorer long-term survival (RR: 1.14; 95%CI: 1.07-1.20; P < 0.0001). No significant difference was detected for the mortality and length of hospital stay. CONCLUSION: This meta-analysis demonstrates that a high BMI not only increases the surgical difficulty and complications but also impairs the long-term survival of patients with gastric cancer.展开更多
Objective To investigate whether overweight and obesity might cause oxidative stress and potential oxidative damage in overweight and obese children, and to explore its possible mechanism. Methods Eighty-five overweig...Objective To investigate whether overweight and obesity might cause oxidative stress and potential oxidative damage in overweight and obese children, and to explore its possible mechanism. Methods Eighty-five overweight and obese children （OOC）, and eighty-five age-matched healthy children （HC） were recruited in this case-control study. The present study analyzed spectrophotometrically vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） in plasma, as well as the activities of superoxide dismutase （SOD）, catalase （CAT）, and the level of malondialdehyde （MDA） in erythrocytes. Results Compared with those of VC, VE, β-CAR, SOD, CAT and MDA in the HC group, the average values of VC, VE, β-CAR, SOD, and CAT in the OOC group were significantly decreased （P〈0.001）, while the average value of MDA in the OOC group was significantly increased （P〈0.001）. The regression analysis demonstrated that VC, VE, β-CAR, SOD, and CAT were negatively correlated （P〈0.05-0.01）, and MDA was positively correlated with BMI （P〈0.05）. Fitting to the model of multiple stepwise regression of BMI on VC, VE, β-CAR, SOD, CAT, and MDA in 85 OOC was Y = 27.0041 ＋ 0,2541MDA - 2.1448β-CAR -- 0.0090CAr, where F = 43.8088, P〈0.001, r = 0.7866, r^2= 0.6187, adjusted r^2= 0.6046. The findings from the reliability analysis for VC, VE, β-CAR, SOD, CAT, and MDA used to reflect increased oxidative stress and potential oxidative damage in the OOC showed that the reliability coefficients （alpha, 6 items） = 0.7231, P〈0.0001, and that the standardized item alpha = 0.9207, P〈0.0001, Conclusion The present study suggests that there exists an increased oxidative stress in overweight and obese children.展开更多
Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-co...Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.展开更多
Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related p...Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.展开更多
BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and...BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and intervene as early as possible.At present,the relationship between maternal and offspring metabolic factors is conflicting.AIM To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age.Offspring birth weight,sex,height,weight,and body mass index(BMI)were measured and calculated.FibroScan-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTS A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having GDM.The mean age of the offspring at follow-up was 8 years old.Thirty-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty liver.The prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and GDM.CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in offspring.Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.展开更多
文摘Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.
文摘BACKGROUND The global rise in overweight and obesity has reached alarming levels,substantially increasing the risk of metabolic disorders such as dyslipidemia.We outlined the evolving trends in baseline blood lipid levels among patients experiencing overweight or obesity,as observed in placebo-controlled randomized trials,to address the unmet clinical requirements.AIM To assess long-term trends in lipid profiles in overweight or obese populations and their association with clinical and treatment factors.METHODS EMBASE,PubMed,Cochrane Library,and Web of Science databases were searched up to October 9,2024.Randomized placebo-controlled trials of participants with overweight or obesity,with reports of baseline lipid levels,were included.The main outcome was a correlation between pooled baseline levels of triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)with study year.Subgroup analysis was conducted based on characteristics of the populations and intervention types.RESULTS A comprehensive meta-analysis encompassing 866 studies across nearly 60 countries and regions worldwide,involving 3300 participants,revealed significant temporal trends in baseline lipid profiles.The analysis revealed a significant decline in TG(Rs=-0.704,P<0.001,I^(2)=98.6%),TC(Rs=-0.884,P<0.001,I^(2)=99.6%),and LDL-C(Rs=-0.808,P<0.001,I^(2)=96.8%)levels.In contrast,HDL-C(Rs=0.336,P=0.041,I^(2)=99.2%)levels exhibited a progressive increase over the study period.Subgroup analyses revealed that sex,body mass index,blood pressure,diabetes status,and type of intervention influenced the observed trends,especially with patients receiving pharmacological therapies demonstrating more pronounced improvements(TG:Rs=-0.449,P_(adj)=0.011;I^(2)=98.9%;TC:Rs=-0.650,P_(adj)=0.001;I^(2)=99.4%;HDL-C:Rs=0.650,P_(adj)=0.002;I^(2)=98.6%;LDL-C:Rs=-0.417,P_(adj)=0.031;I²=98.0%).CONCLUSION Despite rising obesity rates,lipid control has improved over three decades among individuals with overweight or obesity,reflecting the positive impact of public health efforts and effective dyslipidemia treatment strategies.
基金Supported by the New Professor Research Program of KOREATECH,No.202501930001.
文摘This letter critically examines a recent study by Zhang et al investigating the mediating role of overweight in the association between depression and new-onset diabetes among middle-aged and older adults.The study provides com-pelling evidence that overweight mediates approximately 61%of this relationship,suggesting that depression may contribute to diabetes by influencing behaviors that lead to weight gain.This aligns with the understanding that depression can impact appetite regulation and physical activity.While the study employs a longitudinal design and robust statistical methods,limitations such as reliance on self-reported data and body mass index measurements warrant consideration.This analysis emphasizes the need for integrated interventions that address both mental and metabolic health for effective diabetes prevention.Future research should further explore the interplay of lifestyle factors,biological pathways,and social determinants in the development of this complex relationship.Ultimately,an integrated approach targeting both behavioral and biological components is crucial for the prevention and management of new-onset diabetes.
基金supported by the National Nature Science Foundation of China(82173600)Shanghai Leading Academic Project of Public Health,China(GWVI-8).
文摘Objective To investigate the association between long-term exposure to ambient fine particulate matter(PM_(2.5))and its constituents and the risk of incident type 2 diabetes mellitus(T2DM),and to examine the modification roles of overweight status.Methods This prospective study included 27,507 adults living in rural China.The annual mean residential exposure to PM_(2.5)and its constituents was estimated using a satellite-based statistical model.Cox models were used to estimate the risk of T2DM associated with PM_(2.5)and its constituents.Stratified analysis quantified the role of overweight status in the association between PM_(2.5)constituents and T2DM.Results Over a median follow-up of 9.4 years,3,001 new T2DM cases were identified.The hazard ratio(HR)for a 10μg/m^(3)increase in ambient PM_(2.5)was 1.30(95%confidence interval[CI]:1.17,1.45).Among the constituents,the strongest association was observed with black carbon.Being overweight significantly modified the association between certain constituents and the risk of T2DM.Participants who were overweight and exposed to the highest quartile of PM_(2.5)constituents had the highest risk of T2DM(HR:2.46,95%CI:2.04,2.97).Conclusions Our findings indicate that PM_(2.5)was associated with an increased risk of T2DM,with black carbon potentially being the primary contributor.Being overweight appeared to enhance the association between PM_(2.5)and T2DM.This suggests that controlling both PM_(2.5)exposure and overweight status may reduce the burden of T2DM.
基金Supported by the Scientific Research Program of the Tianjin Education Commission(Natural Science),No.2023KJ033.
文摘BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood.AIM To investigate the role of overweight in mediating the association between depression and new-onset diabetes in middle-aged and older populations.METHODS Data of 9426 individuals aged≥50 years from the 1998-2016 Health and Retirement Study database were analyzed.Weighted logistic regression was employed to obtain odds ratios(ORs)and 95%confidence intervals(95%CIs)for depression and new-onset diabetes in the middle-aged and older populations.Mediation analysis and the Sobel test were used to test the mediating effects of overweight between depression and the risk of new-onset diabetes.RESULTS New-onset diabetes was identified in 23.6%of the study population.Depression was significantly associated with new-onset diabetes(OR:1.18,95%CI:1.03-1.35,P value:0.014).Further adjustment for overweight attenuated the effect of depression on new-onset diabetes to 1.14(95%CI:1.00-1.30,P=0.053),with a significant mediating effect(P of Sobel test=0.003).The mediation analysis demonstrated that overweight accounted for 61%in depression for the risk of new-onset diabetes,with overweight having a partially mediating role in the depression-to-diabetes pathway.CONCLUSION New-onset diabetes was not necessarily a direct complication of depression;rather,depression led to behaviors that increase the risk of overweight and,consequently,new-onset diabetes.
文摘Dear Editor,Bronchial asthma (BA) is a common chronic inflammatory disease of the airways,characterized by variable obstruction and airway hyperreactivity.It is a heterogeneous lung disease characterized by variability in both clinical symptoms and the underlying cellular and molecular mechanisms[1].
文摘We report the case of a newly diagnosed overweight patient with type 2 diabetes mellitus who achieved diabetes remission using continuous glucose monitoring(CGM),which promotes patient engagement in self‐management.Key measures included selection of a patient newly diagnosed with type 2 diabetes mellitus,use of CGM,analysis of glucose trends and contributing factors,and patient guidance in maintaining a health diary and developing personalized self‐management strategies(e.g.,dietary modification and exercise regimens).Following 6‐month CGM‐guided self‐management,the patient's glycated hemoglobin level decreased from 7.3%at baseline to 6.0%and his body weight decreased from 83 to 77 kg,a 7%reduction;thus,the patient met the criteria for diabetes remission.
基金Funded by International Life Sciences Institute, Focal Point in China.
文摘Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.
基金Funded by International Life Sciences Institute, Focal Point in China.
文摘Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.
基金supported by a grant (No 30671811) from the national natural science foundation of China
文摘Objective To evaluate trends of overweight and obesity prevalence between 1996 and 2007 in Yi farmers and Yi migrants.Methods An Yi migrant study was conducted in Liangshan Yi Autonomous Prefecture,Sichuan Province,China from 1996 to 2007.Data were collected with identical methods,including standardized questionnaire and body measurements.Results Age‐ and sex‐specific body mass index （BMI） significantly increased from 20.02 in 1996 to 22.36 in 2007,among Yi farmers,which was significantly different from those among Yi migrants （23.67 in 2007 and 20.90 in 1996） （P0.05）.Prevalence of obesity rose from 1.21 % in 1996 to 4.55 % in 2007 （OR=1.15,P0.001） in Yi migrants,while that in Yi farmers from none in 1996 to 0.12 % in 2007 （P0.05）.Prevalence of overweight rose significantly to 26.24 %in 2007 from 17.24 % in 1996 （OR=1.06,P0.001） in Yi migrants,while that in Yi farmers from 1.29 % in 1996 to 4.45 % in 2007 （OR=1.14,P0.001）.Yi migrants appeared to have a 5.52‐fold higher risk ondeveloping overweight and obesity than Yi farmers have.Conclusion The Yi migrants had a steeper increase of overweight with year and consequently caused more obesity.Change in lifestyle may contribute most likely to higher prevalence of overweight and obesity in Yi migrants.
基金fully supported by the Jiangsu Provincial Social Science Foundation Grant(3TYA001)
文摘Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness and health survey in Jiangsu province. A total of 255,581 subjects （50.03% males and 49.97% females） enrolled in 82 school and 10 universities in Jiangsu. Weights and heights were obtained for each subject and its body mass index （BMI） was calculated using the Chinese Working Group on Obesity in China （CWGO）. Results Anthropometric measurement including bodyweight, height, BMI and bust were significantly different between males in urban compared to females living rural areas （P〈0.001）. The total prevalence of overweight and obesity was 12.4% and 5.7%. Males had a significantly higher rate than in female＇s student. The prevalence of overweight and obesity by age groups was （14.5%, 10.3%） at age 7-11 years, （11.2%, 6.8%） at age 12-14 years, （11.7%, 3.1%） at age 15-17 years, and （11.4%, 2.3%） at age 18-22 years. By regions; the highest prevalence of overweight obesity reported in Taizhou （10.0%, 14.2%）, Xuzhou （9.4%, 12.5%）, and Nanjing （9.2%, 15.6%）, respectively. Conclusion The finding declares that overweight and obesity are important health problems among students in Jiangsu Province. Early intervention programme are needed to address this problems.
文摘AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD.Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.
基金supported by National High-Tech Research and Development Program of China (No.2006AA02A406)Natural Science Foundation of China (No.30871042)
文摘We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group （n=397, BMI〈24 kg/m2） and the overweight group （n=400, BMI〉24 kg/m2）. Our results showed that the overweight group had higher blood pressure [（130.15±19.01） mmHg vs （123.66±18.70） mmHg] and higher levels of blood sugar [（7.09±2.89） mmol/L vs （6.21±2.59） mmol/L], triglyceride [（1.93±1.19） mmol/L vs （1.44 ±0.85） mmol/L], total cholesterol [（4.26±1.06） mmol/L vs （4.09±0.99） mmol/L], low-density lipoprotein cholesterol （LDL-C） [（2.56±0.75） mmol/L vs （2.39±0.72） mmol/L], and apoB [（0.83±0.27） mg/L vs （0.78±0.23） mg/L], and a higher apoB/apoA1 ratio （0.83 ±0.27 vs 0.75±0.25） and lower levels high-density lipoprotein cholesterol [（1.10±0.26） mmol/L vs （1.21±0.31） mmol/L] and apoA1 [（1.04±0.20） mg/L vs （1.08±0.22） mg/L] than those of the normal weight group （all P 〈 0.05）. The prevalence of CHD in the over-weight group in the lowest LDL quartile was almost twice greater than that of the highest apoB/apoA1 quartile, compared with the subjects in the lowest apoB/apoA1 quartile. The higher apoB/apoA1 quartile was in agreement with the higher prevalence of CHD. In the overweight and obesity group, the area under ROC curve （AUC） was the highest for apoB/apoA1 （0.655）. The cut-off point of apoB/apoA1 for optimal sensitivity and specificity was at 0.80, with a sensitivity of 57.19% and a specificity of 71.72%. In conclusion, apoB and apoA1 were simple clinical indicators, and the apoB/apoA1 ratio was closely related with CHD in overweight and obese patients. The apoB/apoA1 ratio may provide some useful information in the differential diagnosis.
文摘AIM: To evaluate whether the prevalence of overweight and obese conditions is increased in gastro-esophageal reflux disease (GERD) patients (with 24-h pathological pH recordings) in comparison to general population. METHODS: A total of 196 consecutive patients (103 females, age range 18-83 years) with symptoms of gastro-esophageal reflux (GER) and 24-h pathological esophageal pH-metry. Body mass index (BMI) of the patients was calculated and its distribution (%) was compared with that of the Italian general population as assessed by National Bureau of Census (ISTAT). To evaluate the association of GERD with weight categories, the binomial test was employed. P < 0.05 was considered statistically significant. RESULTS: In males, overweightedness (BMI 25-25.9) was present in 43% of GERD patients vs 41.8% of Italian population (IP) (ns), obesity (BMI ≥ 30) in 10.9% vs 9.1% (ns). In females overweight was present in 34.9% of GERD patients vs 25.7% of IP (P < 0.01), obesity in 13.6% of GERD patients vs 9.1% of IP (P < 0.01). No statistically significant differences were noted in different age classes. CONCLUSION: In comparison to the Italian general population, the prevalence of overweightedness and obesity is increased in female but not in male patients with ascertained gastro-esophageal reflux disease.
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.
文摘AIM: To investigate the effect of being overweight on the surgical results of patients with gastric cancer. METHODS: Comprehensive electronic searches of the PubMed, Web of Science, and Cochrane Library databases were conducted. Studies were identified that included patients with surgical complications from gastric cancer who were classified as normal weight [body mass index (BMI) < 25 kg/m 2 ] or overweight (BMI ≥ 25 kg/m 2 ). The operative time, retrieved lymph nodes, blood loss, and long-term survival were analyzed. A subgroup analysis was conducted based on whether patients received laparoscopic or open gastrectomy procedures. All statistical tests were performed using ReviewerManager 5.1.2 software. RESULTS: This meta-analysis included 23 studies with 20678 patients (15781 with BMI < 25 kg/m 2 ; 4897 with BMI ≥ 25 kg/m 2 ). Overweight patients had significantly increased operation times [MD: -29.14; 95%CI: -38.14-(-20.21); P < 0.00001], blood loss [MD: -194.58; 95%CI: -314.21-(-74.95); P = 0.001], complications (RR: 0.75; 95%CI: 0.66-0.85; P < 0.00001), anastomosis leakages (RR: 0.59; 95%CI: 0.42-0.82; P = 0.002), and pancreatic fistulas (RR: 0.486; 95%CI: 0.34-0.63; P < 0.00001), whereas lymph node retrieval was decreased significantly in the overweight group (MD: 1.69; 95%CI: 0.75-2.62; P < 0.0001). In addition, overweight patients had poorer long-term survival (RR: 1.14; 95%CI: 1.07-1.20; P < 0.0001). No significant difference was detected for the mortality and length of hospital stay. CONCLUSION: This meta-analysis demonstrates that a high BMI not only increases the surgical difficulty and complications but also impairs the long-term survival of patients with gastric cancer.
文摘Objective To investigate whether overweight and obesity might cause oxidative stress and potential oxidative damage in overweight and obese children, and to explore its possible mechanism. Methods Eighty-five overweight and obese children （OOC）, and eighty-five age-matched healthy children （HC） were recruited in this case-control study. The present study analyzed spectrophotometrically vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） in plasma, as well as the activities of superoxide dismutase （SOD）, catalase （CAT）, and the level of malondialdehyde （MDA） in erythrocytes. Results Compared with those of VC, VE, β-CAR, SOD, CAT and MDA in the HC group, the average values of VC, VE, β-CAR, SOD, and CAT in the OOC group were significantly decreased （P〈0.001）, while the average value of MDA in the OOC group was significantly increased （P〈0.001）. The regression analysis demonstrated that VC, VE, β-CAR, SOD, and CAT were negatively correlated （P〈0.05-0.01）, and MDA was positively correlated with BMI （P〈0.05）. Fitting to the model of multiple stepwise regression of BMI on VC, VE, β-CAR, SOD, CAT, and MDA in 85 OOC was Y = 27.0041 ＋ 0,2541MDA - 2.1448β-CAR -- 0.0090CAr, where F = 43.8088, P〈0.001, r = 0.7866, r^2= 0.6187, adjusted r^2= 0.6046. The findings from the reliability analysis for VC, VE, β-CAR, SOD, CAT, and MDA used to reflect increased oxidative stress and potential oxidative damage in the OOC showed that the reliability coefficients （alpha, 6 items） = 0.7231, P〈0.0001, and that the standardized item alpha = 0.9207, P〈0.0001, Conclusion The present study suggests that there exists an increased oxidative stress in overweight and obese children.
基金the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924)the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01HD38700)+2 种基金the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveysthe China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009financial support from the China Scholarship Council for conducting this research
文摘Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.
基金sponsored by the Young Scholar Scientific Research Foundation of China CDC[2010A205]PUMC Youth Fund and supported by the Fundamental Research Funds for the Central Universities[2017330014]
文摘Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.
基金Supported by Collaborative Innovation Program of Shanghai Municipal Health Commission, No. 2020CXJQ01National Natural Science Foundation of China, No. 81873565 and No. 82100605+3 种基金SJTU Trans-med Awards Research, No. 20190104Star Program of Shanghai Jiao Tong University, No. YG2021QN54WBE Liver Fibrosis Foundation, No. CFHPC2020061Hospital Funded Clinical Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 17CSK04 and No. 15LC06
文摘BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and intervene as early as possible.At present,the relationship between maternal and offspring metabolic factors is conflicting.AIM To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age.Offspring birth weight,sex,height,weight,and body mass index(BMI)were measured and calculated.FibroScan-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTS A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having GDM.The mean age of the offspring at follow-up was 8 years old.Thirty-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty liver.The prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and GDM.CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in offspring.Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.
