BACKGROUND Overweight/obesity combined with depression among children and adolescents(ODCA)is a global concern.The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity....BACKGROUND Overweight/obesity combined with depression among children and adolescents(ODCA)is a global concern.The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity.Childhood and adolescence represent critical periods for physical and psychological development,during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.AIM To evaluate the relationship between ODCA,we conduct a bibliometric analysis to aid in formulating prevention and treatment strategies.METHODS From 2004 to 2023,articles related to ODCA were selected using the Science Citation Index Expanded from the Web of Science Core Collection.Bibliometric analysis of relevant publications,including countries/regions,institutions,authors,journals,references,and keywords,was conducted using the online bibliometric analysis platforms,CiteSpace,VOSviewer,and bibliometrix.RESULTS Between 2004 and 2023,a total of 1573 articles were published on ODCA.The United States has made leading contributions in this field,with Harvard University emerging as the leading contributor in terms of research output,and Tanofsky being the most prolific author.The J Adolescent Health has shown significant activity in this domain.Based on the results of the keyword and reference analyses,inequality,adverse childhood experiences,and comorbidities have become hot topics in ODCA.Moreover,the impact of balancedrelated behavior and exploration of the biological mechanisms,including the potential role of key adipocytokines and lipokines,as well as inflammation in ODCA,have emerged as frontier topics.CONCLUSION The trend of a significant increase in ODCA publications is expected to continue.The research findings will contribute to elucidating the pathogenic mechanisms of ODCA and its prevention and treatment.展开更多
AIM: To identify which parameters could help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early atherosclerosis.METHODS: Eighty two of 124 overwe...AIM: To identify which parameters could help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early atherosclerosis.METHODS: Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine amino-transferase, blood pressure and the two imaging para-meters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR. RESULTS: A variable grade of visceral obesity was observed in all subjects with the exception of three.Obesity of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and signif icant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systolic blood pressure 0.66, cut-off 125 mm of Hg, sensibility 64%, specif icity 75%; AUROC for diastolic blood pressure 0.70, cut-off 85 mm of Hg, sensibility 54.5%, specif icity 75%). CONCLUSION: As health care costs are skyrocketing, reliable and mainly inexpensive tools are advisable to better defi ne subjects who really need to lose weight.展开更多
Background: Overweight and obesity are among the most frequently encountered multi-factorial disorders in most populations of the world. In addition, to its health impacts, overweight/obesity leads to many health prob...Background: Overweight and obesity are among the most frequently encountered multi-factorial disorders in most populations of the world. In addition, to its health impacts, overweight/obesity leads to many health problems which reflect on the university students’ physical, psychological, social and environmental aspects of their quality of life. The study aim was to evaluate the effect of an educational program on improving quality of life of overweight/obese university students in Gaza strip. Materials and Methods: quasi-experimental nonequivalent pretest-posttest control group design utilized in this study 74 and 69 students in the intervention and control group respectively. The study conducted at Islamic university of Gaza and data were collected in two stages before and after five months from the application of the educational program, using interviewing questionnaire and world health organization quality of life-BREF instrument;pre-post test and body mass index were calculated. Results: the study results revealed that overall students’ knowledge for posttest was significantly higher than pretest (p-value ≤ 0.05). Overall, mean score of quality of life after the program was significantly (p-value = 0.001) greater than before and greater than control group for all domains. Conclusion: The study concluded that the health educational intervention program had positive effects on knowledge, practices and attitudes regarding overweight/obesity with improving university students’ mean score of quality of life.展开更多
Prenatal overweight/obesity(OW/OB)can alter colostrum lipid patterns,thereby affecting the lipid metabolism and even the cognitive and healthy development of infants.However,studies on changes in colostrum lipids in t...Prenatal overweight/obesity(OW/OB)can alter colostrum lipid patterns,thereby affecting the lipid metabolism and even the cognitive and healthy development of infants.However,studies on changes in colostrum lipids in the context of OW/OB are limited,particularly for glycerides and polar lipids.Therefore,this study investigated the infl uence of maternal prenatal weight on colostrum in lipid subclasses and molecular species.The concentration of triacylglycerols(TAGs)in the colostrum of the OW/OB group(35894.43 mg/L)was higher than that of the normal weight(NW)group(26639.20 mg/L),suggesting that colostrum from OW/OB mothers could provide more energy to their infants.Further analysis of the fatty acid composition of TAGs revealed that elevated maternal body weight enhanced the concentration of TAGs containing saturated or n-6 fatty acids and shortened the carbon number of TAGs.Docosahexaenoic acid(DHA)/arachidonic acid(AA)/choline-containing lipids,such as DHA-containing TAGs,AA/DHA-containing phosphatidylethanolamine,and choline-containing phospholipids,were present in higher levels in the colostrum of OW/OB mothers than NW mothers.However,the concentrations of palmitic acid-containing TAGs,linoleic acid-containing TAGs,dihomo-γ-linolenic acid-containing TAGs,and polar lipids and the ratio of TAGs containing n-6 fatty acid/n-3 fatty acid were signifi cantly higher in the colostrum of OW/OB mothers than in that of NW mothers.The fatty acid composition and sphingoid bases of sphingolipids were also altered due to elevated body weight.In conclusion,OW/OB affects colostrum lipids with respect to composition,concentration,and percentage.Although the colostrum of healthy OW/OB mothers can provide suffi cient DHA/AA/choline-containing lipids to their infants,normalization of body weight and fat reserves should be considered as a strategy for highquality human milk lipids.展开更多
Background Exercise is an effective intervention for obesity and type 2 diabetes,with significant physiological benefits over pharmacological interventions.However,there is limited preclinical data available comparing...Background Exercise is an effective intervention for obesity and type 2 diabetes,with significant physiological benefits over pharmacological interventions.However,there is limited preclinical data available comparing endurance and resistance exercise for the impacts on obesogenic pathology and glycemic control.Methods Male mice were subjected to 8 weeks of diet-induced obesity(DIO)by high-fat diet(HFD)feeding concurrent with voluntary wheel running(endurance exercise(E_(EX)))or weightlifting(resistance exercise(R_(EX))).Sedentary(SED)mice fed on normal chow(NC)or HFD were used as controls.Results E_(EX) and R_(EX) interventions significantly attenuated weight gain vs.HFD-SED due to reduction of fat mass,not changes in lean mass,as assessed by EchoMRI.While REX suppressed visceral and subcutaneous fat accumulation significantly,only E_(EX) enlarged brown fat mass.Exercise tolerance testing(i.e.,run-to-fatigue)revealed significantly improved exercise capacity in E_(EX) group vs.NC-SED.Interestingly,although HFD led to trends of increased skeletal muscle mass,only E_(EX) with HFD led to significant muscle weight gain.Neither exercise modality resulted in significant changes of hindlimb skeletal muscle contractile properties and cardiac function compared to SED mice on HFD.Importantly,REX showed significantly enhanced benefits over EEX in improving homeostatic model assessment of insulin resistance(HOMA-IR),glucose tolerance,and insulin tolerance.Conclusion These results provide a direct and translatable comparison of endurance and resistance exercise training in a preclinical context of obesity and hyperglycemia.The current data set demonstrates an advantage of resistance exercise over endurance exercise in improving glucose and insulin tolerance under the condition of obesity,and that these improvements are independent of significant alterations of muscle weight gain and exercise performance.展开更多
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 investigate the effects of Dapagliflozin combined with insulin treatment on blood glucose index and pancreaticβ-cell function in overweight/obese type 2 diabetes mellitus(T2DM)patients with different dis...Objective To investigate the effects of Dapagliflozin combined with insulin treatment on blood glucose index and pancreaticβ-cell function in overweight/obese type 2 diabetes mellitus(T2DM)patients with different disease durations.Methods A total of 288 patients with impaired pancreatic function who were treated from June 2019 to June 2020 were selected.They were divided into three groups,short duration group(≤10 years group,n=95),medium duration group(10-20 years group,n=96)and long duration group(≥20 years group,n=97).Three groups of patients were treated with Dapagliflozin in addition to the regular insulin therapy for 6 months.Clinical efficacy,blood glucose indices,pancreaticβ-cell function and complications during the treatment period were compared among the three groups.Results After treatment,there was a significant decrease in the values of three groups including WC,FPG,2 hPG,HbA,c,TC,TG,LDL-C,BMI,FIns and HOMA-IR(P<O.05).Meanwhile,HDL-C,C-P,HOMA-βand HOMA-IS values showed a significant increase(P<0.05).After treatment,WC,FPG,2 hPG,HbA,c,TC,TG,LDL-C,FIns and HOMA-IR increased in turn(P<O.05),while HDL-C,C-P,HOMA-βand HOMA-IS decreased in turn in≤1O years group,10-20 years group,≥20 years group(P<0.05).The BMI of 10-20 years group was lower than that of≤10 years group and≥20 years group(P<0.05),while the BMI of≥20 years group was higher than that of≤10 years group(P<0.05).Conclusion In overweight/obese T2DM patients with different DM durations,Dapagliflozin combined with insulin treatment shows a significant advantage in lowering blood glucose indices and improving pancreaticβ-cell function,especially for patients with a shorter disease duration.展开更多
Objective To investigate the clinical efficacy of Liraglutide(Lir)combined with short-termninsulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus(T2DM).Methods A total of ...Objective To investigate the clinical efficacy of Liraglutide(Lir)combined with short-termninsulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 144 newly diagnosed overweight/obese patients with T2DM admitted to the Endocrinology Department of Anqing Municipal Hospital from November 20222to October 2023 were enrolled and randomly divided into intensive treatment(Int)group and Lir group with 72 cases in each group.The Int groupreceivedoral Metformin tablets combined with subcutaneous injections of insulin before meals and insulin glargine before bedtime.The Lir group received subcutaneous injections of Liraglutide in addition to that of the Int group.The changes in blood pressure(BP),weight,BMI,WC,WHR,blood glucose(BG),blood lipids,SUA,HOMAIR,HOMA-β,BG target time,insulin dosage and injection frequency,number of cases of meal-time insulin discontinuation and incidence of hypoglycemia before and after 1,4,and 12 weeks of treatment were evaluated and compared between the two groups.Results After 4 and 12 weeks of treatment,the BP,weight,BMI,WC and WHR were significantly lower than those before treatment in the Lir group(P<0.05).2 hPG at 1,4 and 12 weeks after treatment was significantly lower in Lir group than that in Int group(P<0.05),and HbA,c after 12 weeks of treatment was significantly lower in Lir group than that in Int group[(6.49±0.41)%vs(8.31±0.75)%,P<0.05].After 4 and 12 weeks of treatment,HDL-C,1 hC-P and HOMA-βwere significantly higher in Lir group than those in Int group,while TC,TG,LDL-C,SUA and HOMA-IR was significantly lower in Lir group than that in Int group(P<0.05).The time for BG to reach the standard was significantly shorter in Lir group than that in Int group[(4.23±1.55)us(6.23±1.78)d,P<0.05].After treatment for 4 and 12 weeks,the basal insulin dosage decreased significantly.After treatment for 1,4,and 12 weeks,the insulin dosage during meals,the number of subcutaneous insulin injections,and the incidence of hypoglycemiaawere significantly reduced in Lir group than those in Int group(P<0.05).The number of patients with discontinued insulin during meals significantly increased(P<0.05).Conclusion In newly diagnosed overweight/obese patients with T2DM,the combination of Lir and insulin intensive therapy is beneficial in controlling BP,weight,BMI,WC,WHR,BG and SUA,promoting the improvement of pancreaticβcell function,shortening the time for BG to reach the standard,reducing insulin dosage and injection frequency,and lowering the risk of hypoglycemia.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 investigate the effects of orlistat combined with drospirenone/ethinylestradiol tablets(DRSP/EE)on anthropometric indices,sexual hormones,hepatorenal function parameters of overweight or obese patients wi...Objective:To investigate the effects of orlistat combined with drospirenone/ethinylestradiol tablets(DRSP/EE)on anthropometric indices,sexual hormones,hepatorenal function parameters of overweight or obese patients with polycystic ovary syndrome(PCOS).Methods:75 overweight or obese PCOS patients[body mass index(BMI)>24 kg/m^(2)]were recruited within the Department of Gynecological Endocrinology,Beying Obstetrics and Gynecology Hospital,Capital Medical University,from April 2019 to January 2020,for a prospective,randomized,open-labelled comparing study.They were numbered one by one according to the order of recruitement and randomly divided into two groups,group 1 included 50 patients,orlistat plus DRSP/EE;group 2 included 25 patients treated with DRSP/EE alone.Both groups got the same comprehensive intervention in terms of individualized,standardized managment and monitoring of life-style like diet and exercise.The changes of anthropometric indices,sexual hormones,hepatorenal function parameters before and after three months of treatment in the two groups were compared.Results:After three months of treatment,body weight,waist circumference(WC),hip circumference(HC)and BMI of both groups were significantly decreased(P<0.05).The decrease of body weight,WC,HC and BMI in group 1 was significantly greater than those in group 2(P<0.05).Free testosterone and sex hormone-binding globulin in both groups were significantly changed(P<0.05).There was no significant difference in the hepatorenal function parameters between the two groups after three months treatment(P>0.05).Conclusion:To our knowledge our study is the first to investigate the effects of orlistat combined with DRSP/EE in overweight or obese PCOS patients comparing with the effect of using DRSP/EE alone.Orlistat combined with DRSP/EE was better than use DRSP/EE alone in getting weight loss,which provides an evidence for the choice of rational drug use in clinical practice.展开更多
Active lifestyle and qualitative and quantitative diets are the best way to lose weight. In our study we have assessed the effectiveness and tolerability of a soluble powder rich in fibers and at low glycemic index an...Active lifestyle and qualitative and quantitative diets are the best way to lose weight. In our study we have assessed the effectiveness and tolerability of a soluble powder rich in fibers and at low glycemic index and used, with a portion of fresh fruit, as replacement meal (for a total calorie intake ranging from a minimum of about 130 kcal to a maximum of 260 kcal) in 52 overweight/obese subjects of the outpatient clinic of the Italian National Research Council (CNR) of Rome already in treatment with a low-fat low-carbohydrates qualitative diet. The study was a parallel, prospective trial of two randomized sample groups, “intervention” (26 subjects) and “control” (26 subjects). After 8 weeks, the treatment based on the replacement meal has improved the results obtained through the qualitative diet alone above all in the overweight subjects: 11/16, versus only 2/16 in the control group, became ranged within normal weight. On the contrary, the majority of obese subjects didn’t change their BMI classification suggesting that, in case of obesity, a controlled quantitative correction with weighing food portions could be a better strategy than low-calorie replacement meal.展开更多
AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 ye...AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group(OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1 H MRS was performed for LFC assessment.RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower highdensity lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex(multiple linear regression; β = 0.459, P <0.001).CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.展开更多
Obesity and overweight problems are serious global health issues today and despite many efforts,the prevalence has continued to rise for decades.Interestingly,hypnotherapy has been gaining recognition as an effective ...Obesity and overweight problems are serious global health issues today and despite many efforts,the prevalence has continued to rise for decades.Interestingly,hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems.This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction.Scopus,Pub Med and EBSCO Host databases were applied in the study.The search identified 119 articles,of which seven met the inclusion criteria.A total of 539 respondents(82.7%women and 17.3%men)between the ages of 17 and 67 years were represented in the seven studies.Most studies incorporated lifestyle changes,such as changes of dietary habit and behavioral recommendations in the hypnotic procedure.Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation,and in some cases,one to ten kilograms were lost during follow-up periods.In addition,one study even showed increased physical activity among the hypnotised individuals.This use of hypnotherapy also improved respondents'eating behavior and quality of life.However,a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area.Therefore,further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.展开更多
Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven p...Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven participants(7–16 years) took part in the study: 28 were assigned to the intervention group(IG)(10 boys and 18 girls) and19 in a control group(CG)(8 boys and 11 girls). Body composition(dual-energy X-ray absorptiometry), anthropometrics(body mass, height, and body mass index(BMI)), and eating behavior traits(Three-Factor Eating Questionnaire-R21 C) were determined before and after the VPA intervention.Results: A decrease in the percentage of body fat and BMI(-2.8% and-1.8%, respectively), and an increase in most lean mass variables were found in the IG(all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score(p = 0.04),while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG.Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.展开更多
Probiotics are live microorganisms that,when administered in adequate amounts,confer a health benefit to the host.Specific probiotics or probiotic foods can be used to reduce the risk of diseases associated with aberr...Probiotics are live microorganisms that,when administered in adequate amounts,confer a health benefit to the host.Specific probiotics or probiotic foods can be used to reduce the risk of diseases associated with aberrant gut microbiota composition.The incidence of gestational diabetes mellitus(GDM)has increased annually with the proportion of overweight and obese people.Overweight or obese pregnant women are at high risk of GDM and have obvious changes in gut microbiota compared with normal-weight pregnant women.Specific probiotics or probiotic foods may alter gut microbiota in overweight or obese pregnant women and inhibit the expression of inflammatory factors,consequently resulting in weight loss and reduced insulin resistance.This review discusses the mechanism of probiotics on GDM,as well as the dose,method and duration of probiotics use,and summarizes current evidence on probiotics in improving glucose metabolism and other maternal and infant outcomes in overweight/obese pregnant women.展开更多
The study aimed to determine the relationships between the basal metabolic rate（BMR） and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus（DM）. This cross-sectional clinical stu...The study aimed to determine the relationships between the basal metabolic rate（BMR） and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus（DM）. This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight（24 kg/m2≤BMI〈28 kg/m2, n=99）, or obese（BMI ≥28 kg/m2, n=94）. Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients（P〈0.05） and patients with normal BMI did（P〈0.05）. The measured BMR was significantly lower than the predicted BMR（P〈0.05） in all groups. Obese and overweight DM patients had significantly greater weight, waist circumference, hip circumference, BMI, body surface area, body fat percentage, fat mass, and fat-free mass than patients with normal BMI. Except for waist circumference, these body composition measurements were significantly increased in obese DM patients when compared with those in overweight DM patients（P〈0.05）. Fat-free mass was closely correlated with BMR in both DM patients（r=0.874, P〈0.01） and in healthy controls（r=0.902, P〈0.01）. It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.展开更多
Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascula...Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. Furthermore, obesity is already responsible for 2% -8% of health costs and 10% -13% of deaths in several industrialized countries. Lifestyle modifications involving changes in exercise, diet and psychological support are effective in reducing the incidence of overweight. Moreover, positive effects of physical activity (PA) for weight loss and prevention of weight regain are well documented. It was recognized that health benefits regarding both psychological and physiological aspects, such as improving cardiorespiratory and muscular fitness and/or decreasing depression symptoms, can be obtained from numerous activities. Public health institutions (American College of Sports Medicine, World Health Organization) provide recommendations for PA (volume, frequency, intensity and type of exercise) to achieve positive effects, at all ages and for many diseases and disorders situations. Although exercise under guidelines can be safely performed by obese subjects, several questions still need to be fully answered. In facts, the exercise program should be tailored according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Thus, this review analyzes the intensity of PA parameters. In the last years, research has been focused on the individualization of the right intensity in which different types of subjects’ condition must undergo to achieve the health goals. Aerobic exercise has been commonly used to reach weight loss goal. Prescription of aerobic exercise in clinical practice is frequently based on the percentage of maximum heart rate (%HRmax), heart rate reserve (%HRreserve), rating of perceived exertion (RPE), maximal oxygen consumption (%VO2max) and for unhealthy subjects, peak oxygen consumption (%VO2peak). It has been shown that unhealthy subjects, such as individuals affected by diabetes, obesity and cardiovascular diseases have a reduced maximal aerobic exercise capacity. For instance, using the formula based on percentage of HRmax or VO2max, it could be prescribed heavy exercises, which would result not appropriated and fully functional for the specific individual goal. To avoid this problem, another approach to individualize aerobic exercise could be to consider the gas exchange parameters such us aerobic gas exchange threshold (AerTGE). AerTGE corresponds to the first increase in blood lactate during incremental exercise. This review offers an overview of the different methods to assess exercise intensity, considering the different subjects health characteristics, in order to choose the right methods to achieve the health goals in obese and overweight subjects.展开更多
Background: Increased peak oxygen consumption(VO2 peak) can reduce cardiovascular risks associated with obesity. Our aim was to analyze the effect of a weight loss program on cardiovascular fitness in overweight(W) an...Background: Increased peak oxygen consumption(VO2 peak) can reduce cardiovascular risks associated with obesity. Our aim was to analyze the effect of a weight loss program on cardiovascular fitness in overweight(W) and obese(O) subjects.Methods: One hundred and sixty-seven subjects(77 males and 90 females), aged 18–50 years, performed a modified Bruce protocol before(pre)and after(post) a weight loss program of 24 weeks. This program combined physical training(strength, S; endurance, E; combined strength + endurance, SE; or physical activity recommendation, PA) 3 times per week, with a 25%–30% caloric restriction diet.Results: VO2 peak improved in overweight and obese males(pre and post values in L/min, respectively; W = 3.2 ± 0.6 vs. 3.7 ± 0.5, p < 0.001;O = 3.6 ± 0.6 vs. 3.8 ± 0.6, p = 0.013) as well as in overweight females(2.0 ± 0.3 vs. 2.3 ± 0.4, p < 0.001). VO2 peak in the first ventilatory threshold(VT1) increased for all 4 interventions in males(p < 0.05), except for S in the obese group(1.6 ± 0.2 vs. 1.7 ± 0.3, p = 0.141). In females, it increased in E(0.9 ± 0.2 vs. 1.4 ± 0.3, p < 0.001), SE(0.9 ± 0.2 vs. 1.2 ± 0.4, p = 0.003), and PA(0.9 ± 0.1 vs. 1.2 ± 0.2, p = 0.006) in overweight groups. Time-to-exhaustion improved in all subjects except for females in PA group(15.7 ± 0.3 min vs. 15.9 ± 0.3 min, p = 0.495).Conclusion: Our results suggest that all methods, including the recommendation of physical activity, can improve cardiovascular fitness in overweight subjects and obese males.展开更多
BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effe...BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.展开更多
Introduction: Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular comorbidities. Very limited data are available regarding cardio...Introduction: Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular comorbidities. Very limited data are available regarding cardiometabolic risk factors among this group in Bangladesh. Objective: To observe the cardiometabolic risk factors in overweight and obese children. Methods: This cross-sectional study was carried out in 88 overweight and obese children recruited consecutively by using CDC percentile chart for body mass index (BMI) in children between January 2017 and March 2018 in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. After completing a questionnaire and relevant clinical examination, blood was collected for fasting plasma glucose (FPG), insulin, HbA1c, lipid profile and C-reactive protein (CRP). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to determine insulin resistance. Results: Central obesity (100%), dyslipidaemia (88.6%), raised CRP (81.8%) and metabolic syndrome (69.3%) were the most common cardiometabolic risk factors. Children with grade 3 obesity had significantly higher systolic blood pressure (115.57 ± 11.60 vs 105.71 ± 8.84 mmHg, p = 0.043) and insulin resistance (7.15 ± 4.97 vs 3.53 ± 2.04, p = 0.017) than grade 1 obesity. Blood pressure, insulin resistance and CRP increased while high density lipoprotein (HDL) decreased with increasing severity of obesity. BMI z score was a significant predictor of systolic blood pressure;waist circumference was an independent predictor of diastolic blood pressure and HDL;waist height ratio best predicted insulin resistance, CRP and total cholesterol in overweight/obese children. Conclusions: We have observed a high frequency of cardiometabolic risk factors in overweight and obese children and they increased worsened with increasing grade of obesity.展开更多
基金the National Natural Science Foundation of China,No.82074291the National Natural Science Foundation of China,No.8207153217+1 种基金the High-level Key Discipline of the National Administration of Traditional Chinese Medicine-Traditional Chinese Constitutional Medicine,No.zyyzdxk-2023251the Beijing University of Traditional Chinese Medicine Campus Level Project,No.90010961020140.
文摘BACKGROUND Overweight/obesity combined with depression among children and adolescents(ODCA)is a global concern.The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity.Childhood and adolescence represent critical periods for physical and psychological development,during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.AIM To evaluate the relationship between ODCA,we conduct a bibliometric analysis to aid in formulating prevention and treatment strategies.METHODS From 2004 to 2023,articles related to ODCA were selected using the Science Citation Index Expanded from the Web of Science Core Collection.Bibliometric analysis of relevant publications,including countries/regions,institutions,authors,journals,references,and keywords,was conducted using the online bibliometric analysis platforms,CiteSpace,VOSviewer,and bibliometrix.RESULTS Between 2004 and 2023,a total of 1573 articles were published on ODCA.The United States has made leading contributions in this field,with Harvard University emerging as the leading contributor in terms of research output,and Tanofsky being the most prolific author.The J Adolescent Health has shown significant activity in this domain.Based on the results of the keyword and reference analyses,inequality,adverse childhood experiences,and comorbidities have become hot topics in ODCA.Moreover,the impact of balancedrelated behavior and exploration of the biological mechanisms,including the potential role of key adipocytokines and lipokines,as well as inflammation in ODCA,have emerged as frontier topics.CONCLUSION The trend of a significant increase in ODCA publications is expected to continue.The research findings will contribute to elucidating the pathogenic mechanisms of ODCA and its prevention and treatment.
文摘AIM: To identify which parameters could help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early atherosclerosis.METHODS: Eighty two of 124 overweight/obese females formed the study population, which was divided into two groups (52 and 30 subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and were studied in a cross-sectional manner. The main outcome measures were waist circumference, serum uric acid, high-density lipoprotein-cholesterol and triglycerides, alanine amino-transferase, blood pressure and the two imaging para-meters, hepatic steatosis and longitudinal diameter of the spleen, which were measured in relation to the presence/absence of IR. RESULTS: A variable grade of visceral obesity was observed in all subjects with the exception of three.Obesity of a severe grade was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a clear difference in longitudinal spleen diameter and blood pressure, with raised and signif icant values in the IR group. Metabolic syndrome was frequent in the IR group, and was not modified when adjusted for menopause (P = 0.001). At linear regression, the β values of waist circumference and body mass index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively. Measures of spleen longitudinal diameter were well predicted by body mass index (BMI) values, β = 0.35, P = 0.01, and by HOMA, β = 0.41, P = 0.0001. Blood pressure was predicted by HOMA values, β = 0.39, P = 0.0001). HOMA and hepatic steatosis were highly associated (rho = 0.34, P = 0.002). Interestingly, IR patients were almost twice as likely to have hepatic steatosis as non-IR patients. Among the MS criteria, blood pressure was very accurate in identifying the presence of IR (AUROC for systolic blood pressure 0.66, cut-off 125 mm of Hg, sensibility 64%, specif icity 75%; AUROC for diastolic blood pressure 0.70, cut-off 85 mm of Hg, sensibility 54.5%, specif icity 75%). CONCLUSION: As health care costs are skyrocketing, reliable and mainly inexpensive tools are advisable to better defi ne subjects who really need to lose weight.
文摘Background: Overweight and obesity are among the most frequently encountered multi-factorial disorders in most populations of the world. In addition, to its health impacts, overweight/obesity leads to many health problems which reflect on the university students’ physical, psychological, social and environmental aspects of their quality of life. The study aim was to evaluate the effect of an educational program on improving quality of life of overweight/obese university students in Gaza strip. Materials and Methods: quasi-experimental nonequivalent pretest-posttest control group design utilized in this study 74 and 69 students in the intervention and control group respectively. The study conducted at Islamic university of Gaza and data were collected in two stages before and after five months from the application of the educational program, using interviewing questionnaire and world health organization quality of life-BREF instrument;pre-post test and body mass index were calculated. Results: the study results revealed that overall students’ knowledge for posttest was significantly higher than pretest (p-value ≤ 0.05). Overall, mean score of quality of life after the program was significantly (p-value = 0.001) greater than before and greater than control group for all domains. Conclusion: The study concluded that the health educational intervention program had positive effects on knowledge, practices and attitudes regarding overweight/obesity with improving university students’ mean score of quality of life.
基金supported by the Guangxi Science and Technology Project (AD20297088)the National Natural Science Foundation of China (32272316)the Beijing Innovation Team of Livestock Industry Technology System (BAIC05-2022)
文摘Prenatal overweight/obesity(OW/OB)can alter colostrum lipid patterns,thereby affecting the lipid metabolism and even the cognitive and healthy development of infants.However,studies on changes in colostrum lipids in the context of OW/OB are limited,particularly for glycerides and polar lipids.Therefore,this study investigated the infl uence of maternal prenatal weight on colostrum in lipid subclasses and molecular species.The concentration of triacylglycerols(TAGs)in the colostrum of the OW/OB group(35894.43 mg/L)was higher than that of the normal weight(NW)group(26639.20 mg/L),suggesting that colostrum from OW/OB mothers could provide more energy to their infants.Further analysis of the fatty acid composition of TAGs revealed that elevated maternal body weight enhanced the concentration of TAGs containing saturated or n-6 fatty acids and shortened the carbon number of TAGs.Docosahexaenoic acid(DHA)/arachidonic acid(AA)/choline-containing lipids,such as DHA-containing TAGs,AA/DHA-containing phosphatidylethanolamine,and choline-containing phospholipids,were present in higher levels in the colostrum of OW/OB mothers than NW mothers.However,the concentrations of palmitic acid-containing TAGs,linoleic acid-containing TAGs,dihomo-γ-linolenic acid-containing TAGs,and polar lipids and the ratio of TAGs containing n-6 fatty acid/n-3 fatty acid were signifi cantly higher in the colostrum of OW/OB mothers than in that of NW mothers.The fatty acid composition and sphingoid bases of sphingolipids were also altered due to elevated body weight.In conclusion,OW/OB affects colostrum lipids with respect to composition,concentration,and percentage.Although the colostrum of healthy OW/OB mothers can provide suffi cient DHA/AA/choline-containing lipids to their infants,normalization of body weight and fat reserves should be considered as a strategy for highquality human milk lipids.
基金supported by National Institutes of Health(No.NIH-R01AR050429 and No.NIH-R01AR077440)a grant by Red Gates Foundation to ZY.
文摘Background Exercise is an effective intervention for obesity and type 2 diabetes,with significant physiological benefits over pharmacological interventions.However,there is limited preclinical data available comparing endurance and resistance exercise for the impacts on obesogenic pathology and glycemic control.Methods Male mice were subjected to 8 weeks of diet-induced obesity(DIO)by high-fat diet(HFD)feeding concurrent with voluntary wheel running(endurance exercise(E_(EX)))or weightlifting(resistance exercise(R_(EX))).Sedentary(SED)mice fed on normal chow(NC)or HFD were used as controls.Results E_(EX) and R_(EX) interventions significantly attenuated weight gain vs.HFD-SED due to reduction of fat mass,not changes in lean mass,as assessed by EchoMRI.While REX suppressed visceral and subcutaneous fat accumulation significantly,only E_(EX) enlarged brown fat mass.Exercise tolerance testing(i.e.,run-to-fatigue)revealed significantly improved exercise capacity in E_(EX) group vs.NC-SED.Interestingly,although HFD led to trends of increased skeletal muscle mass,only E_(EX) with HFD led to significant muscle weight gain.Neither exercise modality resulted in significant changes of hindlimb skeletal muscle contractile properties and cardiac function compared to SED mice on HFD.Importantly,REX showed significantly enhanced benefits over EEX in improving homeostatic model assessment of insulin resistance(HOMA-IR),glucose tolerance,and insulin tolerance.Conclusion These results provide a direct and translatable comparison of endurance and resistance exercise training in a preclinical context of obesity and hyperglycemia.The current data set demonstrates an advantage of resistance exercise over endurance exercise in improving glucose and insulin tolerance under the condition of obesity,and that these improvements are independent of significant alterations of muscle weight gain and exercise performance.
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 investigate the effects of Dapagliflozin combined with insulin treatment on blood glucose index and pancreaticβ-cell function in overweight/obese type 2 diabetes mellitus(T2DM)patients with different disease durations.Methods A total of 288 patients with impaired pancreatic function who were treated from June 2019 to June 2020 were selected.They were divided into three groups,short duration group(≤10 years group,n=95),medium duration group(10-20 years group,n=96)and long duration group(≥20 years group,n=97).Three groups of patients were treated with Dapagliflozin in addition to the regular insulin therapy for 6 months.Clinical efficacy,blood glucose indices,pancreaticβ-cell function and complications during the treatment period were compared among the three groups.Results After treatment,there was a significant decrease in the values of three groups including WC,FPG,2 hPG,HbA,c,TC,TG,LDL-C,BMI,FIns and HOMA-IR(P<O.05).Meanwhile,HDL-C,C-P,HOMA-βand HOMA-IS values showed a significant increase(P<0.05).After treatment,WC,FPG,2 hPG,HbA,c,TC,TG,LDL-C,FIns and HOMA-IR increased in turn(P<O.05),while HDL-C,C-P,HOMA-βand HOMA-IS decreased in turn in≤1O years group,10-20 years group,≥20 years group(P<0.05).The BMI of 10-20 years group was lower than that of≤10 years group and≥20 years group(P<0.05),while the BMI of≥20 years group was higher than that of≤10 years group(P<0.05).Conclusion In overweight/obese T2DM patients with different DM durations,Dapagliflozin combined with insulin treatment shows a significant advantage in lowering blood glucose indices and improving pancreaticβ-cell function,especially for patients with a shorter disease duration.
文摘Objective To investigate the clinical efficacy of Liraglutide(Lir)combined with short-termninsulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 144 newly diagnosed overweight/obese patients with T2DM admitted to the Endocrinology Department of Anqing Municipal Hospital from November 20222to October 2023 were enrolled and randomly divided into intensive treatment(Int)group and Lir group with 72 cases in each group.The Int groupreceivedoral Metformin tablets combined with subcutaneous injections of insulin before meals and insulin glargine before bedtime.The Lir group received subcutaneous injections of Liraglutide in addition to that of the Int group.The changes in blood pressure(BP),weight,BMI,WC,WHR,blood glucose(BG),blood lipids,SUA,HOMAIR,HOMA-β,BG target time,insulin dosage and injection frequency,number of cases of meal-time insulin discontinuation and incidence of hypoglycemia before and after 1,4,and 12 weeks of treatment were evaluated and compared between the two groups.Results After 4 and 12 weeks of treatment,the BP,weight,BMI,WC and WHR were significantly lower than those before treatment in the Lir group(P<0.05).2 hPG at 1,4 and 12 weeks after treatment was significantly lower in Lir group than that in Int group(P<0.05),and HbA,c after 12 weeks of treatment was significantly lower in Lir group than that in Int group[(6.49±0.41)%vs(8.31±0.75)%,P<0.05].After 4 and 12 weeks of treatment,HDL-C,1 hC-P and HOMA-βwere significantly higher in Lir group than those in Int group,while TC,TG,LDL-C,SUA and HOMA-IR was significantly lower in Lir group than that in Int group(P<0.05).The time for BG to reach the standard was significantly shorter in Lir group than that in Int group[(4.23±1.55)us(6.23±1.78)d,P<0.05].After treatment for 4 and 12 weeks,the basal insulin dosage decreased significantly.After treatment for 1,4,and 12 weeks,the insulin dosage during meals,the number of subcutaneous insulin injections,and the incidence of hypoglycemiaawere significantly reduced in Lir group than those in Int group(P<0.05).The number of patients with discontinued insulin during meals significantly increased(P<0.05).Conclusion In newly diagnosed overweight/obese patients with T2DM,the combination of Lir and insulin intensive therapy is beneficial in controlling BP,weight,BMI,WC,WHR,BG and SUA,promoting the improvement of pancreaticβcell function,shortening the time for BG to reach the standard,reducing insulin dosage and injection frequency,and lowering the risk of hypoglycemia.
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supported by Beijing Municipal Administration of Hospitals'Ascent Plan of China(No.DFL20181401).
文摘Objective:To investigate the effects of orlistat combined with drospirenone/ethinylestradiol tablets(DRSP/EE)on anthropometric indices,sexual hormones,hepatorenal function parameters of overweight or obese patients with polycystic ovary syndrome(PCOS).Methods:75 overweight or obese PCOS patients[body mass index(BMI)>24 kg/m^(2)]were recruited within the Department of Gynecological Endocrinology,Beying Obstetrics and Gynecology Hospital,Capital Medical University,from April 2019 to January 2020,for a prospective,randomized,open-labelled comparing study.They were numbered one by one according to the order of recruitement and randomly divided into two groups,group 1 included 50 patients,orlistat plus DRSP/EE;group 2 included 25 patients treated with DRSP/EE alone.Both groups got the same comprehensive intervention in terms of individualized,standardized managment and monitoring of life-style like diet and exercise.The changes of anthropometric indices,sexual hormones,hepatorenal function parameters before and after three months of treatment in the two groups were compared.Results:After three months of treatment,body weight,waist circumference(WC),hip circumference(HC)and BMI of both groups were significantly decreased(P<0.05).The decrease of body weight,WC,HC and BMI in group 1 was significantly greater than those in group 2(P<0.05).Free testosterone and sex hormone-binding globulin in both groups were significantly changed(P<0.05).There was no significant difference in the hepatorenal function parameters between the two groups after three months treatment(P>0.05).Conclusion:To our knowledge our study is the first to investigate the effects of orlistat combined with DRSP/EE in overweight or obese PCOS patients comparing with the effect of using DRSP/EE alone.Orlistat combined with DRSP/EE was better than use DRSP/EE alone in getting weight loss,which provides an evidence for the choice of rational drug use in clinical practice.
文摘Active lifestyle and qualitative and quantitative diets are the best way to lose weight. In our study we have assessed the effectiveness and tolerability of a soluble powder rich in fibers and at low glycemic index and used, with a portion of fresh fruit, as replacement meal (for a total calorie intake ranging from a minimum of about 130 kcal to a maximum of 260 kcal) in 52 overweight/obese subjects of the outpatient clinic of the Italian National Research Council (CNR) of Rome already in treatment with a low-fat low-carbohydrates qualitative diet. The study was a parallel, prospective trial of two randomized sample groups, “intervention” (26 subjects) and “control” (26 subjects). After 8 weeks, the treatment based on the replacement meal has improved the results obtained through the qualitative diet alone above all in the overweight subjects: 11/16, versus only 2/16 in the control group, became ranged within normal weight. On the contrary, the majority of obese subjects didn’t change their BMI classification suggesting that, in case of obesity, a controlled quantitative correction with weighing food portions could be a better strategy than low-calorie replacement meal.
基金Supported by Faculty of Associated Medical Sciences,Chiang Mai University,Chiang Mai,Thailand,No.6593(4)1180
文摘AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group(OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1 H MRS was performed for LFC assessment.RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower highdensity lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex(multiple linear regression; β = 0.459, P <0.001).CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.
基金funded by Mentor Mentee Research Grant Universiti Sultan Zainal Abidin(Uni SZA)(R0046-R001)。
文摘Obesity and overweight problems are serious global health issues today and despite many efforts,the prevalence has continued to rise for decades.Interestingly,hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems.This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction.Scopus,Pub Med and EBSCO Host databases were applied in the study.The search identified 119 articles,of which seven met the inclusion criteria.A total of 539 respondents(82.7%women and 17.3%men)between the ages of 17 and 67 years were represented in the seven studies.Most studies incorporated lifestyle changes,such as changes of dietary habit and behavioral recommendations in the hypnotic procedure.Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation,and in some cases,one to ten kilograms were lost during follow-up periods.In addition,one study even showed increased physical activity among the hypnotised individuals.This use of hypnotherapy also improved respondents'eating behavior and quality of life.However,a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area.Therefore,further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.
基金supported by the Consejo Superior de Deportes-High Council for Sports in Spain (CSD-089/ UPB10/11)grant from the Ministerio de Educación, Cultura y Deporte, Spain (AP20105476)
文摘Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven participants(7–16 years) took part in the study: 28 were assigned to the intervention group(IG)(10 boys and 18 girls) and19 in a control group(CG)(8 boys and 11 girls). Body composition(dual-energy X-ray absorptiometry), anthropometrics(body mass, height, and body mass index(BMI)), and eating behavior traits(Three-Factor Eating Questionnaire-R21 C) were determined before and after the VPA intervention.Results: A decrease in the percentage of body fat and BMI(-2.8% and-1.8%, respectively), and an increase in most lean mass variables were found in the IG(all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score(p = 0.04),while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG.Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.
文摘Probiotics are live microorganisms that,when administered in adequate amounts,confer a health benefit to the host.Specific probiotics or probiotic foods can be used to reduce the risk of diseases associated with aberrant gut microbiota composition.The incidence of gestational diabetes mellitus(GDM)has increased annually with the proportion of overweight and obese people.Overweight or obese pregnant women are at high risk of GDM and have obvious changes in gut microbiota compared with normal-weight pregnant women.Specific probiotics or probiotic foods may alter gut microbiota in overweight or obese pregnant women and inhibit the expression of inflammatory factors,consequently resulting in weight loss and reduced insulin resistance.This review discusses the mechanism of probiotics on GDM,as well as the dose,method and duration of probiotics use,and summarizes current evidence on probiotics in improving glucose metabolism and other maternal and infant outcomes in overweight/obese pregnant women.
基金supported by the National Natural Science Foundation of China(No.81370942)
文摘The study aimed to determine the relationships between the basal metabolic rate（BMR） and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus（DM）. This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight（24 kg/m2≤BMI〈28 kg/m2, n=99）, or obese（BMI ≥28 kg/m2, n=94）. Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients（P〈0.05） and patients with normal BMI did（P〈0.05）. The measured BMR was significantly lower than the predicted BMR（P〈0.05） in all groups. Obese and overweight DM patients had significantly greater weight, waist circumference, hip circumference, BMI, body surface area, body fat percentage, fat mass, and fat-free mass than patients with normal BMI. Except for waist circumference, these body composition measurements were significantly increased in obese DM patients when compared with those in overweight DM patients（P〈0.05）. Fat-free mass was closely correlated with BMR in both DM patients（r=0.874, P〈0.01） and in healthy controls（r=0.902, P〈0.01）. It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.
文摘Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. Furthermore, obesity is already responsible for 2% -8% of health costs and 10% -13% of deaths in several industrialized countries. Lifestyle modifications involving changes in exercise, diet and psychological support are effective in reducing the incidence of overweight. Moreover, positive effects of physical activity (PA) for weight loss and prevention of weight regain are well documented. It was recognized that health benefits regarding both psychological and physiological aspects, such as improving cardiorespiratory and muscular fitness and/or decreasing depression symptoms, can be obtained from numerous activities. Public health institutions (American College of Sports Medicine, World Health Organization) provide recommendations for PA (volume, frequency, intensity and type of exercise) to achieve positive effects, at all ages and for many diseases and disorders situations. Although exercise under guidelines can be safely performed by obese subjects, several questions still need to be fully answered. In facts, the exercise program should be tailored according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Thus, this review analyzes the intensity of PA parameters. In the last years, research has been focused on the individualization of the right intensity in which different types of subjects’ condition must undergo to achieve the health goals. Aerobic exercise has been commonly used to reach weight loss goal. Prescription of aerobic exercise in clinical practice is frequently based on the percentage of maximum heart rate (%HRmax), heart rate reserve (%HRreserve), rating of perceived exertion (RPE), maximal oxygen consumption (%VO2max) and for unhealthy subjects, peak oxygen consumption (%VO2peak). It has been shown that unhealthy subjects, such as individuals affected by diabetes, obesity and cardiovascular diseases have a reduced maximal aerobic exercise capacity. For instance, using the formula based on percentage of HRmax or VO2max, it could be prescribed heavy exercises, which would result not appropriated and fully functional for the specific individual goal. To avoid this problem, another approach to individualize aerobic exercise could be to consider the gas exchange parameters such us aerobic gas exchange threshold (AerTGE). AerTGE corresponds to the first increase in blood lactate during incremental exercise. This review offers an overview of the different methods to assess exercise intensity, considering the different subjects health characteristics, in order to choose the right methods to achieve the health goals in obese and overweight subjects.
基金financial support of the Ministerio de Ciencia e Innovación, Convocatoria deAyudas I + D 2008, Proyectos de Investigación Fundamental No Orientada, del VI Plan de Investigación Nacional 2008– 2011 (contract: DEP2008-06354-C04-01)EAC is funded by a predoctoral grant from the Coordination for the Improvement of Higher Education Personnel (CAPES)
文摘Background: Increased peak oxygen consumption(VO2 peak) can reduce cardiovascular risks associated with obesity. Our aim was to analyze the effect of a weight loss program on cardiovascular fitness in overweight(W) and obese(O) subjects.Methods: One hundred and sixty-seven subjects(77 males and 90 females), aged 18–50 years, performed a modified Bruce protocol before(pre)and after(post) a weight loss program of 24 weeks. This program combined physical training(strength, S; endurance, E; combined strength + endurance, SE; or physical activity recommendation, PA) 3 times per week, with a 25%–30% caloric restriction diet.Results: VO2 peak improved in overweight and obese males(pre and post values in L/min, respectively; W = 3.2 ± 0.6 vs. 3.7 ± 0.5, p < 0.001;O = 3.6 ± 0.6 vs. 3.8 ± 0.6, p = 0.013) as well as in overweight females(2.0 ± 0.3 vs. 2.3 ± 0.4, p < 0.001). VO2 peak in the first ventilatory threshold(VT1) increased for all 4 interventions in males(p < 0.05), except for S in the obese group(1.6 ± 0.2 vs. 1.7 ± 0.3, p = 0.141). In females, it increased in E(0.9 ± 0.2 vs. 1.4 ± 0.3, p < 0.001), SE(0.9 ± 0.2 vs. 1.2 ± 0.4, p = 0.003), and PA(0.9 ± 0.1 vs. 1.2 ± 0.2, p = 0.006) in overweight groups. Time-to-exhaustion improved in all subjects except for females in PA group(15.7 ± 0.3 min vs. 15.9 ± 0.3 min, p = 0.495).Conclusion: Our results suggest that all methods, including the recommendation of physical activity, can improve cardiovascular fitness in overweight subjects and obese males.
基金the Clinical Research and Cultivation Plan Project of the Second Affiliated Hospital of Anhui Medical University,No.2021LCYB17.
文摘BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.
文摘Introduction: Childhood obesity is increasing dramatically and represents an important public health issue due to associated metabolic and cardiovascular comorbidities. Very limited data are available regarding cardiometabolic risk factors among this group in Bangladesh. Objective: To observe the cardiometabolic risk factors in overweight and obese children. Methods: This cross-sectional study was carried out in 88 overweight and obese children recruited consecutively by using CDC percentile chart for body mass index (BMI) in children between January 2017 and March 2018 in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. After completing a questionnaire and relevant clinical examination, blood was collected for fasting plasma glucose (FPG), insulin, HbA1c, lipid profile and C-reactive protein (CRP). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to determine insulin resistance. Results: Central obesity (100%), dyslipidaemia (88.6%), raised CRP (81.8%) and metabolic syndrome (69.3%) were the most common cardiometabolic risk factors. Children with grade 3 obesity had significantly higher systolic blood pressure (115.57 ± 11.60 vs 105.71 ± 8.84 mmHg, p = 0.043) and insulin resistance (7.15 ± 4.97 vs 3.53 ± 2.04, p = 0.017) than grade 1 obesity. Blood pressure, insulin resistance and CRP increased while high density lipoprotein (HDL) decreased with increasing severity of obesity. BMI z score was a significant predictor of systolic blood pressure;waist circumference was an independent predictor of diastolic blood pressure and HDL;waist height ratio best predicted insulin resistance, CRP and total cholesterol in overweight/obese children. Conclusions: We have observed a high frequency of cardiometabolic risk factors in overweight and obese children and they increased worsened with increasing grade of obesity.
