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1.
Food Funct ; 15(10): 5510-5526, 2024 May 20.
Article in English | MEDLINE | ID: mdl-38690968

ABSTRACT

This investigation assessed associations between dietary carotenoid intake and the odds of overweight/obesity, as well as inflammatory/oxidative stress biomarkers, in 851 participants with overweight/obesity (BMI ≥25 kg m-2) and 754 normal-weight controls. A 124-item food-frequency-questionnaire (FFQ) and food composition databases were employed to estimate carotenoid intake. Binary logistic regressions assessed the association of carotenoid intake with the odds of overweight/obesity, adjusting for several potential confounders. Multiple linear regression models revealed associations between carotenoid intake and biomarkers (anthropometrics, blood lipids, inflammation, antioxidant status). Logistic regression models adjusted for various confounders and fruits and vegetables showed protective associations for provitamin A carotenoids (i.e., ß-carotene + α-carotene + ß-cryptoxanthin; odds ratio (OR): 0.655, p = 0.041) and astaxanthin (OR: 0.859, p = 0.017). Similarly adjusted multiple linear regressions revealed significant associations between several carotenoids and lower levels of interleukin (IL)-6, IL-1ß, and TNF-α and increased IL-10 and total antioxidant capacity. Further analysis revealed that lycopene was significantly associated with increased odds of overweight/obesity (OR: 1.595, p = 0.032) in a model adjusted for various confounders and vegetables (i.e., unadjusted for fruits). A protective association between the sum of provitamin A carotenoid and astaxanthin dietary intake and the odds of having overweight/obesity was found. The findings that carotenoids other than lycopene were not or inversely associated with the odds of overweight/obesity may point toward differentiating effects of various carotenoids or their associations with different food groups. Provitamin A rich food items including fruits and vegetables appear to be a prudent strategy to reduce inflammation and the odds of having overweight/obesity.


Subject(s)
Biomarkers , Carotenoids , Inflammation , Obesity , Overweight , Oxidative Stress , Humans , Carotenoids/administration & dosage , Female , Oxidative Stress/drug effects , Male , Biomarkers/blood , Middle Aged , Case-Control Studies , Adult , Inflammation/blood , Vitamin A/administration & dosage , Vitamin A/blood , Provitamins/administration & dosage , beta Carotene/administration & dosage , Vegetables/chemistry , Diet , Fruit , Xanthophylls/administration & dosage , Xanthophylls/pharmacology , Beta-Cryptoxanthin/administration & dosage , Interleukin-6/blood , Tumor Necrosis Factor-alpha/blood , Interleukin-1beta/blood
2.
Thromb Res ; 238: 88-96, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38696925

ABSTRACT

INTRODUCTION: Recommendations about proper anticoagulation in obese patients, body mass index (BMI) > 30 kg/m2, are not yet clearly defined. Obese patients were included in randomized controlled trials comparing new anticoagulants (NOACs) with warfarin in patients with atrial fibrillation or thromboembolism. METHODS: We performed a medline search entering proper criteria and finally 6 post-hoc analysis of RCTs, reporting outcome according to BMI, were included in this meta-analysis. Two major outcomes were considered end points in our meta-analysis; thrombosis, including ischemic cerebral events (transient or not) and venous thrombosis (DVD) /pulmonary embolism (PE) and bleeding, including major bleeding and clinically relevant non-major bleeding. RESULTS: In the NOACs treated group, thrombosis occurred less frequently in obese vs non-obese patients; RR and 95 % CI 0,75 (0,58-0,97), p = 0,03, while low heterogeneity was observed (I2= 40 %). In the warfarin treated subgroup there was statistically significant difference with less thrombotic events occurring in the obese vs non-obese patients; RR and (95 % CI) 0,80 (0,66-0,98), p = 0,03, and heterogeneity was low (I2 = 24 %). This protective effect called the obesity paradox is limited to obese patients anticoagulated for non-valvular atrial fibrillation (NVAF); RR (95 % CI) was 0,70 (0,58-0,85) p = 0,03 and I2 = 24 %. Bleeding events were similar under both NOACs and warfarin in obese vs non-obese analysis. CONCLUSIONS: Obese patients anticoagulated for NVAF with either standard dose of xabans or INR guided warfarin are more efficiently protected against thrombosis compared to non-obese patients.


Subject(s)
Anticoagulants , Atrial Fibrillation , Obesity , Randomized Controlled Trials as Topic , Thrombosis , Warfarin , Humans , Atrial Fibrillation/drug therapy , Atrial Fibrillation/complications , Warfarin/therapeutic use , Obesity/complications , Obesity/drug therapy , Anticoagulants/therapeutic use , Thrombosis/prevention & control , Thrombosis/etiology , Hemorrhage/chemically induced , Factor Xa Inhibitors/therapeutic use
3.
Health Place ; 87: 103263, 2024 May.
Article in English | MEDLINE | ID: mdl-38723546

ABSTRACT

This study examined whether the association between neighbourhood disadvantage and obesity was moderated by quantity and quality of greenspace. The sample included 2848 mid-to-older aged adults residing in 200 neighbourhoods in Brisbane, Australia from the HABITAT study. Self-reported height and weight were used to calculate body mass index (BMI), neighbourhood disadvantage was measured using a census-derived composite index and greenspace was measured geospatially. We found evidence of moderation by park quality: lower average BMI at higher levels of park quality was shown in the Q3 rather than the Q1 (least disadvantaged) neighbourhood disadvantage group. The findings suggest that, for reducing socioeconomic inequalities in obesity, the quality of greenspace is imperative.


Subject(s)
Body Mass Index , Obesity , Residence Characteristics , Humans , Female , Male , Obesity/epidemiology , Aged , Middle Aged , Australia/epidemiology , Neighborhood Characteristics , Parks, Recreational/statistics & numerical data , Socioeconomic Factors , Environment Design
4.
Sci Adv ; 10(19): eadk9137, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38728395

ABSTRACT

Obesity, and the associated metabolic syndrome, is a risk factor for increased disease severity with a variety of infectious agents, including influenza virus. Yet, the mechanisms are only partially understood. As the number of people, particularly children, living with obesity continues to rise, it is critical to understand the role of host status on disease pathogenesis. In these studies, we use a diet-induced obese ferret model and tools to demonstrate that, like humans, obesity resulted in notable changes to the lung microenvironment, leading to increased clinical disease and viral spread to the lower respiratory tract. The decreased antiviral responses also resulted in obese animals shedding higher infectious virus for a longer period, making them more likely to transmit to contacts. These data suggest that the obese ferret model may be crucial to understanding obesity's impact on influenza disease severity and community transmission and a key tool for therapeutic and intervention development for this high-risk population.


Subject(s)
Disease Models, Animal , Ferrets , Obesity , Orthomyxoviridae Infections , Animals , Obesity/virology , Orthomyxoviridae Infections/transmission , Orthomyxoviridae Infections/virology , Lung/virology , Lung/pathology , Severity of Illness Index , Diet , Humans , Virus Shedding , Influenza, Human/transmission , Influenza, Human/virology
5.
Physiol Rep ; 12(10): e16023, 2024 May.
Article in English | MEDLINE | ID: mdl-38760177

ABSTRACT

To determine whether body fat and body mass index (BMI) affect the energy cost of walking (Cw; J/kg/m), ventilation, and gas exchange data from 205 adults (115 females; percent body fat range = 3.0%-52.8%; BMI range = 17.5-43.2 kg/m2) were obtained at rest and during treadmill walking at 1.34 m/s to calculate gross and net Cw. Linear regression was used to assess relationships between body composition indices, Cw, and standing metabolic rate (SMR). Unpaired t-tests were used to assess differences between sex, and one-way ANOVA was used to assess differences by BMI categories: normal weight, <25.0 kg/m2; overweight, 25.0-29.9 km/m2; and obese, ≥30 kg/m2. Net Cw was not related to body fat percent, fat mass, or BMI (all R2 ≤ 0.011). Furthermore, mean net Cw was similar by sex (male: 2.19 ± 0.30 J/kg/m; female: 2.24 ± 0.37 J/kg/m, p = 0.35) and across BMI categories (normal weight: 2.23 ± 0.36 J/kg/m; overweight: 2.18 ± 0.33 J/kg/m; obese: 2.26 ± 0.31, p = 0.54). Gross Cw and SMR were inversely associated with percent body fat, fat mass, and BMI (all R2 between 0.033 and 0.270; all p ≤ 0.008). In conclusion, Net Cw is not influenced by body fat percentage, total body fat, and BMI and does not differ by sex.


Subject(s)
Body Mass Index , Energy Metabolism , Walking , Humans , Male , Female , Adult , Walking/physiology , Middle Aged , Energy Metabolism/physiology , Adipose Tissue/metabolism , Adipose Tissue/physiology , Exercise Test/methods , Oxygen Consumption/physiology , Aged , Obesity/physiopathology , Obesity/metabolism , Young Adult
6.
J Pharm Pharm Sci ; 27: 12568, 2024.
Article in English | MEDLINE | ID: mdl-38706718

ABSTRACT

Unhealthy sources of fats, ultra-processed foods with added sugars, and a sedentary lifestyle make humans more susceptible to developing overweight and obesity. While lipids constitute an integral component of the organism, excessive and abnormal lipid accumulation that exceeds the storage capacity of lipid droplets disrupts the intracellular composition of fatty acids and results in the release of deleterious lipid species, thereby giving rise to a pathological state termed lipotoxicity. This condition induces endoplasmic reticulum stress, mitochondrial dysfunction, inflammatory responses, and cell death. Recent advances in omics technologies and analytical methodologies and clinical research have provided novel insights into the mechanisms of lipotoxicity, including gut dysbiosis, epigenetic and epitranscriptomic modifications, dysfunction of lipid droplets, post-translational modifications, and altered membrane lipid composition. In this review, we discuss the recent knowledge on the mechanisms underlying the development of lipotoxicity and lipotoxic cardiometabolic disease in obesity, with a particular focus on lipotoxic and diabetic cardiomyopathy.


Subject(s)
Diabetic Cardiomyopathies , Obesity , Humans , Obesity/metabolism , Obesity/drug therapy , Diabetic Cardiomyopathies/metabolism , Diabetic Cardiomyopathies/drug therapy , Animals , Lipid Metabolism/drug effects
7.
Ann Intern Med ; 177(5): JC56, 2024 May.
Article in English | MEDLINE | ID: mdl-38710083

ABSTRACT

SOURCE CITATION: Kosiborod MN, Verma S, Borlaug BA, et al; STEP-HFpEF Trial Committees and Investigators. Effects of semaglutide on symptoms, function, and quality of life in patients with heart failure with preserved ejection fraction and obesity: a prespecified analysis of the STEP-HFpEF trial. Circulation. 2024;149:204-216. 37952180.


Subject(s)
Glucagon-Like Peptides , Heart Failure , Obesity , Quality of Life , Weight Loss , Humans , Glucagon-Like Peptides/therapeutic use , Glucagon-Like Peptides/adverse effects , Weight Loss/drug effects , Obesity/drug therapy , Obesity/complications , Heart Failure/drug therapy , Health Status , Stroke Volume/drug effects , Male , Aged , Female , Middle Aged
8.
J Nanobiotechnology ; 22(1): 226, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38711066

ABSTRACT

Nanozyme, characterized by outstanding and inherent enzyme-mimicking properties, have emerged as highly promising alternatives to natural enzymes owning to their exceptional attributes such as regulation of oxidative stress, convenient storage, adjustable catalytic activities, remarkable stability, and effortless scalability for large-scale production. Given the potent regulatory function of nanozymes on oxidative stress and coupled with the fact that reactive oxygen species (ROS) play a vital role in the occurrence and exacerbation of metabolic diseases, nanozyme offer a unique perspective for therapy through multifunctional activities, achieving essential results in the treatment of metabolic diseases by directly scavenging excess ROS or regulating pathologically related molecules. The rational design strategies, nanozyme-enabled therapeutic mechanisms at the cellular level, and the therapies of nanozyme for several typical metabolic diseases and underlying mechanisms are discussed, mainly including obesity, diabetes, cardiovascular disease, diabetic wound healing, and others. Finally, the pharmacokinetics, safety analysis, challenges, and outlooks for the application of nanozyme are also presented. This review will provide some instructive perspectives on nanozyme and promote the development of enzyme-mimicking strategies in metabolic disease therapy.


Subject(s)
Metabolic Diseases , Oxidative Stress , Reactive Oxygen Species , Humans , Metabolic Diseases/drug therapy , Metabolic Diseases/metabolism , Animals , Reactive Oxygen Species/metabolism , Oxidative Stress/drug effects , Nanostructures/chemistry , Nanostructures/therapeutic use , Nanoparticles/chemistry , Enzymes/metabolism , Diabetes Mellitus/drug therapy , Diabetes Mellitus/metabolism , Obesity/metabolism , Obesity/drug therapy
9.
Ann Intern Med ; 177(5): ITC65-ITC80, 2024 May.
Article in English | MEDLINE | ID: mdl-38739920

ABSTRACT

Obesity is a common condition and a major cause of morbidity and mortality. Fortunately, weight loss treatment can reduce obesity-related complications. This review summarizes the evidence-based strategies physicians can employ to identify, prevent, and treat obesity, including best practices to diagnose and counsel patients, to assess and address the burden of weight-related disease including weight stigma, to address secondary causes of weight gain, and to help patients set individualized and realistic weight loss goals and an effective treatment plan. Effective treatments include lifestyle modification and adjunctive therapies such as antiobesity medications and metabolic and bariatric surgery.


Subject(s)
Anti-Obesity Agents , Bariatric Surgery , Obesity , Weight Loss , Humans , Obesity/complications , Obesity/therapy , Anti-Obesity Agents/therapeutic use , Life Style , Weight Gain
10.
Sci Rep ; 14(1): 11320, 2024 05 17.
Article in English | MEDLINE | ID: mdl-38760435

ABSTRACT

The difference in the survival of obese patients and normal-weight/lean patients with diabetic MAFLD remains unclear. Therefore, we aimed to describe the long-term survival of individuals with diabetic MAFLD and overweight/obesity (OT2M), diabetic MAFLD with lean/normal weight (LT2M), MAFLD with overweight/obesity and without T2DM (OM), and MAFLD with lean/normal weight and without T2DM (LM). Using the NHANESIII database, participants with MAFLD were divided into four groups. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease (CVD)-related, and cancer-related mortalities for different MAFLD subtypes were evaluated using Cox proportional hazards models. Of the 3539 participants, 1618 participants (42.61%) died during a mean follow-up period of 274.41 ± 2.35 months. LT2M and OT2M had higher risks of all-cause mortality (adjusted HR, 2.14; 95% CI 1.82-2.51; p < 0.0001; adjusted HR, 2.24; 95% CI 1.32-3.81; p = 0.003) and CVD-related mortality (adjusted HR, 3.25; 95% CI 1.72-6.14; p < 0.0001; adjusted HR, 3.36; 95% CI 2.52-4.47; p < 0.0001) than did OM. All-cause and CVD mortality rates in LT2M and OT2M patients were higher than those in OM patients. Patients with concurrent T2DM and MAFLD should be screened, regardless of the presence of obesity.


Subject(s)
Diabetes Mellitus, Type 2 , Obesity , Humans , Male , Female , Obesity/complications , Obesity/mortality , Middle Aged , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/mortality , Adult , Cardiovascular Diseases/mortality , Cardiovascular Diseases/etiology , Non-alcoholic Fatty Liver Disease/mortality , Non-alcoholic Fatty Liver Disease/complications , Proportional Hazards Models , Aged , Risk Factors
11.
Sci Rep ; 14(1): 11265, 2024 05 17.
Article in English | MEDLINE | ID: mdl-38760446

ABSTRACT

We investigated the association between dietary intake and metabolic risk factors in children and adolescents within a semi-rural Malaysian community. Using an interviewer-led questionnaire, we surveyed 623 participants aged 7-18 from the South East Asia Community Observatory (SEACO). Anthropometric and blood pressure data were collected from all participants, while a subset (n = 162) provided blood samples for biomarker analysis, including fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Metabolic syndrome was determined using the International Diabetes Federation's Definition of Metabolic Syndrome in Children and Adolescents. Most participants were Malay (66.8%), with a median household income of MYR1,500 and a balanced sex distribution. Cereals, processed foods, beverages, fruits, and vegetables were commonly consumed. Obesity and abdominal obesity were prevalent, affecting more than a third of participants. Adherence to dietary recommendations was generally poor (ranging from 19.9 to 58.1%) and varied across age, sex, and ethnicity. Notably, some food groups displayed unexpected associations with health markers; for instance, fruit consumption was linked to abdominal obesity in children (abdominal obesity vs. normal: 2.4 servings/day vs. 1.6 servings/day). These findings emphasise the necessity of longitudinal studies to explore the complex relationship between diet and long-term health outcomes, including cardiometabolic diseases, while acknowledging the unique challenges posed by the COVID-19 pandemic on data collection and analysis.


Subject(s)
Diet , Metabolic Syndrome , Humans , Child , Male , Female , Adolescent , Cross-Sectional Studies , Metabolic Syndrome/epidemiology , Metabolic Syndrome/etiology , Diet/adverse effects , Risk Factors , Malaysia/epidemiology , Obesity/epidemiology , Pediatric Obesity/epidemiology
12.
Sci Rep ; 14(1): 11366, 2024 05 18.
Article in English | MEDLINE | ID: mdl-38762543

ABSTRACT

Placental leptin may impact foetal development. Maternal overnutrition has been linked to increased plasma leptin levels and adverse effects on offspring, whereas choline, an essential nutrient for foetal development, has shown promise in mitigating some negative impacts of maternal obesity. Here, we investigate whether a maternal obesogenic diet alters foetal growth and leptin levels in the foetal stomach, amniotic fluid (AF), and placenta in late gestation and explore the potential modulating effects of maternal choline supplementation. Female rats were fed a control (CD) or a western diet (WD) four weeks before mating and during gestation, half of them supplemented with choline (pregnancy days 11-17). Leptin levels (in foetal stomach, AF, and placenta) and leptin gene expression (in placenta) were assessed on gestation days 20 and 21. At day 20, maternal WD feeding resulted in greater leptin levels in foetal stomach, placenta, and AF. The increased AF leptin levels were associated with a premature increase in foetal weight in both sexes. Maternal choline supplementation partially prevented these alterations, but effects differed in CD dams, causing increased AF leptin levels and greater weight in male foetuses at day 20. Maternal choline supplementation effectively mitigates premature foetal overgrowth induced by an obesogenic diet, potentially linked to increased AF leptin levels. Further research is needed to explore the sex-specific effects.


Subject(s)
Amniotic Fluid , Choline , Dietary Supplements , Leptin , Animals , Female , Leptin/blood , Leptin/metabolism , Pregnancy , Choline/administration & dosage , Amniotic Fluid/metabolism , Rats , Male , Placenta/metabolism , Placenta/drug effects , Fetal Development/drug effects , Obesity/metabolism , Obesity/etiology , Fetal Weight/drug effects , Rats, Sprague-Dawley , Diet, Western/adverse effects
13.
Sci Rep ; 14(1): 11341, 2024 05 18.
Article in English | MEDLINE | ID: mdl-38762574

ABSTRACT

The hypothalamus is the key regulator for energy homeostasis and is functionally connected to striatal and cortical regions vital for the inhibitory control of appetite. Hence, the ability to non-invasively modulate the hypothalamus network could open new ways for the treatment of metabolic diseases. Here, we tested a novel method for network-targeted transcranial direct current stimulation (net-tDCS) to influence the excitability of brain regions involved in the control of appetite. Based on the resting-state functional connectivity map of the hypothalamus, a 12-channel net-tDCS protocol was generated (Neuroelectrics Starstim system), which included anodal, cathodal and sham stimulation. Ten participants with overweight or obesity were enrolled in a sham-controlled, crossover study. During stimulation or sham control, participants completed a stop-signal task to measure inhibitory control. Overall, stimulation was well tolerated. Anodal net-tDCS resulted in faster stop signal reaction time (SSRT) compared to sham (p = 0.039) and cathodal net-tDCS (p = 0.042). Baseline functional connectivity of the target network correlated with SSRT after anodal compared to sham stimulation (p = 0.016). These preliminary data indicate that modulating hypothalamus functional network connectivity via net-tDCS may result in improved inhibitory control. Further studies need to evaluate the effects on eating behavior and metabolism.


Subject(s)
Feasibility Studies , Hypothalamus , Obesity , Transcranial Direct Current Stimulation , Humans , Transcranial Direct Current Stimulation/methods , Hypothalamus/physiology , Male , Adult , Female , Obesity/therapy , Obesity/physiopathology , Cross-Over Studies , Appetite/physiology , Middle Aged , Nerve Net/physiology , Appetite Regulation/physiology , Reaction Time/physiology
14.
Cardiovasc Diabetol ; 23(1): 174, 2024 May 18.
Article in English | MEDLINE | ID: mdl-38762719

ABSTRACT

BACKGROUND: Growth differentiation factor 15 (GDF15) is a mitokine, the role of which, total or H-specific, in modulating energy metabolism and homeostasis in obesity-related diseases, such as metabolic dysfunction associated steatotic liver disease (MASLD), has not been fully elucidated in adult humans. We aimed to investigate the fasting and stimulated levels of GDF15, total and H-specific, glucose-dependent insulinotropic polypeptide (GIP) and C-peptide, in two physiology interventional studies: one focusing on obesity, and the other on MASLD. METHODS: Study 1 investigated individuals with normal weight or with obesity, undergoing a 3-h mixed meal test (MMT); and study 2, examined adults with MASLD and controls undergoing a 120-min oral glucose tolerance test (OGTT). Exploratory correlations of total and H-specific GDF15 with clinical, hormonal and metabolomic/lipidomic parameters were also performed. RESULTS: In study 1, 15 individuals were included per weight group. Fasting and postprandial total and H-specific GDF15 were similar between groups, whereas GIP was markedly higher in leaner individuals and was upregulated following a MMT. Baseline and postprandial C-peptide were markedly elevated in people with obesity compared with lean subjects. GIP was higher in leaner individuals and was upregulated after a MMT, while C-peptide and its overall AUC after a MMT was markedly elevated in people with obesity compared with lean subjects. In study 2, 27 individuals were evaluated. Fasting total GDF15 was similar, but postprandial total GDF15 levels were significantly higher in MASLD patients compared to controls. GIP and C-peptide remained unaffected. The postprandial course of GDF15 was clustered among those of triglycerides and molecules of the alanine cycle, was robustly elevated under MASLD, and constituted the most notable differentiating molecule between healthy and MASLD status. We also present robust positive correlations of the incremental area under the curve of total and H-specific GDF15 with a plethora of lipid subspecies, which remained significant after adjusting for confounders. CONCLUSION: Serum GDF15 levels do not differ in relation to weight status in hyperlipidemic but otherwise metabolically healthy individuals. In contrast, GDF15 levels are significantly increased in MASLD patients at baseline and they remain significantly higher compared to healthy participants during OGTT, pointing to a role for GDF15 as a mitokine with important roles in the pathophysiology and possibly therapeutics of MASLD. Trial registration ClinicalTrials.gov NCT03986684, NCT04430946.


Subject(s)
Biomarkers , C-Peptide , Gastric Inhibitory Polypeptide , Growth Differentiation Factor 15 , Hyperlipidemias , Obesity , Postprandial Period , Adult , Female , Humans , Male , Middle Aged , Biomarkers/blood , Blood Glucose/metabolism , C-Peptide/blood , Case-Control Studies , Fatty Liver/blood , Fatty Liver/diagnosis , Gastric Inhibitory Polypeptide/blood , Glucose Tolerance Test , Growth Differentiation Factor 15/blood , Hyperlipidemias/blood , Hyperlipidemias/diagnosis , Obesity/blood , Obesity/diagnosis , Time Factors , Up-Regulation
16.
Mayo Clin Proc ; 99(5): 705-715, 2024 May.
Article in English | MEDLINE | ID: mdl-38702124

ABSTRACT

OBJECTIVE: To describe the outcomes of kidney transplant (KT) candidates with obesity undergoing sleeve gastrectomy (SG) to meet the criteria for KT. METHODS: Retrospective analysis was conducted of electronic medical records of KT candidates with obesity (body mass index >35 kg/m2) who underwent SG in our institution. Weight loss, adverse health events, and the listing and transplant rates were abstracted and compared with the nonsurgical cohort. RESULTS: The SG was performed in 54 patients; 50 patients did not have surgery. Baseline demographic characteristics were comparable at the time of evaluation. Mean body mass index ± SD of the SG group was 41.7±3.6 kg/m2 at baseline (vs 41.5±4.3 kg/m2 for nonsurgical controls); at 2 and 12 months after SG, it was 36.4±4.1 kg/m2 and 32.6±4.0 kg/m2 (P<.01 for both). In the median follow-up time of 15.5 months (interquartile range, 6.4 to 23.9 months), SG was followed by active listing (37/54 people), and 20 of 54 received KT during a median follow-up time of 20.9 months (interquartile range, 14.7 to 28.3 months) after SG. In contrast, 14 of 50 patients in the nonsurgical cohort were listed, and 5 received a KT (P<.01). Three patients (5.6%) experienced surgical complications. There was no difference in overall hospitalization rates and adverse health outcomes, but the SG cohort experienced a higher risk of clinically significant functional decline. CONCLUSION: In KT candidates with obesity, SG appears to be effective, with 37% of patients undergoing KT during the next 18 months (P<.01). Further research is needed to confirm and to improve the safety and efficacy of SG for patients with obesity seeking a KT.


Subject(s)
Bariatric Surgery , Gastrectomy , Kidney Transplantation , Obesity , Weight Loss , Humans , Male , Female , Retrospective Studies , Middle Aged , Obesity/surgery , Obesity/complications , Bariatric Surgery/methods , Adult , Gastrectomy/methods , Gastrectomy/adverse effects , Body Mass Index , Treatment Outcome , Kidney Failure, Chronic/surgery
18.
Am. j. cardiovasc. drugs ; maio.2024. ilus
Article in English | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1554136

ABSTRACT

BACKGROUND: GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. However, the efficacy of these agents in reducing cardiovascular endpoints among patients living with obesity or overweight is unclear. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1 RAs versus placebo in patients with obesity or overweight. We searched PubMed, Cochrane, and Embase databases. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs). RESULTS: A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD - 4.76 mmHg; 95% CI - 6.03, - 3.50; p < 0.001; I2 = 100%) and diastolic blood pressure (MD - 1.41 mmHg; 95% CI - 2.64, - 0.17; p = 0.03; I2 = 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I2 = 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; p = 0.16; I2 = 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; p = 0.38; I2 = 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I2 = 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I2 = 0%). CONCLUSIONS: In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis.


Subject(s)
Glucagon-Like Peptide-1 Receptor Agonists , Obesity , Controlled Clinical Trials as Topic , Overweight
19.
Front Endocrinol (Lausanne) ; 15: 1366015, 2024.
Article in English | MEDLINE | ID: mdl-38774226

ABSTRACT

Introduction: Nonalcoholic fatty liver disease (NAFLD) affects a quarter of the world's population and encompasses a spectrum of liver conditions, from non-alcoholic steatohepatitis (NASH) to inflammation and fibrosis. In addition, NAFLD also links to extrahepatic conditions like diabetes or obesity. However, it remains unclear if NAFLD independently correlates with the onset and progression of atherosclerosis. Material and methods: This cross-sectional study aimed to explore the relationship between NAFLD severity, assessed via liver biopsy, and early atherosclerosis using adventitial vasa vasorum (VV) density. It included 44 patients with obesity (33 with steatosis, 11 with NASH) undergoing bariatric surgery. Results: Results revealed no significant differences in adventitial VV density between steatosis and NASH groups, neither in the mean values [0.759 ± 0.104 vs. 0.780 ± 0.043, P=0.702] nor left-right sides. Similarly, carotid intima-media thickness (cIMT) did not vary between these groups. Additionally, no linear correlation existed between VV density and cIMT. Only gender showed an association with VV density. Conclusion: These findings suggest that NASH severity doesn't independently drive early atherosclerosis or affects cIMT. Gender might play a role in early atherosclerotic disease in NAFLD, impacting VV density and cIMT. This highlights the need to consider other risk factors when evaluating cardiovascular risk in NAFLD patients.


Subject(s)
Carotid Intima-Media Thickness , Non-alcoholic Fatty Liver Disease , Severity of Illness Index , Vasa Vasorum , Humans , Non-alcoholic Fatty Liver Disease/pathology , Non-alcoholic Fatty Liver Disease/complications , Male , Female , Vasa Vasorum/pathology , Cross-Sectional Studies , Middle Aged , Adult , Adventitia/pathology , Atherosclerosis/pathology , Obesity/pathology , Obesity/complications
20.
Pak J Pharm Sci ; 37(1(Special)): 231-234, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38747274

ABSTRACT

Increased levels of bad cholesterol in the body result in increasing blood pressure and weight gain. The rate of mortality in people, especially who are obese, is increasing due to absence of organic sources of fiber in their diets. Chia and fennel seeds are rich sources of fiber. The objective of this study was to evaluate the combined effect of Salvia hispanica (Chia seeds) and Foeniculum vulgare (Fennel seeds) against weight-loss and lipid profile in obese human subjects. The research was conducted on obese people aged 25 to 40 years at the Jinnah Hospital Lahore. The study design was randomized control trial (RCT). The sample size was calculated and was divided in-to two groups. With the duration of study being 3 months, pre-testing of all the participants was done. Group 1 was control group, given placebo treatment and Group 2 was an intervention group and given chia and fennel seeds. Post-testing was done and data were analyzed. Results showed that chia and fennel seeds have significant effect (p <0.05) on BMI and lipid profile hence, both are beneficial for lowering body weight and improving LDL, HDL, serum triglycerides and total cholesterol levels.


Subject(s)
Foeniculum , Obesity , Salvia , Seeds , Weight Loss , Humans , Foeniculum/chemistry , Adult , Obesity/blood , Obesity/drug therapy , Seeds/chemistry , Salvia/chemistry , Female , Male , Weight Loss/drug effects , Lipids/blood , Plant Extracts/pharmacology , Anti-Obesity Agents/pharmacology , Anti-Obesity Agents/therapeutic use , Body Mass Index , Phytotherapy
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