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1.
Life Sci ; 255: 117867, 2020 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-32479954

RESUMEN

Obesity continues to be a growing health concern around the world, and elevated levels of free fatty acids as a result of high-fat intake might play a role in neuroendocrine alterations leading to obesity. However, it is unclear how fatty acids affect neuroendocrine functions and energy metabolism. Since hypothalamic monoamines play a crucial role in regulating neuroendocrine functions relating to energy balance, we investigated the direct effects of oleic acid on hypothalamic monoamines and hypothesized that oleic acid would activate peroxisome proliferator-activated receptor alpha (PPAR-α), a nuclear transcription factor involved with fatty acid metabolism, to affect monoamines. We also hypothesized that this response would be subdued in diet-induced obesity (DIO). To test these hypotheses, hypothalami from Sprague Dawley and DIO rats were incubated with 0 (Control), 0.00132 mM, 0.132 mM, 1.32 mM oleic acid, 50 µM MK 886 (a selective PPAR- α antagonist), or oleic acid + MK 886 in Krebs Ringers Henseleit (KRH) solution. HPLC-EC was used to measure monoamine levels in perfusates. Oleic acid produced a significant increase in norepinephrine, dopamine, and serotonin levels in a dose-dependent manner, and incubation with MK886 blocked these effects. The effect of oleic acid on hypothalamic monoamines was attenuated in DIO rats. These findings suggest that PPARα probably plays an essential role in fatty acid sensing in the hypothalamus, by affecting monoamine efflux and DIO rats are resistant to the effects of oleic acid.


Asunto(s)
Hipotálamo/efectos de los fármacos , Obesidad/fisiopatología , Ácido Oléico/farmacología , PPAR alfa/metabolismo , Animales , Dieta Alta en Grasa/efectos adversos , Dopamina/metabolismo , Relación Dosis-Respuesta a Droga , Ácidos Grasos no Esterificados/metabolismo , Hipotálamo/metabolismo , Indoles/farmacología , Masculino , Norepinefrina/metabolismo , Ácido Oléico/administración & dosificación , Ratas , Ratas Sprague-Dawley , Serotonina/metabolismo
2.
Rev Saude Publica ; 54: 54, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32491053

RESUMEN

The coronavirus disease 2019 (covid-19) pandemic has caused a public health emergency worldwide. Risk, severity and mortality of the disease have been associated with non-communicable chronic diseases, such as diabetes mellitus. Accumulated evidence has caused great concern in countries with high prevalence of this morbidity, such as Brazil. This text shows the picture of diabetes in Brazil, followed by epidemiological data and explanatory hypothesis for the association between diabetes and covid-19. We emphasized how the burden of these two morbidities in a middle-income country has aggravated this pandemic scenario. The comprehension of this association and biological plausibility may help face this pandemic and future challenges.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/epidemiología , Neumonía Viral/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Comorbilidad , Infecciones por Coronavirus/fisiopatología , Complicaciones de la Diabetes/fisiopatología , Diabetes Mellitus/fisiopatología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/fisiopatología , Pandemias , Neumonía Viral/fisiopatología , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad
3.
Diabetes Care ; 43(7): 1392-1398, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32409502

RESUMEN

OBJECTIVE: Patients with obesity are at increased risk of exacerbations from viral respiratory infections. However, the association of obesity with the severity of coronavirus disease 2019 (COVID-19) is unclear. We examined this association using data from the only referral hospital in Shenzhen, China. RESEARCH DESIGN AND METHODS: A total of 383 consecutively hospitalized patients with COVID-19 admitted from 11 January 2020 to 16 February 2020 and followed until 26 March 2020 at the Third People's Hospital of Shenzhen were included. Underweight was defined as a BMI <18.5 kg/m2, normal weight as 18.5-23.9 kg/m2, overweight as 24.0-27.9 kg/m2, and obesity as ≥28 kg/m2. RESULTS: Of the 383 patients, 53.1% were normal weight, 4.2% were underweight, 32.0% were overweight, and 10.7% were obese at admission. Obese patients tended to have symptoms of cough (P = 0.03) and fever (P = 0.06) compared with patients who were not obese. Compared with normal weight patients, those who were overweight had 1.84-fold odds of developing severe COVID-19 (odds ratio [OR] 1.84, 95% CI 0.99-3.43, P = 0.05), while those who were obese were at 3.40-fold odds of developing severe disease (OR 3.40, 95% CI 1.40-2.86, P = 0.007), after adjusting for age, sex, epidemiological characteristics, days from disease onset to hospitalization, presence of hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, liver disease, and cancer, and drug used for treatment. Additionally, after similar adjustment, men who were obese versus those who were normal weight were at increased odds of developing severe COVID-19 (OR 5.66, 95% CI 1.80-17.75, P = 0.003). CONCLUSIONS: In this study, obese patients had increased odds of progressing to severe COVID-19. As the severe acute respiratory syndrome coronavirus 2 may continue to spread worldwide, clinicians should pay close attention to obese patients, who should be carefully managed with prompt and aggressive treatment.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Obesidad/epidemiología , Neumonía Viral/epidemiología , Adulto , Índice de Masa Corporal , China/epidemiología , Comorbilidad , Infecciones por Coronavirus/fisiopatología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Oportunidad Relativa , Sobrepeso/epidemiología , Pandemias , Neumonía Viral/fisiopatología , Factores de Riesgo
4.
Am J Physiol Endocrinol Metab ; 319(1): E43-E47, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-32469255

RESUMEN

The COVID-19 pandemic, caused by the novel coronavirus, SARS-CoV-2, is threating our health systems and daily lives and is responsible for causing substantial morbidity and mortality. In particular, aged individuals and individuals with comorbidities, including obesity, diabetes mellitus, and hypertension, have significantly higher risks of hospitalization and death than normal individuals. The renin-angiotensin system (RAS) plays a pivotal role in the pathogenesis of diabetes mellitus, obesity, and hypertension. Angiotensin-converting enzyme 2 (ACE2), belonging to the RAS family, has received much attention during this COVID-19 pandemic, owing to the fact that SARS-CoV-2 uses ACE2 as a receptor for cellular entry. Additionally, the RAS greatly affects energy metabolism in certain pathological conditions, including cardiac failure, diabetes mellitus, and viral infections. This article discusses the potential mechanisms by which SARS-CoV-2 modulates the RAS and energy metabolism in individuals with obesity and diabetes mellitus. The article aims to highlight the appropriate strategies for combating the COVID-19 pandemic in the clinical setting and emphasize on the areas that require further investigation in relation to COVID-19 infections in patients with obesity and diabetes mellitus from the viewpoint of endocrinology and metabolism.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Diabetes Mellitus/fisiopatología , Metabolismo Energético , Obesidad/fisiopatología , Neumonía Viral/fisiopatología , Sistema Renina-Angiotensina , Betacoronavirus , Diabetes Mellitus/virología , Humanos , Obesidad/virología , Pandemias , Peptidil-Dipeptidasa A/fisiología
6.
J Appl Oral Sci ; 28: e20190694, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32428060

RESUMEN

Objective Obesity is a chronic disease that negatively affects an individual's general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy. Methodology This clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of Tannerella forsythia , Porphyromonas gingivalis , Treponema Denticola , and Aggregatibacter actinomycetemcomitans was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used. Results In both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p<0.05). Obese and non-obese patients equally responded to non-surgical periodontal therapy (p>0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy. Conclusions Obesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.


Asunto(s)
Obesidad/microbiología , Periodontitis/microbiología , Periodontitis/terapia , Adulto , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Análisis de Varianza , Antropometría , Índice de Placa Dental , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Índice Periodontal , Porphyromonas gingivalis/aislamiento & purificación , Estudios Prospectivos , Factores de Riesgo , Estadísticas no Paramétricas , Tannerella forsythia/aislamiento & purificación , Factores de Tiempo , Resultado del Tratamiento , Treponema denticola/aislamiento & purificación
7.
Eur J Endocrinol ; 183(2): 211-220, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32460236

RESUMEN

Background: Data suggest that metabolic health status, incorporating components of metabolic syndrome (MetS), predicts cardiovascular disease (CVD) risk better than BMI. This study explored the association of MetS and obesity with endothelial function, a prognostic risk factor for incident CVD. Methods: Forty-four participants were phenotyped according to BMI as non-obese vs obese (<30 or >30 kg/m2) and according to the International Diabetes Federation criteria of MetS: ≤2 criteria MetS (MetS-) vs ≥3 criteria MetS (MetS+); (1.)non-obese MetS- vs (2.) non-obese MetS+ and (3.) obese MetS- vs (4.) obese MetS+. Flow-mediated dilation (FMD), body composition including liver fat (MRI and spectroscopy), dietary intake, intensities of habitual physical activity and cardio-respiratory fitness were determined. Variables were analysed using a one-factor between-groups ANOVA and linear regression; mean (95% CI) are presented. Results: Individuals with MetS+ displayed lower FMD than those with MetS-. For non-obese individuals mean difference between MetS+ and MetS- was 4.1% ((1.0, 7.3); P = 0.004) and obese individuals had a mean difference between MetS+ and MetS- of 6.2% ((3.1, 9.2); P < 0.001). Although there was no association between BMI and FMD (P = 0.27), an increased number of MetS components was associated with a lower FMD (P = 0.005), and after adjustment for age and sex, 19.7% of the variance of FMD was explained by MetS, whereas only 1.1% was explained by BMI. Conclusions: In this study cohort, components of MetS, rather than obesity per se, contribute to reduced FMD, which suggests a reduced bioavailability of nitric oxide and thus increased risk of CVD.


Asunto(s)
Síndrome Metabólico/fisiopatología , Obesidad/fisiopatología , Vasodilatación , Adiposidad , Adulto , Composición Corporal , Índice de Masa Corporal , Arteria Braquial/fisiopatología , Enfermedades Cardiovasculares/fisiopatología , Estudios de Cohortes , Ingestión de Alimentos , Endotelio Vascular/fisiopatología , Ejercicio Físico , Femenino , Humanos , Hígado/metabolismo , Masculino , Persona de Mediana Edad , Aptitud Física , Factores de Riesgo
8.
Acta Diabetol ; 57(6): 759-764, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32249357

RESUMEN

AIMS: Analyze the relationship between obesity and influenza. METHODS: Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic. RESULTS: Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise. CONCLUSIONS: Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Gripe Humana/epidemiología , Obesidad/epidemiología , Obesidad/virología , Neumonía Viral/epidemiología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Humanos , Gripe Humana/virología , Obesidad/inmunología , Obesidad/fisiopatología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , Prevalencia , Cuarentena , Esparcimiento de Virus
9.
Life Sci ; 252: 117650, 2020 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-32294475

RESUMEN

It has been described that the cardiac dysfunction in the obesity model is because of collagen imbalance and that angiotensin II (Ang II) contributes to myocardial fibrosis. However, it remains undefined if changes in collagen I and III metabolism in obesity is due to the renin-angiotensin system (RAS) dysregulation from myocardium or excessive adipose tissue. AIM: This study aimed to verify whether the changes in myocardial collagen metabolism result from RAS deregulation of cardiac or adipose tissue in an obesity model. MAIN METHODS: Wistar rats were fed with control (CD) and high-fat (HFD) diets for 30 weeks. After the dietary intervention, animals were assigned to be treated with losartan at the 30 mg/kg/day dosage or kept untreated for an additional five weeks. KEY FINDINGS: HFD induced obesity, comorbidities, and cardiac collagen overexpression. The HFD group presented an increase in Ang II levels in both adipose tissue and plasma, as well as AT1 receptor expression in cardiac tissue. Of note, the myocardial Ang II was not changed in the HFD group. Losartan administration reduced some obesity-induced comorbidities regardless of weight loss. The AT1 receptor blockade also decreased the release of Ang II from adipose tissue and myocardial AT1 receptor and collagen. SIGNIFICANCE: It was seen that excessive adipose tissue is responsible for the exacerbated circulating Ang II, which induced cardiac fibrosis development.


Asunto(s)
Tejido Adiposo/metabolismo , Angiotensina II/metabolismo , Miocardio/patología , Obesidad/fisiopatología , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Animales , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Dieta Alta en Grasa/efectos adversos , Fibrosis , Losartán/farmacología , Masculino , Miocardio/metabolismo , Ratas , Ratas Wistar , Sistema Renina-Angiotensina/fisiología
10.
Obesity (Silver Spring) ; 28(7): 1176-1177, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32299148

RESUMEN

As the biomedical community races to disentangle the unknowns associated with severe acute respiratory syndrome coronavirus 2, the virus responsible for causing coronavirus disease, the link between diminished immune function and individuals with obesity raises important questions about the possibility for greater viral pathogenicity in this population. Increased adiposity may undermine the pulmonary microenvironment wherein viral pathogenesis and immune cell trafficking could contribute to a maladaptive cycle of local inflammation and secondary injury. A further challenge to those with obesity during the current pandemic may involve vitamin D deficiency or insufficiency. In the interest of personal and public health, we caution decision- and policy makers alike not to pin all hope on a proverbial "silver bullet." Until further breakthroughs emerge, we should remember that modifiable lifestyle factors such as diet and physical activity should not be marginalized. Decades of empirical evidence support both as key factors promoting health and wellness.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/virología , Ejercicio Físico , Obesidad/virología , Neumonía Viral/virología , Deficiencia de Vitamina D/virología , Dieta/efectos adversos , Humanos , Inflamación , Estilo de Vida , Estado Nutricional , Obesidad/sangre , Obesidad/fisiopatología , Pandemias , Vitamina D/sangre
11.
J Frailty Aging ; 9(1): 37-43, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150212

RESUMEN

BACKGROUND: Sarcopenic obesity (SO) is associated with poorer physical performance in the elderly and will increase in relevance with population ageing and the obesity epidemic. The lack of a consensus definition for SO has resulted in variability in its reported prevalence, poor inter-definitional agreement, and disagreement on its impact on physical performance, impeding further development in the field. While sarcopenia definitions have been compared, the impact of obesity definitions in SO has been less well-studied. OBJECTIVES: To compare 3 widely-adopted definitions of obesity in terms of SO prevalence, inter-definitional agreement, and association with muscle function. DESIGN: Cross-sectional. SETTING: GERILABS study, Singapore Participants: 200 community-dwelling, functionally-independent older adults. MEASUREMENTS: We utilized three commonly-used definitions of obesity: body mass index (BMI), waist circumference (WC) and DXA-derived fat mass percentage (FM%). Sarcopenia was defined using Asian Working Group for Sarcopenia criteria. For muscle function, we assessed handgrip strength, gait speed and Short Physical Performance Battery (SPPB). Subjects were classified into 4 body composition phenotypes (normal, obese, sarcopenic and SO), and outcomes were compared between groups. RESULTS: The prevalence rate for SO was lowest for BMI (0.5%) compared to FM% (10.0%) and WC (10.5%). Inter-definitional agreement was lowest between BMI and WC (κ=0.364), and at best moderate between FM% and WC (κ=0.583). SO performed the worst amongst body composition phenotypes in handgrip strength, gait speed and SPPB (all p<0.01) only when defined using WC. In regression analyses, SO was associated with decreased SPPB scores (ß=-0.261, p=0.001) only for the WC definition. CONCLUSION: There is large variation in the prevalence of SO across different obesity definitions, with low-to-moderate agreement between them. Our results corroborate recent evidence that WC, and thus central obesity, is best associated with poorer muscle function in SO. Thus, WC should be further explored in defining obesity for accurate and early characterization of SO among older adults in Asian populations.


Asunto(s)
Obesidad , Sarcopenia , Terminología como Asunto , Anciano , Estudios Transversales , Humanos , Fuerza Muscular/fisiología , Obesidad/epidemiología , Obesidad/fisiopatología , Prevalencia , Reproducibilidad de los Resultados , Sarcopenia/epidemiología , Sarcopenia/fisiopatología
12.
PLoS One ; 15(3): e0229403, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32210432

RESUMEN

AIM: To determine the association between known risk factors (e.g., obesity, metabolic syndrome and its components) and the development of pre-diabetes or diabetes over time in a cohort of Mexican health workers. METHODS: Participants in the Mexican Health Worker Cohort Study with complete information at two waves of data collection, 2004-2006 (W1) and 2011-2013 (W2), were included in the analysis (n = 1,174). Multivariable binary and multinomial logistic regression were used to examine the cross-sectional associations between specific risk factors and diabetes status (diabetes, pre-diabetes, or neither) at W1 and the longitudinal associations between changes in risk factors and progression of diabetes status from W1 to W2, respectively. RESULTS: Mean time between waves was 7.0 years (SD 1.1). Prevalence of pre-diabetes and diabetes was 16% and 10% at W1 and increased to 30% and 16% at W2, respectively. The cross-sectional prevalence of pre-diabetes and diabetes was significantly higher among men, participants over the age of 45 years, and individuals who were overweight or obese or had metabolic syndrome (MS), three or more components of the MS, elevated alanine aminotransferase (ALT) levels, or elevated uric acid. In longitudinal analyses, remaining obese or gaining weight between waves was associated with an increased risk of developing pre-diabetes. A greater risk of developing pre-diabetes or diabetes was also observed among individuals who either maintained or acquired MS, elevated ALT, or elevated uric acid (only for diabetes) from W1 to W2. CONCLUSIONS: Weight gain and acquiring or maintaining MS, elevated ALT levels, or elevated uric acid were associated with a significant risk of developing pre-diabetes or diabetes. Our findings, especially in the context of the obesity epidemic in Mexico, point towards an urgent need for initiatives to help reduce excess weight in order to avert future cases of pre-diabetes and diabetes.


Asunto(s)
Índice de Masa Corporal , Diabetes Mellitus/epidemiología , Fuerza Laboral en Salud/estadística & datos numéricos , Síndrome Metabólico/complicaciones , Obesidad/complicaciones , Sobrepeso/complicaciones , Estado Prediabético/epidemiología , Adulto , Estudios Transversales , Diabetes Mellitus/etiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Síndrome Metabólico/fisiopatología , México/epidemiología , Persona de Mediana Edad , Obesidad/fisiopatología , Sobrepeso/fisiopatología , Estado Prediabético/etiología , Prevalencia , Factores de Riesgo
13.
Einstein (Sao Paulo) ; 18: eAO5150, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32159605

RESUMEN

OBJECTIVE: To verify the association of obesity and infertility related to anovulatory issues. METHODS: This case-control study was carried out with 52 women, aged 20 to 38 years, divided into two groups (infertile - cases - and fertile - control), seen at outpatient clinics, in the period from April to December, 2017. RESULTS: We found significant evidence that obesity negatively affects women's fertility (p=0.017). The group of infertile women was 7.5-fold more likely to be obese than fertile women. CONCLUSION: Strategies that encourage weight control are indicated for women with chronic anovulation, due to hight metabolic activity of adipose tissue.


Asunto(s)
Anovulación/etiología , Infertilidad Femenina/etiología , Obesidad/complicaciones , Adulto , Anovulación/metabolismo , Anovulación/fisiopatología , Antropometría , Estudios de Casos y Controles , Ejercicio Físico/fisiología , Femenino , Humanos , Infertilidad Femenina/metabolismo , Infertilidad Femenina/fisiopatología , Enfermedades Metabólicas/complicaciones , Enfermedades Metabólicas/fisiopatología , Obesidad/metabolismo , Obesidad/fisiopatología , Factores de Riesgo , Conducta Sedentaria , Encuestas y Cuestionarios , Adulto Joven
15.
Open Heart ; 7(1): e001003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32201580

RESUMEN

Spirulina, a cyanobacteria commonly referred to as a blue-green algae, is one of the oldest lifeforms on Earth. Spirulina grows in both fresh and saltwater sources and is known for its high protein and micronutrient content. This review paper will cover the effects of spirulina on weight loss and blood lipids. The currently literature supports the benefits of spirulina for reducing body fat, waist circumference, body mass index and appetite and shows that spirulina has significant benefits for improving blood lipids.


Asunto(s)
Fármacos Antiobesidad/uso terapéutico , Suplementos Dietéticos , Dislipidemias/tratamiento farmacológico , Hipolipemiantes/uso terapéutico , Lípidos/sangre , Obesidad/tratamiento farmacológico , Spirulina , Pérdida de Peso/efectos de los fármacos , Animales , Fármacos Antiobesidad/efectos adversos , Biomarcadores/sangre , Suplementos Dietéticos/efectos adversos , Dislipidemias/sangre , Dislipidemias/diagnóstico , Humanos , Hipolipemiantes/efectos adversos , Obesidad/diagnóstico , Obesidad/fisiopatología , Resultado del Tratamiento
16.
Am J Clin Nutr ; 111(6): 1127-1136, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32186326

RESUMEN

BACKGROUND: With the rising rates of obesity and associated metabolic disorders, there is a growing need for effective long-term weight-loss strategies, coupled with an understanding of how they interface with human physiology. Interest is growing in the potential role of gut microbes as they pertain to responses to different weight-loss diets; however, the ways that diet, the gut microbiota, and long-term weight loss influence one another is not well understood. OBJECTIVES: Our primary objective was to determine if baseline microbiota composition or diversity was associated with weight-loss success. A secondary objective was to track the longitudinal associations of changes to lower-carbohydrate or lower-fat diets and concomitant weight loss with the composition and diversity of the gut microbiota. METHODS: We used 16S ribosomal RNA gene amplicon sequencing to profile microbiota composition over a 12-mo period in 49 participants as part of a larger randomized dietary intervention study of participants consuming either a healthy low-carbohydrate or a healthy low-fat diet. RESULTS: While baseline microbiota composition was not predictive of weight loss, each diet resulted in substantial changes in the microbiota 3-mo after the start of the intervention; some of these changes were diet specific (14 taxonomic changes specific to the healthy low-carbohydrate diet, 12 taxonomic changes specific to the healthy low-fat diet) and others tracked with weight loss (7 taxonomic changes in both diets). After these initial shifts, the microbiota returned near its original baseline state for the remainder of the intervention, despite participants maintaining their diet and weight loss for the entire study. CONCLUSIONS: These results suggest a resilience to perturbation of the microbiota's starting profile. When considering the established contribution of obesity-associated microbiotas to weight gain in animal models, microbiota resilience may need to be overcome for long-term alterations to human physiology. This trial was registered at clinicaltrials.gov as NCT01826591.


Asunto(s)
Microbioma Gastrointestinal , Obesidad/dietoterapia , Adulto , Bacterias/clasificación , Bacterias/genética , Bacterias/aislamiento & purificación , Dieta Baja en Carbohidratos , Dieta con Restricción de Grasas , Dieta Reductora , Heces , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Obesidad/metabolismo , Obesidad/microbiología , Obesidad/fisiopatología , Pérdida de Peso , Adulto Joven
17.
Tech Vasc Interv Radiol ; 23(1): 100653, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32192633

RESUMEN

Obesity is a public health epidemic in the United States, with implications for patients across many organ systems. Despite improvements in understanding the pathophysiology and increasing number of therapies for obesity, its prevalence continues to rise. The purpose of this review is to provide the interventional radiologist with an understanding of (1) the epidemiology of obesity; (2) the impact of obesity on patients and the healthcare system; (3) the causes of obesity; (4) conservative management of obesity; and (5) pharmacologic management of obesity.


Asunto(s)
Fármacos Antiobesidad/uso terapéutico , Estilo de Vida Saludable , Obesidad/terapia , Conducta de Reducción del Riesgo , Fármacos Antiobesidad/efectos adversos , Regulación del Apetito/efectos de los fármacos , Dieta Saludable , Ejercicio Físico , Conducta Alimentaria , Humanos , Obesidad/epidemiología , Obesidad/fisiopatología , Obesidad/psicología , Factores de Riesgo , Resultado del Tratamiento , Pérdida de Peso
18.
Tech Vasc Interv Radiol ; 23(1): 100654, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32192634

RESUMEN

Bariatric surgery comprises a group of operative procedures designed to improve weight-related medical conditions. In the United States, these include vertical sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, and the duodenal switch procedure. Bariatric surgery is the only durable and effective way for most humans to lose a significant amount of weight, and see improvement in obesity-related comorbidities. It can improve quality of life, prevent a number of cancers, and decrease overall mortality. Bariatric procedures work through several avenues, including restriction of food intake, malabsorption of food calories, an increase in metabolic rate, decreased hunger, increased satiety, and a variety of other hormonal mechanisms. Several other surgical, endoscopic, and non-permanent approaches to weight loss will also be covered in this section.


Asunto(s)
Cirugía Bariátrica , Obesidad/cirugía , Regulación del Apetito , Cirugía Bariátrica/efectos adversos , Conducta Alimentaria , Humanos , Obesidad/diagnóstico , Obesidad/fisiopatología , Obesidad/psicología , Calidad de Vida , Resultado del Tratamiento , Pérdida de Peso
19.
Tech Vasc Interv Radiol ; 23(1): 100655, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32192635

RESUMEN

Obesity poses a significant health care concern in the United States, with 39.8% of adults being classified as obese. Several different methods have been introduced to combat obesity, from medical therapy to surgical options. Bariatric surgery has been demonstrated to be superior to medical therapy alone for weight loss in obese patients. Despite this information, only about 1% of eligible patients undergo bariatric surgery per year. The reason for this treatment gap is multifactorial, but patient apprehension to undergo surgery is a major driving force. Many patients perceive bariatric surgery as dangerous, and believe that living with their current weight is safer than undergoing surgery. To combat this treatment gap, endoscopic therapies have been developed to reach more patients in a less invasive way. This article will review endoscopic treatment options currently available and approved by the Food and Drug Administration, as well as other treatment modalities that are currently in development.


Asunto(s)
Cirugía Bariátrica , Endoscopía Gastrointestinal , Obesidad/cirugía , Pérdida de Peso , Regulación del Apetito , Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/instrumentación , Endoscopía Gastrointestinal/efectos adversos , Endoscopía Gastrointestinal/instrumentación , Diseño de Equipo , Conducta Alimentaria , Humanos , Obesidad/diagnóstico , Obesidad/fisiopatología , Obesidad/psicología , Aceptación de la Atención de Salud , Seguridad del Paciente , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
20.
Tech Vasc Interv Radiol ; 23(1): 100661, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32192636

RESUMEN

Medical devices can help patients lose weight. The Food and Drug Administration (FDA) Center for Devices and Radiological Health is responsible for assuring the safety and effectiveness of devices used for weight loss. Interventional radiologists may conduct clinical studies of devices for weight loss, such as embolization beads to stop blood flow to gastric arteries or cryoablation systems to ablate metabolism-linked nerves. The purposes of this paper are (1) to clarify the FDA's role providing regulatory oversight of clinical studies of medical devices; (2) to explain how to engage with the FDA; and (3) to provide information on the design of clinical studies intended to support a weight loss indication. In particular, Investigational Device Exemptions (IDEs) are needed for significant risk studies for new devices, or for off-label use of legally marketed devices. The FDA is available through the Pre-Submission process to assist when determining if a study requires an IDE, and to discuss plans for submitting an IDE. The FDA works with medical device manufacturers and clinical researchers who want to bring novel weight-loss devices to market.


Asunto(s)
Cirugía Bariátrica/instrumentación , Aprobación de Recursos , Embolización Terapéutica/instrumentación , Obesidad/terapia , Radiografía Intervencional/instrumentación , United States Food and Drug Administration , Pérdida de Peso , Cirugía Bariátrica/efectos adversos , Embolización Terapéutica/efectos adversos , Diseño de Equipo , Humanos , Obesidad/diagnóstico , Obesidad/fisiopatología , Seguridad del Paciente , Radiografía Intervencional/efectos adversos , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento , Estados Unidos
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