Zanthoxylum bungeanum amides ameliorates nonalcoholic fatty liver via regulating gut microbiota and activating AMPK/Nrf2 signaling.

ETHNOPHARMACOLOGICAL RELEVANCE: Zanthoxylum bungeanum Maxim. (Rutaceae) is a known herbal medicine with various bioactivities, including anti-obesity, lipid-lowering, learning & memory improving and anti-diabetes, and amides in Z. bungeanum (AZB) are considered as the major active agents for its bioactivities. AIM OF THE STUDY: This research was carried out to uncover the anti-NAFL effect of AZB and its corresponding molecular mechanisms. METHODS: The central composite design-response surface methodology (CCD-RSM) was utilized to optimize the AZB extraction process, and the anti-NAFL effect of AZB was investigated on high fat diet (HFD) fed mice (HFD mice). The levels of ROS in liver tissues were determined using laser confocal microscopy with DCFH-DA probe staining, and anti-enzymes (such as HO-1, SOD, CAT & GSH-PX) and MDA in liver tissues were measured using commercial detecting kits. GC-MS was used to determine the short-chain fatty acids (SCFAs) contents in feces and blood of mice. 16S high-throughput sequencing, western blotting (WB) assay and immunofluorescence (IF) were used to explore the intestinal flora changes in mice and the potential mechanisms of AZB for treatment of NAFL. RESULTS: Our results showed AZB reduced body weight, alleviated liver pathological changes, reduced fat accumulation, and improved oxidative stress in HFD mice. In addition, we also found AZB improved OGTT and ITT, reduced TG, TC, LDL-C, whereas increased HDL-C in HFD mice. AZB increased total number of the species and interspecies kinship of gut microbiota and reduced the richness and diversity of gut microbiota in HFD mice. Moreover, AZB decreased the ratio of Firmicutes/Bacteroidota, whereas increased the abundance of Allobaculum, Bacteroides and Dubosiella in feces of HFD-fed mice. Furthermore, AZB increased the production of SCFAs, and up-regulated the phosphorylation of AMPK and increased the nuclear transcription of Nrf2 in liver of HFD mice. CONCLUSION: Collectively, our results suggested AZB can improve NAFL, which could reduce body weight, reverse liver lesions and fat accumulation, improve oxidative stress in liver tissues of HFD mice. Furthermore, the mechanisms are related to increase of the abundance of high-producing bacteria for SCFAs (e.g. Allobaculum, Bacteroides and Dubosiella) to activate AMPK/Nrf2 signaling.

Ginsenoside Rg1, lights up the way for the potential prevention of Alzheimer's disease due to its therapeutic effects on the drug-controllable risk factors of Alzheimer's disease.

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional Chinese medicine, Shen Nong, BenCao Jing, and Compendium of Materia Medica (Bencao Gangmu), Panax ginseng, and its prescriptions have been used for the treatment of dementia, depression, weight loss, Xiaoke disease (similar to diabetes), and vertigo. All these diseases are associated with the drug-controllable risk factors for Alzheimer's disease (AD), including depression, obesity, diabetes, and hypertension. Ginsenoside Rg1, one of the main active ingredients of P. ginseng and its congener Panax notoginseng, possesses therapeutic potentials against AD and associated diseases. This suggests that ginsenoside Rg1 might have the potential for AD prevention and treatment. Although the anti-AD effects of ginsenoside Rg1 have received more attention, a systematic review of its effects on depression, obesity, diabetes, and hypertension is not available. AIM OF THE REVIEW: This systematic literature review comprehensively summarized existing literature on the therapeutic potentials of ginsenoside Rg1 in AD prevention for the propose of providing a foundation of future research aimed at enabling the use of such drugs in clinical practice. METHODS: Information on ginsenoside Rg1 was collected from relevant published articles identified through a literature search in electronic scientific databases (PubMed, Science Direct, and Google Scholar). The keywords used were "Ginsenoside Rg1," "Panax ginseng," "Source," "Alzheimer's disease," "Brain disorders," "Depression," "Obesity," "Diabetes," and "Hypertension." RESULTS: The monomer ginsenoside Rg1 can be relatively easily obtained and has therapeutic potentials against AD. In vitro and in vivo experiments have demonstrated the therapeutic potentials of ginsenoside Rg1 against the drug-controllable risk factors of AD including depression, obesity, diabetes, and hypertension. Thus, ginsenoside Rg1 alleviates diseases resulting from AD risk factors by regulating multiple targets and pathways. CONCLUSIONS: Ginsenoside Rg1 has the potentials to prevent AD by alleviating depression, obesity, diabetes, and hypertension.

Dietary sources of branched-chain fatty acids and their biosynthesis, distribution, and nutritional properties.

Branched-chain fatty acids (BCFAs) consist of a wide variety of fatty acids with alkyl branching of methyl group. The most common BCFAs are the types with one methyl group (mmBCFA) on the penultimate carbon (iBCFA) or the antepenultimate carbon (aiBCFA). Long-chain mmBCFAs are widely existing in animal fats, milks and are mostly derived from bacteria in the diet or animal digestive system. Recent studies show that BCFAs benefit human intestinal health and immune homeostasis, but the connection between their content, distribution in the human and their nutritional functions are not well established. In this paper, we reviewed BCFAs from various dietary sources focused on their molecular species. The BCFAs biosynthesis in bacteria, Caenorhabditis elegans, mammals and their distribution in human tissues are summarized. This paper also discusses the nutritional properties of BCFAs including influences on intestinal health, immunoregulatory effects, anti-carcinoma, and anti-obesity activities, by highlighting the most recent research progress.

Does body mass index influence surgical options and overall survival in breast cancer patients?

Obesity is a relevant risk factor in breast cancer (BC), but little is known about the effects of overweight and obesity in surgical outcomes of BC patients. The aim of this study is to analyse surgical options and associated overall survival (OS) in overweight and obese women with BC. In this study, 2143 women diagnosed between 2012 and 2016 at the Portuguese Oncology Institute of Porto (IPO-Porto) were included, and the clinicopathological information was retrieved from the institutional database. Patients were stratified by body mass index (BMI). Statistical analysis included Pearson's chi-squared test with statistical significance set at p < 0.05. Multinomial, binary logistic regression and cox proportional-hazards model were also performed to calculate odd ratios and hazard ratios with 95% confidence intervals for adjusted and non-adjusted models. The results revealed no statistical difference in histological type, topographic localization, tumour stage and receptor status and in the number of surgical interventions. Overweight women have increased probability to be subjected to sentinel node biopsy. Obese and overweight women are more likely to be submitted to conservative surgery and contrariwise, less likely to undergo total mastectomy. Patients submitted to conservative surgery and not submitted to total mastectomy had a favourable OS although without statistical significance. No significant differences were observed in OS when stratified by BMI. Our results revealed significant variations regarding the surgical options in overweight and obese patients, but these were not translated in OS difference. More research is recommended to better address treatment options in overweight and obese BC patients (AU)

Alimentação saudável, atividade física e obesidade

Obesidade

Leptin receptor gene deficiency minimally affects osseointegration in rats.

Metabolic syndrome represents a cluster of conditions such as obesity, hyperglycaemia, dyslipidaemia, and hypertension that can lead to type 2 diabetes mellitus and/or cardiovascular disease. Here, we investigated the influence of obesity and hyperglycaemia on osseointegration using a novel, leptin receptor-deficient animal model, the Lund MetS rat. Machined titanium implants were installed in the tibias of animals with normal leptin receptor (LepR+/+) and those harbouring congenic leptin receptor deficiency (LepR-/-) and were left to heal for 28 days. Extensive evaluation of osseointegration was performed using removal torque measurements, X-ray micro-computed tomography, quantitative backscattered electron imaging, Raman spectroscopy, gene expression analysis, qualitative histology, and histomorphometry. Here, we found comparable osseointegration potential at 28 days following implant placement in LepR-/- and LepR+/+ rats. However, the low bone volume within the implant threads, higher bone-to-implant contact, and comparable biomechanical stability of the implants point towards changed bone formation and/or remodelling in LepR-/- rats. These findings are corroborated by differences in the carbonate-to-phosphate ratio of native bone measured using Raman spectroscopy. Observations of hypermineralised cartilage islands and increased mineralisation heterogeneity in native bone confirm the delayed skeletal development of LepR-/- rats. Gene expression analyses reveal comparable patterns between LepR-/- and LepR+/+ animals, suggesting that peri-implant bone has reached equilibrium in healing and/or remodelling between the animal groups.

5-Aminovaleric acid betaine predicts impaired glucose metabolism and diabetes.

BACKGROUND: 5-Aminovaleric acid betaine (5-AVAB) has recently been identified as a diet and microbial-dependent factor inducing obesity and hepatic steatosis in mice fed a Western diet. Accumulating evidence suggests a role in metabolic dysfunction associated with obesity, diabetes, and fatty liver disease. However, whether 5-AVAB plays a role in human disease is unclear, and human data are sparse. METHODS: We measured circulating 5-AVAB serum levels in 143 individuals with overweight or obesity participating in a randomized intervention study (NCT00850629) investigating the long-term effect of a weight maintenance strategy after diet-induced weight reduction. RESULTS: Higher 5-AVAB serum levels correlate with worse estimates of obesity, glucose metabolism, and hepatic steatosis after weight loss. Furthermore, higher 5-AVAB levels after weight loss independently predict detrimental changes in glucose metabolism 18 months after the successful weight reduction. CONCLUSION: Our human data supports previous findings in rodents indicating a relevant, potentially disadvantageous function of 5-AVAB in the context of metabolic dysbalance.

Assessment of rehabilitation effects in children with mild intellectual disability.

Research on effectiveness of rehabilitation programmes continues to investigate impact of therapeutic interventions on various motor parameters in children with intellectual disability (ID). This study compared the effectiveness of rehabilitation, reflected by physical fitness, static balance, and dynamic balance measurements, in children with mild ID. A total of 70 children with mild ID were enrolled for the study and were divided into two equal groups based on their body mass index (BMI) percentile, reflecting obesity or normal weight. Physical fitness was assessed using the Eurofit Special Test, whereas balance was evaluated with single-leg stance and timed up and go tests. The examinations were performed twice: At the beginning and at the end of a six-month therapy programme. Improvements were shown in the muscle strength of the upper limbs (p < 0.001) and lower limbs (p = 0.001), flexibility (p = 0.005), and static balance (p < 0.001) for the entire cohort. The effects of rehabilitation did not differ significantly between the children with obesity and those with a normal weight. These results may be important from the viewpoint of clinical practice and preventive measures, as they present evidence showing that rehabilitation is equally effective in both obese and normal weight children with mild ID. Therefore, these findings may be of assistance to those designing therapeutic programmes in special education centres.

Uncovering the pathogenesis of obesity complicated with papillary thyroid carcinoma via bioinformatics and experimental validation.

This study aimed to investigate the common molecular mechanism between obesity and papillary thyroid cancer (PTC), the most common pathological type of thyroid cancer. In this study, we obtained gene expression datasets for obesity (GSE151839) and PTC (GSE33630) from the Gene Expression Omnibus (GEO). We used the Perl program and R software to identify differentially expressed genes (DEGs) and common genes, perform GO function and KEGG pathway enrichment analysis, construct a protein-protein interaction (PPI) network, identify hub genes, and perform transcription factors (TFs) analysis. After undergoing validation in external datasets and in vitro experiments, common targets for both diseases were ultimately identified. A total of 23 genes that were differentially expressed (DEGs) between obesity and papillary thyroid carcinoma (PTC) were identified in our study. Among these DEGs, 17 genes were up-regulated while 6 genes were down-regulated. Then the top ten key genes were identified from the PPI network using cytoHubba and MCODE plug-in. Further evidence from external datasets revealed that MMP9, MNDA, TNC, and CHIT1 were identified as hub genes for both diseases. The study utilized Transcriptional Regulatory Relationships Unraveled by Sentence-based Text mining (TRRUST) to perform an enrichment analysis of TFs. This analysis identified ELF4 and STAT3 as common TFs for both diseases. Additionally, in vitro experiments were conducted to further analyze the clinical significance and biological functions of these TFs. The identification and investigation of hub genes and their corresponding TFs that regulate abnormalities in obesity and PTC can enhance our comprehension of the underlying connection between these two diseases, thus leading to the development of novel diagnostic approaches.

Prevalence, Regional Variations, and Predictors of Overweight, Obesity, and Hypertension Among Healthy Reproductive-Age Indian Women: Nationwide Cross-Sectional Polycystic Ovary Syndrome Task Force Study.

BACKGROUND: A clear understanding of the anthropometric and sociodemographic risk factors related to BMI and hypertension categories is essential for more effective disease prevention, particularly in India. There is a paucity of nationally representative data on the dynamics of these risk factors, which have not been assessed among healthy reproductive-age Indian women. OBJECTIVE: This cross-sectional polycystic ovary syndrome (PCOS) task force study aimed to assess the anthropometric and sociodemographic characteristics of healthy reproductive-age Indian women and explore the association of these characteristics with various noncommunicable diseases. METHODS: We conducted a nationwide cross-sectional survey from 2018 to 2022 as part of the Indian Council of Medical Research-PCOS National Task Force study, with the primary aim of estimating the national prevalence of PCOS and regional phenotypic variations among women with PCOS. A multistage random sampling technique was adopted, and 7107 healthy women (aged 18-40 years) from 6 representative geographical zones of India were included in the study. The anthropometric indices and sociodemographic characteristics of these women were analyzed. Statistical analysis was performed to assess the association between exposure and outcome variables. RESULTS: Of the 7107 study participants, 3585 (50.44%) were from rural areas and 3522 (49.56%) were from urban areas. The prevalence of obesity increased from 8.1% using World Health Organization criteria to 40% using the revised consensus guidelines for Asian Indian populations. Women from urban areas showed higher proportions of overweight (524/1908, 27.46%), obesity (775/1908, 40.62%), and prehypertension (1008/1908, 52.83%) categories. A rising trend of obesity was observed with an increase in age. Women aged 18 to 23 years were healthy (314/724, 43.4%) and overweight (140/724, 19.3%) compared with women aged 36 to 40 years with obesity (448/911, 49.2%) and overweight (216/911, 23.7%). The proportion of obesity was high among South Indian women, with 49.53% (531/1072) and 66.14% (709/1072), using both World Health Organization criteria and the revised Indian guidelines for BMI, respectively. BMI with waist circumference and waist-to-height ratio had a statistically significant linear relationship (r=0.417; P<.001 and r=0.422; P<.001, respectively). However, the magnitude, or strength, of the association was relatively weak (0.3<|r|<0.5). Statistical analysis showed that the strongest predictors of being overweight or obese were older age, level of education, wealth quintile, and area of residence. CONCLUSIONS: Anthropometric and sociodemographic characteristics are useful predictors of overweight- and obesity-related syndromes, including prehypertension, among healthy Indian women. Increased attention to the health of Indian women from public health experts and policy makers is warranted. The findings of this study can be leveraged to offer valuable insights, informing health decision-making and targeted interventions that mitigate risk factors of overweight, obesity, and hypertension. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/23437.

Relationship between composite dietary antioxidant index and depression among overweight and obese adults.

BACKGROUND: The use of specific dietary patterns to alleviate depressive symptoms has gained increasing recognition. The Composite Dietary Antioxidant Index (CDAI) is a crucial criterion for assessing antioxidant diets. We examined the relationship between CDAI and depression among overweight and obese adults through a cross-sectional study conducted in the United States. METHODS: We used weighted multivariate logistic regression models with subgroup analysis to study the relationship between CDAI and depression. Generalized additive models were used to determine whether there was a nonlinear association between them. We developed a two-piece linear regression model to calculate the inflection point utilizing a recursive strategy. RESULTS: After adjusting for confounding variables, the odds ratios (ORs; 95 % CI) for the correlation between CDAI and depression were 0.75 (0.67, 0.84). A saturation effect emerged for the overweight group, following which we calculated the inflection point for the overweight population, which displayed ORs (95 % CI) of 0.62 (0.47, 0.80) before the inflection point of 0.83 and the ORs (95 % CI) of 1.01 (0.77, 1.31) after 0.83. The interaction was statistically significant in the sex stratification of the obese population. CONCLUSIONS: Our study highlighted a negative association between CDAI and depression among overweight and obese adults. Saturation effects and sex differences were observed in the overweight population.

Adipose transplantation improves olfactory function and neurogenesis via PKCα-involved lipid metabolism in Seipin Knockout mice.

BACKGROUND: Lipodystrophy-associated metabolic disorders caused by Seipin deficiency lead to not only severe lipodystrophy but also neurological disorders. However, the underlying mechanism of Seipin deficiency-induced neuropathy is not well elucidated, and the possible restorative strategy needs to be explored. METHODS: In the present study, we used Seipin knockout (KO) mice, combined with transcriptome analysis, mass spectrometry imaging, neurobehavior test, and cellular and molecular assay to investigate the systemic lipid metabolic abnormalities in lipodystrophic mice model and their effects on adult neurogenesis in the subventricular zone (SVZ) and olfactory function. After subcutaneous adipose tissue (AT) transplantation, metabolic and neurological function was measured in Seipin KO mice to clarify whether restoring lipid metabolic homeostasis would improve neurobehavior. RESULTS: It was found that Seipin KO mice presented the ectopic accumulation of lipids in the lateral ventricle, accompanied by decreased neurogenesis in adult SVZ, diminished new neuron formation in the olfactory bulb, and impaired olfactory-related memory. Transcriptome analysis showed that the differentially expressed genes (DEGs) in SVZ of adult Seipin KO mice were significantly enriched in lipid metabolism. Mass spectrometry imaging showed that the levels of glycerophospholipid and diglyceride (DG) were significantly increased. Furthermore, we found that AT transplantation rescued the abnormality of peripheral metabolism in Seipin KO mice and ameliorated the ectopic lipid accumulation, concomitant with restoration of the SVZ neurogenesis and olfactory function. Mechanistically, PKCα expression was up-regulated in SVZ tissues of Seipin KO mice, which may be a potential mediator between lipid dysregulation and neurological disorder. DG analogue (Dic8) can up-regulate PKCα and inhibit the proliferation and differentiation of neural stem cells (NSCs) in vitro, while PKCα inhibitor can block this effect. CONCLUSION: This study demonstrates that Seipin deficiency can lead to systemic lipid disorder with concomitant SVZ neurogenesis and impaired olfactory memory. However, AT restores lipid homeostasis and neurogenesis. PKCα is a key mediator mediating Seipin KO-induced abnormal lipid metabolism and impaired neurogenesis in the SVZ, and inhibition of PKCα can restore the impaired neurogenesis. This work reveals the underlying mechanism of Seipin deficiency-induced neurological dysfunction and provides new ideas for the treatment of neurological dysfunction caused by metabolic disorders.

A type 2 immune circuit in the stomach controls mammalian adaptation to dietary chitin.

Dietary fiber improves metabolic health, but host-encoded mechanisms for digesting fibrous polysaccharides are unclear. In this work, we describe a mammalian adaptation to dietary chitin that is coordinated by gastric innate immune activation and acidic mammalian chitinase (AMCase). Chitin consumption causes gastric distension and cytokine production by stomach tuft cells and group 2 innate lymphoid cells (ILC2s) in mice, which drives the expansion of AMCase-expressing zymogenic chief cells that facilitate chitin digestion. Although chitin influences gut microbial composition, ILC2-mediated tissue adaptation and gastrointestinal responses are preserved in germ-free mice. In the absence of AMCase, sustained chitin intake leads to heightened basal type 2 immunity, reduced adiposity, and resistance to obesity. These data define an endogenous metabolic circuit that enables nutrient extraction from an insoluble dietary constituent by enhancing digestive function.

Efectos del entrenamiento de la musculatura inspiratoria en personas con sobrepeso y obesidad / Effects of inspiratory muscle training in overweight and obese people

Objetivo: determinar los efectos que produce el entrenamiento de la musculatura inspiratoria (EMI) en la población con sobrepeso y obesidad respecto al rendimiento funcional, a la capacidad pulmonar y al perfil metabólico.Método: se llevó a cabo una revisión. Las búsquedas se realizaron en Pubmed, Scopus y Web of Science (WOS), usando descriptores: breathing excercise, inspiratory muscle training, inspiratory training, respiratory training y truncamiento de la palabra obes*. Se incluyeron ensayos clínicos publicados en inglés, español o francés desde 2010 hasta diciembre de 2021. Se seleccionaron los estudios que incluyeron población con obesidad/sobrepeso y si se aplicaba EMI.Resultados: se recogieron 15 estudios en la revisión. En total participaron 560 personas. Los estudios mostraron resultados beneficiosos del EMI: aumento de fuerza y resistencia de la musculatura inspiratoria, mejora el rendimiento funcional, disminuyendo el coste de oxígeno, el consumo de oxígeno e incrementando del consumo máximo de oxígeno. No provoca cambios en el perfil lipídico, aunque sí estimula la síntesis de hormona del crecimiento, reduciendo los problemas de hiposomatotropismo derivados de la obesidad. En cuanto a las cirugías bariátricas, el EMI se asoció con reducción de complicaciones derivadas del acto quirúrgico.Conclusión: el EMI es una práctica sencilla que reduce la sensación de disnea, aumenta la tolerancia al ejercicio y, por tanto, mejora la percepción de calidad de vida. Se trata de una terapia que se incluye en muchos programas de cuidados de Enfermería en el área hospitalaria y que puede ser aplicable en Atención Primaria y en el ámbito domiciliario.(AU)

Objective: to determine the effects caused by inspiratory muscle training (IMT) in the population with overweight and obesity regarding their functional performance, pulmonary volume, and metabolic profile.Method: a review was conducted. There were searches in Pubmed, Scopus and Web of Science (WOS), using the descriptors: breathing exercise, inspiratory muscle training, inspiratory training, respiratory training, and truncation of the term “obes”. Clinical trials published in English, Spanish or French were included, since 2010 to December 2021. Those studies including population with obesity / overweight and application of IMT were selected.Results: fifteen (15) studies were included in the review; in total, there were 560 participants. The studies showed beneficial results of IMT: increase in strength and resistance by the inspiratory muscles, improvement in functional performance reducing oxygen cost and oxygen use, and increase in the maximum use of oxygen. This did not entail changes in the lipid profile, although it stimulated growth hormone synthesis, thus reducing the hyposomatotropism problems derived of obesity. Regarding bariatric surgery, IMT was associated with a reduction in complications derived of the surgical act.Conclusion: IMT is a simple practice that reduces the sensation of dyspnea, increases tolerance to exercise and, therefore, improves the perception of quality of life. This therapy is included in many nursing care programs in the hospital setting, and it can be applicable in Primary Care and in the home setting.(AU)

Relación de los índices de adiposidad visceral (VAI) y disfuncional (DAI) con parámetros de obesidad / Visceral adiposity index (VAI) and dysfunctional adiposity index (DAI). Relationship with obesity parameters

Introducción La obesidad es una pandemia mundial con repercusión en morbilidad y mortalidad crecientes. Valoramos la fortaleza asociativa del índice de adiposidad visceral (VAI) y del índice de adiposidad disfuncional (DAI) en obesidad y riesgo asociado utilizando diversos métodos. Material y métodos Estudio transversal en 418.343 trabajadores de diferentes comunidades autónomas en España, estimando prevalencia de obesidad con: perímetro de cintura, Índice cintura/altura, IMC, CUN-BAE, ECORE-BF, RFM, Palafolls, IMG, METS-VF calculados ajustándose a sus fórmulas específicas. Se realizó análisis descriptivo de las variables categóricas y fortaleza asociativa de VAI y DAI para obesidad con curvas ROC considerando riesgo elevado cuando el valor AUC.0,8 y moderado con AUC.0,7 y.0,8. Se utilizó SPSS 27.0, considerando significación estadística p.0,05. Resultados La prevalencia de obesidad varía según el método utilizado, siendo alta con Palafolls (72,92% en mujeres y 86,98% en hombres) y baja con METS-VF (1,31% en mujeres y 8,54% en hombres). Los valores medios de VAI y DAI son siempre superiores en hombres. El AUC de la curva ROC para VAI fue alta con METS-VF: en mujeres 0,836 (intervalo de confianza del 95% [IC 95%] 0,829-0,843), en hombres 0,848 (IC 95% 0,845-0,850) y con perímetro de cintura en hombres: 0,819 (IC 95% 0,816-0,822). DAI fue alto para METS-VF en mujeres: 0,809 (IC 95% 0,801-0,817). Conclusiones La prevalencia de obesidad y riesgo relacionado difiere según el método de valoración utilizado. VAI muestra alta fortaleza asociativa en obesidad y masa grasa para METS-VF en ambos sexos y con perímetro de cintura en hombres; DAI para METS-VF en mujeres (AU)

Introduction Obesity is a global pandemic with a growing impact on morbidity and mortality. We assessed the associative strength of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) in obesity and associated risk using different methods. Material and methods Cross-sectional study in 418 343 workers from different autonomous communities in Spain, estimating prevalence of obesity with: waist circumference, waist/height index, BMI, CUN-BAE, ECORE-BF, RFM, PALAFOLLS, IMG, METS-VF calculated according to their specific formulas. Descriptive analysis of categorical variables and associative strength of VAI and DAI for obesity was performed with ROC curves considering high risk when the AUC value.0.8 and moderate with AUC.0.7 and.0.8. SPSS 27.0 was used, considering statistical significance p.0.05. Results The prevalence of obesity varied according to the method used, being high with Palafolls (72.92% in women and 86.98% in men) and low with METS-VF (1.31% in women and 8.54% in men). The mean values of VAI and DAI are always higher in men. The AUC of the ROC curve for VAI was high with METS-VF: in women 0.836 (95%CI 0.829-0.843), in men 0.848 (95%CI 0.845-0.850) and with waist circumference in men: 0.819 (95%CI 0.816-0.822). DAI was high for METS-FV in women: 0.809 (95%CI 0.801-0.817). Conclusions The prevalence of obesity and related risk differs according to the assessment method used. VAI shows high strength of association with obesity and fat mass for METS-VF in both sexes and with waist circumference in men; DAI for METS-VF in women (AU)

Beneficios de la dieta mediterránea y la actividad física en adolescentes / Benefits of the Mediterranean diet and physical activity in adolescents

Introducción: Más de 340 millones de niños y adolescentes en todo el mundo presentan sobrepeso oobesidad, lo que convierte la obesidad en un problema urgente para la población mundial. Este período dela vida es crucial ya que los rápidos cambios cognitivos, físicos, psicológicos y emocionales afectan la saludy el bienestar. Participar en comportamientos de estilo de vida saludables, como la actividad física o seguiruna dieta, se asocia con un menor riesgo de sufrir enfermedades crónicas y degenerativas en la edadadulta. Objetivo: Describir la importancia de la dieta y la actividad física en adolescentes, valorar el grado deadherencia a estos patrones y resaltar los beneficios que supone participar en estilos de vida saludables. Método: Búsqueda sistemática de la literatura científica publicada en materia de dieta mediterránea yactividad física en este grupo de población. Resultados: Los niños y adolescentes se han ido alejando de estos estilos de vida saludables, generandola necesidad de aplicar estrategias de intervención que promuevan nuevos hábitos en adolescentes, entrelos que se incluya una adecuada alimentación basada en la dieta mediterránea, asociada a un programade actividad física semanal, lo aporta múltiples beneficios tanto a nivel cardio respiratorio, metabólico,musculoesquelético, como cognitivo y emocional. Conclusiones: Se puede resaltar la importancia de aplicar la dieta mediterránea y la actividad física en loshábitos de vida de los adolescentes ya que incluyen numerosos beneficios a nivel físico, cognitivo ypsicológico, necesarios para un correcto desarrollo en esta etapa del desarrollo.(AU)

Introduction: Over 340 million children and adolescents worldwide are overweight or obese, which makesobesity an urgent problem for the world's population. This period of life is crucial since rapid cognitive,physical, psychological, and emotional changes affect health and well-being. Engaging in healthy lifestylebehaviors, such as being physically active or following a diet, is associated with a lower risk of chronic anddegenerative diseases in later life. Objective: Describe the importance of diet and physical activity in adolescents, assess the degree ofadherence to these patterns, and highlight the benefits of participating in healthy lifestyles.Method: Systematic search of the published scientific literature on the Mediterranean diet and physicalactivity in this population group. Results: Children and adolescents have been moving away from these healthy lifestyles, generating theneed to apply intervention strategies that promote new habits in adolescents, including an adequate dietbased on the Mediterranean diet, associated with a program of weekly physical activity, which providesmultiple benefits both at the cardio-respiratory, metabolic, musculoskeletal, cognitive, and emotional levels. Conclusions: The importance of applying the Mediterranean diet and physical activity to the lifestyle ofadolescents can be highlighted since they include numerous benefits at physical, cognitive, andpsychological levels, which are necessary for correct development at this stage of development.(AU)

Analysis of risk factors for non-alcoholic fatty liver disease in hospitalized children with obesity before the late puberty stage.

Objective: This study aimed to determine the clinical characteristics of obese pediatric non-alcoholic fatty liver disease (NAFLD) in central China and verify the applicability of some known risk factors for pediatric NAFLD before late puberty. Methods: This was a retrospective case-control study. A total of 1,029 inpatients at Wuhan Children's Hospital before the late puberty stage were enrolled in the study, including 815 children with obesity (non-NAFLD group) and 214 children with obesity and NAFLD (NAFLD group) diagnosed by liver ultrasound. Subgroup analyses were performed according to sex and puberty. The anthropometric indices and laboratory test data of these 1,029 children were sorted. After intergroup comparison, a logistic regression model was used to determine the risk factors for pediatric NAFLD. Significant risk factors for NAFLD were further tested using receiver operating characteristic (ROC) curves to evaluate their ability to predict an early diagnosis of NAFLD. Results: The NAFLD group had a mean age of 11.03 ± 1.66, with 11.18 ± 1.66 and 10.27 ± 1.45 years for male and female children, respectively (p < 0.05 and p < 0.01, respectively). Even subdivided by both sex and puberty, raised body mass index (BMI), homeostatic model-insulin resistance, triglycerides, alanine transaminase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (γ-GT) were still found in the non-NAFLD and NAFLD groups (p < 0.05 and p < 0.01, respectively). The results of logistic regression analysis showed that BMI (odds ratio [OR], 1.468;95% confidence interval [CI], 1.356-1.590; p<0.001) and ALT (OR, 1.073;95%CI, 1.060-1.087; P<0.001) were two most independent risk factors for NAFLD. The maximal OR for BMI was 1.721 (95% CI, 1.336-2.217). In the female group, the maximal OR of ALT was found to be 1.104 (95% CI, 1.061-1.148). Age and thyroid-stimulating hormone (TSH) and γ-GT levels were also risk factors, but they appeared only in some groups. The results of the ROC analysis showed that ALT was a better predictor of pediatric NAFLD than BMI. The maximum area under the ROC curve in six of the nine groups belongs to ALT. Conclusions: BMI, ALT, and age are risk factors for NAFLD in children with obesity before late puberty. BMI had the greatest exposure risk for NAFLD, and ALT had the highest predictive value for the diagnosis of NAFLD. At the stratified level, for exposure risk, age was specific to the male sex, TSH was specific to the early puberty stage, and γ-GT was specific to the female sex plus the prepuberty stage. On a stratified level, for the female sex, even with age stratification, BMI rather than ALT has a better ability for the diagnosis of NAFLD.

Controlled attenuation parameters to assess liver steatosis in obese patients with polycystic ovary syndrome.

Objectives: This study was performed to investigate the changes and influencing factors of liver controlled attenuation parameter (CAP) in obese patients with polycystic ovary syndrome (PCOS), and to determine the prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) in PCOS patients with obesity. Methods: Forty-one PCOS patients with obesity and twenty age- and body mass index (BMI)-matched control women without PCOS were enrolled in this study. General data, body composition, biochemical parameters, sex hormones, and liver CAP in the two groups were collected and compared. Liver CAP was measured using transient elastography. Results: NAFLD was more common in the Obese PCOS group than in the control group (75.61% vs. 45.00%, P=0.018). Compared to the control group, the obese PCOS group showed apparent increases in alanine transaminase (ALT), aspartate transaminase (AST), CAP, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), totle testosterone (TT), free androgen index (FAI), fasting insulin (FIns), and homeostasis model assessment-insulin resistance (HOMA-IR), along with lower high-density lipoprotein cholesterol (HDL-C) and sex hormone binding globulin (SHBG) levels. In addition, as shown by Spearman analysis, liver CAP in PCOS patients with obesity had a positive correlation with ALT, AST, TG, TT, FAI, FIns, and HOMA-IR, and a negative correlation with SHBG. Logistic regression analysis showed that TG, TT, FIns, and HOMA-IR were risk factors for NAFLD, while TT was an independent risk factor for NAFLD in PCOS patients with obesity. Conclusion: PCOS patients with obesity had a significantly higher prevalence of NAFLD. Furthermore, in PCOS patients with obesity, liver CAP was associated with disorders of lipid metabolism, insulin resistance, and hyperandrogenemia, with elevated testosterone levels being an independent risk factor for NAFLD in PCOS patients with obesity.