Excessive Accumulation Of Adipose Tissue Research Articles

Liraglutide as an innovative and multifunctional drug for patients with obesity – the current state of knowledge and future prospects

Obesity is considered a disease of civilization representing a global health and social problem. Currently, 21% of adult Poles suffer from obesity, so every fifth patient contacted by a doctor is obese. Obesity is a chronic disease, associated with excessive accumulation of adipose tissue, which causes a deterioration in the health and quality of life of an obese patient. It also consequently leads to an increased risk of developing many diseases - including cardiovascular, metabolic and neoplastic diseases. Excessive body weight ranks sixth in importance as a risk factor responsible for the number of deaths worldwide. The mainstay of obesity treatment is lifestyle modification. It includes changing eating habits and increasing physical activity. However, due to the high prevalence of obesity in developed countries, its serious consequences and the unsatisfactory effect of weight loss in some patients with an appropriate diet, pharmacological methods of obesity treatment were searched for. Currently, there are three drugs approved for the treatment of obesity in Poland: orlistat, a combined preparation of naltrexone + bupropion and liraglutide – agonist of a glucagon-like peptide-1 receptor. The effectiveness of one of them - liraglutide - is particularly significant, and the effect of this drug in reducing cardiovascular risk is also promising, which is extremely important in obese patients. For this reason, in the latest recommendations of the Polish Obesity Treatment Association, liraglutide is indicated as the drug of first choice for obese or overweight patients with a BMI ≥27 kg / m2, in whom coexisting: pre-diabetes, type 2 diabetes, arterial hypertension, polycystic ovary syndrome, nonalcoholic fatty liver disease, metabolic syndrome, atherosclerosis or sleep apnea syndrome. Due to the presence of GLP-1 receptors in many organs, the use of liraglutide in the future would probably extend to more diseases than obesity and type 2 diabetes.

Pathomorphological changes in the liver and internal organs in obese cats

Obesity is the accumulation of excessive adipose tissue in the body and is the most common nutritional disorder in pets. Obesity is one of the most prevalent health conditions in companion animals globally. It is associated with premature mortality, metabolic dysfunction, and multiple health conditions across species. Obesity is, therefore, of importance in the field of veterinary medicine. The regulation of adiposity is a homeostatic process vulnerable to disruption by many genetic and environmental factors. Among dogs, cases are found in 22–24 %, and among cats – in 20 % of animals that visited a veterinary clinic. Approximately one-third of cats older than 12 years of age may have a decreased ability to digest fat, whereas one in five may have a compromised ability to digest protein. More than 40 % of dogs between the ages of 5 and 10 years are overweight or obese. Among the risk factors that cause excessive fat deposition is noted: breed, age, sex, sterilization, lifestyle, endocrine diseases, drug treatment and contraception, feeding, social factor, and the number of animals in the household. Obesity, in turn, affects several metabolic processes and is a factor that affects the development of pathological processes: dyslipidemia, hyperlipidemia, insulin resistance, hyperinsulinemia, type 2 diabetes, excessive deposition of fat in the liver and pancreas, coronary heart disease, disease gallbladder, osteoarthritis, urethral sphincter dysfunction, may increase the risk of certain types of cancer. For research, two groups of cats aged 3–7 years were formed, but breed data were not taken into account. Laboratory blood tests confirmed the clinical observations of specialists regarding overweight cats. The pathoanatomical autopsy with subsequent pathohistological studies made it possible to finally confirm the diagnosis of obesity, which was accompanied by fatty dystrophy of internal organs.

Essential amino acid enriched meal replacement improves body composition and physical function in obese older adults: A randomized controlled trial.

Older adults are threatened by the risk of muscle atrophy and excess accumulation of adipose tissue. The objective of this study was to determine whether an essential amino acid enriched meal replacement would reduce excess fat and foster skeletal muscle retention, potentially improving physical function in this cohort. Using a double blind, randomized controlled trial, we compared the influence of an experimental meal replacement enriched with essential amino acids (EMR) to a commercially available, widely used meal replacement (Optifast®) provided once/day (q.d.) for four weeks on body composition, skeletal muscle and physical function in obese older participants. Twenty-eight individuals completed either EMR (n=13) or Optifast® (n=15) supplementation protocols. Measurements of body composition, thigh skeletal muscle cross-sectional area (CSA), blood panels, intrahepatic lipid, and physical function were completed pre- and post-supplementation. Body fat mass, visceral fat mass and volume, and intrahepatic lipid were reduced with EMR but not with Optifast®. Thigh muscle CSA increased (Δ 2.4±3.0cm2) with EMR but not Optifast® (Δ-1.8±6.0cm2). There was a significant increase in the distance covered during the 6-min walk test with EMR (Δ 23±27m) but no change in Optifast® (Δ 11±37m). Beneficial alterations in fat and muscle support the use of EMR-based meal replacements in obese older adults. ISRCTN registry under Reference Number ISRCTN15814848.

234 Microrna-199a-3p Does not Alter Stearoyl-CoA Desaturase Expression in Vitro

Abstract The presence of subcutaneous adipose tissue in excess on a carcass can significantly contribute to financial losses for the producer and processor. Technology with the potential to limit this excess accumulation of adipose tissue could provide another avenue to improve animal efficiency. Stearoyl-CoA desaturase 1 (SCD1) has been identified as a potential genetic target, as it seems tohave a crucial role in fatty acid metabolism. MiR-199a-3p has been reported to alter the expression of SCD-1, in-vitro, in mouse adipocytes; a connection has yet to be formed in large mammal adipocytes. Texel-Suffolk (n=5) and Suffolk-Suffolk (n=4) cross lambs were finished to 203 days of age, and subcutaneous fat was harvested. Primary pre-adipocytes were isolated from both breeds. Pre-adipocytes were then propagated, differentiated, and treated over a 3-day period. Treatments consisted of controls, AgomiR-199a-3p (50nm), and AntagomiR-199a-3p (500nm). Cells were harvested daily over the 3 days to determine if day-to-day differences were present. MiR-199a-3p expression was upregulated in AgomiR treatments compared with controls beginning on d 1 to 3 (P< 0.05). MiR-199a-3p expression in the AgomiR treatment was upregulated more on day 1 in comparison with d 2 and 3 (P< 0.05). MiR-199a-3p expression was downregulated in AntagomiR treatments compared with controls beginning on d 1 to 3 (P< 0.05). MiR-199a-3p expression in the AntagomiR treatment was downregulated more on d 2 in comparison with d 1 and 3 (P< 0.05). MiR-199a-3p expression did not differ between the non-treatment control and Lipofectamine control over the treatment period (P > 0.05). Data showed no significant alteration in SCD-1 expression between treatments or between days (P > 0.05). MiR-199a-3p expression can be altered using AgomiR and AntagomiRs, but SCD-1 expression is unaffected. Thus, additional research is needed to examine targets of miR-199a-3p in ovine.

Percutaneous full-endoscopic uniportal decompression for the treatment of symptomatic idiopathic lumbar spinal epidural lipomatosis: Technical note.

BackgroundLumbar spinal epidural lipomatosis (SEL) is a rare condition characterized by an excessive accumulation of adipose tissue within the spinal canal, compressing the dura sac and/or nerve roots. When conservative treatments fail and clinical symptoms progress quickly and seriously, surgical decompression should be considered. With the rapid development of endoscopic armamentaria and techniques, the pathological scope that can be treated by percutaneous endoscopic spine surgery is ever expanding.ObjectiveIn this paper, the authors describe a patient with lumbar spinal epidural lipomatosis who was treated with a percutaneous full-endoscopic uniportal decompression surgery successfully. This article aims to validate the feasibility of percutaneous full-endoscopic uniportal decompression for the treatment of symptomatic idiopathic spinal epidural lipomatosis via interlaminar approach.MethodsWe describe a case of a 69-year-old man with a 10-year history of low back pain, intermittent claudication, and bilateral leg neuropathic pain. He was diagnosed with lumbar epidural lipomatosis, which did not respond to conservative therapy. After a comprehensive evaluation, he underwent percutaneous endoscopic spine surgery to remove hyperplastic adipose tissue and decompress nerve roots and dura sac.ResultsThe patient was treated with a percutaneous full-endoscopic uniportal decompression surgery successfully. After the procedure, his leg pain decreased and his walking capacity improved. There were no surgery-related complications, such as cerebrospinal fluid leakage, incision infection, etc.ConclusionsThe case with SEL was successfully treated with a percutaneous full-endoscopic uniportal surgery, which has the advantages of excellent presentation of anatomical structures, expanded field of vision, less surgical-related trauma, and bleeding. The key point of the procedure is to release and cut off the bands which divide the epidural space into small rooms filled with excess adipose tissue.

A new era in gut hormone-based pharmacotherapy for people with obesity.

Obesity, excess adipose tissue accumulation that may impair health, is a major global healthcare challenge that increases the risk of several life-limiting diseases, reduces quality of life and leads to premature mortality. Weight loss improves or leads to the resolution of obesity-related diseases. Lifestyle interventions are the cornerstone for all weight management programmes and lead to health benefits. However, for the majority of people with severe obesity, lifestyle interventions and currently available anti-obesity medications lead to insufficient weight loss to improve their health. For these patients the only effective treatment option is bariatric surgery, which whilst highly effective, is difficult to access and not suitable for everyone, leaving a 'treatment gap' between lifestyle interventions and bariatric surgery. Unfortunately, the history of development of drugs to treat obesity has been marred by poor efficacy and safety issues. This is now set to change as a result of scientific advancements, which have increased the understanding of the role that gut hormones play in regulating energy and glucose homoeostasis. This has led to the development of effective, safe drugs based on gut hormones that target the body's own appetite regulating systems that herald a new era of treatments for people living with obesity.

The effect of obesity on adipose-derived stromal cells and adipose tissue and their impact on cancer.

The significant increase in the incidence of obesity represents the next global health crisis. As a result, scientific research has focused on gaining deeper insights into obesity and adipose tissue biology. As a result of the excessive accumulation of adipose tissue, obesity results from hyperplasia and hypertrophy within the adipose tissue. The functional alterations in the adipose tissue are a confounding contributing factor to many diseases, including cancer. The increased incidence and aggressiveness of several cancers, including colorectal, postmenopausal breast, endometrial, prostate, esophageal, hematological, malignant melanoma, and renal carcinomas, result from obesity as a contributing factor. The increased morbidity and mortality of obesity-associated cancers are attributable to increased hormones, adipokines, and cytokines produced by the adipose tissue. The increased adipose tissue levels observed in obese patients result in more adipose stromal/stem cells (ASCs) distributed throughout the body. ASCs have been shown to impact cancer progression in vitro and in preclinical animal models. ASCs influence tumor biology via multiple mechanisms, including the increased recruitment of ASCs to the tumor site and increased production of cytokines and growth factors by ASCs and other cells within the tumor stroma. Emerging evidence indicates that obesity induces alterations in the biological properties of ASCs, subsequently leading to enhanced tumorigenesis and metastasis of cancer cells. As the focus of this review is the interaction and impact of ASCs on cancer, the presentation is limited to preclinical data generated on cancers in which there is a demonstrated role for ASCs, such as postmenopausal breast, colorectal, prostate, ovarian, multiple myeloma, osteosarcoma, cervical, bladder, and gastrointestinal cancers. Our group has investigated the interactions between obesity and breast cancer and the mechanisms that regulate ASCs and adipocytes in these different contexts through interactions between cancer cells, immune cells, and other cell types present in the tumor microenvironment (TME) are discussed. The reciprocal and circular feedback loop between obesity and ASCs and the mechanisms by which ASCs from obese patients alter the biology of cancer cells and enhance tumorigenesis will be discussed. At present, the evidence for ASCs directly influencing human tumor growth is somewhat limited, though recent clinical studies suggest there may be some link.

Meta-analysis of the effects of palmitic acid on microglia activation and neurodegeneration

Abstract Objectives Evidence suggests that obesity may represent a risk factor for neurodegenerative pathologies including Alzheimer’s disease (AD). With excessive accumulation of adipose tissue, obesity is associated with chronic low-grade inflammation, increased production of adipokines, elevated levels of free fatty acids (FFAs) including palmitic acid (PA), the most abundant saturated fatty acid (SFA) in circulation. Excessive PA has been shown to induce lipotoxicity in many different types of cells including microglia and neuronal cells. We hypothesized that PA may contribute to the development of obesity-associated neurological conditions. Methods This study was designed to examine how increased PA may affect microglia activation and neurodegeneration using QIAGEN Ingenuity Pathway Analysis (IPA). Kramer analysis was used to quantitatively characterize the impact of PA on microglia activation and neurodegeneration. Results Simulated increase of PA enhanced the activities of intermediating molecules including CCL5, IL1β, IL1RN, IL6, NF-κB, NOS2, PTGS2, TLR2, TLR4, and TNF. Increased PA level induced microglia activation with a z score of 2.38 (p=0.0173) and neurodegeneration with a z score of 1.55 (p=0.121). Increased PA level also activated neuroinflammation signaling pathway, the top canonical pathway associated with both microglia activation and neurodegeneration. Conclusions Our IPA analysis demonstrated that increased PA significantly induced microglia activation and might augment neurodegeneration by altering the activities of key intermediating molecules and canonical pathways. Our findings shed light on how increased PA level may contribute to the development of neurodegenerative pathologies in the course of obesity.

ЗАТЛЪСТЯВАНЕТО – ПАНДЕМИЯ, ЗА КОЯТО СЕ ГОВОРИ ТИХО

In this report, Ms. Baneva and Mr. Dinev want to give voice to a problem that is spoken of quietly and present our practice for solving this problem to adolescents. Obesity is an official disease defined as such in 1998 by the WHO and is due to excessive accumulation of adipose tissue in a person’s body. This is a complex disease that leads to a number of other complications and diseases. The good practice we share with this report is a binary lesson on „Obesity – a pandemic that is talked about quietly“, conducted with students in 1bth grade and students from 2nd grade in an all-day form of training in St. Constantine and Helena Primary School. „Cyril and Methodius“, Gotse Delchev.

New Discovered Adipokines Associated with the Pathogenesis of Obesity and Type 2 Diabetes.

Obesity is defined as abnormal or excessive accumulation of adipose tissue, closely associated with the increased risk of various comorbidities, especially type 2 diabetes mellitus (T2DM). Adipose tissue is a complex structure responsible for not only fat storage but also releasing adipokines which may play roles in the pathogenesis and could be developed into biomarkers for diagnosis, treatment and prognosis of obesity-related metabolic diseases. This review aims to summarize several adipokines discovered recently that have promising functions in obesity and T2DM. Among them, the levels of FSTL1, WISP1 and Asprosin in subjects with obesity or diabetes are commonly higher than in normal controls, suggesting that they may be pathogenic. Inversely, SFRP5, Metrnl, NRG4 and FAM19A5 may serve as the protective factors.

Dietary habits, prevalence of obesity and overweight in developed and developing countries

Obesity is the accumulation of excess adipose tissue that affects a person's health and physical and psychosocial well-being. The classification is based on the body mass index, which makes it possible to compare prevalence rates worldwide. Obesity and overweight have become a global epidemic in both developed and developing countries. The objective of this study is to assess the prevalence of obesity and overweight in some countries. The results showed that in the last two decades, the prevalence of obesity and overweight in the world has more than doubled. The predominance of obesity and overweight is more pronounced in Western and Westernized countries, which are more developed, than in developing countries where malnutrition and obesity coexist. This global epidemic is seen in adults, adolescents and children without exception of gender. Obesity and overweight are one of the main factors in the increase of non-communicable diseases such as cardiovascular diseases, diabetes, musculoskeletal disorders and some types of cancer in the world. Poor diet is the main cause of the growing prevalence of obesity.

Spinal Epidural Lipomatosis Causing Lumbar Canal Stenosis: A Pictorial Essay on Radiological Grading and the Role of Bariatric Surgery Versus Laminectomy

Spinal epidural lipomatosis (SEL) is a rare condition characterized by an excessive accumulation of adipose tissue in the spinal canal that can have a compressive effect on intraspinal neuroanatomical structures, leading to clinical symptoms. Several different conservative and surgical treatment strategies have been proposed but the treatment and outcomes remain controversial. There is a lack of severity-based evidence documenting the success of decompressive laminectomy in SEL and there are only anecdotal reports of clinico-radiological success with weight loss from bariatric surgery. This article demonstrates the resolution of SEL in two patients with bariatric surgery with the help of pre and postoperative MR imaging. The authors also highlight the classic “types” of spinal epidural lipomatosis with a surgically relevant grading system and elucidate the existence of concurrent extraspinal lipomatosis (i.e. mediastinal and intra-abdominal lipomatosis), drawing parallels with the natural history of SEL. The controversial question remains whether a symptomatic SEL patient needs a multilevel laminectomy for spinal decompression or bariatric surgery that can indirectly help the spinal condition. We propose that bariatric intervention could be better frontline management in patients with multifocal/multisystem lipomatosis (i.e., combined spinal and extraspinal) and spinal decompression would be ideal for those SEL patients with coexisting bony and/or ligamentous spinal canal or foraminal stenosis. This manuscript serves as a comprehensive and contemporary update on the radiological profile and two plausible treatment paths and will look toward further verification by a randomized clinical trial.

The role of adipokines in the development of adipose tissue dysfunction and other metabolic disorders

The role of specific adipokines in the formation of adipose tissue dysfunction is considered. Obesity is a multifactorial disease that is characterized by excessive adipose tissue accumulation in the body and is a risk factor for the development of several other diseases, including type 2 diabetes mellitus, cardiovascular diseases, and non-alcoholic fatty liver disease. Obesity is one of the main causes of chronic diseases and disability in modern society. Adipose tissue takes an active part in cellular reactions and metabolic homeostasis and does not represent inert tissue only for energy storage. In obesity, excessive accumulation of visceral fat causes adipose tissue dysfunction, which greatly contributes to the occurrence of concomitant diseases. Adipose tissue is capable of synthesizing and releasing a large number of hormones, cytokines, extracellular matrix proteins, growth factors, and vasoactive factors, which are collectively called adipokines, affecting various physiological and pathophysiological processes in the body. Perivascular adipose tissue produces cytokines that affect angiogenesis and peripheral vascular resistance. Adiponectin suppresses the production of glucose in the liver and enhances fatty acid oxidation in the skeletal muscles, which together contribute to a favorable metabolic effect in energy homeostasis, protect cells from apoptosis, and reduce inflammation in various cell types through receptor-dependent mechanisms. Leptin modulates vasoconstriction depending on sympathetic activity while resistin is involved in insulin resistance due to inflammation, wherein its high level determines metabolically unhealthy obesity. Additionally, visfatin plays an important role in the pathogenesis of vascular inflammation in obesity and diabetes mellitus while osteopontin regulates the production of inflammatory mediators by immune cells and omentin plays an important anti-inflammatory and insulin-sensitizing role. The production of most inflammatory mediators in adipose tissue dysfunction increases and contributes to the progression of obesity and related metabolic and vascular disorders. Considering adipokines as biological markers of pathological processes is necessary since their study will create prerequisites for preventive measures and will contribute to the positive treatment process.

NUCB2/Nesfatin-1 Reduces Obesogenic Diet Induced Inflammation in Mice Subcutaneous White Adipose Tissue.

Background: Excess adipose tissue accumulation and obesity are characterised by chronic, low-grade, systemic inflammation. Nestfatin-1 is a neuropeptide derived from the precursor protein nucleobindin-2 (NUCB2), which was initially reported to exert anorexigenic effects. The present study aimed to investigate the effects of an obesogenic diet (OD; high-fat, high-sugar) in NUCB2 knockout (KO) mice and of nesfatin-1 treatment in LPS-stimulated 3T3-L1 preadipocytes. Methods: Subcutaneous white adipose tissue (Sc-WAT) samples from wild type (WT) and NUCB2 KO mice that were fed a normal diet (ND), or the OD for 12 weeks were used for RNA and protein extraction, as well as immunohistochemistry. 3T3-L1 cells were treated with 100 nM nesfatin-1 during differentiation and stimulated with 1 µg/mL LPS for measuring the expression and secretion of pro-inflammatory mediators by qPCR, western blotting, immunofluorescence, Bioplex, and ELISA. Results: Following the OD, the mRNA, protein and cellular expression of pro-inflammatory mediators (Tnfα, Il-6, Il-1β, Adgre1, Mcp1, TLR4, Hmbgb1 and NF-kB) significantly increased in the ScWAT of NUCB2 KO mice compared to ND controls. Adiponectin and Nrf2 expression significantly decreased in the ScWAT of OD-fed NUCB2 KO, without changes in the OD-fed WT mice. Furthermore, nesfatin-1 treatment in LPS-stimulated 3T3-L1 cells significantly reduced the expression and secretion of pro-inflammatory cytokines (Tnfα, Il-6, Il-1β, Mcp1) and hmgb1. Conclusion: An obesogenic diet can induce significant inflammation in the ScWAT of NUCB2 KO mice, involving the HMGB1, NRF2 and NF-kB pathways, while nesfatin-1 reduces the pro-inflammatory response in LPS-stimulated 3T3-L1 cells. These findings provide a novel insight into the metabolic regulation of inflammation in WAT.

Вплив гострого інтервального голодування на артеріальний тиск, маркери запалення і метаболічні показники

Obesity is increasingly common in post-industrial societies and poses a threat to public health. The main reason for the accumulation of excess adipose tissue is a violation of human energy balance. Modification of eating behavior is the basis for prevention and treatment of obesity and overweight. The purpose of the study was to examine the effect of acute fasting, over 16 hours in overweight and obese young and middle-aged people, on the level of highly sensitive C-reactive protein, interleukin 1-beta, blood lipids, fasting glucose, daily blood pressure and tolerability. Materials and methods. A prospective study was conducted involving 21 overweight and obese patients with a median age of 51 (28 ÷ 61) years. All hypertensive patients received stable antihypertensive therapy for three months and had office blood pressure targets at enrollment. A daily blood pressure study was performed in all patients using Heaco ABPM50. The test of rational nutrition with the calculation of daily calories was conducted using the program TRP-D02 Ukraine. All patients were tested for fasting glucose, blood lipids, creatinine, and C-reactive protein. All studies were conducted at the beginning and after intermittent fasting. Statistical analysis was performed using SPSS IBM 19.0. Results and discussion. The level of inflammation markers was assessed in all study participants, the level of highly sensitive C-reactive protein decreased from 10.591±8.679 mg/l to 4.861±3.239 mg/l (p >0.05), and the initial level of interleukin-1 beta was 2.704±0.671 pg/ml, which did not change significantly after intermittent fasting – 2.607±0.698 pg/ml (p <0.05). Study participants were divided into two groups, the older age group with body mass index of 32.6±5.0 kg/m2 and the young age group with body mass index of 23.9±2.8 kg/m2 (p <0.01). It was found that after intermittent fasting, the level of triglycerides decreased from 1.8±0.8 to 1.5±0.3 (p = 0.05) mmol/l in the older age group. It was found that during fasting daytime systolic and diastolic blood pressure decreased, and night systolic and diastolic blood pressure increased (p >0.05) in two groups. A balanced diet is a basis for preventing and treating obesity and overweight. A low-calorie diet is often recommended, but not all patients can follow this regimen. A new and alternative method is intermittent fasting with greater adherence in patients. However, there is insufficient data in the world literature on the effects of intermittent fasting, especially acute fasting, on inflammation, blood pressure and tolerability of the fasting period in different age groups. Conclusion. Acute intermittent fasting leads to changes in blood pressure, does not cause hypotension and is well tolerated by overweight and obese patients in the older age group

Different Expression of Micro-RNA in the Subcutaneous and Visceral Adipose Tissue of Obese Subjects.

Obesity is a pathology characterized by an excessive accumulation of adipose tissue and it is a condition associated with complex alterations affecting different organs and systems. Obesity has great influences on cardiovascular and respiratory morbidity and mortality, and impairs the multiple aspects of metabolism. Since micro-RNAs (miRNAs) are thought to play a role in the regulation of various pathological processes, in this complex framework, the investigation of these classes of noncoding regulatory RNA seems to be promising. Selected group of obese subjects was recruited. We analyzed the expression of seven miRNAs from obese adipose tissue supposed to have a role in the pathogenesis of cardiovascular and respiratory disease related to obesity and we compared it with the expression of the same miRNAs in a group of nonobese controls. In this study what emerged is miR-27b and miR-483 significant downregulation in subcutaneous adipose tissue from obese group compared with nonobese ones. For visceral adipose tissue, a significant decrease in miR-27b and miR-223 expression was observed in obese group. Moreover, a different expression of miR-26a and miR-338 in the obese group was found. Those findings could help the individuation of previously unknown key players in the development of different diseases usually associated with obesity, such as cardiovascular and pulmonary diseases. Clinical Trials.gov ID: Ref 17/CE/2014.

Historical and cultural aspects of obesity: From a symbol of wealth and prosperity to the epidemic of the 21st century.

World Health Organization defines obesity as abnormal or excess adipose tissue accumulation. Nowadays, this condition is a serious threat to the public health in most countries around the world. Obesity adversely affects physical, mental, and in most cultures, social well-being. However, throughout the ages-from ancient times to the 21st century-this condition has been subject to various interpretations. As a matter of fact, obesity has not always been regarded as a disease. For many decades, excessive body weight has been considered rather a symbol of health. It was a marker of wealth and prosperity, as well as a sign of high social status. The centuries that passed on the development of science and medicine have gradually changed its face, but significant progress in understanding the causes and consequences of obesity has been made in the last 30 years. This paper presents the historical outline of obesity and its treatment from ancient times to the present-from its affirmation to the epidemic in the late 20th and 21st century.

Vitamin D deficiency: a potential risk factor for cancer in obesity?

Obesity is considered an abnormal or excessive accumulation of adipose tissue, due to a prolonged positive energy balance that arises when energy intake is greater than energy expenditure, leading to an increased risk for the individual health and for the development of metabolic chronic diseases including several different types of cancer. Vitamin D deficiency is a metabolic alteration, which is often associated with the obesity condition. Vitamin D is a liposoluble vitamin, which plays a pivotal role in calcium-phosphate metabolism but extraskeletal effects have also been described. Among these, it plays an important role also in adipocyte physiology and glucose metabolism, typically dysregulated in subjects affected by obesity. Moreover, it is now recognized that Vitamin D also influences the processes of cell proliferation, differentiation, adhesion potentially leading to carcinogenesis. Indeed, data indicate a potential link between vitamin D levels and cancer, and higher vitamin D concentrations have been associated with a lower risk of developing different kinds of tumors, including breast, colon, lymphoma, lung, and prostate cancers. Thus, this review will revise the literature regarding this issue investigating and highlighting the potential mechanism of action, which might lead to new therapeutical options.

HEPATIC STEATOSIS IN SCHOOLCHILDREN AND ADOLESCENTS WITH CENTRAL OBESITY

Introduction: Non-alcoholic hepatic steatosis is defined as the excessive accumulation of adipose tissue in the absence of alcohol consumption, being rare in the pediatric population. However, with the advent of the twentieth century pandemic, such as obesity, this pathology has increased its incidence, as well as others that belong to the metabolic syndrome. Objective: To determine the presence of hepatic steatosis in schoolchildren and adolescents with central obesity. Methods: observational, descriptive and cross-sectional research. The sample was of a census type, represented by 32 schoolchildren and adolescents who met the inclusion criteria, which are: age between 6 and 19 with central obesity - prior signing the informed consent. They underwent measurement of the waist circumference, abdominal ultrasound, measurement of the lipid profile and the determination of the level of physical activity through the application of the Pictorial Questionnaire of Infant Physical Activity. Results: 32 patients were studied, 18 (56.3%) male, adolescents 59.37%. With normal ultrasound (29/32) and with hepatic steatosis (3/32), of which 66.7% are grade II and 33.3% are grade III. Hypertriglyceridemia and borderline triglyceride levels 81.27% and hypercholesterolemia and borderline cholesterol levels 75%. Conclusion: School and adolescent patients with central obesity have borderline lipid profiles or dyslipidemia, in which, despite belonging to the pediatric population, moderate and severe cases of hepatic steatosis are evident.
 Keywords: fatty liver, non-alcoholic fatty liver disease, dyslipidemia, obesity.

Pretilost u dječijoj dobi

According to the International Classification of Diseases, Eleventh Revision, ICD-11, obesity is classified as an endocrine disease, dietary and metabolic disease (ICD-XI; E66). It is a chronic multifactorial disease accompanied by abnormal or excessive accumulation of adipose tissue that poses a health risk. The World Health Organization describes the epidemic of childhood obesity as: "One of the most serious public health challenges of the 21st century". According to the same, 41 million children under the age of 5 and 340 million children and adolescents aged 5 to 19 are overweight or obese. Obesity can have a significant impact on health, well-being (social and psychological) and self-esteem of the child. It is associated with poor academic performance and the lower quality of life a child experiences. An obese child requires an individually tailored multidisciplinary approach. Diagnosis requires a thorough clinical examination that identifies the etiology of obesity, comorbidities present, eating habits, physical activity, social, family, and psychological factors that predispose obesity, readiness, and motivation for treatment. Obesity therapy primarily aims to permanently change the child's eating habits and lifestyle.