Normal-weight Men Research Articles

Metabolic syndrome prevalence has increased in Finland from 2000 to 2023

Abstract Obesity presents a metabolic burden that leads to increased non-communicable disease (NCD) morbidity with metabolic syndrome (MS) as a pathway. The aim was to examine the trends in the obesity and MS prevalences. The study included health examination survey data collected in 2000 and 2023 (n = 7 258, 20-64 years). Examination measurements, blood samples, questionnaires, and register data were collected. MS criteria (ATPIII/AHA) included at least 3 of the following: increased waist circumference, elevated fasting glucose or medication, elevated triglyceride or medication, elevated blood pressure (BP) or medication, and decreased HDL-cholesterol or medication. Participants were divided according to BMI (normal weight 18.5-24.9 kg/m2, overweight 25.0-29.9 kg/m2, obesity 30.0-34.9 kg/m2, severe obesity = >35.0 kg/m2). Weighted prevalence and 95% confidence intervals (CIs) of MS and obesity were calculated considering sampling design and non-response. Prevalences of normal weight decreased from 2000 (men 32%, 95% CI 30-35; women 45%, 95% CI 43-47) to 2023 (men 26%, 95% CI 23-28; women 34%, 95% CI 32-37) and obesity increased from 2020 (men 17%, 95% CI 15-18; women 15%, 95% CI 14-17) to 2023 (men 20%, 95% CI 18-22; women 18%, 95% CI 16-20) as did severe obesity (in 2000: men 4%, 95% CI 3-5; 6%, 95% CI 5-7 - in 2023 men10%, 95% CI 8-12; women 13%; 95% CI 11-14). The prevalence of MS increased from 37% (95% CI 34-39) to 45% (95% CI 43-48) in men and 30% (95% CI 28-32) to 37% (95% CI 34-39) in women. The prevalence of MS with obesity varied from 2000 to 2023 from 73-77% in men and 69-61% in women and with severe obesity from 88-91% in men and 79-76% in women. From 2000 to 2023, no MS components remained stable with normal weight (men 29-25%, women 44%) and obesity (both sexes <1%). The prevalence of MS has increased in the last 20 years. Obesity is a major risk factor for MS that increases the future burden MS and, consequently, of NCD on societies. Key messages • Metabolic syndrome has increased in Finland from 2000 to 2023. At the same time, the prevalence of those with normal weight has decreased and severe obesity increased. • The global obesity pandemic will further increase the burden of NCD’s in the future. This is already visible with increasing metabolic syndrome prevalence.

Assessment of Paraoxonase 1 and Arylesterase Activities and Lipid Profile in Bodybuilders: A Comparative Study of Physical Activity and Anthropometry on Atherosclerosis.

Background and Objectives: Atherosclerosis, driven by dyslipidaemia and oxidative stress, is a leading cause of cardiovascular morbidity and mortality. This study evaluates the effects of vigorous-intensity bodybuilding exercise (VIBBE) on atherosclerosis biomarkers-including paraoxonase-1 (PON1) and arylesterase (ARE) activities-and lipid profiles in male bodybuilders who do not use anabolic-androgenic steroids. Comparisons were made with individuals engaged in moderate-intensity aerobic exercise (MIAE), as well as overweight/obese sedentary (OOS) and normal-weight sedentary (NWS) individuals. Materials and Methods: A cross-sectional study was conducted involving 122 healthy male participants aged 18-45 years, divided into four groups: VIBBE (n = 31), OOS (n = 30), MIAE (n = 32), and NWS (n = 29). Anthropometric assessments were performed, and fasting blood samples were collected for biochemical analyses, including lipid profiles and PON1 and ARE activities. Statistical analyses compared the groups and evaluated correlations between adiposity measures and atherosclerosis biomarkers. Results: The VIBBE group exhibited significantly lower levels of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and logarithm of the TG to high-density lipoprotein cholesterol (HDL-C) ratio [log(TG/HDL-C)] compared to the OOS group (p < 0.05 for all), indicating improved lipid profiles. However, these improvements were not significant when compared to the NWS group (p > 0.05), suggesting that VIBBE may not provide additional lipid profile benefits beyond those associated with normal weight status. PON1 and ARE activities were significantly lower in the VIBBE group compared to the MIAE group (p < 0.05 for both), suggesting that VIBBE may not effectively enhance antioxidant defences. Correlation analyses revealed significant inverse relationships between PON1 and ARE activities and adiposity measures, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat percentage (BFP), fat mass index (FMI), and obesity degree (OD) (p < 0.05 for all). Positive correlations were observed between oxLDL and log(TG/HDL-C) and adiposity measures (p < 0.05 for all). Conclusions: Vigorous-intensity bodybuilding exercise improves certain lipid parameters compared to sedentary obese individuals but does not significantly enhance antioxidant enzyme activities or further improve lipid profiles beyond those observed in normal-weight sedentary men. Conversely, moderate-intensity aerobic exercise significantly enhances PON1 and ARE activities and improves lipid profiles, offering superior cardiovascular benefits. These findings underscore the importance of incorporating moderate-intensity aerobic exercise into physical activity guidelines to optimize cardiovascular health by balancing improvements in lipid metabolism with enhanced antioxidant defences.

TLCD4 as Potential Transcriptomic Biomarker of Cold Exposure.

(1) Background: Cold exposure induces metabolic adaptations that can promote health benefits, including increased energy disposal due to lipid mobilization in adipose tissue (AT). This study aims to identify easily measurable biomarkers mirroring the effect of cold exposure on AT. (2) Methods: Transcriptomic analysis was performed in peripheral blood mononuclear cells (PBMCs) and distinct AT depots of two animal models (ferrets and rats) exposed to cold, and in PBMCs of cold-exposed humans. (3) Results: One week of cold exposure (at 4 °C) affected different metabolic pathways and gene expression in the AT of ferrets, an animal model with an AT more similar to humans than that of rodents. However, only one gene, Tlcd4, was affected in the same way (overexpressed) in aortic perivascular and inguinal AT depots and in PBMCs, making it a potential biomarker of interest. Subsequent targeted analysis in rats showed that 1 week at 4 °C also induced Tlcd4 expression in brown AT and PBMCs, while 1 h at 4 °C resulted in reduced Tlcd4 mRNA levels in retroperitoneal white AT. In humans, no clear effects were observed. Nevertheless, decreased PBMC TLCD4 expression was observed after acute cold exposure in women with normal weight, although this effect could be attributed to short-term fasting during the procedure. No effect was evident in women with overweight or in normal-weight men. (4) Conclusions: Our results obtained for different species point toward TLCD4 gene expression as a potential biomarker of cold exposure/fat mobilization that could tentatively be used to address the effectiveness of cold exposure-mimicking therapies.

Ramadan Intermittent Fasting and Plasma Volume Variations in Individuals with Different Body Weights.

Background: There is increasing awareness of the physiological effects of Ramadan intermittent fasting (RIF) in obese subjects. However, there are no data on the effects of RIF on plasma volume changes (ΔPV) in individuals with different body weights. Background and Objectives: This study investigated the effects of RIF on ΔPV in normal-weight (NW) and overweight (OW) adult men, and adult men with obesity (OB) and severe obesity (SO). Materials and Methods: Thirty-two male subjects (32) were divided into four groups (n = 8 per group) according to their body mass index (BMI): normal weight (NW) (BMI < 25 kg/m2; age = 27.4 ± 3.8), overweight (OW) (BMI between 25 and 29.9 kg/m2; age = 26.8 ± 3.7), obese subjects (OB) (BMI between 30 and 34.9 kg/m2; age = 25.6 ± 2.9), and severely obesity (SO) (BMI between 35 and 40 kg/m2; age = 24.0 ± 4.1). Blood samples were collected for 24 h on 4 different occasions, at T0 before the start of the Ramadan month, at T1 15 days after the start of Ramadan, at T2 one day after the end of Ramadan, and at T3 on the 21st day after the end of Ramadan to determine ΔPV. All groups completed their fasting rituals for the 30 days of Ramadan. Results: A significant group × time effect occurred for body mass (p = 0.001; ES = 0.53), BMI (p = 0.001; ES = 0.53), and body fat percentage (p = 0.001; ES = 0.52). Post hoc tests indicated reductions in body mass in OB and SO at T1 (p = 0.03; ES = 0.21 and p = 0.002; ES = 0.12) and T2 (p = 0.03; ES = 0.31 and p = 0.02; ES = 0.23), reductions in BMI in OB and SO at T1 (p = 0.04; ES = 0.35 and p = 0.03; ES = 0.42) and T2 (p = 0.03; ES = 0.52 and p = 0.005; ES = 0.48), and reductions in body fat percentage only in OB AT T1 (p = 0.002; ES = 0.31) and T2 (p = 0.001; ES = 0.17). A significant group × time effect occurred for hematocrit (p = 0.02; ES = 0.34), hemoglobin (p = 0.01; ES = 0.35), and ΔPV (p = 0.02; ES = 0.18). Post hoc tests indicated increases in hematocrit in OB at T2 (p = 0.03; ES = 0.36) and hemoglobin in OB and SO at T1 (p = 0.03; ES = 0.35 and p = 0.002; ES = 0.32) and T2 (p = 0.003; ES = 0.21 and p = 0.002; ES = 0.33). There were also increases in ΔPV in OB at T1 and T2 (p = 0.002; ES = 0.25 and p = 0.003; ES = 0.22) and in SO only at T2 (p = 0.02; ES = 0.37). Contrast analysis indicated that NW was significantly lower than the grand mean of OW, Ob, and SO for all anthropometric and PVV variables (all p < 0.05). Conclusions: The effects of RIF on ΔPV and anthropometric characters was greater in obese individuals compared to normal-weight and overweight participants, suggesting that the improvements in body composition and ΔPV produced by RIF could positively influence obesity.

CARDIORESPIRATORY FITNESS, HIGH BODY FAT PERCENTAGE AND THE RISK OF CORONARY CALCIFICATION IN MIDDLE–AGED MEN

Objective: Low levels of cardiorespiratory fitness (CRF) have been showed to increase the risk of cardiovascular disease(CVD). We tested the hypothesis that central obesity is associated with coronary artery calcification (CAC), but that fitness attenuates this association. Design and method: We analyzed men who participated in a health screening program. We measured CAC using multidetector computed tomography (MDCT) with a calculation of Agatston coronary artery calcium score. CAC score over 400 were defined as the prevalence of moderate to severe subclinical atherosclerosis. Central obesity was defined as body mass index (BMI) over 25kg/m2 and body fat percentage (BFP) over 30% in men. Fitness was directly measured by peak oxygen uptake (VO2peak) and divided into unfit (low tertile) and fit (middle and upper tertile) categories based on age-specific VO2peak percentiles. Results: Compared with normal weight men, central obese men was associated with a higher prevalence of CAC after adjusting for age, SBP, lipid profile, logCRP, s-glucose, heart rate, diabetes, and hypertension. The fit men was associated with lower odds ratios for having CAC. However, the fit with central obesity had odds ratios for CAC that were similar to those of the fit with normal weight. Conclusions: Our findings demonstrate that BMI and BFP are associated with increased risk of moderate to severe CAC score, but that high fitness appears to attenuate the risk in men.

Silhouette showcards confirm altered obesity-associated body image perception in international cohort study of African-origin populations

ObjectivesGiven the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This...

(199) The Impact of Obesity on Sperm Parameters in Young Adult Males: A Retrospective Study of Sperm Donors

Abstract Introduction Studies estimate that sperm concentrations have declined by 52.4% over the past 40 years. Concurrent with this decline in male fertility, obesity remains a growing epidemic in the United States, with the prevalence in men rising from 26.6% in 1999 to 38.4% in 2016. Thus, this decline in sperm concentration may be attributable to many causes, including lifestyle factors such as obesity. The gold standard diagnostic method for assessing male fertility is semen analysis. Due to screening criteria, sperm banks offer a unique sample of individual-level semen analyses of healthy men without comorbidities including cardiovascular disease, hypertension, heart failure, and diabetes. While the association between BMI and sperm parameters has previously been shown, these studies do not exclude individuals with obesity-related comorbidities, as participants presented as couples who were seeking care for infertility. Objective To utilize a large sample of healthy young men who meet strict sperm bank donor eligibility criteria to evaluate the association between BMI and individual sperm parameters, independent of comorbidities. Methods Sperm parameters from donor candidates at sperm banks across the United States were obtained between 2008 to 2021. Donors were healthy men aged 18-46 years old who abstained from ejaculation for 48 hours prior to donation. Semen samples were analyzed in a Clinical Laboratory Improvement Amendments (CLIA) certified lab using guidelines by the World Health Organization (WHO). A univariable model between BMI and individual sperm parameters (total sperm count, volume, sperm concentration, progressive motility) was conducted. Results There was a total of 135,578 sperm donations included in our study. The median age was 26 (IQR: 8), with 1146 (0.8%) men identified as underweight, 89,590 (66%) as normal weight, 41,362 as overweight (31%), 3,438 (3%) as obesity class I and 42 (0.03%) as obesity class II (Table 1). Participants had a median total motile sperm count of 194 (IQR: 134 million), volume of 3.45 (IQR: 1.8mL), sperm concentration of 58 (IQR: 34 million/mL) and a motility of 61.5 (IQR: 18%). We found that total motile sperm count (B = -69, p &amp;lt; 0.01) and volume (B = -1.14, p &amp;lt;0.01) were significantly lower in men with a BMI ≥ 35, compared to normal weight men (sperm count = 213 million; volume = 3.67 mL; Table 2). Conclusions We report significantly lower total sperm count and semen volume in healthy young men who have a BMI ≥ 35 as compared to those who are normal weight. Although these values are within the normal range of sperm parameters established by the WHO, our ability to detect differences even within this specific population of men without obesity-related comorbidities highlights the importance of maintaining a healthy weight for preserving high sperm counts. With the increase in infertility concerns amongst younger men and the rise of obesity prevalence within the United States, our work highlights the importance of maintaining a healthy diet and exercise regimen throughout early adulthood to maintain normal sperm parameters. Disclosure No.

Interactions of obesity, body shape, diabetes and sex steroids with respect to prostate cancer risk in the UK Biobank cohort.

Obesity and diabetes are associated inversely with low-grade prostate cancer risk and affect steroid hormone synthesis but whether they modify each other's impact on prostate cancer risk remains unknown. We examined the independent associations of diabetes, body mass index (BMI), 'a body shape index' (ABSI), hip index (HI), circulating testosterone, sex hormone binding globulin (SHBG) (per one standard deviation increase) and oestradiol ≥175 pmol/L with total prostate cancer risk using multivariable Cox proportional hazards models for UK Biobank men. We evaluated multiplicative interactions (pMI ) and additive interactions (relative excess risk from interaction (pRERI ), attributable proportion (pAR ), synergy index (pSI )) with obese (BMI ≥30 kg/m2 ) and diabetes. During a mean follow-up of 10.3 years, 9417 incident prostate cancers were diagnosed in 195,813 men. Diabetes and BMI were associated more strongly inversely with prostate cancer risk when occurring together (pMI = 0.0003, pRERI = 0.032, pAP = 0.020, pSI = 0.002). ABSI was associated positively in obese men (HR = 1.081; 95% CI = 1.030-1.135) and men with diabetes (HR = 1.114; 95% CI = 1.021-1.216). The inverse associations with obesity and diabetes were attenuated for high-ABSI ≥79.8 (pMI = 0.022, pRERI = 0.008, pAP = 0.005, pSI <0.0001 obesity; pMI = 0.017, pRERI = 0.047, pAP = 0.025, pSI = 0.0005 diabetes). HI was associated inversely in men overall (HR = 0.967; 95% CI = 0.947-0.988). Free testosterone (FT) was associated most strongly positively in normal weight men (HR = 1.098; 95% CI = 1.045-1.153) and men with diabetes (HR = 1.189; 95% CI = 1.081-1.308). Oestradiol was associated inversely in obese men (HR = 0.805; 95% CI = 0.682-0.951). The inverse association with obesity was stronger for high-FT ≥243 pmol/L (pRERI = 0.040, pAP = 0.031, pSI = 0.002) and high-oestradiol (pRERI = 0.030, pAP = 0.012, pSI <0.0001). The inverse association with diabetes was attenuated for high-FT (pMI = 0.008, pRERI = 0.015, pAP = 0.009, pSI = 0.0006). SHBG was associated inversely in men overall (HR = 0.918; 95% CI = 0.895-0.941), more strongly for high-HI ≥49.1 (pMI = 0.024). Obesity and diabetes showed synergistic inverse associations with prostate cancer risk, likely involving testosterone reduction for diabetes and oestrogen generation for obesity, which were attenuated for high-ABSI. HI and SHBG showed synergistic inverse associations with prostate cancer risk.

Relationship between the thrombospondin-1/Toll-like receptor 4 (TSP1/TLR4) pathway and vitamin D levels in obese and normal weight subjects with different metabolic phenotypes

Thrombospondin-1 (TSP1) contributes to obesity-associated inflammation via activating Toll-like receptor 4 (TLR4). The regulatory role of vitamin D on this pathway has been suggested. This study aimed to investigate the relationship between TSP1/TLR4 pathway and vitamin D in obese and normal weight subjects with different metabolic phenotypes. Thirty obese and thirty normal weight men were selected. Anthropometric parameters and serum TSP1, TLR4, TNF-α, vitamin D, and metabolic profile were determined. Metabolic phenotypes of obese and normal weight subjects were determined. Findings revealed enhanced TSP1/TLR4/TNF-α levels and reduced 25(OH)D levels in obese compared to normal weight subjects and metabolically unhealthy compared to metabolically healthy subjects. TSP1 correlated positively with parameters of unhealthy metabolic profile. TSP1, TLR4 and TNF-α levels significantly negatively correlated with vitamin D levels. In conclusion, vitamin D might exert a regulatory role on TSP1/TLR4 pathway, providing a potential mechanism that links hypovitaminosis D with risk of metabolic dysfunction.

Sex Differences in the Associations of Obesity with Tau, Amyloid PET, and Cognitive Outcomes in Preclinical Alzheimer's Disease: Cross-Sectional A4 Study.

The association between obesity and Alzheimer's disease (AD) is complex. Recent studies indicated the relationships between obesity and AD may differ by sex, and women may benefit from being overweight in terms of AD risk. We investigated whether sex modifies the associations of obesity with tau positron emission tomography (PET), amyloid PET, and cognition in preclinical AD. We included 387 cognitively-unimpaired amyloid-positive participants (221 women, 166 men, 87.6% non-Hispanic White) with available 18F-flortaucipir PET, 18F-florbetapir PET, and completed the Preclinical Alzheimer Cognitive Composite (PACC) tests from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study. Participants were categorized based on body mass index (BMI: kg/m2): normal-weight (BMI: 18.5-25), overweight (BMI: 25-30), and obese (BMI≥30). Significant sex by BMI category interactions on PACC and its components: Mini-Mental State Examination (MMSE) and Reminding Test-Free+Total Recall (FCSRT96) revealed that overweight and obese women outperformed normal-weight women on FCSRT96, while obese men showed poorer MMSE performance than normal-weight men. These interactions were independent of APOE4. There were no significant interactions of sex by BMI category on tau and amyloid PET. However, sex-stratified analyses observed obesity was associated with less regional tau and mean cortical amyloid in women, not in men. This study found that in preclinical AD, overweight and obesity were associated with better verbal memory in women, whereas obesity was associated with worse global cognition among men. Future studies focusing on the mechanism for this relationship may inform sex-specific interventions for AD prevention.

Levels of leptin, irisin, oxytocin and insulin in obese and normal weight Iraqi young men

Introduction and Aim: Obesity is a serious, life-threatening health condition that is prevalent in Iraq and the world as a whole. Since Leptin, irisin, oxytocin and insulin are proposed to play main roles in energy expenditure, glucose homeostasis, regulating body weight, reducing obesity and improving life expectancy so the aim of this study was to evaluate the concentrations of these anti-obesity hormones plus insulin resistance Materials and Methods: The study was conducted on 100 obese young men with a mean age of 29.95 years and fifty normal weight young men with a mean age of 28.44. Results: In obese men, the mean leptin concentration was 24.08±9.91 ng/ml which was significantly higher than in normal weight men 5.48 ng/ml. Serum irisin levels in obese men and normal weight were 8.9 ng/ml, 2.4 ng/ml respectively, and it was significantly higher in obese group in comparison to the normal weight group. The mean serum oxytocin concentration was significantly lower in obese group 6.41pg/ml in comparison to normal weight 29.55 pg/ml. Serum insulin levels in obese and normal weight were 19.55±5.56 and 3.64 micro lU/ml respectively and it was significantly higher in obese men. The mean fasting blood glucose concentration in obese men was 98.67mg/dl and it was significantly higher than in normal weight 84±9.85 mg/ml. Insulin resistance (HOMA IR) was significantly higher in obese men 6.6 than in normal weight 0.68. Conclusion: Serum levels of leptin, irisin, insulin, and insulin resistance are higher in obese young men, while oxytocin levels were noticeably low. Our study also shows that obesity increases the likelihood of insulin resistance.

O-071 Paternal body mass index affects early embryo development but does not impact clinical outcomes: a timelapse study of 7,656 embryos in oocyte donation cycles

Abstract Study question Does paternal body mass index (BMI) affect preimplantation development and clinical outcomes in oocyte donation cycles? Summary answer High paternal BMI was associated with delays in early development and poorer embryo quality on day 3, but this did not adversely affect pregnancy outcomes. What is known already Maternal obesity is known to negatively affect preimplantation development and clinical outcomes. While oocyte competence plays a major role in early embryogenesis, male obesity has been linked to poorer semen parameters and epigenetic alterations in sperm. Such characteristics may inherently compromise preimplantation development and ultimately impair reproductive success. Only a few reports have assessed the effects of male BMI on the progression of cell divisions and embryo morphokinetic patterns. However, current findings remain contradictory, while the effects of male obesity on fertility continue to be understudied. Study design, size, duration This retrospective study included 7,656 embryos from 1,342 oocyte donation ICSI cycles, performed between April 2018 and December 2021 across two fertility centres. Sperm originated from the partner (n = 1087) or donor (n = 255) and was either fresh (n = 460) or frozen (n = 835). Only the first fresh (n = 1,140) or frozen (n = 202) embryo transfer (ET) was considered. Our database included 1,089 single and 238 double ETs performed at either the cleavage (n = 424) or blastocyst stage (n = 903) of development. Participants/materials, setting, methods Males were stratified according to BMI, based on WHO guidelines, defined as: normal weight (BMI&amp;lt;24.9, n = 677); pre-obese, (BMI=25.0–29.9, n = 533); and obese (BMI&amp;gt;30, n = 132). Patients with severe male factor and preimplantation genetic testing cycles were excluded. Univariate analyses and logistic regression were used to evaluate associations between BMI, embryo morphokinetics and clinical outcomes. Analyses were adjusted for various confounders pertaining to patient demographics, sperm and cycle parameters. A p-value of &amp;lt; 0.05 was considered significant. Main results and the role of chance Overall, obese men displayed poorer sperm motility and underwent more day 2-4 embryo transfers and freeze-all cycles, compared to pre-obese and normal weight men (p &amp;lt; 0,05). Fertilization rates were not affected by male BMI (77.0% ± 18.9 normal weight; 77.4% ± 18.1 pre-obese; 75.3% ± 19.9 obese; p = 0.62), also in our adjusted analysis. Several morphokinetic parameters were delayed in embryos from pre-obese and obese patients, including pronuclei fading (tPNf, p = 0.0064) and division timings from the 2 to 5-cell stage (t2-t3-t4-t5, p &amp;lt; 0,05). Successively, the number of good quality cleavage embryos decreased significantly with higher BMI (normal weight, 62%; pre-obese, 59%; obese, 50.8%; p = 0.02). In contrast, developmental events past the 5-cell stage, including time to 8-cells (t8), blastulation (tSB) and expanded blastocyst (tB) were comparable amongst the groups (p &amp;gt; 0.05). Similarly, we observed no effect of male BMI on blastocyst quality (normal weight, 70.2%; pre-obese, 73.4%; obese, 75.5%; p = 0.06). Despite early developmental delays, we observed no significant effects on biochemical pregnancy (normal weight, 64.7%; pre-obese 64.1%; obese, 58.7%; p = 0.45), ongoing pregnancy (normal weight, 60.0%; pre-obese, 58.8%; obese, 52.9%; p = 0.35) and live birth rate (normal weight, 41.9%; pre-obese, 42.0%; obese, 34.9%; p = 0.27). Our adjusted analysis corroborated these findings. Limitations, reasons for caution The main limitation of this study is its retrospective design, which may not account for all confounders. Moreover, lifestyle factors, such as smoking or alcohol consumption were not considered. As such, results cannot be generalized to all patient populations. Wider implications of the findings Obese males show lower motile sperm counts and delayed cleavage development. While these changes impaired day 3 embryo quality, they did not affect blastocyst development and quality. That translates into comparable clinical outcomes, suggesting that specific counselling is not required in obese patients. Trial registration number not applicable

The paradox of obesity with normal weight; a cross-sectional study.

To evaluate the prevalence of excessive adiposity among normal-weight individuals, and their cardiometabolic risk. This cross-sectional study included 3,001 participants (ages 20-95, 52% men, BMI 28.0 ± 5.5 kg/m2) who completed an anthropometric evaluation, dual x-ray absorptiometry (DXA) scan to measure body composition, and cardiometabolic blood markers. Excess adiposity was defined as ≥25% for men and ≥ 35% for women. Of the entire study participants, 967 were in normal BMI (18.5-24.9 kg/m2) with a wide body fat distribution (4-49%). Of them, 26% of men and 38% of women were classified with excess adiposity. As compared to normal-weight lean participants, normal-weight obese men and women had higher triglycerides (76.5 ± 37.3 vs. 101.2 ± 50.3 mg/dL, p = 0.004 and 84 ± 44.2 vs. 101.4 ± 91.1 mg/dL, p = 0.030; respectively) and elevated low-density lipoprotein cholesterol (103.3 ± 31.7 vs. 119.6 ± 45.5 mg/dL, p = 0.011) and total cholesterol (171.5 ± 40.3 vs. 190.2 ± 39 mg/dL, p = 0.007) for men only. Among NWO, abdominal circumference was prevalent in 60% of the females with NWO (≥88 cm), but only in 4% of males (≥102 cm). Higher adiposity, even within normal weight, increases cardiometabolic risk, and abdominal waist circumference misclassified obesity in normal-weight individuals. This study highlights the need for a body composition evaluation to determine cardiometabolic risk for adults with normal body weight.

Elevated Body Mass Index Is Associated with Improved Overall Survival in Castration-Resistant Prostate Cancer Patients Undergoing Prostate-Specific Membrane Antigen-Directed Radioligand Therapy.

In patients with prostate cancer scheduled for systemic treatment, being overweight is linked to prolonged overall survival (OS), whereas sarcopenia is associated with shorter OS. We investigated fat-related and body composition parameters in patients undergoing prostate-specific membrane antigen (PSMA)-directed radioligand therapy (RLT) to assess their predictive value for OS. Methods: Body mass index (BMI, in kg/m2) and CT-derived body composition parameters (total, subcutaneous, visceral fat area, and psoas muscle area at the L3-L4 level) were determined for 171 patients scheduled for PSMA-directed RLT. After normalization for stature, the psoas muscle index was used to define sarcopenia. Outcome analysis was performed using Kaplan-Meier curves and Cox regression including fat-related and other clinical parameters (Gleason score, C-reactive protein [CRP], lactate dehydrogenase [LDH], hemoglobin, and prostate-specific antigen levels). The Harrell C-index was used for goodness-of-fit analysis. Results: Sixty-five patients (38%) had sarcopenia, and 98 patients (57.3%) had increased BMI. Relative to the 8-mo OS in normal-weight men (BMI < 25), overweight men (25 ≥ BMI > 30) and obese men (BMI ≥ 30) achieved a longer OS of 14 mo (hazard ratio [HR], 0.63; 95% CI, 0.40-0.99; P = 0.03) and 13 mo (HR, 0.47; 95% CI, 0.29-0.77; P = 0.004), respectively. Sarcopenia showed no impact on OS (11 vs. 12 mo; HR, 1.4; 95% CI, 0.91-2.1; P = 0.09). Most of the body composition parameters were tightly linked to OS on univariable analyses, with the highest C-index for BMI. In multivariable analysis, a higher BMI (HR, 0.91; 95% CI, 0.86-0.97; P = 0.006), lower CRP (HR, 1.09; 95% CI, 1.03-1.14; P < 0.001), lower LDH (HR, 1.08; 95% CI, 1.03-1.14; P < 0.001), and longer interval between initial diagnosis and RLT (HR, 0.95; 95% CI, 0.91-0.99; P = 0.02) were significant predictors of OS. Conclusion: Increased fat reserves assessed by BMI, CRP, LDH, and interval between initial diagnosis and RLT, but not CT-derived body composition parameters, were relevant predictors for OS. As BMI can be altered, future research should investigate whether a high-calorie diet before or during PSMA RLT may improve OS.

Does an increase in adipose tissue 'weight' affect male fertility? A systematic review and meta-analysis based on semen analysis performed using the WHO 2010 criteria.

Obesity negatively impact on the metabolism of sex hormones, leading to reduced testosterone serum levels. However, how the obesity could negatively impact on the overall gonadal function, particularly on male fertility, remained unclear so far. To systematically review evidences regarding the influence of body weight excess on the sperm production. A meta-analysis was conducted, searching all prospective and retrospective observational studies reporting male subjects older than 18 years old, with body weight excess from overweight to severe obesity were considered. Only studies using the V edition of the World Health Organization (WHO) manual for semen analysis interpretation were considered. No specific interventions were considered. Search was focused on studies comparing overweight/obese to normal weight subjects. Twenty-eight studies were considered. Total sperm count and sperm progressive motility were significantly lower in overweight compared to normal weight subjects. Meta-regression analyses demonstrated that patients' age impacted on sperm parameters. Similarly, obese men showed lower sperm concentration, total sperm number, progressive and total motilities, and normal morphology lower than normal weight subjects. Reduced sperm concentration in obese men was influenced by age, smoking habit, varicocele, and total testosterone serum levels at meta-regression analyses. The male potential fertility is reduced in subjects with increased body weight, compared to normal weight men. The higher was the increased body weight, the worst was the sperm quantity/quality. This result comprehensively included obesity among non-communicable risk factor for male infertility, shedding new lights on the negative impact of increased body weight on overall gonadal function.

Saliva insulin tracks plasma insulin across the day following high-carbohydrate and low-carbohydrate meals.

Non-invasive monitoring of insulin could hold promise to identify those with, or at risk for developing, insulin resistance. We aimed to examine saliva insulin responses across the day following high- and low-carbohydrate meals and evaluate whether changes in saliva insulin might accurately reflect changes in plasma insulin. In two randomized crossover studies, young normal weight men (NW; n=8; Study 1) and adults with overweight/obesity (OO; n=8; Study 2) completed two 9-h experimental trials in which the participants consumed isocaloric mixed high-carbohydrate (HC) or low-carbohydrate (LC) meals at 0, 3, and 6 h. Plasma and saliva samples were collected at fasted baseline and every 30 min for a total of 19 samples across 9 h. Overall, findings revealed a similar trend for postprandial saliva and plasma insulin responses regardless of the time of the day with a ∼30-45 min lag between saliva and plasma insulin responses. In both NW and OO groups, saliva and plasma insulin area under the curve (AUC) and incremental AUC were significantly higher in HC condition as compared to LC condition (all P≤0.002). Nine-hour plasma and saliva insulin total AUCs were strongly and very strongly correlated in both HC (r=0.68; P=0.007) and LC (r=0.84, P<0.001) conditions, respectively. Saliva insulin is proportionate to and appears to reasonably track plasma insulin across the day with a ∼30-45 min delay. Saliva insulin shows promise as a non-invasive method to discern between low and high plasma insulin and may have utility in predicting the degree of insulin resistance (NCT03374436).

The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort

BackgroundFew studies have examined the effect of obesity indices on total number of hospitalizations. We examined the associations between body mass index (BMI) and waist circumference (WC) and rate of all-cause hospitalizations among Iranian adult participated in the Tehran Lipid and Glucose Study cohort.MethodsThis study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median of 18 years. Participants were categorized into three groups according to their baseline BMI: normal weight, overweight and obese. In addition, they were classified according to WC in two categories: normal WC and high WC. Negative Binomial regression model was used to estimate the incidence rate ratios (IRRs) and 95% confidence interval (95% CI) of all-cause hospitalizations in relation to obesity indices.ResultsThe overall crude rate of all-cause hospitalizations were 77.6 (95% CI, 73.9–81.2) and 76.9 (73.4–80.3) per 1000 person-year in men and women, respectively. The covariate adjusted rate of all-cause hospitalizations was 27% higher in obese men than normal weight men (IRR (95% CI): 1.27 (1.11–1.42)). Among women, overweight and obese individuals had 17% (1.17 (1.03–1.31)) and 40% (1.40 (1.23–1.56)) higher rate of hospitalization compared to normal weight women. Having high WC was associated with 18% (1.18 (1.08–1.29)) and 30% (1.30 (1.18–1.41)) higher rate of all-cause hospitalization in men and women, respectively.ConclusionsObesity and high WC were associated with increased hospitalization rates during long-term follow-up. Our findings suggests that successful obesity prevention programs may decrease the number of hospitalizations, particularly, in women.

Late, but Not Early, Night Sleep Loss Compromises Neuroendocrine Appetite Regulation and the Desire for Food

Objective: There is evidence that reduced sleep duration increases hunger, appetite, and food intake, leading to metabolic diseases, such as type 2 diabetes and obesity. However, the impact of sleep timing, irrespective of its duration and on the regulation of hunger and appetite, is less clear. We aimed to evaluate the impact of sleep loss during the late vs. early part of the night on the regulation of hunger, appetite, and desire for food. Methods: Fifteen normal-weight ([mean ± SEM] body-mass index: 23.3 ± 0.4 kg/m2) healthy men were studied in a randomized, balanced, crossover design, including two conditions of sleep loss, i.e., 4 h sleep during the first night-half (‘late-night sleep loss’), 4 h sleep during the second night-half (‘early-night sleep loss’), and a control condition with 8h sleep (‘regular sleep’), respectively. Feelings of hunger and appetite were assessed through visual analogue scales, and plasma ghrelin and leptin were measured from blood samples taken before, during, and after night-time sleep. Results: Ghrelin and feelings of hunger and appetite, as well as the desire for food, were increased after ‘late-night sleep loss’, but not ‘early-night sleep loss’, whereas leptin remained unaffected by the timing of sleep loss. Conclusions: Our data indicate that timing of sleep restriction modulates the effects of acute sleep loss on ghrelin and appetite regulation in healthy men. ‘Late-night sleep loss’ might be a risk factor for metabolic diseases, such as obesity and type 2 diabetes. Thereby, our findings highlight the metabolic relevance of chronobiological sleep timing.

The triglyceride glucose-waist-to-height ratio outperforms obesity and other triglyceride-related parameters in detecting prediabetes in normal-weight Qatari adults: A cross-sectional study.

The triglyceride-glucose (TyG)-driven indices, incorporating obesity indices, have been proposed as reliable markers of insulin resistance and related comorbidities such as diabetes. This study evaluated the effectiveness of these indices in detecting prediabetes in normal-weight individuals from a Middle Eastern population. Using the data of 5,996 adult Qatari participants from the Qatar Biobank cohort, we employed adjusted logistic regression to assess the ability of various obesity and triglyceride-related indices to detect prediabetes in normal-weight (18.5 ≤ BMI <25 kg/m2) adults (≥18 years). Of the normal-weight adults, 13.62% had prediabetes. TyG-waist-to-height ratio (TyG-WHTR) was significantly associated with prediabetes among normal-weight men [OR per 1-SD 2.68; 95% CI (1.67-4.32)] and women [OR per 1-SD 2.82; 95% CI (1.61-4.94)]. Compared with other indices, TyG-WHTR had the highest area under the curve (AUC) value for prediabetes in men [AUC: 0.76, 95% CI (0.70-0.81)] and women [AUC: 0.73, 95% CI (0.66-0.80)], and performed significantly higher than other indices (p < 0.05) in detecting prediabetes in men. Tyg-WHTR shared similar diagnostic values as fasting plasma glucose (FPG). Our findings suggest that the TyG-WHTR index could be a better indicator of prediabetes for general clinical usage in normal weight Qatari adult men than other obesity and TyG-related indices. TyG-WHTR can help identify a person's risk for developing prediabetes in both men and women when combined with FPG results.

Relationship between overweight and obesity and insufficient micronutrient intake: a nationwide study in Taiwan.

The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.