Normal Weight Subjects Research Articles

Association of Non-alcoholic Fatty Liver Disease with Body Fat Percentage in Normal-Weight Individuals

Background: Recent data have suggested that nonalcoholic fatty liver disease (NAFLD) can occur in normal-weight subjects. This study examined the association of body fat percentage (BF%) with NAFLD and its risk factors in normal-weight individuals. Objectives: The present study aimed to explain the association of body fat with NAFLD and its cardiometabolic risk factors. Methods: A total of 59 subjects with body mass index (BMI) within the range of 18.5 - 24.9 kg/m2 were selected from referrals to two major university polyclinics in Shiraz, Iran, from April to June 2019. Fatty liver grade, anthropometric characteristics, body composition, and cardiometabolic risk factors were measured in this study. Results: Waist circumference (P = 0.012), fat mass (P < 0.001), triglycerides (TG) (P = 0.027), very-low-density lipoprotein (VLDL) (P = 0.007), and TG/high-density lipoprotein cholesterol (HDL-C) ratio (P = 0.003) increased; however, skeletal muscle mass decreased (P < 0.001) across the tertiles of BF%. The average of fatty liver grade was similar in the first and second tertiles; nevertheless, the fatty liver grade of participants in the third tertile was significantly higher (1.3 ± 0.9 vs. 0.4 ± 0.7; P = 0.005). In ordinal regression analysis, BF% (1.13; 95% CI: 1.04 - 1.22; P = 0.003), BMI (1.95; 95% CI: 1.02 - 3.74; P = 0.045), VLDL (1.77; 95% CI: 1.00 - 3.12; P = 0.049), and TG/HDL-C ratio (2.21; 95% CI: 1.26 - 3.86; P = 0.006) had positive associations with NAFLD; nonetheless, HDL-C (0.33; 95% CI: 0.16 - 0.67; P = 0.002) and dietary cholesterol (0.97; 95% CI: 0.95 - 0.997; P = 0.028) had inverse associations with NAFLD after the adjustments for age, gender, BMI, and physical activity. Conclusions: The results of this study suggested that within normal weight ranges, NAFLD occurs more frequently in individuals with higher BF%. In addition, BF% can be used as an important marker in NAFLD screening.

Hair Lead, Aluminum, and Other Toxic Metals in Normal-Weight and Obese Patients with Coronary Heart Disease.

The objective of the present study was to evaluate hair toxic metal levels in patients with obesity and/or coronary heart disease (CHD). Following a 2 × 2 factorial design, subjects without CHD were grouped into normal weight control (n = 123) and obese groups (n = 140). Patients suffering from CHD were divided into normal weight (n = 180) and obese CHD subjects (n = 240). Hair Al, As, Cd, Hg, Ni, and Pb levels were evaluated using inductively-coupled plasma mass-spectrometry. The data demonstrate that hair Al and Hg levels were higher in obese subjects as compared to normal weight controls. Normal weight CHD patients were characterized by significantly higher hair Al, As, Cd, and Pb levels when compared to healthy subjects. The highest hair Al, As, and Pb levels were observed in obese CHD patients, significantly exceeding the respective values in other groups. Factorial analysis revealed significant influence of factorial interaction (CHD*obesity) only for hair Pb content. Given the role of obesity as a risk factor for CHD, it is proposed that increased toxic metal accumulation in obesity may promote further development of cardiovascular diseases.

Index-based dietary patterns and stomach cancer in a Chinese population.

Dietary factors are of importance in the development of stomach cancer. This study aims to examine index-based dietary patterns associated with stomach cancer in a Chinese population. Using data from a population-based case-control study conducted in Jiangsu Province, China, we included a total of 8432 participants (1900 stomach cancer cases and 6532 controls). Dietary data collected by food frequency questionnaire was evaluated by modified Chinese Healthy Eating Index-2016 (mCHEI-2016) and the US Healthy Eating Index-2015 (HEI-2015). Multiple logistic regression analyses were applied to examine the association of mCHEI-2016 and HEI-2015 with stomach cancer while adjusting for potential confounders. The possible interactions between mCHEI-2016 or HEI-2015 and established risk factors were explored. Among nonproxy interviews, after adjusting for potential confounding factors, a higher score of sodium, reflecting lower intake per day, was inversely associated with stomach cancer [odds ratio (OR), 0.95; 95% CI, 0.91-0.99 for mCHEI-2016; OR, 0.97; 95% CI, 0.94-0.99 for HEI-2015]. No clear associations with stomach cancer were identified for total scores of HEI-2015 (OR, 0.98; 95% CI, 0.87-1.10 with a 10-point increase, P trend = 0.98) and mCHEI-2016 (OR, 1.05; 95% CI, 0.94-1.17 with a 10-point increase, P trend = 0.22). However, the relation between stomach cancer and the mCHEI-2016 was modified by BMI, with a possible inverse association in normal-weight subjects. Our findings highlight that reduced intake of dietary sodium would prevent the development of stomach cancer. The data indicate a heterogeneity between normal weight and overweight's dietary factors in relation to stomach cancer.

The First Report of Bacteroides fragilis and Bacteroides thetaiotaomicron Relative Abundance in Obese Iranian Population

Background: Obesity is a multifactorial disorder, and gut microbiota has a fundamental role in its pathophysiology. Bacteroides spp. has significant roles in gut microbiota- host interactions that determine health and disease development. Since the gut microbiota pattern changes based on different criteria in each population, we studied the abundance of two important Bacteroides strains, Bacteroides fragilis, and Bacteroides thetaiotaomicron, in Iranian obese and normal-weight subjects for the first time. Methods: In this study, 100 participants were recruited and classified based on their body mass index (BMI). The subjects were divided into normal (average BMI, 22.37 kg/m2) and obese (average BMI, 29.10 kg/m2) groups. Bacterial DNA was extracted from the samples, and quantitative polymerase chain reaction (qPCR) was conducted based on 16s rDNA universal primers. Finally, the correlation between bacterial abundance and obesity was investigated. Results: The results of qPCR showed that the relative abundance means of B. fragilis in normal weight and obese subjects was 8.68 × 1012 and 9.27 × 1012 cfu/mL, respectively. Also, the relative abundance mean of B. thetaiotaomicron in normal weight and obese subjects was 2.32 × 1012 and 5.39 × 1012 cfu/mL, respectively. Although obese subjects had more B. fragilis and B. thetaiotaomicron abundance compared to subjects with normal weight, no significant difference was identified between relative abundance of B. fragilis (P = 0.79) and B. thetaiotaomicron (P = 0.18) in the two groups. Conclusions: Although obese subjects had more B. fragilis and B. thetaiotaomicron abundance compared to normal-weight subjects, no significant difference was identified between the two groups. Since Bacteroides spp. have significant role in gut microbiota-host interaction, determination of their abundance in obesity development and targeting restoration of gut microbiota pattern could be valuable in controlling obesity. In this regard, dietary intervention could be based on determination of gut microbiota pattern in certain populations.

Growth Hormone (GH) Treatment Decreases Plasma Kisspeptin Levels in GH-Deficient Adults with Prader-Willi Syndrome.

Obesity and growth hormone (GH)-deficiency are consistent features of Prader–Willi syndrome (PWS). Centrally, kisspeptin is involved in regulating reproductive function and can stimulate hypothalamic hormones such as GH. Peripherally, kisspeptin signaling influences energy and metabolic status. We evaluated the effect of 12-month GH treatment on plasma kisspeptin levels in 27 GH-deficient adult PWS patients and analyzed its relationship with metabolic and anthropometric changes. Twenty-seven matched obese subjects and 22 healthy subjects were also studied. Before treatment, plasma kisspeptin concentrations in PWS and obese subjects were similar (140.20 (23.5–156.8) pg/mL vs. 141.96 (113.9–165.6) pg/mL, respectively, p = 0.979)) and higher (p = 0.019) than in healthy subjects (124.58 (107.3–139.0) pg/mL); plasma leptin concentrations were similar in PWS and obese subjects (48.15 (28.80–67.10) ng/mL vs. 33.10 (20.50–67.30) ng/mL, respectively, p = 0.152) and higher (p < 0.001) than in healthy subjects (14.80 (11.37–67.30) ng/mL). After GH therapy, lean body mass increased 2.1% (p = 0.03), total fat mass decreased 1.6% (p = 0.005), and plasma kisspeptin decreased to levels observed in normal-weight subjects (125.1(106.2–153.4) pg/mL, p = 0.027). BMI and leptin levels remained unchanged. In conclusion, 12-month GH therapy improved body composition and decreased plasma kisspeptin in GH deficient adults with PWS. All data are expressed in median (interquartile range).

Comparison of Associations between One-Carbon Metabolism, Lipid Metabolism, and Fatty Liver Markers in Normal-Weight and Overweight People Aged 20–40 Years

The aim of the present study was to compare biomarkers of one-carbon metabolism (OCM), lipid metabolism, and fatty liver in people with normal and increased body weight. The study was performed on 421 participants, aged 20–40 years, enrolled in Poznan, Poland, in 2016–2018. Choline and betaine intakes were assessed. DNA samples were genotyped for polymorphisms of phosphatidylethanolamine N-methyltransferase (PEMT; rs7946 and rs12325817), methylene tetrahydrofolate reductase (MTHFR; rs180113), methylenetetrahydrofolate dehydrogenase (MTHFD1; rs2236225), and dihydrofolate reductase (DHFR; rs70991108). To assess the associations between blood metabolites (choline, betaine, folate, L-carnitine, o-acetyl-L-carnitine, and trimethylamine N-oxide]), circulating lipids, and fatty liver indices, multiple logistic regression analyses were performed. Overweight/obese participants had 5.8% higher choline (p < 0.05) and 10% higher L-carnitine (p < 0.001) levels than normal-weight subjects. Serum folate and betaine levels were associated with lower total cholesterol (p < 0.001 and p < 0.05), low-density lipoprotein (LDL) cholesterol (p < 0.001 and p < 0.05, respectively), triacylglycerols (p < 0.01 and p < 0.001), and triglyceride glucose index (p < 0.001 and p < 0.01, respectively), though only in overweight/obese people. The PEMT rs12325817 CC genotype was associated with higher levels of high-density lipoprotein (HDL) cholesterol (p < 0.01) in overweight/obese people. The associations between OCM markers, fatty liver indices, and blood lipids differ in subjects with normal and excessive body weight.

Taste perception and expression in stomach of bitter taste receptor tas2r38 in obese and lean subjects

Differences in taste perception have been related to eating behavior, nutritional status, and diseases. Recently, taste receptors have been identified in several extra-oral tissues, such as the gastrointestinal tract, where they seem to influence processes like digestion, sense of satiety as well as energy balance and intraluminal changes occurring in obesity.Our study aims to analyze differences in taste perception among 42 obese patients (OB) and 41 normal-weight subjects (LEAN). Polymorphisms in the gene codifying for the bitter taste receptor TAS2R38 and its expression on the surface of the gastric mucosa were tested and compared among OB and LEAN.Taste intensity of PROP (6-n-propylthiouracil), quinine, sucrose, citric acid and NaCl were measured on a labeled magnitude scale. DNA from peripheral whole blood was extracted and three polymorphisms in the TAS2R38 gene (rs713598, rs1726866, rs10246939) analyzed. Gastric biopsies were collected during bariatric surgery in OB and during endoscopy in LEAN. RNA was extracted and TAS2R38 gene expression assessed by RT-Real-Time qPCR. Anamnestic and anthropometric data were recorded in all participants during baseline visits.Logistic regression analysis showed that OB perceives sweet (sucrose) and bitter (PROP or 6-n-propylthiouracil) taste more intensely than LEAN (p-value = 0.02 and p-value = 0.005, respectively). While polymorphisms in TAS2R38 gene did not differ among OB and LEAN, we observed a significant increase of TAS2R38 mRNA levels in the stomach of OB compared to LEAN (p = 0.01).Our results provide new evidence of a link between obesity and altered taste perception as well as TAS2R38 expression in the stomach.

Urinary Metabolites Reveal Hyperinsulinemia and Insulin Resistance in Polycystic Ovarian Syndrome (PCOS).

The identification of insulin resistance and hyperinsulinemia in polycystic ovary syndrome (PCOS) is not a minor issue. The homeostasis model assessment of insulin resistance index (HOMA) is the most used index of IR (Insulin Resistance), validated in overweight and obese patients but not in normal-weight PCOS subjects, who can still present with increased insulin secretion by an oral glucose tolerance test (OGTT). The evaluation of insulin secretion and resistance represents a still unresolved problem. The aim of this study is to identify a possible yet noninvasive method to properly evaluate the insulin metabolism in young non-diabetic subjects. Girls aged 14–22 years, afferent to the center of Gynecological Diseases in Childhood and Adolescence of Cagliari (Italy), were screened for PCOS. A total of 42 subjects comprised the study group. Hormonal assays, OGTT, transabdominal (TA) or transvaginal (TV) US, and urine collection for 1H-NMR analysis were assayed in the early follicular phase. A 1H-NMR coupled multivariate statistical analysis was performed. The OPLS model indicated that the NMR profile of urine had a good fit and prediction ability for the AUC OGTT with R2 = 0.813. Metabolomics can be a promising tool to the potential identification of biomarkers of an exaggerated insulin response to OGTT and can encourage substantial progress for a more accurate and early diagnosis in PCOS.

Effect of Different Acute Exercise Intensities on the Inflammatory Markers in Overweight and Obese Subjects

The aim of this work was to investigate the effect of an acute bout of different exercise intensities on modifying the inflammatory markers in overweight and obese subjects. Sixty adult males divided into: a control group (n=30) included normal weight subjects (BMI < 25 kg/m2) and an overweight (OW) and obese group (n=30) included subjects with BMI ≥ 25 kg/m2. Each group was randomly subdivided into three groups (n=10 each): low, moderate and high intensity exercise groups. Anthropometric measurements obtained and plasma C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels were measured before and thirty minutes after twenty minutes incremental exercise, at 45%, 60% or 80% of predicted maximum heart rate, on a motor driven treadmill. Following an acute bout of moderate or high intensity exercise, OW and obese subjects showed significant increase in CRP and IL-6 levels; however, TNF-α levels significantly decreased. Nevertheless, an acute low intensity exercise induced no significant changes in any of the measured markers in the OW and obese subjects. In conclusion, an acute bout of moderate or high intensity exercise, but not low intensity exercise, induces an inflammatory response, characterized by a rise in levels of CRP and IL-6, and a decrease in TNF-α level in overweight and obese subjects.

Estimated glomerular filtration rate and cardiometabolic risk factors in a longitudinal cohort of children

Associations between glomerular filtration rate (GFR) and cardiometabolic risk factors have been reported in adult and pediatric patients with renal disease. We aimed to assess the relationship between the estimated GFR (eGFR) and cardiometabolic risk factors in apparently healthy children. A longitudinal study in 401 asymptomatic Caucasian children (mean age 8 years) followed up after 4 years (mean age 12 years). GFR was estimated using the pediatric form of the FAS-equation. Children were classified at baseline according to their obesity status (normal weight and overweight) and according to eGFR levels (lower, average, and higher). The association of eGFR with anthropometric data [body mass index (BMI) and waist], blood pressure [systolic (SBP) and diastolic (DBP)], metabolic parameters [glucose, insulin resistance (HOMA-IR) and serum lipids], and renal ultrasonography measurements were assessed at baseline and follow-up. Baseline eGFR associated with several cardiometabolic risk factors at follow-up including higher waist, SBP, HOMA-IR, and kidney size (all p < 0.0001) in both normal weight and overweight children. In multivariate analysis, baseline eGFR was independently associated with follow-up HOMA-IR and SBP in both normal weight and overweight subjects (model R2: 0.188–0.444), and with follow-up BMI and waist in overweight subjects (model R2: 0.367–0.477). Moreover, children with higher filtration rates at baseline showed higher waist, SBP, DBP, HOMA-IR and renal size both at baseline and follow-up. eGFR is related to insulin resistance, blood pressure and adiposity measures in school-age children. eGFR may help to profile the cardiometabolic risk of children.

MO138ASSOCIATION OF NT-PROBNP WITH OBESITY IN CKD PATIENTS

Abstract Background and Aims Obesity is associated with lower circulating levels of N-terminal pro-BNP (NT-proBNP) both in the general population and in patients with heart failure. In asymptomatic patients with CKD, NT-proBNP levels are generally elevated. The prevalence of obesity is markedly increasing among patients with CKD. However, whether obesity affects NT-proBNP levels and thresholds for increased risk of clinical outcomes is unclear. Method We examined the associations between NT-proBNP and obesity in 408 stage 3–5 CKD patients (268 men and 140 women; mean age 65±13 years) free of heart failure at baseline, who were categorized into 3 groups according to body mass index (BMI; kg/m2) as normal (&amp;lt;24.0), overweight (24.0–27.9), and obese (≥28.0). Multivariate Cox proportional hazards models were used to compare the risk associations of NT-proBNP with the composite of ESKD (needing chronic dialysis or kidney transplantation) or all-cause mortality across BMI categories. Results NT-proBNP levels were significantly lower in obese patients than in normal weight and overweight subjects (P &amp;lt;0.001). Within each CKD stage, NT-proBNP levels decreased with increasing BMI. In a multivariate analysis, NT-proBNP was inversely associated with obesity, as well as BMI and its fat and lean body mass components (all P &amp;lt;0.001), independent of demographics, comorbidities, and severity of CKD. During a median follow-up of 2.2 years, 117 patients progressed to ESKD and 46 patients died. Overall, higher NT-proBNP levels were independently associated with ESKD or death (HR, 1.52; 95% CI, 1.22–1.89). Specifically, higher NT-proBNP levels were consistently associated with poor outcomes in all BMI categories (P for interaction = 0.096). Conclusion Obese CKD patients have significantly lower NT-proBNP levels. Nevertheless, BMI category did not modify the relationship between NT-proBNP and clinical outcomes. Increased risk may be seen at relatively lower levels of NT-proBNP in obese CKD patients.

Association between high pre-pregnancy body mass index and antenatal depression: A study among pregnant women of upper socio-economic strata in North-West Delhi, India

BackgroundMagnitude of antenatal depression (AD) remains underexplored especially in the Indian population despite the growing body of research regarding the benefits of healthy pregnancy. Further, National Family Health Survey (NFHS- 3 and NFHS-4) data indicate that there is an escalating rise in the proportion of overweight/obese women of reproductive age from 26.4% to 34.9% residing in Delhi. Synergistic impact of high pre-pregnancy weight and AD can adversely affect obstetric outcome. Hence, the present study aimed to assess and compare the prevalence of AD among normal weight, overweight and obese pregnant women. MethodsPresent data is a part of an ongoing longitudinal study among pregnant women belonging to upper socio-economic strata residing in Delhi, India. A total of 186 subjects attending private antenatal clinics in North-West Delhi were enrolled at ≤16 week of gestation. The subjects were screened for AD using Edinburgh Postnatal Depression Scale, regularly at baseline (≤16th week), midterm (18th-20th week) and end-line (≥32nd week) of their pregnancies. Additional socio-demographic characteristics, anthropometric measurements and obstetric history were recorded and analysed using SPSS (Statistical Package for Social Sciences) version 25. ResultsMore than one-third of subjects screened positive for depression throughout pregnancy. Prevalence of AD was highest among obese subjects (50%,48.3%,51%) as compared to normal weight (36.7%,30.4%,37.5%) and overweight (27.6%,32%,29.2%) subjects during baseline, midterm and end-line respectively. ConclusionPrevalence of AD was high irrespective of weight category. Obese women were likely to have more symptoms of depression compared to normal weight and overweight women throughout pregnancy. A holistic approach needs to be adopted by health care professionals including regular screening of AD and provide healthy lifestyle related advice to pregnant women.

TMT-based proteomic and bioinformatic analyses of human granulosa cells from obese and normal-weight female subjects

BackgroundIncreasing evidence supports a relationship between obesity and either infertility or subfertility in women. Most previous omics studies were focused on determining if the serum and follicular fluid expression profiles of subjects afflicted with both obesity-related infertility and polycystic ovary syndrome (PCOS) are different than those in normal healthy controls. As granulosa cells (GCs) are essential for oocyte development and fertility, we determined here if the protein expression profiles in the GCs from obese subjects are different than those in their normal-weight counterpart.MethodsGC samples were collected from obese female subjects (n = 14) and normal-weight female subjects (n = 12) who were infertile and underwent in vitro fertilization (IVF) treatment due to tubal pathology. A quantitative approach including tandem mass tag labeling and liquid chromatography tandem mass spectrometry (TMT) was employed to identify differentially expressed proteins. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were then conducted to interrogate the functions and pathways of identified proteins. Clinical, hormonal, and biochemical parameters were also analyzed in both groups.ResultsA total of 228 differentially expressed proteins were noted, including 138 that were upregulated whereas 90 others were downregulated. Significant pathways and GO terms associated with protein expression changes were also identified, especially within the mitochondrial electron transport chain. The levels of free fatty acids in both the serum and follicular fluid of obese subjects were significantly higher than those in matched normal-weight subjects.ConclusionsIn GCs obtained from obese subjects, their mitochondria were damaged and the endoplasmic reticulum stress response was accompanied by dysregulated hormonal synthesis whereas none of these changes occurred in normal-weight subjects. These alterations may be related to the high FFA and TG levels detected in human follicular fluid.

Natural history of nonfunctioning adrenal incidentalomas: a 10-year longitudinal follow-up study.

Most data on the natural history of nonfunctioning adrenal incidentalomas (NFAI) are provided by follow-ups up to 5 years. We conducted a 10.5 (9.1–11.9)-year prospective follow-up study of NFAI in 67 participants (20 (29.9%) males, 47 (70.1%) females) of mean age 57.9 (52.3–63.9) years and BMI 27.42 (24.07–30.56) kg/m2). We also evaluated the associations between baseline BMI and changes of NFAIs’ characteristics at follow-up. Progression to mild autonomous cortisol excess (MACE) was observed in 15 (22 %) patients, with 14 of them having post overnight dexamethasone suppression test (ODST) cortisol between 50 and138 nmol/L and only one > 138 nmol/L. The progression rate was significantly higher in overweight and obese than in normal-weight subjects. Patients that developed MACE had a significantly higher baseline mean cortisol after 1 mg ODST. Tumor enlargement ≥10 mm occurred in 8.9% of patients. In comparison with reports of shorter observational periods, we observed a higher growth rate ≥ 10 mm and higher progression rate from NFAI to MACE, particularly in overweight and obese subjects. All tumors had persistent radiological characteristics typical for adrenal adenoma. We concluded that the duration of the follow-up period is an important factor in characterizing the natural history of NFAI. Higher baseline BMI and higher baseline cortisol after ODST might predict the long-term likelihood of progression in hormonal activity. The magnitudes of observed progressions in growth or hormonal activity were clinically insignificant. Our long-term follow-up, therefore, clearly supports the general view that a long-term monitoring of patients with NFAI is not necessary.

Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity.

BackgroundCOVID-19 is associated with unintentional weight loss. Little is known on whether and how patients regain the lost weight. We assessed changes in weight and abdominal adiposity over a three-month follow-up after discharge in COVID-19 survivors.MethodsIn this sub-study of a large prospective observational investigation, we collected data from individuals who had been hospitalized for COVID-19 and re-evaluated at one (V1) and three (V2) months after discharge. Patient characteristics upon admission and anthropometrics, waist circumference and hunger levels assessed during follow-up were analyzed across BMI categories.ResultsOne-hundred-eighty-five COVID-19 survivors (71% male, median age 62.1 [54.3; 72.1] years, 80% with overweight/obesity) were included. Median BMI did not change from admission to V1 in normal weight subjects (−0.5 [−1.2; 0.6] kg/m2, p = 0.08), but significantly decreased in subjects with overweight (−0.8 [−1.8; 0.3] kg/m2, p < 0.001) or obesity (−1.38 [−3.4; −0.3] kg/m2, p < 0.001; p < 0.05 vs. normal weight or obesity). Median BMI did not change from V1 to V2 in normal weight individuals (+0.26 [−0.34; 1.15] kg/m2, p = 0.12), but significantly increased in subjects with overweight (+0.4 [0.0; 1.0] kg/m2, p < 0.001) or obesity (+0.89 [0.0; 1.6] kg/m2, p < 0.001; p = 0.01 vs. normal weight). Waist circumference significantly increased from V1 to V2 in the whole group (p < 0.001), driven by the groups with overweight or obesity. At multivariable regression analyses, male sex, hunger at V1 and initial weight loss predicted weight gain at V2.ConclusionsPatients with overweight or obesity hospitalized for COVID-19 exhibit rapid, wide weight fluctuations that may worsen body composition (abdominal adiposity).ClinicalTrials.gov registrationNCT04318366.

Reversal of Functional Brain Activity Related to Gut Microbiome and Hormones After VSG Surgery in Patients With Obesity.

ContextVertical sleeve gastrectomy (VSG) is becoming a prioritized surgical intervention for obese individuals; however, the brain circuits that mediate its effective control of food intake and predict surgical outcome remain largely unclear.ObjectiveWe investigated VSG-correlated alterations of the gut-brain axis.MethodsIn this observational cohort study, 80 patients with obesity were screened. A total of 36 patients together with 26 normal-weight subjects were enrolled and evaluated using the 21-item Three-Factor Eating Questionnaire (TFEQ), MRI scanning, plasma intestinal hormone analysis, and fecal sample sequencing. Thirty-two patients underwent VSG treatment and 19 subjects completed an average of 4-month follow-up evaluation. Data-driven regional homogeneity (ReHo) coupled with seed-based connectivity analysis were used to quantify VSG-related brain activity. Longitudinal alterations of body weight, eating behavior, brain activity, gastrointestinal hormones, and gut microbiota were detected and subjected to repeated measures correlation analysis.ResultsVSG induced significant functional changes in the right putamen (PUT.R) and left supplementary motor area, both of which correlated with weight loss and TFEQ scores. Moreover, postprandial levels of active glucagon-like peptide-1 (aGLP-1) and Ghrelin were associated with ReHo of PUT.R; meanwhile, relative abundance of Clostridia increased by VSG was associated with improvements in aGLP-1 secretion, PUT.R activity, and weight loss. Importantly, VSG normalized excessive functional connectivities with PUT.R, among which baseline connectivity between PUT.R and right orbitofrontal cortex was related to postoperative weight loss.ConclusionVSG causes correlated alterations of gut-brain axis, including Clostridia, postprandial aGLP-1, PUT.R activity, and eating habits. Preoperative connectivity of PUT.R may represent a potential predictive marker of surgical outcome in patients with obesity.

How Personality and Unpredictability of Resources Impact Binge Eating Symptoms in Normal Weight Subjects: A Path Analysis

STUDIES ASSESSING SENSITIVITY TO ENVIRONMENTAL STIMULI INDICATE THAT SUBJECTS WITH BINGE EATING DISORDER (BED) ARE MORE PRONE TO REACT TO STRESSFUL SITUATIONS, AND MORE WILLING TO PURSUE IMMEDIATE REWARDS IN COMPARISON TO SUBJECTS WITHOUT BED. UNPREDICTABILITY OF FAMILY RESOURCES RELEVANT TO CHILD DEVELOPMENT INCREASES THE CHANCES OF EXTERNALIZING BEHAVIORS IN CHILDHOOD AND, COUPLED WITH PERSONALITY PROFILES LINKED TO BED, MAY INCREASE THE ODDS OF MANIFESTING BINGE EATING (BE) IN ADULTHOOD. THIS STUDY AIMED TO INVESTIGATE WHETHER PERSONALITY AND UNPREDICTABILITY OF RESOURCES INTERACT TO PREDICT BE SYMPTOMS IN YOUNG ADULTS, EVEN BEFORE THE ONSET OF OBESITY. THE SAMPLE CONSISTED OF 257 ADULTS (AGES 20.73 ± 1.78 YEARS, MEAN ± SD), MOSTLY WHITE (N = 233), UNDERGRADUATES (N = 236), AND WITH A BMI OF 21.84 ± 1.68 KG/M². PERSONALITY WAS STUDIED USING THE BIS AND BAS SCALES THAT ASSESS, RESPECTIVELY, AVOIDANCE OF AVERSIVE STIMULI AND CONFLICT SITUATIONS, AND APPROACH TO AND DESIRE OF REWARD STIMULI. UNPREDICTABILITY OF NURTURE AND CARE, FINANCIAL RESOURCES, AND MEAL AVAILABILITY WERE ASSESSED USING THE FAMILY UNPREDICTABILITY SCALE (FU). BE SYMPTOMS WERE ASSESSED USING THE BINGE EATING SCALE (BES). A PATH ANALYSIS MODEL WAS USED TO ANALYZE THE DATA. PERSONALITY FACTORS WERE TREATED AS PRINCIPAL PREDICTORS, FU AS MEDIATORS, AND BE SYMPTOMS AS THE DEPENDENT/OUTCOME VARIABLE. GENDER, BMI, AND SOCIOECONOMIC STATUS WERE INCLUDED IN THE MODEL AS COVARIATES. AN EXCELLENT MODEL FIT WAS OBTAINED, [χ² (31) = 26.588, P = 0.692; RMSEA < 0.01; CFI = 1.000; TFI = 1.041], AND THE FINAL MODEL EXPLAINED 20.1% OF BE VARIANCE. THE POSITIVE EFFECTS OVER BE VARIANCE SUGGEST THAT FEMALE PARTICIPANTS (β = 0.180) WITH A HIGHER TENDENCY TO SEEK FOR IMMEDIATE REWARDS (BAS SUBSCALE, β = 0.205) AND AVOID CONFLICT SITUATIONS (BIS SCALE, β = 0.304), AND WITH A BMI CLOSER TO 25 KG/M² (β = 0.130) SCORED HIGHER IN BES. ONLY ONE FU FACTOR WAS RELATED TO BE, WITH MARGINAL SIGNIFICANT RESULTS (NURTURE AND CARE, β = 0.145, P = 0.056). HIGHER POSITIVE REACTIONS TO BRIEF REWARDS - ANOTHER BAS SUBSCALE - WERE NEGATIVELY (β = − 0.123) RELATED TO BE SYMPTOMS, REPRESENTING A PROTECTIVE FACTOR. THE OBSERVED EFFECTS OF PERSONALITY AND GENDER ARE CONSONANT WITH THE AFFECT REGULATION THEORY OF EATING DISORDERS, AS BE MIGHT BE AN IMPULSIVE STRATEGY TO REGULATE EMOTION IN FEMALE PATIENTS WITH GENETICALLY INFLUENCED PERSONALITY TRAITS LINKED TO STRESS VULNERABILITY AND REWARD SENSITIVITY. RESPONSIVENESS TO BRIEF REWARDS IS A PROTECTIVE FACTOR FOR DEPRESSIVE SYMPTOMS LINKED ALSO TO HEALTHY BEHAVIORS, AND IT MAY HELP PATIENTS TO PLAN AND ENGAGE IN STRATEGIES TO PREVENT BE. LONGITUDINAL MONITORING OF THESE PARTICIPANTS MAY ANSWER WHETHER PERSONALITY PROFILES IMPACT WEIGHT GAIN AND ADHERENCE TO WEIGHT REDUCTION INTERVENTIONS IN THE FUTURE.

Trends in Serum Lipid Profiles and Lifestyle Factors Among Korean Adolescents, 2007–2018

Objectives: Trends in serum lipids among teenagers would be crucial predictors of potential cardiovascular disease in adults. We aimed to investigate the trends in lipid profiles and related factors, including obesity, smoking, exercise, alcohol use, and total fat intakes in Korean adolescents from 2007 to 2018. Methods: We analyzed 5,967 participants aged 12–19 yrs from the Korea NHANES 2007–2018. Fasting total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) levels were measured. Results: All kinds of lipid profiles, except TG, showed increasing trends from 2007 to 2018 (P<0.01). Nevertheless, the prevalence of dyslipidemia showed a trend of decreasing in boys (from 33.3 to 26.6%; P=0.002) and maintained in girls (from 28.4 to 30.2%; P=0.465), mainly due to a substantial decrease in hypo-HDL-cholesterolemia (9% reduction in boys, 5% reduction in girls). This occurred amid an increasing trend of central obesity in boys (P<0.001). In lifestyle factors, there were no significant changes in alcohol use and muscle-strengthening exercise, while a substantial decrease in smoking rate was observed. A favorable effect of muscle-strengthening exercise on both TG and HDL-C and an unfavorable impact of smoking on HDL-C were observed. Alcohol use was associated with higher HDL-C in both genders, but it showed opposite associations with TG between boys (unfavorable) and girls (favorable). Regarding dietary factors, there were increasing trends in total fat intakes and the percentage of energy supply from total dietary fat (〔total fat (%E)〕 in both genders. In boys, an increase in total fat (%E) was related to the higher HDL-C in normal-weight subjects (P<0.01 in both genders); however, it was associated with higher LDL-C in overweight girls (P=0.001). Conclusions: Increases in fat intakes and a decline in smoking rates appeared to have positively impacted HDL-C in Korean adolescents over the past 12 years. We confirmed a rise in fat intakes was linked with the increase in LDL-C among overweight adolescents. Therefore, close monitoring for the dyslipidemia prevalence is essential in Korean adolescents whose obesity prevalence is on the rise.

Extracellular Endothelial Microvesicles Causative Agents in Obesity‐Related Endothelial Dysfunction

Obesity is associated with increased cardiovascular disease morbidity and mortality. Moreover, obese individuals demonstrate accelerated rates of atherosclerosis, as well as increased incidence of myocardial infarction and stroke. Extracellular microvesicles, particularly endothelial cell-derived microvesicles (EMVs), are seminal functional modulators of vascular health and disease. We have previously demonstrated that EMVs are elevated with obesity and associated with endothelial dysfunction, although the underlying mechanisms are unknown. The experimental aim of this study was to determine the effects of EMVs isolated from obese adults on endothelial cell inflammation, apoptosis and nitric oxide (NO) production. Twenty-four middle-aged adults were studied: 12 normal weight (8M/4F; BMI: 24.4+0.3 kg/m2; EMVs: 85+13 EMV/µL) and 12 obese (6M/6F; BMI: 31.1+0.4 kg/m2; EMVs: 160+18 EMV/µL). All subjects were sedentary, non-smokers, normotensive, normolipidemic, non-diabetic and free of overt coronary artery disease. EMVs (CD31+/CD42b-) were identified, enumerated, and isolated from plasma by flow cytometry. Human umbilical vein endothelial cells were cultured and treated with EMVs from either normal weight or obese adults. EMVs from obese adults induced significantly greater release of both IL-6 (108.2±2.3 vs 90.9±2.9 pg/mL) and IL-8 (74.5±2.9 vs 59.5±3.3 pg/mL) from endothelial cells vs EMVs from normal weight adults. Intracellular expression of total NF-kB p65 was not significantly different in cells treated with EMVs from the normal weight (78.2+9.3 AU) or obese (86.5+8.7 AU) subjects. However, EMVs from obese subjects induced ~25% higher expression of phosphorylated-NF-kB p65 (Ser536; active NF-kB) (145.0+9.8 vs 114.5+8.8 AU). There were no significant differences in cellular expression of total p38-MAPK (190.6+18.4 vs 163.2+9.5 AU) and caspase-3 (250.9±20.9 vs 283.0±19.4 AU) in cells treated with EMVs from normal weight and obese adults. However, EMVs from obese adults induced significantly higher (~50%) expression of phospho-p38-MAPK(15.4+1.6 vs 9.2+0.7 AU) and active caspase-3 (168.2±18.9 vs 107.8±11.7 AU) than EMVs from normal weight adults. Total eNOS expression was not significantly different between cells treated with EMVs from normal weight (110.9+12.0 AU) and obese (112.8+14.4 AU) adults; however, p-eNOS (Ser1177) expression was ~50% lower (P<0.05) in the cells treated with EMVs from obese adults (18.4+3.4 vs 34.6+2.8 AU). Consistent with changes in p-eNOS, NO production was ~20% lower (6.9+0.4 vs 8.7+0.2 mmol/L) in cells treated with EMVs from obese adults. Increased inflammation, apoptosis susceptibility and decreased eNOS activity and NO production renders the vascular endothelium prone to atherosclerosis and thrombosis. Circulating EMVs likely contribute to the proatherogenic endothelial phenotype and, in turn, the increased incidence of cardiovascular disease with obesity.

Obesity and Ideal Cardiovascular Health: Results from the My Research Legacy Study

Obesity is associated with increased risk for cardiovascular diseases compared to normal-weight and overweight status. We hypothesized that obese subjects would have lower ideal cardiovascular health than normal-weight and overweight subjects, but a subset among the obese would have a favorable cardiovascular health profile. Differences in ideal cardiovascular health between normal-weight (n = 523), overweight (n = 378), and obese (n = 660) subjects were examined using data from the Life’s Simple 7 survey and digital health devices. Obese participants were more likely to have prevalent cardiovascular disease, diabetes mellitus, hypertension, and hypercholesterolemia compared to normal weight and overweight (all p &lt; 0.01). Life’s Simple 7 Health Scores, a measure of ideal cardiovascular health, were lower in obese than in normal-weight and overweight groups (5.6 ± 1.2 vs. 8.0 ± 1.1 vs. 6.8 ± 1.1, p &lt; 0.01). A subset of obese with ideal cardiovascular health scores was identified (n = 103). Compared to obese with non-ideal health scores (n = 557), these individuals were more likely to have ideal cardiovascular risk factor status, diet, and exercise profiles. These findings indicate that there is heterogeneity among obese persons and suggest that an assessment of cardiovascular health factors and behaviors can identify areas for intervention beyond weight reduction alone to optimize cardiovascular health.