Adult Obese Subjects Research Articles

Thiamine status and genes encoding intestinal thiamine transporters and transcription factors in obese subjects

Background and aimsThe inconsistent data on thiamine status in obese subjects necessitates an examination of genes associated with intestinal absorption of thiamine. We aimed to reveal thiamine status in obese subjects and examine the expression of SLC19A2/3 genes encoding thiamine transporters and Sp1 transcription factor. Methods and resultsThirty-five adult obese subjects and 11 healthy controls were included in this cross-sectional study. Small intestine epithelial cells were used for quantitative RT-PCR analysis of the gene expression. The daily thiamine and energy intake were assessed with a food frequency questionnaire. Thiamine phosphate esters were hydrolyzed to free thiamine, and liquid chromatography with a tandem mass spectrometry-based method was used to measure total thiamine in whole blood. Daily energy intake according to body weight and daily carbohydrate intake were not significantly different between groups after adjustment for sex. Although daily thiamine intake was significantly lower in the obesity group (p = 0.015), obese subjects had significantly higher whole blood thiamine levels than controls (44.96 ± 14.6 ng/mL and 33.05 ± 8.6 ng/mL, p = 0.002). There was a significant positive correlation between whole blood thiamine and BMI (r = 0.342, p = 0.020). SLC19A2 gene expression was lower in those with BMI ≥35 kg/m2 (p = 0.036). A significant positive correlation was found between SLC19A2 expression and whole blood thiamine level (r = 0.310, p = 0.038). ConclusionA possible association between intestinal thiamine intake and total thiamine in whole blood was determined. The transcriptional changes of genes encoding the high-affinity membrane thiamine transporters, especially SLC19A2, probably play a role in this relationship.

EFFECT OF GLP-1 RECEPTOR AGONISTS ON OFFICE BLOOD PRESSURE LEVELS AMONG OVERWEIGHT OR OBESE SUBJECTS TREATED WITH ANTIPSYCHOTIC DRUGS: A META-ANALYSIS

Objective: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) constitute a drug class primarily developed for the treatment of subjects with type 2 diabetes. Subjects suffering from psychotic disorders and receiving antipsychotic drug treatment are prone to developing obesity, which is a major contributing factor to elevated blood pressure (BP) levels. Herein we sought to determine whether treatment with GLP-1RAs among overweight/obese subjects treated with antipsychotic drugs has any beneficial impact on BP levels. Design and method: We searched PubMed and the Cochrane Library from inception to 1 December 2022, for randomized controlled trials (RCTs) enrolling obese or overweight adult subjects with an underlying psychotic disorder treated with antipsychotic drugs, randomized either to GLP-1RAs or control. Effect of GLP-1RA treatment on office systolic and diastolic BP (SBP and DBP, respectively) levels was assessed. Results: We pooled data from 4 RCTs (2 utilizing liraglutide and 2 utilizing exenatide) in a total of 199 enrolled subjects. GLP-1RA treatment compared to control resulted in a non-significant effect on office SBP (p = 0.47). Similarly, GLP-1RA treatment compared to control failed to produce a significant decrease in office DBP (p = 0.53). Conclusions: Despite their significant weight loss properties in overweight or obese subjects, preliminary evidence suggests that GLP-1RAs do not confer a significant effect on BP levels among overweight/obese subjects treated with antipsychotic drug classes. Further, large-scale trials are required to clarify this interesting clinical aspect.

Influence of dietary and lifestyle factors on levels of inflammatory markers (IL-6, IFN-γ and TNF-α) in obese subjects.

The low-grade inflammation occurring in obese individuals leads to many diseases, including cardiovascular disease (CVD). Dietary patterns, food groups or nutrients in a well-balanced diet may reduce the level of pro-inflammatory markers and the risk of obesity-related morbidities. Our study aims to describe three cytokines in obese patients in relation to dietary habits, lifestyle and body composition. Serum samples were collected from 84 obese adult volunteer subjects [body mass index (BMI) ≥ 30 kg/m2] to analyze the concentrations of interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ). The subjects were tested by bioelectrical impedance analysis (BIA) and completed a three-day food diary and original questionnaire with the FFQ-6 food consumption frequency questionnaire. Higher serum levels of IL-6 and IFN-γ were found in patients with atherosclerosis, but the group was too small for a reliable correlation. Subcutaneous but not visceral adipose tissue correlated positively with IL-6 levels. Dietary factors such as amount of sugars, including galactose and sucrose, in the diet and the frequency of consumption of sweet flavored dairy products correlated positively with the levels of IL-6 and TNF-α, while the frequency of alcohol consumption negatively correlated with the level of IL-6. The greater the frequency of sports, the higher was the level of IL-6. In obese individuals, the level of pro-inflammatory cytokines could predispose to atherosclerosis and is associated with dietary factors and lifestyle.

Altered Red Blood Cell Fatty Acid and Serum Adipokine Profiles in Subjects with Obesity.

Adipokines, as well as the fatty acid profile of red blood cell (RBC) membranes, are known to play important roles in the development and progression of metabolic complications induced by obesity. Thus, the objective of this study is to compare the serum adipokine profile and the RBC membrane fatty acid profile of normal-weight and obese adults, and to analyze their relationship with serum biochemical parameters. An observational case-control study was performed in 75 normal-weight and obese adult subjects. Biochemical serum parameters, eight serum adipokines and the RBC membrane fatty acid profiles were measured. Associations between parameters were established using regression analysis. Subjects with obesity showed increased levels of leptin, fibroblast growth factor 21 (FGF21) and overexpressed nephroblastoma (NOV/CCN3), decreased adiponectin, and similar levels of vaspin and chemerin compared to normal-weight subjects. Significant positive and negative correlations were found with triglycerides and high-density lipoprotein-cholesterol (HDL-c), respectively. An increase in the total ω-6 fatty acids in the RBC membrane fatty acid profiles in subjects with obesity was observed, because of higher levels of both dihomo-γ-linolenic acid (DGLA) and arachidonic acid (AA), and decreased total ω-3 fatty acids, mainly due to lower levels of docosahexaenoic acid (DHA). The ω-6/ω-3 ratio in the RBCs was significantly higher, suggesting an inflammatory status, as was also suggested by a reduced adiponectin level. A negative association between DGLA and adiponectin, and a positive association between DHA and serum triglycerides, was observed. Important alterations in serum adipokine and RBC fatty acid profiles are found in subjects with obesity.

Correlation of Lipid Profile and Apolipoprotein B/A-I Ratio with Insulin Resistance in Non-Diabetes Mellitus Subjects

Obesity is defined as an increase in total body mass due to excess fat, as measured by the body mass index. Obesity affects metabolism through factors such as insulin resistance, which triggers the development of chronic diseases. Lipid and ApoB/ApoA-I ratios can be considered additional assessments, especially in patients at high risk of cardiovascular diseases such as diabetes. This study aims to determine the relationship between lipid and ApoB/ApoA-I ratios with Homa-IR in in non-diabetes mellitus adult subjects. The method used in this study was a cross-sectional study involving a total of 80 non-diabetic adult subjects, consisting of 38 male and 42 female subjects. The results showed that there were significant differences between the ratios of CHOL/HDL, TG/HDL, ApoB/ApoA-I, and HOMA-IR in non-obese and obese non-DM adult subjects (4.64 ± 2.18 vs 5.23 ± 1.87, p = 0.045; 2.38 ± 1.20 vs. 3.18±1.77, p=0.013;0.58±0.17 vs. 0.66±0.17, p=0.035 and 1.47±0.80 vs. 3.34±4.37, p = 0.000), and there was no significant difference between LDL/HDL (p = 0.117). The correlation test results between the ratios of CHOL/HDL to HOMA-IR, LDL/HDL to HOMA-IR, TG/HDL to HOMA-IR, and ApoB/ApoA-I to HOMA-IR in non-DM adult subjects (p=0.05, r=0.308; p=0.037, r=0.233; p=0.000, r=0.402; p=0.19, r=0.261). This study concluded that there was a significant correlation between lipid and ApoB/ApoA-I ratios with Homa-IR in non-diabetes mellitus adult subjects.

Technological Solutions for Human Movement Analysis in Obese Subjects: A Systematic Review.

Obesity has a critical impact on musculoskeletal systems, and excessive weight directly affects the ability of subjects to realize movements. It is important to monitor the activities of obese subjects, their functional limitations, and the overall risks related to specific motor tasks. From this perspective, this systematic review identified and summarized the main technologies specifically used to acquire and quantify movements in scientific studies involving obese subjects. The search for articles was carried out on electronic databases, i.e., PubMed, Scopus, and Web of Science. We included observational studies performed on adult obese subjects whenever reporting quantitative information concerning their movement. The articles must have been written in English, published after 2010, and concerned subjects who were primarily diagnosed with obesity, thus excluding confounding diseases. Marker-based optoelectronic stereophotogrammetric systems resulted to be the most adopted solution for movement analysis focused on obesity; indeed, wearable technologies based on magneto-inertial measurement units (MIMUs) were recently adopted for analyzing obese subjects. Further, these systems are usually integrated with force platforms, so as to have information about the ground reaction forces. However, few studies specifically reported the reliability and limitations of these approaches due to soft tissue artifacts and crosstalk, which turned out to be the most relevant problems to deal with in this context. In this perspective, in spite of their inherent limitations, medical imaging techniques-such as Magnetic Resonance Imaging (MRI) and biplane radiography-should be used to improve the accuracy of biomechanical evaluations in obese people, and to systematically validate less-invasive approaches.

Effect of Glucagon-like Peptide-1 Receptor Agonists on Cardio-Metabolic Risk Factors among Obese/Overweight Individuals Treated with Antipsychotic Drug Classes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) constitute a drug class primarily developed for the treatment of subjects with type 2 diabetes, although they have also provided significant benefit for subjects with obesity without underlying diabetes. Individuals with psychotic disorders who are receiving antipsychotic treatment are a patient population at risk of developing obesity, which is linked to other metabolic disturbances. We searched PubMed and the Cochrane Library from inception to 1 December 2022, for randomized controlled trials (RCTs) enrolling obese or overweight adult subjects with an underlying psychotic disorder treated with antipsychotic drugs, randomized either to GLP-1RAs or a control. We set as the primary efficacy outcome the change in body weight and as secondary efficacy outcomes the change in body mass index (BMI) and in waist circumference, along with indices of glycemia, lipid profile, and blood pressure. We pooled data from 4 trials (2 with liraglutide and 2 with exenatide) in a total of 199 enrolled subjects. GLP-1RA treatment, compared to control, resulted in a significant decrease in body weight by 3.8 kg [mean difference (MD) = -3.80, 95% CI; -6.35 to -1.24, I2 = 64%]. In addition, GLP-1RA treatment led to a significant decrease in BMI, compared to control, of 1.04 kg/m2 (MD = -1.04, 95% CI; -1.92 to -0.17, I2 = 35%). However, no significant effect on waist circumference was shown (MD = -3.2, 95% CI; -6.47 to 0.08, I2 = 88%). A significant improvement in glycemia and lipid profiles was also demonstrated with GLP-1RAs. No subgroup difference between liraglutide and exenatide was shown, and the use of GLP-1RAs did not increase the risk for treatment discontinuation compared to the control group. Treatment with GLP-1RAs can significantly improve weight loss and other cardiometabolic risk factors in obese people taking antipsychotic medications.

Revised Harris-Benedict Equation: New Human Resting Metabolic Rate Equation.

This paper contains a revision of the Harris-Benedict equations through the development and validation of new equations for the estimation of resting metabolic rate (RMR) in normal, overweight, and obese adult subjects, taking into account the same anthropometric parameters. A total of 722 adult Caucasian subjects were enrolled in this analysis. After taking a detailed medical history, the study enrolled non-hospitalized subjects with medically and nutritionally controlled diseases such as diabetes mellitus, cardiovascular disease, and thyroid disease, excluding subjects with active infections and pregnant or lactating women. Measurement of somatometric characteristics and indirect calorimetry were performed. The values obtained from RMR measurement were compared with the values of the new equations and the Harris-Benedict, Mifflin-St Jeor, FAO/WHO/UNU, and Owen equations. New predictive RMR equations were developed using age, body weight, height, and sex parameters. RMR males: (9.65 × weight in kg) + (573 × height in m) - (5.08 × age in years) + 260; RMR females: (7.38 × weight in kg) + (607 × height in m) - (2.31 × age in years) + 43; RMR males: (4.38 × weight in pounds) + (14.55 × height in inches) - (5.08 × age in years) + 260; RMR females: (3.35 × weight in pounds) + (15.42 × height in inches) - (2.31 × age in years) + 43. The accuracy of the new equations was tested in the test group in both groups, in accordance with the resting metabolic rate measurements. The new equations showed more accurate results than the other equations, with the equation for men (R-squared: 0.95) showing better prediction than the equation for women (R-squared: 0.86). The new equations showed good accuracy at both group and individual levels, and better reliability compared to other equations using the same anthropometric variables as predictors of RMR. The new equations were created under modern obesogenic conditions, and do not exclude individuals with regulated (dietary or pharmacological) Westernized diseases (e.g., cardiovascular disease, diabetes, and thyroid disease).

Circulating galectin-3 levels are inversely associated with subclinical cardiovascular disease in obese adults.

Galectin-3 is a new cytokine that is mainly secreted by activated macrophages. It is involved in apoptosis, inflammation and may play a role in the development of cardiovascular disease (CVD). However, there is little information about the association between circulating galectin-3 and subclinical atherosclerosis in humans. We measured serum galectin-3 in 483 obese adult subjects (aged 40years and over) who had the measurement of carotid intima-media thickness (CIMT) recruited from the community. Adults with lower levels of circulating galectin-3 had increased CIMT (p < 0.05). In multivariable linear regression analyses, circulating galectin-3 was independently associated with CIMT. The risks of increased CIMT were significantly decreased by 65.1% (OR (95% CI): 0.349 (0.165-0.739)), adjusting for possible confounding factors. Notably, individuals in the lowest quartile of serum galectin-3 were 1.80 times (p < 0.05) more likely to have increased CIMT than those in the highest quartile in multivariable logistic regression analyses; however, such associations with circulating galectin-3 were not noted for carotid plague. These findings propose that circulating galectin-3 concentrations are inversely associated with increased CIMT in obese adults, which may be a potential biomarker of CVD.

Amoxicillin dosing and pharmacokinetics in obesity for the treatment of bacterial respiratory infection secondary to COVID-19: a systematic review

Objective: To conduct a systematic review of Amoxicillin (AMX) dosing and pharmacokinetics (PK) in obese subjects for the treatment of the outpatient respiratory tract infection which may be a secondary co-infection with COVID-19. Methodology: A systematic review was performed up to January 2022 on MEDLINE, EMBASE, and Web of Science. Full-text manuscripts describing AMX dosing for respiratory infection or PK in obese children, adults, and RYGB bariatric patients treated with AMX were included. Results: A total of 179 records were screened, of which 8 met the inclusion criteria. Four studies described AMX dosing in obese children and adults, while 4 described PK in obese adults and RYGB bariatric subjects. Overall, in the dosing studies, 54% of children &gt;20 kg and 10% &lt;40 kg with respiratory infection were considered underdosed, according to guidelines or recommendations. Underdosing of 10% occurred in both overweight and non-obese children’s groups. For morbidly obese adults, 70% were considered underdosed. In the PK studies, obese and bariatric adult subjects showed reduced exposure compared to normal weight patients for all AMX formulations. Conclusion: More PK studies are needed to confirm the optimal dose of AMX for obese patients, particularly in children. However, considering that all obese and bariatric adults had reduced exposure compared to subjects of normal weight, 1 g 8/8h should be recommended and liquid formulations are preferable for bariatric patients. To minimize the risks of therapeutic failure and avoid toxicity, a higher threshold of doses should be prescribed for obese children.

ASSOCIATION OF ADULT OBESITY AND SERUM B12 DEFICIENCY - A CASECONTROL STUDY FROM INDIA

Introduction: Vitamin B12, also known as cobalamin; has been implicated as an important factor in regulating various metabolic processes, thus playing a role in the etiology of obesity. To assess whether obese adults a Objectives: re at an increased risk for vitamin B12 deciency. This study aimed to assess the serum vitamin B12 status of obese Indians to see if there were any associations between body mass index (BMI) and serum B12 concentration. Medicine outpatient at a medical college university hospita Settings: Methods: l. We included 224 adult participants aged ≥19 years. Overweight and obesity were dened as BMI ≥ 25-29.9 kg/m2 and ≥ 30 kg/m2 respectively. The study subjects were divided into 2 groups as normal BMI (&lt; 25 kg/m2) group, and the obese BMI (≥ 25 kg/m2) group. BMI was calculated as weight in kilograms divided by height in meters square. Fasting venous blood samples were taken from the subjects for the estimation of serum B12 concentrations which were measured using the fully automated electrochemiluminescence immunoassay. Low serum B12 was dened concentration &lt; 197 pg/mL, and B12 deciency was dened as concentration below 150 pg/mL. The adjusted odds ratio (OR) and 95% condence interval (CI) were obtained by the binary logistic regression method. The correlation between serum B12 and BMI was calculated using Pearson's correlation coefcient (r) across various BMI categories. Serum B12 level was signicantly lower among obese adults compa Results: red with non-obese adults. There were signicant negative associations between BMI and serum B12 (p =0.004). Pearson correlation coefcient was strongly negatively associated for BMI with serum B12 level (r= -0.703, p&lt;0.00001). Obesity in otherwise healthy adults was associated with Conclusions: an increased risk of serum B12 deciency. A negative association was found between serum B12 concentrations in obese adult subjects. This association was more pronounced with higher grades of obesity; further research at a large scale is needed to understand the underlying mechanisms and its prevalence in the obese population. We recommend that the possibility of vitamin B12 deciency should always be considered in obese adults.

Policaptil Gel Retard® reduces body weight and improves insulin sensitivity in obese subjects

Policaptil Gel Retard® (PGR), a natural fiber-based molecule, has been shown to prevent weight gain and ameliorate insulin-resistance indices in obese children and adolescents. The aim of this study was to compare the effects of 12 weeks of low calories and low glycemic index (LC-LGI) diet associated or not with the intake of PGR on anthropometric, bioimpedance, and metabolic parameters. Data from 20 obese adult subjects (10 per group) were analyzed. An LC-LGI diet with or without PGR intake reduced weight, BMI, and waist circumference. PGR intake elicited a reduction in fasting plasma insulin and insulin resistance index together with an improvement in insulin sensitivity.

Risk of Dyslipidemia in Obese Young Adult Subjects as Measured by Various Obesity Indices

Background: Obesity is strongly associated with atherogenic dyslipidemia phenotype and is an independent risk factor of cardiovascular disease (CVD). Besides body mass index (BMI), there are various obesity indices, namely waist circumference (WC) to detect central obesity, and percentage of body fat (%BF) using bioimpedance analysis (BIA) to detect peripheral-central obesity. The aim of this study is to determine which obesity index is better in predicting dyslipidemia. Methods: This cross-sectional study involved 99 professionally active doctors working at tertiary hospital, from January to March 2021. Obesity was measured by obesity indices such as BMI, WC, and %BF using BIA. After that, the serum lipid profile was then measured. Dyslipidemia is a disorder of lipoprotein metabolism, including lipoprotein overproduction or deficiency that may be manifested by high total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and low high-density lipoprotein cholesterol (HDL) cholesterol. Results: Of the total 99 subjects, 49.5% were male, while 50.5% were female. The prevalence of obesity based on BMI, WC, and %BF using BIA was 57.6%, 74.8%, and 72.7%, respectively. Obesity based on BMI has 9.8 times the risk of having low HDL cholesterol levels (odds ratio (OR) = 9.814, 95% confidence interval (CI): 1.213 - 79.379) and 4.6 times of having high triglycerides levels (OR = 4.618, 95% CI: 1.240 - 17.204). Meanwhile, central obesity based on WC has 3.1 times the risk of having high LDL cholesterol levels (OR = 3.100, 95% CI: 1.170 - 8.218). On the contrary, the results of the analysis on obesity based on %BF on lipid profile were not significant. Conclusions: Obesity based on BMI and WC measurements are better than %BF in predicting dyslipidemia. J Endocrinol Metab. 2022;12(3):102-106 doi: https://doi.org/10.14740/jem819

Rare Variant Analysis of Obesity-Associated Genes in Young Adults With Severe Obesity From a Consanguineous Population of Pakistan.

Recent advances in genetic analysis have significantly helped in progressively attenuating the heritability gap of obesity and have brought into focus monogenic variants that disrupt the melanocortin signaling. In a previous study, next-generation sequencing revealed a monogenic etiology in ∼50% of the children with severe obesity from a consanguineous population in Pakistan. Here we assess rare variants in obesity-causing genes in young adults with severe obesity from the same region. Genomic DNA from 126 randomly selected young adult obese subjects (BMI 37.2 ± 0.3 kg/m2; age 18.4 ± 0.3 years) was screened by conventional or augmented whole-exome analysis for point mutations and copy number variants (CNVs). Leptin, insulin, and cortisol levels were measured by ELISA. We identified 13 subjects carrying 13 different pathogenic or likely pathogenic variants in LEPR, PCSK1, MC4R, NTRK2, POMC, SH2B1, and SIM1. We also identified for the first time in the human, two homozygous stop-gain mutations in ASNSD1 and IFI16 genes. Inactivation of these genes in mouse models has been shown to result in obesity. Additionally, we describe nine homozygous mutations (seven missense, one stop-gain, and one stop-loss) and four copy-loss CNVs in genes or genomic regions previously linked to obesity-associated traits by genome-wide association studies. Unexpectedly, in contrast to obese children, pathogenic mutations in LEP and LEPR were either absent or rare in this cohort of young adults. High morbidity and mortality risks and social disadvantage of children with LEP or LEPR deficiency may in part explain this difference between the two cohorts.

Comparison of the Effectiveness of Two-Handed Mask Ventilation Techniques (C-E versus V-E) in Obese Patients Requiring General Anesthesia in an Indian Population.

Background:Two-handed mask ventilation techniques are often used in cases of difficult mask ventilation scenarios. A comparison of two methods of two-handed techniques in terms of tidal volume was undertaken in the context of the obese population.Aims and Objectives:To determine and compare the effectiveness of mask ventilation in obese Indian adult subjects by using either the C-E technique or the V-E technique after induction of general anaesthesia.Material and Methods:This was a randomised interventional study conducted on eighty obese patients. They were randomized into Group A ventilated with C-E technique and Group B with V-E technique. Expired tidal volume (VTe), Peak inspiratory pressure (PIP), SpO2, EtCO2 and vital signs were noted.Results:The BMI and hemodynamic parameters were comparable between the two groups. The expired tidal volume of 702 ± 77 mL with the V-E technique was significantly more than the C-E technique, which was 492 ± 71 mL. The ventilatory failure rate with the C-E technique was 15% and 0% with the V-E technique. There was no significant difference between the peak airway pressures for the two techniques: 20.3 ± 1.5 mm H2O for Group A and 20.5 ± 1.2 mm H2O for Group B.Conclusions:Mask ventilation with the two-handed V-E technique is associated with better tidal volumes and reduced failure rates in the obese population. So the V-E technique should be attempted first as a rescue measure in obese adult patients if the return of spontaneous breathing and tracheal intubation is impossible.

Circulating adipsin is associated with asymptomatic carotid atherosclerosis in obese adults

BackgroundAdipsin has been identified as a secreted adipokine that plays a critical pathogenic role in metabolic disorders. However, it is not clear regarding the association of circulating adipsin with cardiovascular disease (CVD). This study will explore the association between circulating adipsin and asymptomatic carotid atherosclerosis in Chinese obese adults.MethodsA total of 483 obese adult subjects (aged 40 years or older) were enrolled in this study. Serum adipsin concentrations and carotid intima-media thickness (CIMT) were measured to determine these associations.ResultsIndividuals with increased CIMT and asymptomatic carotid atherosclerosis had lower levels of circulating adipsin than controls (both p < 0.05). The prevalence of asymptomatic carotid atherosclerosis was significantly higher in subjects with lower levels of serum adipsin than those with higher values (42.5% vs. 36.7%, p < 0.05). Notably, subjects in the lowest quartile of serum adipsin were 1.94 times (p = 0.059) more likely to have increased CIMT and 2.91 times (p = 0.03) more likely to have asymptomatic carotid atherosclerosis than those in the highest quartile in multivariable logistic regression analyses, adjusting for age, gender, current smoking, alcohol consumption, physical activity, BMI, systolic BP, fasting glucose, total cholesterol, HDL-c, and HOMA-IR. However, such associations with circulating adipsin were not noted for atherosclerotic plaque.ConclusionsThese findings suggest that circulating adipsin concentrations are a potential marker of risks of increased CIMT and asymptomatic carotid atherosclerosis in obese Chinese adults.

Evaluation of Neutrophil-Lymphocyte Ratio and Monocyte Count among Adult Obese Subjects in Sapele, Southern Nigeria

Background/Objectives: Obesity is a public health problem with hematological consequences in developing nations. This study aims to evaluate the impacts of obesity on hematological parameters such as: Neutrophil-Lymphocyte Ratio (NLR) and monocyte count among adults in Sapele. Materials and Methods: This cross sectional and descriptive study was carried out at Central Hospital, Sapele, General Hospital, Oghara and Biomed Diagnostic Centre, Sapel all in Southern Nigeria. 415 subjects with age between 18 and 65years were enrolled for this study including 312 obese experimental subjects (comprising of 111males and 201females) and 103 non-obese normal control subjects (comprising 40males and 63females). 5.0mls of venous blood was collected from all subjects into EDTA container and Full Blood Count (FBC) was determined using Sysmex XN330 automated hematology analyzer while NLR was calculated from the FBC results. Collated data were analyzed using Student’s t-test, One-way ANOVA, LSD post-hoc test and results were expressed as mean ± standard deviation. Results: Body-Mass-Index (BMI) of obese and control subjects were 36.82±0.55kg/m2, and 20.43±0.29 kg/m2, respectively at p 0.05. On the other hand, Monocyte count for Obese subject was 6.40±0.23 X 109/l, while control group had monocyte count of 5.14±0.18 X 109/l, at p<0.001. Furthermore, the Neutrophil Lymphocyte Ratio (NLR) of obese and control subjects was 1.57±0.21 and 1.18±0.05 respectively. Conclusion: Obese subjects had significantly higher values of BMI, NLR, Monocyte count at p<0.05 when compared with control subjects in Sapele, Southern Nigeria.

The effect of serum insulin on the blood pressure responses after oral glucose load in lean and centrally obese adult male subjects

Background: The vasodilator action of insulin might contribute to the reduction of blood pressure in the postprandial state and it remains to be clarified whether this action is impaired in the insulin- resistant obese state or not.&#x0D; Aims and Objective: The present study aimed to determine the blood pressure responses after an oral glucose load in lean and insulin resistant centrally obese adult male subjects.&#x0D; Materials and Methods: This study was carried out in eleven lean and eleven centrally obese adult male subjects. After a 75 g oral glucose load, blood pressures were measured at 15-minute intervals and the serum insulin level was determined at 30-minute intervals for two hours. Blood pressure was measured by indirect sphygmomanometry and serum insulin concentration was analyzed by ELISA method.&#x0D; Results: All centrally obese subjects were insulin resistant (HOMA-IR≥2.6). After oral glucose load, the per cent change in glucose-stimulated insulin responses at 30 minutes (626% vs 344%, p&lt;0.05) and at 60 minutes (756% vs 417%, p&lt;0.01) were significantly greater in the lean group than the centrally obese group. The fall in postprandial blood pressures started at 15 minutes and returned to baseline values at 120 minutes. The per cent change in SBP at 15 minutes (-2.2% vs -1.2%, p&lt;0.05) and at 30 minutes (-3.2% vs -2.1%, p&lt;0.05) were significantly greater in the lean group than the centrally obese group.&#x0D; Conclusion: The present findings suggest that attenuation in BP responses as well as a lesser change in glucose-stimulated insulin responses in the centrally obese subjects might be attributable to the presence of insulin resistance.

Transpulmonary Pressure-Guided Lung-Protective Ventilation Improves Pulmonary Mechanics and Oxygenation Among Obese Subjects on Mechanical Ventilation.

Transpulmonary pressure (PL) is used to assess pulmonary mechanics and guide lung-protective mechanical ventilation (LPV). PL is recommended to individualize LPV settings for patients with high pleural pressures and hypoxemia. We aimed to determine whether PL-guided LPV settings, pulmonary mechanics, and oxygenation improve and differ from non-PL-guided LPV among obese patients after 24 h on mechanical ventilation. Secondary outcomes included classification of hypoxemia severity, count of ventilator-free days, ICU length of stay, and overall ICU mortality. This is a retrospective analysis of data. Ventilator settings, pulmonary mechanics, and oxygenation were recorded on the initial day of PL measurement and 24 h later. PL-guided LPV targeted inspiratory PL < 20 cm H2O and expiratory PL of 0-6 cm H2O. Comparisons were made to repeat measurements. Twenty subjects (13 male) with median age of 49 y, body mass index 47.5 kg/m2, and SOFA score of 8 were included in our analysis. Fourteen subjects received care in a medical ICU. PL measurement occurred 16 h after initiating non-PL-guided LPV. PL-guided LPV resulted in higher median PEEP (14 vs 18 cm H2O, P = .009), expiratory PL (-3 vs 1 cm H2O, P = .02), respiratory system compliance (30.7 vs 44.6 mL/cm H2O, P = .001), and [Formula: see text] (156 vs 240 mm Hg, P = .002) at 24 h. PL-guided LPV resulted in lower [Formula: see text] (0.53 vs 0.33, P < .001) and lower PL driving pressure (10 vs 6 cm H2O, P = .001). Tidal volume (420 vs 435 mL, P = .64) and inspiratory PL (7 vs 7 cm H2O, P = .90) were similar. Subjects had a median of 7 ventilator-free days, and median ICU length of stay was 14 d. Three of 20 subjects died within 28 d after ICU admission. PL-guided LPV resulted in higher PEEP, lower [Formula: see text], improved pulmonary mechanics, and greater oxygenation when compared to non-PL-guided LPV settings in adult obese subjects.

Policaptil Gel Retard in adult subjects with the metabolic syndrome: Efficacy, safety, and tolerability compared to metformin

BackgroundPolicaptil Gel Retard® (PGR), is a new macromolecule complex based on polysaccharides slowing the rate of carbohydrate and fat absorption. It proved to significantly reduce body weight, acanthosis nigricans expression, HbA1c levels, and glucose metabolism abnormalities in obese, hyper-insulinemic adolescents. No such data are available for adults. Aimto compare the effects of PGR vs. metformin in adult subjects with the Metabolic Syndrome (MS) and T2DM on a Low Glycemic Index diet. Subjects and methodsThis spontaneous clinical, longitudinal, single-blind, randomized study based on a per-protocol analysis enrolled 100 outpatients with MS and T2DM consecutively referring to our clinic for three months, and randomly assigned to either the active treatment (Group A:, 6 tablets/day) or the comparator (Group B: Metformin tablets, 1500–2000 mg/day in two divided doses during the two main meals, to minimize side effects) to be taken 30 min before each main meal in equally divided doses. Serum lipid profile, anthropometry, HOMA-IR index, and tolerability parameters were evaluated before and after a 6-month follow-up period. Resultsall parameters improved at a similar rate in both groups but for the lipid profile, which got even better in Group A. Group A also experienced less prominent gastrointestinal side effects than its counterpart. ConclusionFor the first time, we showed the non-inferiority of PGR compared to metformin in obese adult subjects with the MS and T2DM as for glycemic control and a clear-cut superiority of PGR in terms of both serum lipid-lowering capacity and tolerability.